At the legislative level in China,there has been insufficient theoretical preparation to explicitly include“sexual autonomy”within the scope of general personality rights.In handling the increasing number of dispute...At the legislative level in China,there has been insufficient theoretical preparation to explicitly include“sexual autonomy”within the scope of general personality rights.In handling the increasing number of disputes related to violations of“sexual autonomy,”judicial biases have emerged during the trial process when courts determine the attribute of the right to“sexual autonomy.”This situation necessitates a clear legal analysis of the concept and attributes of“sexual autonomy”to establish its essential attribute as a personality right,and,from the perspective of legal doctrine,enable the justification of the right to“sexual autonomy”as either a general personality right or other personality interests,thereby providing theoretical support for courts to“adjudicate according to law.”By delineating and categorizing instances of violations of“sexual autonomy,”the constitutive elements and fundamental characteristics of such violations can be clarified.By examining the legal norms governing civil litigation and civil litigation associated with criminal cases concerning violations of“sexual autonomy,”the responsibility determination,remedies,and existing regulatory loopholes regarding violations of“sexual autonomy,”especially in cases involving both criminal and civil matters,can be defined.Based on this foundation,the legal basis,determination mechanism,and compensation standards for claiming compensation for mental damages resulting from violations of“sexual autonomy”can be elucidated.展开更多
The risk analysis evaluates the probability of occurrence with the impact of said risks.In the hydrocarbon sector,an environmental liability is an improperly abandoned facility,soil contaminated by spills or others.Th...The risk analysis evaluates the probability of occurrence with the impact of said risks.In the hydrocarbon sector,an environmental liability is an improperly abandoned facility,soil contaminated by spills or others.The objective of this work is to define a risk management plan.The characterization of the residue and the area was carried out.Hazardous events were identified:overflow spill,soil contamination by infiltration,as well as radiant heat and suffocating and toxic fumes from a fire.The matrix method was applied considering the probability of occurrence against vulnerability.The danger of infiltration implied a high level of risk.The risk management plan was drawn up,its main action being the liquidation of the pool and the sanitation of the area.展开更多
AIM:To assess the clinical efficacy and safety of combining panretinal photocoagulation(PRP)with intravitreal conbercept(IVC)injections for patients with high-risk proliferative diabetic retinopathy(HR-PDR)complicated...AIM:To assess the clinical efficacy and safety of combining panretinal photocoagulation(PRP)with intravitreal conbercept(IVC)injections for patients with high-risk proliferative diabetic retinopathy(HR-PDR)complicated by mild or moderate vitreous hemorrhage(VH),with or without diabetic macular edema(DME).METHODS:Patients diagnosed with VH with/without DME secondary to HR-PDR and received PRP combined with IVC injections were recruited in this retrospective study.Upon establishing the patient’s diagnosis,an initial IVC was performed,followed by prompt administration of PRP.In cases who significant bleeding persisted and impeded the laser operation,IVC was sustained before supplementing with PRP.Following the completion of PRP,patients were meticulously monitored for a minimum of six months.Laser therapy and IVC injections were judiciously adjusted based on fundus fluorescein angiography(FFA)results.Therapeutic effect and the incidence of adverse events were observed.RESULTS:Out of 42 patients(74 eyes),29 were male and 13 were female,with a mean age of 59.17±12.74y(33-84y).The diabetic history was between 1wk and 26y,and the interval between the onset of visual symptoms and diagnosis of HR-PDR was 1wk-1y.The affected eye received 2.59±1.87(1-10)IVC injections and underwent 5.5±1.02(4-8)sessions of PRP.Of these,68 eyes received PRP following 1 IVC injection,5 eyes after 2 IVC injections,and 1 eye after 3 IVC injections.Complete absorption of VH was observed in all 74 eyes 5-50wk after initial treatment,with resolution of DME in 51 eyes 3-48wk after initial treatment.A newly developed epiretinal membrane was noted in one eye.Visual acuity significantly improved in 25 eyes.No complications such as glaucoma,retinal detachment,or endophthalmitis were reported.CONCLUSION:The study suggests that the combination of PRP with IVC injections is an effective and safe modality for treating diabetic VH in patients with HR-PDR.展开更多
BACKGROUND Non-alcoholic fatty liver disease(NAFLD)with hepatic histological NAFLD activity score≥4 and fibrosis stage F≥2 is regarded as“at risk”non-alcoholic steatohepatitis(NASH).Based on an international conse...BACKGROUND Non-alcoholic fatty liver disease(NAFLD)with hepatic histological NAFLD activity score≥4 and fibrosis stage F≥2 is regarded as“at risk”non-alcoholic steatohepatitis(NASH).Based on an international consensus,NAFLD and NASH were renamed as metabolic dysfunction-associated steatotic liver disease(MASLD)and metabolic dysfunction-associated steatohepatitis(MASH),respectively;hence,we introduced the term“high-risk MASH”.Diagnostic values of seven non-invasive models,including FibroScan-aspartate transaminase(FAST),fibrosis-4(FIB-4),aspartate transaminase to platelet ratio index(APRI),etc.for high-risk MASH have rarely been studied and compared in MASLD.AIM To assess the clinical value of seven non-invasive models as alternatives to liver biopsy for diagnosing high-risk MASH.METHODS A retrospective analysis was conducted on 309 patients diagnosed with NAFLD via liver biopsy at Beijing Ditan Hospital,between January 2012 and December 2020.After screening for MASLD and the exclusion criteria,279 patients wereincluded and categorized into high-risk and non-high-risk MASH groups.Utilizing threshold values of each model,sensitivity,specificity,positive predictive value(PPV),and negative predictive values(NPV),were calculated.Receiver operating characteristic curves were constructed to evaluate their diagnostic efficacy based on the area under the curve(AUROC).RESULTS MASLD diagnostic criteria were met by 99.4%patients with NAFLD.The MASLD population was analyzed in two cohorts:Overall population(279 patients)and the subgroup(117 patients)who underwent liver transient elastography(FibroScan).In the overall population,FIB-4 showed better diagnostic efficacy and higher PPV,with sensitivity,specificity,PPV,NPV,and AUROC of 26.9%,95.2%,73.5%,72.2%,and 0.75.APRI,Forns index,and aspartate transaminase to alanine transaminase ratio(ARR)showed moderate diagnostic efficacy,whereas S index and gamma-glutamyl transpeptidase to platelet ratio(GPR)were relatively weaker.In the subgroup,FAST had the highest diagnostic efficacy,its sensitivity,specificity,PPV,NPV,and AUROC were 44.2%,92.3%,82.1%,67.4%,and 0.82.The FIB-4 AUROC was 0.76.S index and GPR exhibited almost no diagnostic value for high-risk MASH.CONCLUSION FAST and FIB-4 could replace liver biopsy as more effectively diagnostic methods for high-risk MASH compared to APRI,Forns index,ARR,S index,and GPR;FAST is superior to FIB-4.展开更多
