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

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

An Experimental Study of Network-based Language Learning in Less-developed Areas

The advent of the Age of Information brings about bright prospects to Network-based Language Learning(NBLL).The thesis adopts the Engagement Theory as guided principles.The purpose is to use the novel NBLL model effectively with the help of modern technology especially in less-developed areas.This thesis focuses on network-based experimental study.The research shows that the students under NBLL environment have cultivated the capabilities in information collection,computer operation,and information evaluation,as well as the abilities in problem solving,reasoning with criticism,and cooperating with others.

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

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

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

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

A Network-Based VPN Architecture Using Virtual Routing

A network-based Virtual Private Network (VPN) architecture by using fundamental routing mechanism is proposed. This network is a virtual overlay network based on the relay of IP-in-IP tunneling of virtual routing modules. The packet format employs the encapsulation of IPSec ESP(Encapsulating Security Payload), an impact path code and an extended DS(Differentiated Services) code to support multi-path routing and QoS. Comparing with other models of VPN, this network system can be deployed in the current network with little investment, and it is easy to implement. The simulation result shows its performance is better than the traditional VPN system of black box mode.

A precise tidal prediction mechanism based on the combination of harmonic analysis and adaptive network-based fuzzy inference system model

An efficient and accurate prediction of a precise tidal level in estuaries and coastal areas is indispensable for the management and decision-making of human activity in the field wok of marine engineering. The variation of the tidal level is a time-varying process. The time-varying factors including interference from the external environment that cause the change of tides are fairly complicated. Furthermore, tidal variations are affected not only by periodic movement of celestial bodies but also by time-varying interference from the external environment. Consequently, for the efficient and precise tidal level prediction, a neuro-fuzzy hybrid technology based on the combination of harmonic analysis and adaptive network-based fuzzy inference system（ANFIS）model is utilized to construct a precise tidal level prediction system, which takes both advantages of the harmonic analysis method and the ANFIS network. The proposed prediction model is composed of two modules： the astronomical tide module caused by celestial bodies’ movement and the non-astronomical tide module caused by various meteorological and other environmental factors. To generate a fuzzy inference system（FIS） structure,three approaches which include grid partition（GP）, fuzzy c-means（FCM） and sub-clustering（SC） are used in the ANFIS network constructing process. Furthermore, to obtain the optimal ANFIS based prediction model, large numbers of simulation experiments are implemented for each FIS generating approach. In this tidal prediction study, the optimal ANFIS model is used to predict the non-astronomical tide module, while the conventional harmonic analysis model is used to predict the astronomical tide module. The final prediction result is performed by combining the estimation outputs of the harmonious analysis model and the optimal ANFIS model. To demonstrate the applicability and capability of the proposed novel prediction model, measured tidal level samples of Fort Pulaski tidal station are selected as the testing database. Simulation and experimental results confirm that the proposed prediction approach can achieve precise predictions for the tidal level with high accuracy, satisfactory convergence and stability.

Bottleneck Prediction Method Based on Improved Adaptive Network-based Fuzzy Inference System (ANFIS) in Semiconductor Manufacturing System

Semiconductor manufacturing (SM) system is one of the most complicated hybrid processes involved continuously variable dynamical systems and discrete event dynamical systems. The optimization and scheduling of semiconductor fabrication has long been a hot research direction in automation. Bottleneck is the key factor to a SM system, which seriously influences the throughput rate, cycle time, time-delivery rate, etc. Efficient prediction for the bottleneck of a SM system provides the best support for the consequent scheduling. Because categorical data (product types, releasing strategies) and numerical data (work in process, processing time, utilization rate, buffer length, etc.) have significant effect on bottleneck, an improved adaptive network-based fuzzy inference system (ANFIS) was adopted in this study to predict bottleneck since conventional neural network-based methods accommodate only numerical inputs. In this improved ANFIS, the contribution of categorical inputs to firing strength is reflected through a transformation matrix. In order to tackle high-dimensional inputs, reduce the number of fuzzy rules and obtain high prediction accuracy, a fuzzy c-means method combining binary tree linear division method was applied to identify the initial structure of fuzzy inference system. According to the experimental results, the main-bottleneck and sub-bottleneck of SM system can be predicted accurately with the proposed method.

