Actuality and underlying mechanisms of systemic immuneinflammation index and geriatric nutritional risk index prognostic value in hepatocellular carcinoma

This editorial contains comments on the article“Correlation between preoperative systemic immune inflammation index,nutritional risk index,and prognosis of radical resection of liver cancer”in a recent issue of the World Journal of Gastrointestinal Surgery.It pointed out the actuality and importance of the article and focused primarily on the underlying mechanisms making the systemic immuneinflammation index(SII)and geriatric nutritional risk index(GNRI)prediction features valuable.There are few publications on both SII and GNRI together in hepatocellular carcinoma(HCC)and patient prognosis after radical surgery.Neutrophils release cytokines,chemokines,and enzymes,degrade extracellular matrix,reduce cell adhesion,and create conditions for tumor cell invasion.Neutrophils promote the adhesion of tumor cells to endothelial cells,through physical anchoring.That results in the migration of tumor cells.Pro-angiogenic factors from platelets enhance tumor angiogenesis to meet tumor cell supply needs.Platelets can form a protective film on the surface of tumor cells.This allows avoiding blood flow damage as well as immune system attack.It also induces the epithelial-mesenchymal transformation of tumor cells that is critical for invasiveness.High SII is also associated with macro-and microvascular invasion and increased numbers of circulating tumor cells.A high GNRI was associated with significantly better progression-free and overall survival.HCC patients are a very special population that requires increased attention.SII and GNRI have significant survival prediction value in both palliative treatment and radical surgery settings.The underlying mechanisms of their possible predictive properties lie in the field of essential cancer features.Those features provide tumor nutrition,growth,and distribution throughout the body,such as vascular invasion.On the other hand,they are tied to the possibility of patients to resist tumor progression and development of complications in both postoperative and cancer-related settings.The article is of considerable interest.It would be helpful to continue the study follow-up to 2 years and longer.External validation of the data is needed.

Associations between Geriatric Nutrition Risk Index,bone mineral density and body composition in type 2 diabetes patients

BACKGROUND Type 2 diabetes mellitus(T2DM),a fast-growing issue in public health,is one of the most common chronic metabolic disorders in older individuals.Osteoporosis and sarcopenia are highly prevalent in T2DM patients and may result in fractures and disabilities.In people with T2DM,the association between nutrition,sarcopenia,and osteoporosis has rarely been explored.AIM To evaluate the connections among nutrition,bone mineral density(BMD)and body composition in patients with T2DM.METHODS We enrolled 689 patients with T2DM for this cross-sectional study.All patients underwent dual energy X-ray absorptiometry(DXA)examination and were categorized according to baseline Geriatric Nutritional Risk Index(GNRI)values calculated from serum albumin levels and body weight.The GNRI was used to evaluate nutritional status,and DXA was used to investigate BMD and body composition.Multivariate forward linear regression analysis was used to identify the factors associated with BMD and skeletal muscle mass index.RESULTS Of the total patients,394 were men and 295 were women.Compared with patients in tertile 1,those in tertile 3 who had a high GNRI tended to be younger and had lower HbA1c,higher BMD at all bone sites,and higher appendicular skeletal muscle index(ASMI).These important trends persisted even when the patients were divided into younger and older subgroups.The GNRI was positively related to ASMI(men:r=0.644,P<0.001;women:r=0.649,P<0.001),total body fat(men:r=0.453,P<0.001;women:r=0.557,P<0.001),BMD at all bone sites,lumbar spine(L1-L4)BMD(men:r=0.110,P=0.029;women:r=0.256,P<0.001),FN-BMD(men:r=0.293,P<0.001;women:r=0.273,P<0.001),and hip BMD(men:r=0.358,P<0.001;women:r=0.377,P<0.001).After adjustment for other clinical parameters,the GNRI was still significantly associated with BMD at the lumbar spine and femoral neck.Additionally,a low lean mass index and higherβ-collagen special sequence were associated with low BMD at all bone sites.Age was negatively correlated with ASMI,whereas weight was positively correlated with ASMI.CONCLUSION Poor nutrition,as indicated by a low GNRI,was associated with low levels of ASMI and BMD at all bone sites in T2DM patients.Using the GNRI to evaluate nutritional status and using DXA to investigate body composition in patients with T2DM is of value in assessing bone health and physical performance.