Background: Since 2021, high-risk Human Papilloma Virus (HR-HPV) testing has been the recommended screening test for cervical cancer for all settings;either used alone in a “test and treat” strategy, or with a triag...Background: Since 2021, high-risk Human Papilloma Virus (HR-HPV) testing has been the recommended screening test for cervical cancer for all settings;either used alone in a “test and treat” strategy, or with a triage test, with or without biopsy, before treatment. Cameroon has rolled out immunization against HPV 16 and 18, but studies show a higher prevalence of non-16/18 HR-HPV types. Objectives: Determine the prevalence of precancerous lesions, in women with HR-HPV infection and evaluate association of digital cervicography (DC) VIA/VILI positivity with HPV serotype, as a measure of their contribution to precancer and cancer incidence. Methodology: The study was cross-sectional, descriptive, and analytic. It took place at the Etoug-Ebe and Ekoudoum Baptist Hospitals in Yaoundé, during the period April-September 2022. We reviewed the records of women screened for cervical cancer between February 2020 and December 2021 and evaluated the prevalence of lesions on digital cervicography (DC) with VIA/VILI for women positive for HR-HPV serotypes. The data were analyzed using SPSS version 20.0 for Windows. P values Results: We identified 315 cases with a positive HR-HPV deoxyribonucleic acid (DNA) test, 224 (71.1%) had a DC VIA/VILI triage test done. Of these, 30 (13.4%) women had a positive DC VIA/VILI, with five women (2.2%) having lesions suggestive of cancer. Out of 11 cases positive for HPV 16 alone, 05 (45.5%) had a positive DC VIA/VILI test. Of the 14 cases positive for HPV 18 alone, 03 (21.4%) had a positive VIA/VILI, meanwhile only 19 (10.7%) of the 177 cases positive for non-16/18 HPV had a positive VIA/VILI test. Conclusion: A high proportion of women (13.4%) with HR HPV had a positive DC VIA/VILI, with a significant proportion (2.2%) having lesions suggestive of invasive cervical cancer HR-HPV serotype was associated with DC VIA/VILI positivity;HPV 16 had the strongest association (45.5%), followed by HPV 18 (21.4%), and non-16/18 HR-HPV (10.7%), suggesting a decreasing order of oncogenicity.展开更多
Objective: Given the unique cultural background, way of life, and physical environment of the Tibetan Plateau, this study aims to investigate the effects of health education using problem-based learning (PBL) approach...Objective: Given the unique cultural background, way of life, and physical environment of the Tibetan Plateau, this study aims to investigate the effects of health education using problem-based learning (PBL) approaches on the knowledge, attitude, practice, and coping skills of women with high-risk pregnancies in this region. Methods: 76 high-risk pregnancy cases were enrolled at Tibet’s Linzhi People’s Hospital between September 2023 and April 2024. 30 patients admitted between September 2023 and December 2023 were selected as the control group and were performed with regular patient education. 46 patients admitted between January 2024 and April 2024 were selected as the observation group and were performed regular patient education with problem-based learning approaches. Two groups’ performance on their health knowledge, attitude, practice and coping skills before and after interventions were evaluated, and patient satisfaction were measured at the end of the study. Results: There was no statistical significance (P P P Conclusions: Health education with problem-based learning approaches is worth promoting as it can help high-risk pregnant women in plateau areas develop better health knowledge, attitude and practice and healthier coping skills. Also, it can improve patient sanctification.展开更多
BACKGROUND Anastomotic leaks remain one of the most dreaded complications in gastrointestinal surgery causing significant morbidity,that negatively affect the patients’quality of life.Experimental studies play an imp...BACKGROUND Anastomotic leaks remain one of the most dreaded complications in gastrointestinal surgery causing significant morbidity,that negatively affect the patients’quality of life.Experimental studies play an important role in understanding the pathophysiological background of anastomotic healing and there are still many fields that require further investigation.Knowledge drawn from these studies can lead to interventions or techniques that can reduce the risk of anastomotic leak in patients with high-risk features.Despite the advances in experimental protocols and techniques,designing a high-quality study is still challenging for the investigators as there is a plethora of different models used.AIM To review current state of the art for experimental protocols in high-risk anastomosis in rats.METHODS This systematic review was performed according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.To identify eligible studies,a comprehensive literature search was performed in the electronic databases PubMed(MEDLINE)and Scopus,covering the period from conception until 18 October 2023.RESULTS From our search strategy 102 studies were included and were categorized based on the mechanism used to create a high-risk anastomosis.Methods of assessing anastomotic healing were extracted and were individually appraised.CONCLUSION Anastomotic healing studies have evolved over the last decades,but the findings are yet to be translated into human studies.There is a need for high-quality,well-designed studies that will help to the better understanding of the pathophysiology of anastomotic healing and the effects of various interventions.展开更多
Objective: To evaluate the application value of neutrophils/lymphocytes (NLR), platelets/lymphocytes (PLR), lymphocytes/monocytes (LMR), HEART (history, electrocardiogram, age, risk factors, and troponin) score, and p...Objective: To evaluate the application value of neutrophils/lymphocytes (NLR), platelets/lymphocytes (PLR), lymphocytes/monocytes (LMR), HEART (history, electrocardiogram, age, risk factors, and troponin) score, and point-of- care testing (POCT) in the early warning and precise diagnosis of high-risk chest pain in emergency medicine. Methods: A total of 157 patients with acute chest pain who were admitted to the emergency department and chest pain treatment unit of our hospital between August 2022 and September 2023 were selected. Rapid testing of bedside myocardial markers (ultrasensitive troponin (hs-cTnI), myoglobin (MYO), creatine kinase isoenzyme (CK-MB), D-dimer (D-Dimer), and N-terminal B-type natriuretic peptide precursor (NT-proBNP)) was performed on the patients using a POCT device (ThermoKing BioMQ60proB). A HEART score was used to classify the patients into low (n = 53), intermediate (n = 59), and high-risk (n = 45) groups, and the NLR, PLR, and LMR were calculated. The NLR, PLR, and LMR values were compared among the three groups of patients, and the optimal cutoff values as well as sensitivity and specificity were determined based on receiver operating characteristic (ROC) analysis. Results: The HEART scores of patients in the low-risk, intermediate-risk, and high-risk groups were (2.72 ± 0.24), (4.75 ± 0.56), and (5.32 ± 0.73) respectively, and the differences were statistically significant (P < 0.05). Compared with the low-risk group, the intermediate-risk group and high-risk group had a significantly higher NLR and PLR, and a significantly lower LMR;the high-risk group had higher NLR and PLR and lower values of LMR as compared to the other two groups, and the difference was statistically significant (P < 0.05). The ROC curves suggested that the area under the curve, sensitivity, and specificity of the combined diagnosis of NLR, PLR, LMR, HEART score, and POCT were greater than those of LR, PLR, and LMR with HEART score and POCT alone. Conclusion: The combined application of NLR, PLR, LMR, HEART score, and POCT has significant application value in the early warning and precise diagnosis of emergency high-risk chest pain. It provides a more simple, easy-to-access, and efficient assessment index for the clinical prediction and treatment of emergency high- risk chest pain.展开更多