基于Z-Score动态压缩的高效联邦学习算法

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

Predictive Tracking Control of Network-Based Agents With Communication Delays

This paper investigates the remote tracking control problem of Network-based Agents with communication delays existing in both forward and feedback communication channels.A networked predictive tracking controller is proposed to compensate the negative effects caused by bilateral time-delays in a wireless network. Furthermore, the problem of consecutive data loss in the feedback channel is solved using aforementioned controller, where lateral movement perturbations are introduced.Simulations and experiments are provided for several cases,which verify the realizability and effectiveness of the proposed controller.

Parallel Neural Network-Based Motion Controller for Autonomous Underwater Vehicles

A parallel neural network-based controller （PNNC） is presented for the motion control of underwater vehicles in this paper. It consists of a real-time part, a self-learning part and a desired-state programmer, and it is different from normal adaptive neural network controller in structure. Owing to the introduction of the self-learning part, on-line learning can be performed without sample data in several sample periods, resulting in high learning speed of the controller and good control performance. The desired-state programmer is utilized to obtain better learning samples of the neural network to keep the stability of the controller. The developed controller is applied to the 4-degree of freedom control of the AUV “IUV- IV” and is successful on the simulation platform. The control performance is also compared with that of neural network controller with different structures such as normal adaptive neural network and different learning methods. Current effects and surge velocity control are also included to demonstrate the controller＇ s performance. It is shown that the PNNC has a great possibility to solve the problems in the control system design of underwater vehicles.

Probe on Network-based Collaborative Maintenance Model for After-sales Equipment

In order to make equipment run safely, economically and continuously, some new maintenance models were put forward to improve the equipment after-sale maintenance service, such as E-maintenance, third-party maintenance, etc. To certain extent, the models solved the problem of the distance between the manufacturer and customer and the dispersion of the maintenance technologies, however, those resources are still widely distributed and do not collaborate efficiently. In this paper, a network-based collaborative maintenance service model was proposed for after-sales equipment to solve the problem of maintenance resources integration. Concretely, equipment designers, maintainers, spare parts suppliers and maintenance experts were grouped together to establish dynamic alliance. The leader of the alliance is the manufacturer under guaranty period or equipment user exceeding the guaranty period. The process of maintenance service was divided into three stages which are fault diagnosis, maintenance decision and maintenance implementation. The sub-alliances were established to carry out maintenance work at each stage. In addition, the business process of network-based collaborative maintenance was analyzed and collaborative business system for equipment＇s after-sales collaborative maintenance service was designed. In the end, an informational economics model of network-based collaborative maintenance was established to demonstrate the effectiveness of this maintenance model.

基于F-score和二进制灰狼优化的肿瘤基因选择方法

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

Design and implementation of self-protection agent for network-based intrusion detection system

Static secure techniques, such as firewall, hierarchy filtering, distributed disposing,layer management, autonomy agent, secure communication, were introduced in distributed intrusion detection. The self-protection agents were designed, which have the distributed architecture,cooperate with the agents in intrusion detection in a loose-coupled manner, protect the security of intrusion detection system, and respond to the intrusion actively. A prototype self-protection agent was implemented by using the packet filter in operation system kernel. The results show that all the hosts with the part of network-based intrusion detection system and the whole intrusion detection system are invisible from the outside and network scanning, and cannot apperceive the existence of network-based intrusion detection system. The communication between every part is secure. In the low layer, the packet streams are controlled to avoid the buffer leaks exist ing in some system service process and back-door programs, so as to prevent users from misusing and vicious attack like Trojan Horse effectively.