Malnutrition Assessed Using the Geriatric Nutritional Risk Index Is Associated with Preoperative Incidence of Deep Vein Thrombosis in Japanese Patients Undergoing Total Knee Arthroplasty

Purpose: Few studies have evaluated the association between malnutrition and the risk of preoperative deep vein thrombosis (DVT) in patients undergoing primary total joint arthroplasty. This study aimed to investigate the prevalence of preoperative DVT in Japanese patients undergoing total knee arthroplasty (TKA) and the importance of malnutrition in the risk of preoperative DVT. Methods: We retrospectively analyzed 394 patients admitted for primary TKA at our institution between January 2019 and December 2023. All patients scheduled for TKA at our institution had serum D-dimer levels measured preoperatively. Lower-limb ultrasonography was examined to confirm the presence of DVT in patients with D-dimer levels ≥ 1.0 µg/mL or who were considered to be at high risk of DVT by the treating physician. Based on the results of lower-limb ultrasonography, all patients were divided into the non-DVT and DVT groups. The incidence of and risk factors for preoperative DVT were investigated, as well as the correlation of DVT with the patient’s nutritional parameters. We used two representative tools for nutritional assessment: the Geriatric Nutritional Risk Index (GNRI) and Controlling Nutritional Status Score. Results: The mean age was 77.8 ± 6.9 years. Preoperative DVT was diagnosed in 57 of the 394 (14.5%) patients. Multivariate logistic regression analysis showed that advanced age and malnutrition status, assessed using the GNRI, were independent risk factors for preoperative DVT. Conclusion: A high incidence of preoperative DVT was observed in patients who underwent TKA. Malnutrition status, as assessed using the GNRI, increased the risk of preoperative DVT. Our findings suggest that clinicians should consider these factors when tailoring preventive strategies to mitigate DVT risk in patients undergoing TKA.

Ecological risk assessment of heavy metals in sediments of Xiawan Port based on modified potential ecological risk index

Modified potential ecological risk index （MRI） was proposed based on the potential ecological risk index （RI） and risk assessment code （RAC） by modifying an index. The modified index was relevant to the chemical speciation of heavy metals. Xiawan Port, a typical region contaminated by industrial production, was selected as a case study area. The total concentrations and chemical speciation of heavy metals in sediments of Xiawan Port were analyzed. The experimental data indicate that Xiawan Port is seriously polluted by heavy metals, especially by Cd. The risks of heavy metals are evaluated by RI, RAC and MRI, respectively. The resluts of MRI show that the risks of heavy metals are in the decreasing order of Cd〉Pb〉Cu〉Zn. Comparison of results by different methods reveals that MRI integrates the characters of RI and RAC. MRI is recognized to be useful for risk managemnt of heavy metals in sediments.

Validation of nutritional risk index method against patientgenerated subjective global assessment in screening malnutrition in colorectal cancer patients

Objective：To validate malnutrition screening tool of nutrition risk index （NRI） against patent-generated subjective global assessment （PG-SGA） as a gold standard tool in colorectal cancer patients before radiotherapy.Methods：Nutritional status of 52 volunteer colorectal cancer patients with a mean age of 54.1±16.8 years who referred to radiotherapy center were assessed by PG-SGA （gold standard method） and NRI.Serum albumin levels of patients were determined by colorimetric method.A contingency table was used to determine the sensitivity,specificity,and predictive value of the NRI in screening patients at risk of malnutrition,in comparison with the PG-SGA in patients before radiotherapy.Results：The findings of PG-SGA and NRI showed that 52％ and 45％ of patients in our study were moderately or severely malnourished respectively.The NRI had a sensitivity of 66％ and a specificity of 60％ against PG-SGA.The positive predictive value was 64％ and the negative predicative value was 62％.The agreement between NRI and PG-SGA was statistically insignificant （kappa =0.267; P＞0.05）.Conclusions：The findings of present study showed that the prevalence of malnutrition was high in patients with colorectal cancer.Moreover,NRI method had low sensitivity and specificity in assessing nutritional status of patients with cancer.It seems that the combination of anthropometric,laboratory parameters and a subjective scoring system may be helpful tools in screening of malnutrition in cancer patients.