This study presents a review of the various methods to predict the spontaneous combustion liability of coal and coal-shale. The relative propensity of coal to undergo self-heating can be established by different metho...This study presents a review of the various methods to predict the spontaneous combustion liability of coal and coal-shale. The relative propensity of coal to undergo self-heating can be established by different methods. These methods are well established in their usage, but the fact that no particular test method has become a standard to predict the spontaneous combustion liability indicates that doubt still exists as to the validity of all of them. The underlying principle of all the tests is that the more readily the coal undergoes exothermic oxidation, the more liable it is to self-heat. Comprehensive studies that centres on the international position on research being conducted by academics, different research institutes and industries on spontaneous combustion of coal and coal mine fires were evaluated. Relationships between the geochemical analysis (proximate and ultimate analysis, forms of sulphur, petrographic properties, X-ray diffraction and X-ray fluorescence) and spontaneous combustion testing methods (numerical and experimental approaches) used to predict the spontaneous combustion liability of coal were reviewed. The combination of these tests provides a better understanding of the mechanism that controls the spontaneous combustion phenomena. However, irrespective of the extensive studies that have been conducted over time, spontaneous combustion is still a major problem in the coal value chain.展开更多
A replenishment decision-making model for supply-hub is firstly established from the angle of supplier, and optimal replenishment decision of the supplier is analyzed. Then, inventory optimization model for supply-hub...A replenishment decision-making model for supply-hub is firstly established from the angle of supplier, and optimal replenishment decision of the supplier is analyzed. Then, inventory optimization model for supply-hub is formulated from the angle of the manufacturer, and the optimization algorithm for obtaining optimal inventory levels is given. The result shows that liability period decides the share of the inventory cost between two sides in supply chain. With the increase of liability period, the service level has been quickly reduced even though the manufacturer's cost has been cut down by transferring the inventory cost to the supplier. As to the safety inventory, if the lower bound of components safety inventory increases, the supplier's cost will rise up more slowly than the liability period does, while the service levels increases as the safety inventory's lower bound is raised.展开更多
Coal burst is a severe hazard that can result in fatalities and damage of facilities in underground coal mines.To address this issue,a robust unascertained combination model is proposed to study the coal burst hazard ...Coal burst is a severe hazard that can result in fatalities and damage of facilities in underground coal mines.To address this issue,a robust unascertained combination model is proposed to study the coal burst hazard based on an updated database.Four assessment indexes are used in the model,which are the dynamic failure duration(DT),elastic energy index(WET),impact energy index(KE)and uniaxial compressive strength(RC).Four membership functions,including linear(L),parabolic(P),S and Weibull(W)functions,are proposed to measure the uncertainty level of individual index.The corresponding weights are determined through information entropy(EN),analysis hierarchy process(AHP)and synthetic weights(CW).Simultaneously,the classification criteria,including unascertained cluster(UC)and credible identification principle(CIP),are analyzed.The combination algorithm,consisting of P function,CW and CIP(P-CW-CIP),is selected as the optimal classification model in function of theory analysis and to train the samples.Ultimately,the established ensemble model is further validated through test samples with 100%accuracy.The results reveal that the hybrid model has a great potential in the coal burst hazard evaluation in underground coal mines.展开更多
The characterization of the physical and chemical properties of coal on a standard provides an understanding of its characteristics towards spontaneous combustion.The trend of linear relationships between coal recordi...The characterization of the physical and chemical properties of coal on a standard provides an understanding of its characteristics towards spontaneous combustion.The trend of linear relationships between coal recording standards(%air-dried(ad),%dry(db)and%dry ash free(daf)basis)of 30 selected coal samples from the Witbank coalfields and spontaneous combustion liability indices were evaluated.The spontaneous combustion liability indices of these samples were evaluated by crossing point temperature(XPT),Stage II Slope,FCC(Feng,Chakravorty,Cochrane)and the Wits-Ehac tests,while the coal properties were determined from the proximate and ultimate analyses.The results obtained from these coal properties were related to different liability indices to develop trends of linear relationships using regression analysis.The ad basis indicated higher correlation coefficients than the db and daf basis for the XPT and FCC index,while the daf showed higher correlation coefficients than the ad and db basis for the Wits-Ehac index.It was found that the trend of linear relationships of these coal properties differs from one liability index to the next.The XPTs showed a better trend followed by the Stage II Slope on the coal properties among the spontaneous combustion liability indices evaluated.展开更多
Since the entry into force of the International Convention on liability and compensation for oil spill damage, there have been many discussions on the improvement of this regime. Based on the existing tworegimes, the ...Since the entry into force of the International Convention on liability and compensation for oil spill damage, there have been many discussions on the improvement of this regime. Based on the existing tworegimes, the writer tried to analysis the advantages of the new regimes and foresee the trends of the international regime of liability and compensation for oil pollution damage.展开更多
As the responsibilities for clinical pharmacists have increased in recent years, the pharmacy practitioner finds the need for professional liability insurance. This report describes the practice changes under way and ...As the responsibilities for clinical pharmacists have increased in recent years, the pharmacy practitioner finds the need for professional liability insurance. This report describes the practice changes under way and describes the malpractice insurance options available to current pharmacy practitioners.展开更多
The existing liability division methods for harmonic pollution are either inexplicit or incomplete in physical meaning. To compensate these defects, two new methods are proposed based on line-transferred power compone...The existing liability division methods for harmonic pollution are either inexplicit or incomplete in physical meaning. To compensate these defects, two new methods are proposed based on line-transferred power components in this paper. At first, all harmonic sources are represented by ideal equivalent current source, line current components and bus voltage components of a source are determined by stimulation of this source with all other sources disabled. Then, the line-trans- ferred power component owing to a source under all sources action together is determined by the theory of line-transferred power components, and called source’s line-transferred power component. At last, the liability of a source for line-end harmonic pollution is divided by two methods: the ration of the source’s line-transferred active power component to the total line-transferred power, and the ration of projection of the source’s line-transferred complex power component to absolute value of the total line-transferred complex power. These two methods are taken into account not only harmonic voltage but also harmonic current in the liability division. Simulation results show that the proposed liability division method based on active power component is the most effective and ideal one.展开更多