Where Have Network-based Self-learning Classes Gone?——Reflections & Expectations on the Employment of Network-based Self-learning Classes

To respond to the further development of college English reforms,many universities employed network-based selflearning classes to aid the traditional classroom teaching,especially in teaching listening,but as time went by,some universities gradually gave them up.The paper intends to reflect on the employment of network-based self-learning listening classes,analyz ing the learning with and without its aid,and meanwhile introduce the need to re-employ it,and discuss how we can improve the network-based self-learning classes to help with students' listening.

A Scoring System to Assess Patients with Diabetes: Nutech Functional Score

Background: Diabetes mellitus (DM) is a metabolic disorder characterized by hyperglycemia. The symptoms of hyperglycemia include polyuria, polydypsia, polyphagia, blurred vision and weight loss. Various diagnostic tests are used for the diagnosis of DM in patients, but the findings of these tests cannot be assumed to be completely valid. This study aimed at developing a novel scoring system to assess the patients suffering from DM. Method: We assessed the patients based on various diagnostic tests available for DM and prepared a single list of these tests. The tests were categorized and graded based on the World Health Organization (WHO) criteria. Further, we coverted the grades into numeric values for easy use. Results: NFS for diabetes is an 11-point scoring system that assesses the patient’s condition before and after therapy. To facilitate the conduct of probability based studies, we have converted the scores into numeric values in the range of (0, 1). Each symptom is graded as (1, 2, 3, 4, 5) that runs in BAD → GOOD direction. Conclusion: NFS is a beneficial scoring system that can be used worldwide to assess the patients with DM.

Gustave Roussy Immune Score——结直肠癌患者的新型预后评分

目的探讨Gustave Roussy Immune Score(GRIm评分)在结直肠癌(CRC)根治术后患者预后评估中的价值。方法本研究共纳入2004年6月至2019年8月271例CRC根治术后患者。分析GRIm评分与CRC临床病理特征的关系。采用Kaplan-Meier法绘制CRC患者无病生存时间(DFS)曲线,生存差异行Log-rank检验;Cox风险比例回归模型分析影响CRC患者预后的因素;校准曲线和受试者工作特征(ROC)曲线检验基于GRIm评分的列线图的预测效能。结果GRIm评分与性别、肿瘤部位、神经侵犯、N分期、美国癌症联合委员会(AJCC)分期、白蛋白(ALB)评分和乳酸脱氢酶(LDH)评分有关(P<0.05);GRIm简化评分与肿瘤部位、肿瘤直径、癌栓、ALB评分和LDH评分有关(P<0.05)。Cox风险比例回归模型显示,GRIm评分是影响CRC患者DFS的独立因素(HR=2.546,95%CI:1.644~3.943,P<0.05)。包括GRIm评分的列线图对CRC患者DFS的预测能力优于第8版AJCC分期系统。结论GRIm评分是影响CRC患者DFS的独立因素,基于GRIm评分的列线图可以帮助临床医师有效评估CRC患者的预后,制定个体化治疗方案。

基于中心偏移的Fisher score与直觉邻域模糊熵的多标记特征选择

现有多标记Fisher score模型中边缘样本会影响算法分类效果。鉴于邻域直觉模糊熵处理不确定信息时具有更强的表达能力与分辨能力的优势,文中提出了一种基于中心偏移的Fisher score与邻域直觉模糊熵的多标记特征选择方法。首先,根据标记将多标记论域划分为多个样本集,计算样本集的特征均值作为标记下样本的原始中心点,以最远样本的距离乘以距离系数,去除边缘样本集,定义了新的有效样本集,计算中心偏移处理后的标记下每个特征的得分以及标记集的特征得分,进而建立了基于中心偏移的多标记Fisher score模型,预处理多标记数据。然后,引入多标记分类间隔作为自适应模糊邻域半径参数,定义了模糊邻域相似关系和模糊邻域粒,由此构造了多标记模糊邻域粗糙集的上、下近似集;在此基础上提出了多标记邻域粗糙直觉隶属度函数和非隶属度函数,定义了多标记邻域直觉模糊熵。最后,给出了特征的外部和内部重要度的计算公式,设计了基于邻域直觉模糊熵的多标记特征选择算法,筛选出最优特征子集。在多标记K近邻分类器下、9个多标记数据集上的实验结果表明,所提算法选择的最优子集具有良好的分类性能。