Cigarette smoking,body mass index associated with the risks of age-related cataract in male patients in northeast China

AIM: To determine the association between cigarettes smoking, body mass index (BMI) and the risk of age-related cataract (ARC) in middle-aged and elderly men in Northeast China. METHODS: A hospital-based case control study was conducted. Cases (n =362) were men who had surgically treated ARC, 45-85 years old; controls frequency-matched (n=362) were men who had been admitted to the same hospital as cases for other diseases not related with eye diseases. Cases and controls were matched with 1:1. The cases and controls were interviewed during their hospital stay, using a structured interviewer-administrated questionnaire that included information on sociodemographic characteristics, socioeconomic, lifestyle habits (tobacco smoking and alcohol consumption, etc.), anthropometric measures, personal medical history, and family history of ARC in first-degree relatives, and simultaneously BMI was calculated. The odds ratios (OR) and 95% confidence intervals (CI) of ARC were estimated using multiple logistic regression models. RESULTS: After adjusting for age and multiple potential confounders, higher BMI was associated with an increased risk of ARC. Cigarette smoking, years smoking or moderate cigarette smoking (1-29 cigarettes per day) had no relation with the risk of ARC (P>0.05), although patients smoking >= 30 cigarettes per day had an elevated risk of ARC as compared with the non-smokers (OR=1.55, 95% CI; 1.16-2.85, P=0.026). Higher BMI was associated with an increased risk of ARC. Both overweight and obesity was associated with an obviously increased risk for surgically ARC (OR=1.55, 95% CI:1.02-1.98, P=0.015 and OR=1.71, 95% CI:1.32-2.39, P=0.013 respectively) compared to normal BMI. Then participants were grouped into quartiles of BMI (Q1 to Q4), compared to controls in the lowest quartile, the ORfor cases in the highest quartile of BMI was 1.54 (OR=1.54, 95% CI: 1.08-2.46, P=0.022). The results of univariate analysis showed cigarette smoking was not associated with ARC formation for men with lower or normal BMI (P >0.05). Compared to the non-smokers, for men of overweight or obesity, cigarette smoking was associated with a significantly increased risk for surgically ARC (OR=2.00, 95% CI: 1.49-6.65, P=0.003 and OR=1.66, 95% CI: 1.63-13.21, P=0.002 respectively). Similarly, smokers in the highest quartile of BMI had approximately 1.5 times the risk of ARC as non-smokers in the lowest quartile (OR =1.46, 95% CI: 1.06-5.29, P<0.001). Followed multivariate models revealed that the association had never changed. CONCLUSION: Current cigarette smoking is positively related to ARC only among those who smoking 30 or more cigarettes per day. For men who are both overweight and obesity, cigarette smoking is associated with a significantly increased risk for ARC.

Risk Assessment Index System of Natural Gas Industrial Chain in China

This paper establishes a risk assessment index system for the natural gas industrial chain. China＇s natural gas industrial chain is entering a stage of rapid growth. In order to guarantee healthy development of the natural gas industrial chain, it is urgent to establish a risk alert system, which is based on a risk assessment index system. First of all, the risks of the natural gas industrial chain are defined in the paper; then the risk factors are analyzed according to the present status of the natural gas industrial chain, and five categories of risk factors are summarized： resource risk, transport risk, marketing risk, risk of unbalanced chain links, and environment risk. The paper presents the principles of the risk assessment index system. The natural gas industrial chain risk assessment index system is established with four levels and forty-six risk indices.