AIM:To investigate whether the two-step strategy[conjunctival flap covering surgery(CFCS)combined with secondary deep anterior lamellar keratoplasty(DALK)]is effective for patients with high-risk fungal keratitis(FK)....AIM:To investigate whether the two-step strategy[conjunctival flap covering surgery(CFCS)combined with secondary deep anterior lamellar keratoplasty(DALK)]is effective for patients with high-risk fungal keratitis(FK).METHODS:In this noncomparative,retrospective case series,10 subjects(6 males,4 females)with a mean age of 56.5±7.1(range 47-72)y with high-risk FK undergone the two-step strategy were included.Reported outcome measures were healing of the corneal ulcer,recurrence of FK,reject reaction,improvement in best corrected visual acuity(BCVA)and relevant complications.RESULTS:The average diameter of corneal infiltrates was 7.50±0.39 mm,ranging from 6.94 to 8.13 mm.The mean depth of corneal infiltrates was 422.4±77.1μm,ranging from 350 to 535μm.The mean corneal thickness was 597.4±117.3μm,ranging from 458 to 851μm.Hypopyon and endothelial plaques were presented in all patients.The period between the two steps was 3.65±0.9(ranging from 3 to 5)mo.The graft diameter was 7.75±0.39 mm.At the last follow-up(average 9.25±3.39,ranging from 5.5 to 17mo),no fungal recurrence or graft rejection appeared,and all patients showed improvement of BCVA.One patient suffered from liver function impairment due to oral voriconazole for 4wk and recovered spontaneously after 1wk of drug withdrawal.CONCLUSION:The two-step strategy is safe and effective in the treatment of high-risk FK by transforming intentional therapeutic penetrating keratoplasty during acute infection to later optical DALK.It is a practical strategy,especially in areas lacking fresh donor corneas and eye bank services.展开更多
We used the allele-specific PCR-double digestion method on peripheral myelin protein 22 (PMP22) to determine duplication and deletion mutations in the proband and family members of one family with Charcot-Marie-Toot...We used the allele-specific PCR-double digestion method on peripheral myelin protein 22 (PMP22) to determine duplication and deletion mutations in the proband and family members of one family with Charcot-Marie-Tooth disease type 1 and one family with hereditary neuropathy with liability to pressure palsies. The proband and one subclinical family member from the Charcot-Marie-Tooth disease type 1 family had a PMP22 gene duplication; one patient from the hereditary neuropathy with liability to pressure palsies family had a PMP22 gene deletion. Electron microscopic analysis of ultrathin sections of the superficial peroneal nerve from the two probands demonstrated demyelination and myelin sheath hyperplasia, as well as an 'onion-like' structure in the Charcot-Marie-Tooth disease type 1A patient. We observed an irregular thickened myelin sheath and 'mouse-nibbled'-Iike changes in the patient with hereditary neuropathy with liability to pressure palsies. In the Charcot-Marie-Tooth disease type 1A patient, nerve electrophysiological examination revealed moderate-to-severe reductions in the motor and sensory conduction velocities of the bilateral median nerve, ulnar nerve, tibial nerve, and sural nerve. Moreover, the compound muscle action potential amplitude was decreased. In the patient with hereditary neuropathy with liability to pressure palsies, the nerve conduction velocity of the bilateral tibial nerve and sural nerve was moderately reduced, and the nerve conduction velocity of the median nerve and ulnar nerve of both upper extremities was slightly reduced.展开更多
BACKGROUND Acute bleeding due to esophageal varices(EVs)is a life-threatening complication in patients with cirrhosis.The diagnosis of EVs is mainly through upper gastrointestinal endoscopy,but the discomfort,contrain...BACKGROUND Acute bleeding due to esophageal varices(EVs)is a life-threatening complication in patients with cirrhosis.The diagnosis of EVs is mainly through upper gastrointestinal endoscopy,but the discomfort,contraindications and complications of gastrointestinal endoscopic screening reduce patient compliance.According to the bleeding risk of EVs,the Baveno VI consensus divides varices into high bleeding risk EVs(HEVs)and low bleeding risk EVs(LEVs).We sought to identify a non-invasive prediction model based on spleen stiffness measurement(SSM)and liver stiffness measurement(LSM)as an alternative to EVs screening.AIM To develop a safe,simple and non-invasive model to predict HEVs in patients with viral cirrhosis and identify patients who can be exempted from upper gastrointestinal endoscopy.METHODS Data from 200 patients with viral cirrhosis were included in this study,with 140 patients as the modelling group and 60 patients as the external validation group,and the EVs types of patients were determined by upper gastrointestinal endoscopy and the Baveno Ⅵ consensus.Those patients were divided into the HEVs group(66 patients)and the LEVs group(74 patients).The effect of each parameter on HEVs was analyzed by univariate and multivariate analyses,and a noninvasive prediction model was established.Finally,the discrimination ability,calibration ability and clinical efficacy of the new model were verified in the modelling group and the external validation group.RESULTS Univariate and multivariate analyses showed that SSM and LSM were associated with the occurrence of HEVs in patients with viral cirrhosis.On this basis,logistic regression analysis was used to construct a prediction model:Ln[P/(1-P)]=-8.184-0.228×SSM+0.642×LSM.The area under the curve of the new model was 0.965.When the cut-off value was 0.27,the sensitivity,specificity,positive predictive value and negative predictive value of the model for predicting HEVs were 100.00%,82.43%,83.52%,and 100%,respectively.Compared with the four prediction models of liver stiffness-spleen diameter to platelet ratio score,variceal risk index,aspartate aminotransferase to alanine aminotransferase ratio,and Baveno VI,the established model can better predict HEVs in patients with viral cirrhosis.CONCLUSION Based on the SSM and LSM measured by transient elastography,we established a non-invasive prediction model for HEVs.The new model is reliable in predicting HEVs and can be used as an alternative to routine upper gastrointestinal endoscopy screening,which is helpful for clinical decision making.展开更多
Though bearing technical and legal attributes,environmental quality standards are neither rules nor regulatory documents.With the binding force coming from the legal norms where they are cited,environmental quality st...Though bearing technical and legal attributes,environmental quality standards are neither rules nor regulatory documents.With the binding force coming from the legal norms where they are cited,environmental quality standards are designed and implemented as a yardstick for measuring environmental quality.They also play a role in the functions of goal setting,merit appraisals,inspiration,supervision and accountability in conjunction with the legal norms and administrative plans where they are cited.Characteristically,environmental quality standards adopt sort management in concept,take holistic values and methodologies,establish phased goals and accept the resulting policy choices.These standards are not applicable to determine tort liability caused by environmental pollution from the perspective of legal norms but provide limited evidence for finding the same in the view of factual analysis by delivering scientific support to prove negative effects on the environment.Hence,environmental quality standards do contribute to finding torts,thus making the production of evidence less difficult.Also,they can be used to prove the relevance between torts and damage.展开更多