Role of albumin-bilirubin score in non-malignant liver disease

The albumin-bilirubin(ALBI)score,which was proposed to assess the prognosis of patients with hepatocellular carcinoma,has gradually been extended to other liver diseases in recent years,including primary biliary cholangitis,liver cirrhosis,hepatitis,liver transplantation,and liver injury.The ALBI score is often compared with classical scores such as the Child-Pugh and model for end-stage liver disease scores or other noninvasive prediction models.It is widely employed because of its immunity to subjective evaluation indicators and ease of obtaining detection indicators.An increasing number of studies have confirmed that it is highly accurate for assessing the prognosis of patients with chronic liver disease;additionally,it has demonstrated good predictive performance for outcomes beyond survival in patients with liver diseases,such as decompensation events.This article presents a review of the application of ALBI scores in various non-malignant liver diseases.

Current status of magnetic resonance imaging radiomics in hepatocellular carcinoma:A quantitative review with Radiomics Quality Score

BACKGROUND Radiomics is a promising tool that may increase the value of magnetic resonance imaging(MRI)for different tasks related to the management of patients with hepatocellular carcinoma(HCC).However,its implementation in clinical practice is still far,with many issues related to the methodological quality of radiomic studies.AIM To systematically review the current status of MRI radiomic studies concerning HCC using the Radiomics Quality Score(RQS).METHODS A systematic literature search of PubMed,Google Scholar,and Web of Science databases was performed to identify original articles focusing on the use of MRI radiomics for HCC management published between 2017 and 2023.The methodological quality of radiomic studies was assessed using the RQS tool.Spearman’s correlation(ρ)analysis was performed to explore if RQS was correlated with journal metrics and characteristics of the studies.The level of statistical significance was set at P<0.05.RESULTS One hundred and twenty-seven articles were included,of which 43 focused on HCC prognosis,39 on prediction of pathological findings,16 on prediction of the expression of molecular markers outcomes,18 had a diagnostic purpose,and 11 had multiple purposes.The mean RQS was 8±6.22,and the corresponding percentage was 24.15%±15.25%(ranging from 0.0% to 58.33%).RQS was positively correlated with journal impact factor(IF;ρ=0.36,P=2.98×10^(-5)),5-years IF(ρ=0.33,P=1.56×10^(-4)),number of patients included in the study(ρ=0.51,P<9.37×10^(-10))and number of radiomics features extracted in the study(ρ=0.59,P<4.59×10^(-13)),and time of publication(ρ=-0.23,P<0.0072).CONCLUSION Although MRI radiomics in HCC represents a promising tool to develop adequate personalized treatment as a noninvasive approach in HCC patients,our study revealed that studies in this field still lack the quality required to allow its introduction into clinical practice.

Diagnostic tools for fecal incontinence: Scoring systems are the crucial first step

The main aim of this editorial is to comment on the recent article published by Garg et al in the World Journal of Gastroenterology 2023;29:4593-4603.This original research presents a new scoring system for fecal incontinence.Fecal incontinence is a chronic disease with a severe impact on the quality of life of the patients.Substantial social stigmatization often leads to significant underreporting of the condition even during visits to a specialist and could lead to further misman-agement or non-existent management of the disease.An important fact is that patients are often unable to describe their condition when not asked precisely defined questions.This problem is partially resolved by scoring questionnaires.Several scoring systems are commonly used;however,each of them has their shortcomings.For example,the absence of different kinds of leakage besides flatus and stool could further lead to underscoring the incontinence severity.Therefore,there has long been a call for a more precise scoring system.The correct identification of the presence and severity of fecal incontinence is paramount for further diagnostic approach and for choosing the appropriate therapy option.This editorial describes fecal incontinence,its effect on quality of life in general and further evaluates the diagnostic approach with a particular focus on symptom scoring systems and their implications for clinical practice.