Real-world effectiveness of a new powered stapling system with gripping surface technology on the intraoperative clinical and economic outcomes of gastrectomy for gastric cancer.

BACKGROUND: Surgical staplers have been widely used to facilitate surgeries, and this study aimed to examine the real-world effectiveness of a new powered stapling system with Gripping Surface Technology (GST) on intraoperative outcomes of gastrectomy for gastric cancer. METHOD: The data were extracted from the Fourth Hospital of Hebei Medical University's (FHHMU) medical records system. Participants (N = 121 patients) were classified into the GST (n = 59) or non-GST group (n = 62), based on the use of the GST system. The intraoperative outcomes such as bleeding were assessed by reviewing video records. T-tests, Chi-square tests, and Mann-Whitney-U tests were used to compare the baseline characteristics between groups. Multivariate logistic regression was conducted for adjusting outcomes to study the effect of variables. RESULTS: Compared with the non-GST group, the GST group had significantly lower risks for intraoperative bleeding, intraoperative anastomosis intervention rate, intraoperative suture, and intraoperative pression (aORs: 0.0853 (p < 0.0001), 0.076 (p = 0.0003), 0.167 (p = 0.0012), and 0.221 (p = 0.0107), respectively). The GST group also consumed one fewer cartridge than the non-GST group (GST:5 vs non-GST: 6, p = 0.0241). CONCLUSION: The use of the GST system was associated with better intraoperative outcomes and lower cartridge consumption in Chinese real-world settings.

Preoperative assessment of high-grade endometrial cancer using a radiomic signature and clinical indicators.

Aim: To develop and validate a radiomics-based combined model (ModelRC) to predict the pathological grade of endometrial cancer. Methods: A total of 403 endometrial cancer patients from two independent centers were enrolled as training, internal validation and external validation sets. Radiomic features were extracted from T2-weighted images, apparent diffusion coefficient map and contrast-enhanced 3D volumetric interpolated breath-hold examination images. Results: Compared with the clinical model and radiomics model, ModelRC showed superior performance; the areas under the receiver operating characteristic curves were 0.920 (95% CI: 0.864-0.962), 0.882 (95% CI: 0.779-0.955) and 0.881 (95% CI: 0.815-0.939) for the training, internal validation and external validation sets, respectively. Conclusion: ModelRC, which incorporated clinical and radiomic features, exhibited excellent performance in the prediction of high-grade endometrial cancer.

Accurate preoperative evaluation of the pathological grade of endometrial carcinoma is very important for the selection of treatment and prognosis. This study tried to develop a simple combined model based on radiomic features from endometrial carcinoma MRI and clinical features of patients. Compared with the clinical model and the radiomic model, the combined model showed superior performance. Therefore, this combined model would help patients and clinicians to make more rational decisions when choosing treatment strategies.

Using a grey relational analysis in an improved Grunow-Finke assessment tool to detect unnatural epidemics.

The Grunow-Finke epidemiological assessment tool (GFT) has several limitations in its ability to differentiate between natural and man-made epidemics. Our study aimed to improve the GFT and analyze historical epidemics to validate the model. Using a gray relational analysis (GRA), we improved the GFT by revising the existing standards and adding five new standards. We then removed the artificial weights and final decision threshold. Finally, by using typically unnatural epidemic events as references, we used the GRA to calculate the unnatural probability and obtain assessment results. Using the advanced tool, we conducted retrospective and case analyses to test its performance. In the validation set of 13 historical epidemics, unnatural and natural epidemics were divided into two categories near the unnatural probability of 45%, showing evident differences (p < 0.01) and an assessment accuracy close to 100%. The unnatural probabilities of the Ebola virus disease of 2013 and Middle East Respiratory Syndrome of 2012 were 30.6% and 36.1%, respectively. Our advanced epidemic assessment tool improved the accuracy of the original GFT from approximately 55% to approximately 100% and reduced the impact of human factors on these outcomes effectively.

Three-Dimensional High-Resolution Magnetic Resonance Imaging for the Assessment of Cervical Artery Dissection.