Based on the fact that the parent company has actual control over the subsidiary company,this paper analyzes the possibility of the parent company using the subsidiary company to seek benefits and damage the interests...Based on the fact that the parent company has actual control over the subsidiary company,this paper analyzes the possibility of the parent company using the subsidiary company to seek benefits and damage the interests of creditors.Moreover,under the intangible protection of the current limited liability system and the independent personality of the company,it can“retreat”.This is undoubtedly against the original intention of the establishment of enterprise groups and has great potential harm to creditors.In addition,on the basis of the relief measures for the rights and interests of the parent company caused by the bad behavior of the subsidiary,the legal defects that should be carefully considered are determined.Considering whether there are other remedies that may have the same effect as disclosure,some are more moderate than disclosure.With Britain’s strong caution about lifting the veil,a more moderate direction could be considered.展开更多
文摘At the legislative level in China,there has been insufficient theoretical preparation to explicitly include“sexual autonomy”within the scope of general personality rights.In handling the increasing number of disputes related to violations of“sexual autonomy,”judicial biases have emerged during the trial process when courts determine the attribute of the right to“sexual autonomy.”This situation necessitates a clear legal analysis of the concept and attributes of“sexual autonomy”to establish its essential attribute as a personality right,and,from the perspective of legal doctrine,enable the justification of the right to“sexual autonomy”as either a general personality right or other personality interests,thereby providing theoretical support for courts to“adjudicate according to law.”By delineating and categorizing instances of violations of“sexual autonomy,”the constitutive elements and fundamental characteristics of such violations can be clarified.By examining the legal norms governing civil litigation and civil litigation associated with criminal cases concerning violations of“sexual autonomy,”the responsibility determination,remedies,and existing regulatory loopholes regarding violations of“sexual autonomy,”especially in cases involving both criminal and civil matters,can be defined.Based on this foundation,the legal basis,determination mechanism,and compensation standards for claiming compensation for mental damages resulting from violations of“sexual autonomy”can be elucidated.
文摘The risk analysis evaluates the probability of occurrence with the impact of said risks.In the hydrocarbon sector,an environmental liability is an improperly abandoned facility,soil contaminated by spills or others.The objective of this work is to define a risk management plan.The characterization of the residue and the area was carried out.Hazardous events were identified:overflow spill,soil contamination by infiltration,as well as radiant heat and suffocating and toxic fumes from a fire.The matrix method was applied considering the probability of occurrence against vulnerability.The danger of infiltration implied a high level of risk.The risk management plan was drawn up,its main action being the liquidation of the pool and the sanitation of the area.
基金Supported by Research Grants from the fund of Suzhou Kowloon Hospital(No.SZJL202106).
文摘AIM:To assess the clinical efficacy and safety of combining panretinal photocoagulation(PRP)with intravitreal conbercept(IVC)injections for patients with high-risk proliferative diabetic retinopathy(HR-PDR)complicated by mild or moderate vitreous hemorrhage(VH),with or without diabetic macular edema(DME).METHODS:Patients diagnosed with VH with/without DME secondary to HR-PDR and received PRP combined with IVC injections were recruited in this retrospective study.Upon establishing the patient’s diagnosis,an initial IVC was performed,followed by prompt administration of PRP.In cases who significant bleeding persisted and impeded the laser operation,IVC was sustained before supplementing with PRP.Following the completion of PRP,patients were meticulously monitored for a minimum of six months.Laser therapy and IVC injections were judiciously adjusted based on fundus fluorescein angiography(FFA)results.Therapeutic effect and the incidence of adverse events were observed.RESULTS:Out of 42 patients(74 eyes),29 were male and 13 were female,with a mean age of 59.17±12.74y(33-84y).The diabetic history was between 1wk and 26y,and the interval between the onset of visual symptoms and diagnosis of HR-PDR was 1wk-1y.The affected eye received 2.59±1.87(1-10)IVC injections and underwent 5.5±1.02(4-8)sessions of PRP.Of these,68 eyes received PRP following 1 IVC injection,5 eyes after 2 IVC injections,and 1 eye after 3 IVC injections.Complete absorption of VH was observed in all 74 eyes 5-50wk after initial treatment,with resolution of DME in 51 eyes 3-48wk after initial treatment.A newly developed epiretinal membrane was noted in one eye.Visual acuity significantly improved in 25 eyes.No complications such as glaucoma,retinal detachment,or endophthalmitis were reported.CONCLUSION:The study suggests that the combination of PRP with IVC injections is an effective and safe modality for treating diabetic VH in patients with HR-PDR.
基金Supported by National Natural Science Foundation of China,No.82170591Natural Science Foundation of Beijing,No.7222097.
文摘BACKGROUND Non-alcoholic fatty liver disease(NAFLD)with hepatic histological NAFLD activity score≥4 and fibrosis stage F≥2 is regarded as“at risk”non-alcoholic steatohepatitis(NASH).Based on an international consensus,NAFLD and NASH were renamed as metabolic dysfunction-associated steatotic liver disease(MASLD)and metabolic dysfunction-associated steatohepatitis(MASH),respectively;hence,we introduced the term“high-risk MASH”.Diagnostic values of seven non-invasive models,including FibroScan-aspartate transaminase(FAST),fibrosis-4(FIB-4),aspartate transaminase to platelet ratio index(APRI),etc.for high-risk MASH have rarely been studied and compared in MASLD.AIM To assess the clinical value of seven non-invasive models as alternatives to liver biopsy for diagnosing high-risk MASH.METHODS A retrospective analysis was conducted on 309 patients diagnosed with NAFLD via liver biopsy at Beijing Ditan Hospital,between January 2012 and December 2020.After screening for MASLD and the exclusion criteria,279 patients wereincluded and categorized into high-risk and non-high-risk MASH groups.Utilizing threshold values of each model,sensitivity,specificity,positive predictive value(PPV),and negative predictive values(NPV),were calculated.Receiver operating characteristic curves were constructed to evaluate their diagnostic efficacy based on the area under the curve(AUROC).RESULTS MASLD diagnostic criteria were met by 99.4%patients with NAFLD.The MASLD population was analyzed in two cohorts:Overall population(279 patients)and the subgroup(117 patients)who underwent liver transient elastography(FibroScan).In the overall population,FIB-4 showed better diagnostic efficacy and higher PPV,with sensitivity,specificity,PPV,NPV,and AUROC of 26.9%,95.2%,73.5%,72.2%,and 0.75.APRI,Forns index,and aspartate transaminase to alanine transaminase ratio(ARR)showed moderate diagnostic efficacy,whereas S index and gamma-glutamyl transpeptidase to platelet ratio(GPR)were relatively weaker.In the subgroup,FAST had the highest diagnostic efficacy,its sensitivity,specificity,PPV,NPV,and AUROC were 44.2%,92.3%,82.1%,67.4%,and 0.82.The FIB-4 AUROC was 0.76.S index and GPR exhibited almost no diagnostic value for high-risk MASH.CONCLUSION FAST and FIB-4 could replace liver biopsy as more effectively diagnostic methods for high-risk MASH compared to APRI,Forns index,ARR,S index,and GPR;FAST is superior to FIB-4.