Nutritional risk index as a predictor of postoperative wound complications after gastrectomy

AIM： To investigate the correlation between the nutri- tional risk index （NRI） and postoperative wound com- plications.

Contamination and Ecological Risk Assessment of Heavy Metal in the Sediment of Turag River, Bangladesh: An Index Analysis Approach

Encroachment, disposal of untreated domestic and industrial wastewater and dumping of solid wastes have degraded the overall quality of the river Turag, which is located in Dhaka—the Capital City of Bangladesh. The present study investigated the extent of pollution of sediments of this river and analyzed the regional variability for the concentrations of Cr, Pb, Zn, Cu and Cd—all of concern because of their potential toxicity, using atomic absorption spectrophotometer. As per US EPA sediment quality guideline, metal concentrations ranged between Cd: 0.00 - 0.80, Cr: 32.00 - 75.50, Cu: 46.30 - 60.00, Pb: 28.30 - 36.40, and Zn: 94.60 - 190.10 mg/kg in the Turag river sediments. Cr, Cu, Zn belongs to moderately to highly polluted, Pb and Cd belongs to not polluted for Turag river. The heavy metals contamination in the sediments were also evaluated by applying Index of geo-accumulation (Igeo), contamination factor (Cf), pollution load index (PLI) etc. Toxicity characteristics leaching procedure (TCLP) test (US EPA 1311) for sediment samples have been performed also for metals (Pb, Cd, Cr, Cu and Zn) to determine the readily toxicity level of heavy metals. Sieve analysis of sediment performed in this study to determine the physical characteristic of sediment samples. The metal concentrations are well below the regulated level as per US EPA. This index can be complemented with the contamination index, which allows more site-specific and accurate information on contaminant levels. If the aim of work on contamination evaluation is to assess the overall contamination of a study area, the indices are highly appropriate.

Risk Index Prediction of Civil Aviation Based on Deep Neural Network

Safety is the foundation of sustainable development in civil aviation.Although catastrophic accidents are rare,indicators of potential incidents and unsafe events frequently materialize.Therefore,a history of unsafe data are considered in predicting safety risks.A deep learning method is adopted for extracting reactions in safety risks.The deep neural network(DNN)model for safety risk prediction is shown to extract complex data characteristics better than a shallow network model.Using extended unsafe data and monthly risk indices,hidden layers and iterations are determined.The effectiveness of DNN is also revealed in comparison with the traditional neural network.Through early risk detection using the method in the paper,airlines and the government can mitigate potential risk and take proactive measures to improve civil aviation safety.

Geriatric Nutritional Risk Index as a Simple Predictor of Mortality in Maintenance Hemodialysis Patients: A Single Center Study

Background: Malnutrition is associated with higher risk of mortality in maintenance hemodialysis (MHD) patients. The geriatric nutritional risk index (GNRI) has been developed as a tool to assess the nutritional risk. Objectives: The purpose of the present study was to examine the significance of the GNRI as a mortality predictor in MHD patients. Methods: We retrospectively examined the GNRI of 259 MHD patients aged 59.2 ± 12.8 years, and followed up for 36 months. The patients were divided into two groups according to GNRI values of 91.0. Predictors for all-cause mortality were examined using Kaplan-Meier and Cox proportional-hazards analyses. Results: During the follow-up period of 36 months, a total of 76 patients died. Kaplan-Meier survival analysis showed that the subjects with a GNRI 91 (n = 230) (Log-rank test,

Correlation between preoperative systemic immune inflammation index, nutritional risk index, and prognosis of radical resection of liver cancer