Background and Purpose: Diagnosing cervical artery dissection (CAD) is still a challenge based on the current radiographic criteria. This study aimed to assess the value of three-dimensional high-resolution magnetic resonance imaging (3D HRMRI) in the detection of the signs of CAD and its diagnosis. Materials and Methods: Patients with CAD from January 2016 to January 2021 were recruited from our 3D HRMRI database. The signs of dissection (intramural hematomas, intimal flap, double lumen), length and location of the dissection, thickness of the intramural hematoma, intraluminal thrombus, and percentage of dilation of the outer contour of the dissection on 3D HRMRI were assessed. Results: Fourteen patients with 16 CADs, including 12 carotid CADs and 4 vertebral CADs, were finally diagnosed in this study. On 3D HRMRI, intramural hematomas were detected in 13/16 (81.3%) lesions with high sensitivity (100%) and high specificity (100%). Intimal flaps were found in 9/16 (56.3%) lesions with moderate sensitivity (64.3%) and high specificity (88.9%). Double lumen signs were observed in 4/16 (25.0%) lesions with high sensitivity (80.0%) and high specificity (100%). In addition, concomitant intraluminal thrombus were detected in 4/16 (25.0%) lesions with high sensitivity (80.0%) and high specificity (100%). The mean length of dissection was (25.1 ± 13.7) mm. The mean thickness of the intramural hematoma was (4.3 ± 2.3) mm. The mean percentage of dilation for the outer contour of the dissection was (151.3 ± 28.6)%. Conclusion: The 3D HRMRI enables detection of the dissecting signs, such as intramural hematoma, intimal flap, double lumen, and intraluminal thrombus with high sensitivity and specificity, suggesting a useful, and non-invasive tool for definitively diagnosing CAD.

Assessment of the Chinese Literature for Nursing Informatics Education Initiatives.

The purpose of this study is to understand the state of the literature on nursing informatics education in Mainland China. We used the CNKI database (China National Knowledge Infrastructure) to extract all papers of nursing informatics education from 2009 to 2018. 20 high-frequency keywords, a co-word matrix, and three research themes were conducted on the 18 papers. These results can be used to improve our understanding of nursing informatics education in Mainland China.

Combination Analysis of a Radiomics-Based Predictive Model With Clinical Indicators for the Preoperative Assessment of Histological Grade in Endometrial Carcinoma.

BACKGROUND: Histological grade is one of the most important prognostic factors of endometrial carcinoma (EC) and when selecting preoperative treatment methods, conducting accurate preoperative grading is of great significance. PURPOSE: To develop a magnetic resonance imaging (MRI) radiomics-based nomogram for discriminating histological grades 1 and 2 (G1 and G2) from grade 3 (G3) EC. METHODS: This was a retrospective study included 358 patients with histologically graded EC, stratified as 250 patients in a training cohort and 108 patients in a test cohort. T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI) and a dynamic contrast-enhanced three-dimensional volumetric interpolated breath-hold examination (3D-VIBE) were performed via 1.5-Tesla MRI. To establish ModelADC, the region of interest was manually outlined on the EC in an apparent diffusion coefficient (ADC) map. To establish the radiomic model (ModelR), EC was manually segmented by two independent radiologists and radiomic features were extracted. The Radscore was calculated based on the least absolute shrinkage and selection operator regression. We combined the Radscore with carbohydrate antigen 125 (CA125) and body mass index (BMI) to construct a mixed model (ModelM) and develop the predictive nomogram. Receiver operator characteristic (ROC) and calibration curves were assessed to verify the prediction ability and the degree of consistency, respectively. RESULTS: All three models showed some amount of predictive ability. Using ADC alone to predict the histological risk of EC was limited in both the cohort [area under the curve (AUC), 0.715; 95% confidence interval (CI), 0.6509-0.7792] and test cohorts (AUC, 0.621; 95% CI, 0.515-0.726). In comparison with ModelADC, the discrimination ability of ModelR showed improvement (Delong test, P < 0.0001 for both the training and test cohorts). ModelM, established based on the combination of radiomic and clinical indicators, showed the best level of predictive ability in both the training (AUC, 0.925; 95% CI, 0.898-0.951) and test cohorts (AUC, 0.915; 95% CI, 0.863-0.968). Calibration curves suggested a good fit for probability (Hosmer-Lemeshow test, P = 0.673 and P = 0.804 for the training and test cohorts, respectively). CONCLUSION: The described radiomics-based nomogram can be used to predict EC histological classification preoperatively.