文摘Background: Since 2021, high-risk Human Papilloma Virus (HR-HPV) testing has been the recommended screening test for cervical cancer for all settings;either used alone in a “test and treat” strategy, or with a triage test, with or without biopsy, before treatment. Cameroon has rolled out immunization against HPV 16 and 18, but studies show a higher prevalence of non-16/18 HR-HPV types. Objectives: Determine the prevalence of precancerous lesions, in women with HR-HPV infection and evaluate association of digital cervicography (DC) VIA/VILI positivity with HPV serotype, as a measure of their contribution to precancer and cancer incidence. Methodology: The study was cross-sectional, descriptive, and analytic. It took place at the Etoug-Ebe and Ekoudoum Baptist Hospitals in Yaoundé, during the period April-September 2022. We reviewed the records of women screened for cervical cancer between February 2020 and December 2021 and evaluated the prevalence of lesions on digital cervicography (DC) with VIA/VILI for women positive for HR-HPV serotypes. The data were analyzed using SPSS version 20.0 for Windows. P values Results: We identified 315 cases with a positive HR-HPV deoxyribonucleic acid (DNA) test, 224 (71.1%) had a DC VIA/VILI triage test done. Of these, 30 (13.4%) women had a positive DC VIA/VILI, with five women (2.2%) having lesions suggestive of cancer. Out of 11 cases positive for HPV 16 alone, 05 (45.5%) had a positive DC VIA/VILI test. Of the 14 cases positive for HPV 18 alone, 03 (21.4%) had a positive VIA/VILI, meanwhile only 19 (10.7%) of the 177 cases positive for non-16/18 HPV had a positive VIA/VILI test. Conclusion: A high proportion of women (13.4%) with HR HPV had a positive DC VIA/VILI, with a significant proportion (2.2%) having lesions suggestive of invasive cervical cancer HR-HPV serotype was associated with DC VIA/VILI positivity;HPV 16 had the strongest association (45.5%), followed by HPV 18 (21.4%), and non-16/18 HR-HPV (10.7%), suggesting a decreasing order of oncogenicity.
文摘Objective: Given the unique cultural background, way of life, and physical environment of the Tibetan Plateau, this study aims to investigate the effects of health education using problem-based learning (PBL) approaches on the knowledge, attitude, practice, and coping skills of women with high-risk pregnancies in this region. Methods: 76 high-risk pregnancy cases were enrolled at Tibet’s Linzhi People’s Hospital between September 2023 and April 2024. 30 patients admitted between September 2023 and December 2023 were selected as the control group and were performed with regular patient education. 46 patients admitted between January 2024 and April 2024 were selected as the observation group and were performed regular patient education with problem-based learning approaches. Two groups’ performance on their health knowledge, attitude, practice and coping skills before and after interventions were evaluated, and patient satisfaction were measured at the end of the study. Results: There was no statistical significance (P P P Conclusions: Health education with problem-based learning approaches is worth promoting as it can help high-risk pregnant women in plateau areas develop better health knowledge, attitude and practice and healthier coping skills. Also, it can improve patient sanctification.
文摘BACKGROUND Anastomotic leaks remain one of the most dreaded complications in gastrointestinal surgery causing significant morbidity,that negatively affect the patients’quality of life.Experimental studies play an important role in understanding the pathophysiological background of anastomotic healing and there are still many fields that require further investigation.Knowledge drawn from these studies can lead to interventions or techniques that can reduce the risk of anastomotic leak in patients with high-risk features.Despite the advances in experimental protocols and techniques,designing a high-quality study is still challenging for the investigators as there is a plethora of different models used.AIM To review current state of the art for experimental protocols in high-risk anastomosis in rats.METHODS This systematic review was performed according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.To identify eligible studies,a comprehensive literature search was performed in the electronic databases PubMed(MEDLINE)and Scopus,covering the period from conception until 18 October 2023.RESULTS From our search strategy 102 studies were included and were categorized based on the mechanism used to create a high-risk anastomosis.Methods of assessing anastomotic healing were extracted and were individually appraised.CONCLUSION Anastomotic healing studies have evolved over the last decades,but the findings are yet to be translated into human studies.There is a need for high-quality,well-designed studies that will help to the better understanding of the pathophysiology of anastomotic healing and the effects of various interventions.
文摘Objective: To evaluate the application value of neutrophils/lymphocytes (NLR), platelets/lymphocytes (PLR), lymphocytes/monocytes (LMR), HEART (history, electrocardiogram, age, risk factors, and troponin) score, and point-of- care testing (POCT) in the early warning and precise diagnosis of high-risk chest pain in emergency medicine. Methods: A total of 157 patients with acute chest pain who were admitted to the emergency department and chest pain treatment unit of our hospital between August 2022 and September 2023 were selected. Rapid testing of bedside myocardial markers (ultrasensitive troponin (hs-cTnI), myoglobin (MYO), creatine kinase isoenzyme (CK-MB), D-dimer (D-Dimer), and N-terminal B-type natriuretic peptide precursor (NT-proBNP)) was performed on the patients using a POCT device (ThermoKing BioMQ60proB). A HEART score was used to classify the patients into low (n = 53), intermediate (n = 59), and high-risk (n = 45) groups, and the NLR, PLR, and LMR were calculated. The NLR, PLR, and LMR values were compared among the three groups of patients, and the optimal cutoff values as well as sensitivity and specificity were determined based on receiver operating characteristic (ROC) analysis. Results: The HEART scores of patients in the low-risk, intermediate-risk, and high-risk groups were (2.72 ± 0.24), (4.75 ± 0.56), and (5.32 ± 0.73) respectively, and the differences were statistically significant (P < 0.05). Compared with the low-risk group, the intermediate-risk group and high-risk group had a significantly higher NLR and PLR, and a significantly lower LMR;the high-risk group had higher NLR and PLR and lower values of LMR as compared to the other two groups, and the difference was statistically significant (P < 0.05). The ROC curves suggested that the area under the curve, sensitivity, and specificity of the combined diagnosis of NLR, PLR, LMR, HEART score, and POCT were greater than those of LR, PLR, and LMR with HEART score and POCT alone. Conclusion: The combined application of NLR, PLR, LMR, HEART score, and POCT has significant application value in the early warning and precise diagnosis of emergency high-risk chest pain. It provides a more simple, easy-to-access, and efficient assessment index for the clinical prediction and treatment of emergency high- risk chest pain.