BACKGROUND Radical surgery is the most commonly used treatment for hepatocellular carcinoma(HCC).However,the surgical effect remains not ideal,and prognostic evaluation is insufficient.Furthermore,clinical intervention is rife with uncertainty and not conducive to prolonging patient survival.AIM To explore correlations between the systemic immune inflammatory index(SII)and geriatric nutritional risk index(GNRI)and HCC operation prognosis.METHODS This retrospective study included and collected follow up data from 100 HCC.Kaplan–Meier survival curves were used to analyze the correlation between SII and GNRI scores and survival.SII and GNRI were calculated as follows:SII=neutrophil count×platelet count/lymphocyte count;GNRI=[1.489×albumin(g/L)+41.7×actual weight/ideal weight].We analyzed the predictive efficacy of the SII and GNRI in HCC patients using receiver operating characteristic(ROC)curves,and the relationships between the SII,GNRI,and survival rate using Kaplan–Meier survival curves.Cox regression analysis was utilized to analyze independent risk factors influencing prognosis.RESULTS After 1 year of follow-up,24 patients died and 76 survived.The area under the curve(AUC),sensitivity,specificity,and the optimal cutoff value of SII were 0.728(95%confidence interval:0.600-0.856),79.2%,63.2%,and 309.14,respectively.According to ROC curve analysis results for predicting postoperative death in HCC patients,the AUC of SII and GNRI combination was higher than that of SII or GNRI alone,and SII was higher than that of GNRI(P<0.05).The proportion of advanced differentiated tumors,tumor maximum diameter(5–10 cm,>10 cm),lymph node metastasis,and TNM stage III-IV in patients with SII>309.14 was higher than that in patients with SII≤309.14(P<0.05).The proportion of patients aged>70 years was higher in patients with GNRI≤98 than that in patients with GNRI>98(P<0.05).The 1-year survival rate of the SII>309.14 group(compared with the SII≤309.14 group)and GNRI≤98 group(compared with the GNRI>98 group)was lower(P<0.05).CONCLUSION The prognosis after radical resection of HCC is related to the SII and GNRI and poor in high SII or low GNRI patients.

Disease Risk Comorbidity Index for Patients Receiving Haploidentical Allogeneic Hematopoietic Transplantation

We aimed to develop a disease risk comorbidity index(DRCI)based on disease risk index(DRI)and Hematopoietic Cell Transplantation-Specific Comorbidity Index(HCT-CI)in patients receiving haploidentical hematopoietic stem cell transplantation(haplo-HSCT).We identified the prognostic factors of disease-free survival(DFS)in a training subset(n=593),then assigned a weighted score using these factors to the remaining patients(validation subset;n=296).The multivariable model identified two independent predictors of DFS:DRI and HCT-CI before transplantation.In this scoring system,we assigned a weighted score of 2 to very high-risk DRI,and assigned a weighted score of 1 to high-risk DRI and intermediate-and high-risk HCT-CI(i.e.,haplo-DRCI).In the validation cohort,the three-year DFS rate was 65.2%(95%confidence interval(CI),58.2%–72.2%),55.8%(95%CI,44.9%–66.7%),and 32.0%(95%CI,5.8%–58.2%)for the low-,intermediate-,and high-risk group,respectively(P=0.005).Haplo-DRCI can also predict DFS in disease-specific subgroups,particularly in acute leukemia patients.Increasing score was also significantly predictive of increased relapse,increased non-relapse mortality(NRM),decreased DFS,and decreased overall survival(OS)in an independent historical cohort(n=526).These data confirmed that haplo-DRCI could effectively risk stratify haplo-HSCT recipients and provide a tool to better predict who will best benefit from haplo-HSCT.