[Human Health Risk Assessment of Phenol in Poyang Lake Basin].

Phenol is widely used in the production of insulation and thermal insulation materials, adhesives, perfumes, coatings for food containers, paints, and pharmaceutical production, and is also widely detected in the aquatic environment. Long-term exposure to phenol can elicit adverse effects, such as skin burn, liver and central system damage. Here, phenol concentrations in the water and aquatic products of Poyang Lake were investigated. Human health risks from phenol to adults and adolescents were also assessed based on local population exposure parameters. The exposure concentration range of phenol in the studied water and aquatic products was not detected (ND)-556.26 ng·L-1 and 11.98-255.51 µg·kg-1, respectively. Human health risk based on drinking water in different areas ranged from 3.80×10-7-8.46×10-5. Higher human health risks from drinking water was detected in the southern area of Poyang Lake and at the confluence of the Yangtze River to the north. Health risks caused by different types of aquatic products ranges 2.65×10-5-1.47×10-4. In particular, human health risks from the consumption of yellow catfish and catfish are an order of magnitude higher than for other aquatic products. Probabilistic risk assessment was also conducted through Monte Carlo simulation to analyze the health risk to the population in the Poyang Lake Basin and assess its sensitivity of different exposure parameters. The 95th percentile health risk of drinking water and aquatic product consumption in the Poyang Lake Basin was calculated as being acceptable. Overall, the concentrations of phenol had the greatest impact on the calculated health risk values. This study provides valuable information for phenol risk management in the Poyang Lake basin.

[Distribution and Risk Assessment of Polycyclic Aromatic Hydrocarbons in Water Bodies in Seven Basins of China].

The concentrations and spatial distribution characteristics of 16 US EPA priority Polycyclic Aromatic Hydrocarbons (PAHs) in water bodies in seven basins in China were systematically analyzed and summarized. The acute ecological risks of 8 PAHs to aquatic organisms were evaluated by means of species sensitivity distribution (SSD). The joint acute ecological risks of ΣPAH8 to aquatic organisms were evaluated by concentration addition model and response addition model. The health risks of PAHs ingestion were estimated by hazard quotients. The results showed that the 2-, 3-, and 4 ringed-PAHs had higher-than-average concentrations in the water bodies from the seven basins, and the mean concentration of ΣPAH16 was 2596.25 ng·L-1, which is higher than in most foreign water bodies. The composition characteristics and sources of PAHs in water bodies of China and other countries were similar. The pollution of ΣPAH16 in northern water bodies was more serious compared with that of southern water bodies. The potentially affected fraction (PAF) values of naphthalene, acenaphthene, fluorene, phenanthrene, fluoranthene, pyrene, and anthracene to aquatic organisms in the seven basins were less than 4%. Except for the Haihe River and Yangtze River basins, the PAF values of benzo (a) pyrene to aquatic organisms exceeded 5%, which indicates that benzo (a) pyrene had high acute ecological risks to aquatic organisms. The concentration addition model was not suitable for water ecological risk assessments of PAHs. The results of risk assessments based on response addition model showed that except for the Haihe River, the multisubstance PAF (msPAF) values of ΣPAH8 to aquatic organisms in other basins exceeded 5%, which indicates that ΣPAH8 constitutes high joint acute ecological risks to aquatic organisms. The health risks through ingestion of carcinogenic PAHs from water bodies of the seven basins were at 10-5 level, which is higher than the baseline value of acceptable risk (10-6) from the US EPA. The health risks through the ingestion of non-carcinogenic PAHs were at 10-9 level, which is far lower than the baseline value of acceptable risk. The results indicate that there are potential carcinogenic risks to human health through ingestion of PAHs from seven basins in China.