文摘This study presents a review of the various methods to predict the spontaneous combustion liability of coal and coal-shale. The relative propensity of coal to undergo self-heating can be established by different methods. These methods are well established in their usage, but the fact that no particular test method has become a standard to predict the spontaneous combustion liability indicates that doubt still exists as to the validity of all of them. The underlying principle of all the tests is that the more readily the coal undergoes exothermic oxidation, the more liable it is to self-heat. Comprehensive studies that centres on the international position on research being conducted by academics, different research institutes and industries on spontaneous combustion of coal and coal mine fires were evaluated. Relationships between the geochemical analysis (proximate and ultimate analysis, forms of sulphur, petrographic properties, X-ray diffraction and X-ray fluorescence) and spontaneous combustion testing methods (numerical and experimental approaches) used to predict the spontaneous combustion liability of coal were reviewed. The combination of these tests provides a better understanding of the mechanism that controls the spontaneous combustion phenomena. However, irrespective of the extensive studies that have been conducted over time, spontaneous combustion is still a major problem in the coal value chain.
基金Projects(71102174,70971036) supported by the National Natural Science Foundation of ChinaProject(9123028) supported by the Beijing Natural Science Foundation,China+3 种基金Project(20111101120019) supported by the Specialized Research Fund for Doctoral Program of Higher Education of ChinaProject(11JGC106) supported by the Beijing Philosophy&Social Science Foundation of ChinaProjects(NCET-10-0048,NCET-10-0043) supported by the Program for New Century Excellent Talents in Universities of ChinaProject(2010YC1307) supported by the Excellent Young Teacher in Beijing Institute of Technology of China
文摘A replenishment decision-making model for supply-hub is firstly established from the angle of supplier, and optimal replenishment decision of the supplier is analyzed. Then, inventory optimization model for supply-hub is formulated from the angle of the manufacturer, and the optimization algorithm for obtaining optimal inventory levels is given. The result shows that liability period decides the share of the inventory cost between two sides in supply chain. With the increase of liability period, the service level has been quickly reduced even though the manufacturer's cost has been cut down by transferring the inventory cost to the supplier. As to the safety inventory, if the lower bound of components safety inventory increases, the supplier's cost will rise up more slowly than the liability period does, while the service levels increases as the safety inventory's lower bound is raised.
基金funded by the National Science Foundation of China(Nos.72088101 and 41807259)the Innovation-Driven Project of Central South University(No.2020CX040)the Shenghua Lieying Program of Central South University(Principle Investigator:Dr.Jian Zhou)。
文摘Coal burst is a severe hazard that can result in fatalities and damage of facilities in underground coal mines.To address this issue,a robust unascertained combination model is proposed to study the coal burst hazard based on an updated database.Four assessment indexes are used in the model,which are the dynamic failure duration(DT),elastic energy index(WET),impact energy index(KE)and uniaxial compressive strength(RC).Four membership functions,including linear(L),parabolic(P),S and Weibull(W)functions,are proposed to measure the uncertainty level of individual index.The corresponding weights are determined through information entropy(EN),analysis hierarchy process(AHP)and synthetic weights(CW).Simultaneously,the classification criteria,including unascertained cluster(UC)and credible identification principle(CIP),are analyzed.The combination algorithm,consisting of P function,CW and CIP(P-CW-CIP),is selected as the optimal classification model in function of theory analysis and to train the samples.Ultimately,the established ensemble model is further validated through test samples with 100%accuracy.The results reveal that the hybrid model has a great potential in the coal burst hazard evaluation in underground coal mines.
文摘The characterization of the physical and chemical properties of coal on a standard provides an understanding of its characteristics towards spontaneous combustion.The trend of linear relationships between coal recording standards(%air-dried(ad),%dry(db)and%dry ash free(daf)basis)of 30 selected coal samples from the Witbank coalfields and spontaneous combustion liability indices were evaluated.The spontaneous combustion liability indices of these samples were evaluated by crossing point temperature(XPT),Stage II Slope,FCC(Feng,Chakravorty,Cochrane)and the Wits-Ehac tests,while the coal properties were determined from the proximate and ultimate analyses.The results obtained from these coal properties were related to different liability indices to develop trends of linear relationships using regression analysis.The ad basis indicated higher correlation coefficients than the db and daf basis for the XPT and FCC index,while the daf showed higher correlation coefficients than the ad and db basis for the Wits-Ehac index.It was found that the trend of linear relationships of these coal properties differs from one liability index to the next.The XPTs showed a better trend followed by the Stage II Slope on the coal properties among the spontaneous combustion liability indices evaluated.
文摘Since the entry into force of the International Convention on liability and compensation for oil spill damage, there have been many discussions on the improvement of this regime. Based on the existing tworegimes, the writer tried to analysis the advantages of the new regimes and foresee the trends of the international regime of liability and compensation for oil pollution damage.
文摘As the responsibilities for clinical pharmacists have increased in recent years, the pharmacy practitioner finds the need for professional liability insurance. This report describes the practice changes under way and describes the malpractice insurance options available to current pharmacy practitioners.
文摘The existing liability division methods for harmonic pollution are either inexplicit or incomplete in physical meaning. To compensate these defects, two new methods are proposed based on line-transferred power components in this paper. At first, all harmonic sources are represented by ideal equivalent current source, line current components and bus voltage components of a source are determined by stimulation of this source with all other sources disabled. Then, the line-trans- ferred power component owing to a source under all sources action together is determined by the theory of line-transferred power components, and called source’s line-transferred power component. At last, the liability of a source for line-end harmonic pollution is divided by two methods: the ration of the source’s line-transferred active power component to the total line-transferred power, and the ration of projection of the source’s line-transferred complex power component to absolute value of the total line-transferred complex power. These two methods are taken into account not only harmonic voltage but also harmonic current in the liability division. Simulation results show that the proposed liability division method based on active power component is the most effective and ideal one.