The Establishment of a New Air Health Index Integrating the Mortality Risks Due to Ambient Air Pollution and Non-Optimum Temperature

A composite Air Health Index(AHI)is helpful for separately emphasizing the health risks of multiple stimuli and communicating the overall risks of an adverse atmospheric environment to the public.We aimed to establish a new AHI by integrating daily mortality risks due to air pollution with those due to non-optimum temperature in China.Based on the exposure-response(E-R)coefficients obtained from time-series models,the new AHI was constructed as the sum of excess mortality risk associated with air pollutants and non-optimum temperature in 272 Chinese cities from 2013 to 2015.We examined the association between the“total AHI”(based on total mortality)and total mortality,and further compared the ability of the“total AHI”to predict specific cardiopulmonary mortality with that of“specific AHIs”(based on specific mortalities).On average,air pollution and non-optimum temperature were associated with 28.23%of daily excess mortality,of which 23.47%was associated with non-optimum temperature while the remainder was associated with fine particulate matter(PM2.5)(1.12%),NO2(2.29%,),and O3(2.29%).The new AHI uses a 10-point scale and shows an average across all 272 cities of 6 points.The E-R curve for AHI and mortality is approximately linear,without any thresholds.Each one unit increase in“total AHI”is associated with a 0.84%increase in all-cause mortality and 1.01%,0.98%,1.02%,1.66%,and 1.71%increases in cardiovascular disease,coronary heart disease,stroke,respiratory diseases,and chronic obstructive pulmonary disease mortality,respectively.Cause-specific mortality risk estimates using the“total AHI”are similar to those predicted by“specific AHIs.”In conclusion,the“total AHI”proposed herein could be a promising tool for communicating health risks related to exposure to the ambient environment to the public.

Association between pre-pregnancy body mass index and gestational weight gain and the risk of preeclampsia:A systematic review and meta-analysis

Objective:To analyze the relationship between body mass index(BMI)before pregnancy and gestational weight gain throughout pregnancy with the incidence of preeclampsia.Methods:This was a systematic review-meta analysis of literature collected from three e-databases:Scopus,PubMed,and Science Direct.Quality assessment was measured with the Effective Public Health Practice Project methods.Meta-analysis was done by calculating the fixed and random-effects of odds ratio(OR)for each BMI category and gestational weight gain as compared with the incidence of preeclampsia.Results:Overweight was associated with a significantly increased risk of preeclampsia(OR=2.152,95%CI 1.363-3.400;P=0.001).Obesity was also associated with a noticeably increased risk of preeclampsia(OR=2.856,95%CI 1.755-4.649;P<0.001).Meanwhile,underweight was associated with a significantly reduced risk of preeclampsia(OR=0.639,95%CI 0.500-0.817;P<0.001)when compared with normal BMI.Pregnant women who gained weight below the standard throughout pregnancy was a protective factor from preeclampsia(OR=0.813,95%CI 0.610-1.083;P=0.157)whereas pregnant women who gained weight above the standard had almost doubled risk of preeclampsia(OR=1.850,95%CI 1.377-2.485;P<0.001).Conclusions:The result of this study affirms the role of overweight-obesity pre-pregnancy,and gestational weight gain above the standard during pregnancy as significant risk factors for developing preeclampsia.

Evaluation of groundwater quality using pollution index of groundwater(PIG) and non-carcinogenic health risk assessment in part of the Gangetic Basin