Energetic-environmental-economic assessment of the biogas system with three utilization pathways: Combined heat and power, biomethane and fuel cell.

A typical biogas system with three utilization pathways, i.e., biogas upgrading, biogas combined heat and power (CHP), biogas solid oxide fuel cells (SOFCs) were designed. It was assessed from the viewpoint of energy, environment and economy by using energy efficiency, green degree and net present value index respectively. The assessment considered the trade-off relationships among these indexes, which is more comprehensive than previous systematic evaluation work only included single or two of the pathway(s) by using one or two of the index(es). Assessment results indicated that biogas upgrading pathway has the highest systematic energy efficiency (46.5%) and shortest payback period (8.9year) with the green degree production is the lowest (9.29gd/day). While for biogas SOFC pathway, although the green degree production is the highest (21.77gd/day), the payback period is longer (14.5year) and the energy efficiency is 13.6% lower than the biogas upgrading pathway.

[Measured and Predicted Aquatic Life Criteria and Risk Assessment of Chromium (VI) in Liaohe River].

In this study, toxicity data of aquatic species in Liaohe River for heavy metal chromium (VI) was collected and selected. The aquatic life criteria for chromium (VI) in Liaohe River was derived based on these toxicity data. Moreover, water samples of 25 sites in Liaohe River were collected, and the concentrations of chromium (VI) in these samples were analyzed. Finally, ecological risk assessment of chromium (VI) in Liaohe River was performed. Moreover, interspecies correlation estimation method (ICE) established by US EPA was used to predict the acute toxicity of species in Liaohe River, and aquatic life criteria based on predicted toxicity data was derived. The results showed that: the measured CMC (criteria maximum concentration), measured CCC (criteria continuous concentration) and the predicted CMC were 17. 73, 12. 15 and 13. 97 µg . L -1, respectively. Therefore, the ICE method could be used to predict the aquatic life criteria, because the predicted criteria value was very similar to the measured criteria value. Analysis of chromium (V) showed that the chromium (VI) concentrations of the 25 sites in Liaohe River were all below Class I or Class II water quality standards (GB 3838-2002), and the water quality was in good condition. However, for the potential risk of chromium (VI) exposure to the aquatic life of Liaohe River, the result of ecological risk assessment showed that chromium (V) concentrations in 7 sites exceeded the CCC in July, and chromium (VI) concentrations in 6 sites exceeded the CCC in December. Therefore, unacceptable effect on aquatic species caused by chromium (VI) exposure might have occurred in some sites of Liaohe River.

Comparison and analysis of biological agent category lists based on biosafety and biodefense.

Biological agents pose a serious threat to human health, economic development, social stability and even national security. The classification of biological agents is a basic requirement for both biosafety and biodefense. We compared and analyzed the Biological Agent Laboratory Biosafety Category list and the defining criteria according to the World Health Organization (WHO), the National Institutes of Health (NIH), the European Union (EU) and China. We also compared and analyzed the Biological Agent Biodefense Category list and the defining criteria according to the Centers for Disease Control and Prevention (CDC) of the United States, the EU and Russia. The results show some inconsistencies among or between the two types of category lists and criteria. We suggest that the classification of biological agents based on laboratory biosafety should reduce the number of inconsistencies and contradictions. Developing countries should also produce lists of biological agents to direct their development of biodefense capabilities.To develop a suitable biological agent list should also strengthen international collaboration and cooperation.

Laparoendoscopic single-site urethrovesical anastomosis training in an economical porcine model.