基金Supported by the National Natural Science Foundation of China(No.82171025No.82070934)+2 种基金the Fundamental Research Funds for the Central Universities(No.HUST:2019kfy XMBZ065)the Key Research and Development Program of Hubei Province(No.2021BCA146)the Clinical Research Foundation of Wuhan Union Hospital(No.2021xhlcyj03)。
文摘AIM:To investigate whether the two-step strategy[conjunctival flap covering surgery(CFCS)combined with secondary deep anterior lamellar keratoplasty(DALK)]is effective for patients with high-risk fungal keratitis(FK).METHODS:In this noncomparative,retrospective case series,10 subjects(6 males,4 females)with a mean age of 56.5±7.1(range 47-72)y with high-risk FK undergone the two-step strategy were included.Reported outcome measures were healing of the corneal ulcer,recurrence of FK,reject reaction,improvement in best corrected visual acuity(BCVA)and relevant complications.RESULTS:The average diameter of corneal infiltrates was 7.50±0.39 mm,ranging from 6.94 to 8.13 mm.The mean depth of corneal infiltrates was 422.4±77.1μm,ranging from 350 to 535μm.The mean corneal thickness was 597.4±117.3μm,ranging from 458 to 851μm.Hypopyon and endothelial plaques were presented in all patients.The period between the two steps was 3.65±0.9(ranging from 3 to 5)mo.The graft diameter was 7.75±0.39 mm.At the last follow-up(average 9.25±3.39,ranging from 5.5 to 17mo),no fungal recurrence or graft rejection appeared,and all patients showed improvement of BCVA.One patient suffered from liver function impairment due to oral voriconazole for 4wk and recovered spontaneously after 1wk of drug withdrawal.CONCLUSION:The two-step strategy is safe and effective in the treatment of high-risk FK by transforming intentional therapeutic penetrating keratoplasty during acute infection to later optical DALK.It is a practical strategy,especially in areas lacking fresh donor corneas and eye bank services.
基金funded by the National Natural Science Foundation of China, grant No. 81071001 and 30600200
文摘We used the allele-specific PCR-double digestion method on peripheral myelin protein 22 (PMP22) to determine duplication and deletion mutations in the proband and family members of one family with Charcot-Marie-Tooth disease type 1 and one family with hereditary neuropathy with liability to pressure palsies. The proband and one subclinical family member from the Charcot-Marie-Tooth disease type 1 family had a PMP22 gene duplication; one patient from the hereditary neuropathy with liability to pressure palsies family had a PMP22 gene deletion. Electron microscopic analysis of ultrathin sections of the superficial peroneal nerve from the two probands demonstrated demyelination and myelin sheath hyperplasia, as well as an 'onion-like' structure in the Charcot-Marie-Tooth disease type 1A patient. We observed an irregular thickened myelin sheath and 'mouse-nibbled'-Iike changes in the patient with hereditary neuropathy with liability to pressure palsies. In the Charcot-Marie-Tooth disease type 1A patient, nerve electrophysiological examination revealed moderate-to-severe reductions in the motor and sensory conduction velocities of the bilateral median nerve, ulnar nerve, tibial nerve, and sural nerve. Moreover, the compound muscle action potential amplitude was decreased. In the patient with hereditary neuropathy with liability to pressure palsies, the nerve conduction velocity of the bilateral tibial nerve and sural nerve was moderately reduced, and the nerve conduction velocity of the median nerve and ulnar nerve of both upper extremities was slightly reduced.
基金Supported by the Shaanxi Provincial Key Research and Development Plan,No.2020SF-159.
文摘BACKGROUND Acute bleeding due to esophageal varices(EVs)is a life-threatening complication in patients with cirrhosis.The diagnosis of EVs is mainly through upper gastrointestinal endoscopy,but the discomfort,contraindications and complications of gastrointestinal endoscopic screening reduce patient compliance.According to the bleeding risk of EVs,the Baveno VI consensus divides varices into high bleeding risk EVs(HEVs)and low bleeding risk EVs(LEVs).We sought to identify a non-invasive prediction model based on spleen stiffness measurement(SSM)and liver stiffness measurement(LSM)as an alternative to EVs screening.AIM To develop a safe,simple and non-invasive model to predict HEVs in patients with viral cirrhosis and identify patients who can be exempted from upper gastrointestinal endoscopy.METHODS Data from 200 patients with viral cirrhosis were included in this study,with 140 patients as the modelling group and 60 patients as the external validation group,and the EVs types of patients were determined by upper gastrointestinal endoscopy and the Baveno Ⅵ consensus.Those patients were divided into the HEVs group(66 patients)and the LEVs group(74 patients).The effect of each parameter on HEVs was analyzed by univariate and multivariate analyses,and a noninvasive prediction model was established.Finally,the discrimination ability,calibration ability and clinical efficacy of the new model were verified in the modelling group and the external validation group.RESULTS Univariate and multivariate analyses showed that SSM and LSM were associated with the occurrence of HEVs in patients with viral cirrhosis.On this basis,logistic regression analysis was used to construct a prediction model:Ln[P/(1-P)]=-8.184-0.228×SSM+0.642×LSM.The area under the curve of the new model was 0.965.When the cut-off value was 0.27,the sensitivity,specificity,positive predictive value and negative predictive value of the model for predicting HEVs were 100.00%,82.43%,83.52%,and 100%,respectively.Compared with the four prediction models of liver stiffness-spleen diameter to platelet ratio score,variceal risk index,aspartate aminotransferase to alanine aminotransferase ratio,and Baveno VI,the established model can better predict HEVs in patients with viral cirrhosis.CONCLUSION Based on the SSM and LSM measured by transient elastography,we established a non-invasive prediction model for HEVs.The new model is reliable in predicting HEVs and can be used as an alternative to routine upper gastrointestinal endoscopy screening,which is helpful for clinical decision making.
基金a stage result of “Study on Legal Issues of Hazardous Waste Multivariate Treatment under Market Economy”(15BFX181)of National Social Sciences Fund of China
文摘Though bearing technical and legal attributes,environmental quality standards are neither rules nor regulatory documents.With the binding force coming from the legal norms where they are cited,environmental quality standards are designed and implemented as a yardstick for measuring environmental quality.They also play a role in the functions of goal setting,merit appraisals,inspiration,supervision and accountability in conjunction with the legal norms and administrative plans where they are cited.Characteristically,environmental quality standards adopt sort management in concept,take holistic values and methodologies,establish phased goals and accept the resulting policy choices.These standards are not applicable to determine tort liability caused by environmental pollution from the perspective of legal norms but provide limited evidence for finding the same in the view of factual analysis by delivering scientific support to prove negative effects on the environment.Hence,environmental quality standards do contribute to finding torts,thus making the production of evidence less difficult.Also,they can be used to prove the relevance between torts and damage.
文摘Based on the fact that the parent company has actual control over the subsidiary company,this paper analyzes the possibility of the parent company using the subsidiary company to seek benefits and damage the interests of creditors.Moreover,under the intangible protection of the current limited liability system and the independent personality of the company,it can“retreat”.This is undoubtedly against the original intention of the establishment of enterprise groups and has great potential harm to creditors.In addition,on the basis of the relief measures for the rights and interests of the parent company caused by the bad behavior of the subsidiary,the legal defects that should be carefully considered are determined.Considering whether there are other remedies that may have the same effect as disclosure,some are more moderate than disclosure.With Britain’s strong caution about lifting the veil,a more moderate direction could be considered.