The aim of this study was to evaluate groundwater fitness for domestic and irrigational use in Unnao district of Uttar Pradesh,India.For this study,block wise(n=16)groundwater samples were collected,and measured parameters were analyzed using the pollution index of groundwater(PIG),various irrigational indices,and graphical techniques.The results of this study suggested that most of the parameters were within the prescribed limits of WHO and BIS,excluding F-(0.4 to 2.6 mg L^(-1))and Fe^(2+)(0.1 to 1.7 mg L^(-1)).Concentrations of total dissolved solids(TDS)were exceeded the desirable limit(>500 mg L^(-1))in 43.75%of samples at some sites.The Gibbs plot revealed that groundwater chemistry was governed by rock-water interaction in the region,especially silicate weathering.The Piper plot suggested that Ca^(2+)-HCO3-is dominant hydrochemical facies in the area followed by mixed Ca^(2+)-Na^(+)-HCO_(3)^(-)type,Na^(+)-Cl^(-)type,and Na^(+)-HCO_(3)^(-)type.PIG evaluation revealed that the contribution of F-and Fe2+in groundwater degradation is high in comparison to other elements in the region,about 18.75%samples showed low pollution,while about 6.25%samples shows moderate pollution,and 6.25%samples reflected high pollution.The human health risk(HHR)assessment finding suggested that children(mean:1.36)are more vulnerable than adults(mean:1.01).Sodium absorption ration(SAR),Residual sodium carbonate(RSC),and Permeability index(PI)indicated that most of the groundwater was suitable for irrigation,whereas,Magnesium hazard ration(MHR)and Potential salinity(PS)indices suggested that only 37.5%and 56.25%of the samples were suitable for irrigational use,respectively.This regional study would help in decision making for stakeholders and relevant authorities in the execution of groundwater management and remediation plans in the area.

Risk management of stock index futures

The Hong Kong Hang Seng index futures is taken as a study object and a method of empirical analysis is adopted in order to verify the validity of the application of the value-at-risk (VaR) method in the risk measurement of the stock index futures market. The results suggest that under normal market conditions it is feasible to apply the VaR method in the measurement of the market risks of stock index futures. The daily VaR value of the stock index futures provides a foreseeable profit and loss of the stock index futures. Financial supervisors can adjust their supervising strategies according to the daily VaR value. The speculators can adjust risk capital reserve rates in the same way. The application of this method in China's stock index futures market requires the solutions to specific problems: the absence of historical data, the difficult confirmation of non-risk interest rates etc.

Dynamic Risk Assessment Index System for Earth-Rock Dam during Construction

During the construction of earth-rock dam,mutual exclusive construction goals such as quality,safety,progress and cost all have influences on each other,with risk factors being everchanging as the construction progresses.Accurate identification of the risk factors,as well as clearing any possible effect that any risk factors might have on the construction project is the key and foundation to our cooperative control of the construction goals.According to the construction planning of earth-rock dam,the hall3 D structure was used to identify the potential changes of risk factors,and the possible means of any risk factors to interfere with the construction goals.The dynamic risk assessment index system is established by deploying the WBS-RBS(work breakdown structurerisk breakdown structure)method,aiming at the construction goals of earth-rock dam.The case study shows that the index system is very effective at risk management of earth-rock dam during construction,and relatively practicable.

Financial Innovation Way of Avoiding Risk of Climate Disasters in Food Production:Weather Index Insurance

Climate change will lead to a variety of climate disasters, and climate disasters have a greater impact on China＇s food production. Weather index insurance is a new financial way to avoid risk of climate disasters effectively in China＇s food production. Firstly, the relationship between weather index insurance and food production in China was elaborated, and then the development status, advantages and disadvantages of weather index insurance in China at present were analyzed. Finally, some countermeasures against the problems of weather index insurance in China were put forward.

Use of the Tinetti Index to Assess Fall Risk in Patients with Sequelae of Stroke

Background and Objective: The knowledge about risk of falls in patients with sequelae of stroke by applying a scale constitutes an important factor fort nurses since it allows planning for quality care and consequently improves the quality of life of such patients. The present study aimed to assess the risk of falls of patients with sequelae of stroke using Tinetti Index. Methods: Transversal descriptive study with 61 hospitalized patients. The data were collected through the application of Tinetti Index, the total score of which is 28 points. Results: The index evaluation shows que 47.9% had 19 points under the ideal score, indicating a high risk of falls, 41.7% from 24 to 28, indicating moderate risk and 10.4% from 19 to 23 points, indicating low risk of falls. The final average was (15.23), the median (16.50) and standard deviation (±11.034). Conclusions: There is a high risk of falls in this population, a quantification of impaired balance and gait anticipate the future risk of falls. The use of assessment instruments has important implications for improving the quality of life in patients with symptomatic stroke.