PURPOSE: To develop an economical animal model for laparoendoscopic single-site surgery (LESS) urethrovesical anastomosis (UVA) training. MATERIALS AND METHODS: A homemade single-port device was used and the uterus cervix and the ileum were chosen to simulate UVA to reduce costs. Ten trainees were randomly divided into two groups: the conventional LESS UVA (CLUVA) group and the transurethral assistant LESS UVA (TALUVA) group. In TALUVA, a laparoscopic forceps was inserted through the urethra to assist operation after the bladder neck was disconnected, whereas CLUVA followed the conventional steps. Anastomosis time and knotting time were recorded, and the learning curves of both groups were analyzed. After training, questionnaires were given to the trainees to assess the difficulties and the satisfaction of the training. RESULTS: The final mean operating time significantly declined in both groups. Except for the first lesson, the trainees in the TALUVA group operated faster than those in the other group. The results from the questionnaires show that all trainees were satisfied with the training, and LESS UVA was considered more difficult in the CLUVA group than in the TALUVA group. CONCLUSIONS: The female porcine model for LESS UVA was feasible and cost-effective. TALVUA could effectively reduce the difficulties involved in LESS UVA.

Progress of environmental management and risk assessment of industrial chemicals in China.

With China's rapid economic growth, chemical-related environmental issues have become increasingly prominent, and the environmental management of chemicals has garnered increased attention from the government. This review focuses on the current situation and the application of risk assessment in China's environmental management of industrial chemicals. The related challenges and research needs of the country are also discussed. The Chinese government promulgated regulations for the import and export of toxic chemicals in 1994. Regulations for new chemical substances came into force in 2003, and were revised in 2010 based on the concept of risk management. In order to support the implementation of new regulations, Guidance for Risk Assessment of Chemicals is under development in an attempt to provide the concepts and techniques of risk assessment. With increasing concern and financial support from Chinese government, China is embarking on the fast track of research and development in environmental management of industrial chemicals.

[Spatial distribution and risk assessment of polycyclic aromatic hydrocarbons in partial surface sediments of Liaohe River].

Nineteen surface sediment samples were collected from Liaohe River and analysed for polycyclic aromatic hydrocarbons (PAHs) with GC-MS. The concentrations of 15 detected PAH compounds ranged from 123.5 to 21 233.4 ng x g(-1) in dry season with the average concentration was 3208.1 ng x g(-1); and were 37.9 to 9014.0 ng x g(-1) in wet season with the average concentration was 1612.0 ng x g(-1). The isomeric ratio method using characteristic compounds of PAHs for source analysis, and the main source was attributed to fuel combustion. Average commercial use of sediment quality benchmarks (mSQG-Q) on the PAHs risk assessment of Liaohe Basin was applied, fluorene and pyrene showed the potential of low-level ecological effects. In wet season, Fushun segment L3-1 points have a higher ecological risk. In dry season, Shenyang segment L1-1 point, Fushun segment L3-1 point and L3-2 point pose a strong negative effect.

Comparison of trends in the quantity and variety of Science Citation Index (SCI) literature on human pathogens between China and the United States.

The proportion of pathogenic microorganisms in the microbial world is relatively small, while their threat to human health, economic development and social stability is severe. The quantity and variation of Science Citation Index (SCI) literature related to pathogenic microorganisms may reflect the level of relevant research and the degree of attention. Here we compared trends in the quantity and variety of SCI literature relating to certain important pathogenic microorganisms published by scientists from United States and China from 1996 to 2010 by searching the Science Citation Index database. The pathogenic microorganisms in this study comprise two categories of pathogens: Bacillus anthracis, Yersinia pestis, Francisella tularensis, Ebola virus, Burkholderia pseudomallei, which belong to biodefense-associated pathogens (BDAPs) and the human immunodeficiency virus (HIV), SARS coronavirus, hepatitis B virus (HBV), Mycobacterium tuberculosis, influenza virus, which belong to the commonly encountered health-threatening pathogens. Our results showed that the United States (US) published much more SCI literature on these pathogens than China. Furthermore, literature on BDAPs published by scientists from the US has increased sharply since 2002. However, the numbers of literature relating to CEHTPs from China has demonstrated a gradual increase from 1996 to 2010. Research into pathogenic microorganisms requires three balance to be achieved: investment in BDAP and CEHTP studies; basic and applied research; a faster pace of research into pathogens and fulfilling biosafety and biosecurity requirements.