Online calculator for predicting the risk of malignancy in patients with pancreatic cystic neoplasms: A multicenter, retrospective study.

BACKGROUND: Efficient and practical methods for predicting the risk of malignancy in patients with pancreatic cystic neoplasms (PCNs) are lacking. AIM: To establish a nomogram-based online calculator for predicting the risk of malignancy in patients with PCNs. METHODS: In this study, the clinicopathological data of target patients in three medical centers were analyzed. The independent sample t-test, Mann-Whitney U test or chi-squared test were used as appropriate for statistical analysis. After univariable and multivariable logistic regression analysis, five independent factors were screened and incorporated to develop a calculator for predicting the risk of malignancy. Finally, the concordance index (C-index), calibration, area under the curve, decision curve analysis and clinical impact curves were used to evaluate the performance of the calculator. RESULTS: Enhanced mural nodules [odds ratio (OR): 4.314; 95% confidence interval (CI): 1.618-11.503, P = 0.003], tumor diameter ≥ 40 mm (OR: 3.514; 95%CI: 1.138-10.849, P = 0.029), main pancreatic duct dilatation (OR: 3.267; 95%CI: 1.230-8.678, P = 0.018), preoperative neutrophil-to-lymphocyte ratio ≥ 2.288 (OR: 2.702; 95%CI: 1.008-7.244, P = 0.048], and preoperative serum CA19-9 concentration ≥ 34 U/mL (OR: 3.267; 95%CI: 1.274-13.007, P = 0.018) were independent risk factors for a high risk of malignancy in patients with PCNs. In the training cohort, the nomogram achieved a C-index of 0.824 for predicting the risk of malignancy. The predictive ability of the model was then validated in an external cohort (C-index: 0.893). Compared with the risk factors identified in the relevant guidelines, the current model showed better predictive performance and clinical utility. CONCLUSION: The calculator demonstrates optimal predictive performance for identifying the risk of malignancy, potentially yielding a personalized method for patient selection and decision-making in clinical practice.

Acute and life-threatening complications in patients with anorexia nervosa: A case report and literature study.

Anorexia nervosa (AN) is characterized by a strong fear of weight gain and body image disorders and is classified as a mental illness that can cause direct damage to one's mental health and body. Many individuals with AN tend to commit suicide. Additionally, the disease can lead to chronic undernutrition and low body weight, adversely affecting each body system, exacerbating systemic medical complications, especially acute life-threatening complications. Therefore, AN has the highest mortality and disability rates among all mental diseases. There is a basic clinical need to identify and address the acute and critical complications of this disease as soon as possible. However, the current literature has a poor description of the acute and critical complications of AN and lacks a systematic review. We report a case of a patient with AN and severe hypokalemia, significant Q-T interval prolongation, stomach dilation, and intestinal obstruction who recovered after conservative treatment. The defecation method we used, to our knowledge, has not been previously reported in the literature. We also briefly review the various acute and life-threatening complications of AN.

The Influence of Self-Efficacy and Work Input on Physical Education Teachers' Creative Teaching.

OBJECTIVES: To explore the influence of different background factors on middle school PE teachers' self-efficacy, work input and creative teaching, and to reveal the relationship between teaching self-efficacy and work input on creative teaching. METHODS: By means of self-efficacy, work engagement and creative teaching scale, a questionnaire survey was conducted among middle school PE teachers, and the data were processed and modeled by SPSS and AMOS statistical analysis software. RESULTS: Physical education (PE) teachers' self-teaching effectiveness was influenced by background factors such as gender, age, teaching age, full-time or part-time work and educational level. Work input was only affected by age, teaching experience and educational level, while creative teaching seemed to be only related to background factors such as educational background and full-time or part-time work; PE teachers' general teaching effectiveness and personal teaching effectiveness had significant positive effects on energy input, concentration input, dedication input, cognitive creativity, skill creativity and emotional creativity; Concentration input had a significant positive impact on the three-dimensional of creative teaching, while energy input and dedication input had no impact on the three-dimensional of creative teaching; Work input as an intermediary variable of self-efficacy's influence on creative teaching had been verified, but the real intermediary role was not the whole work input, but the concentration input in its structure. CONCLUSION: Both general and individual teaching effectiveness had positive effects on work input and creative teaching, but the energetic and dedicated input in work input cannot promote teachers' creative teaching effectively. Therefore, the professional ethics training of PE teachers in their enthusiasm and dedication to work should be strengthened.

[Quantitative analysis of insect pest and natural enemy communities in Red Fuji apple orchard].

The insect pest and natural enemy communities in Red Fuji apple orchard in Mouping District of Yantai City were quantitatively analyzed by multivariate analysis. The temporal structure of the communities was grouped into five continuous stages by using optimal sorting method, and the community characteristics at each stage were described. The dominant pests and natural enemies were determined at different growth stages of apple trees through analyzing the sub-communities of the insect pests and the predatory and parasitic enemies by principal component analysis and factor analysis. Canonical correlation analysis showed that there were significant correlations between the dominant insect pests and the dominant natural enemies, especially between Lithocolletis ringoniella and its parasitoids, between Aphis citricola and its parasitoids, and between Tetranychus viennensis and its obligatory predatory enemies, Stethorus punctillum and Amblyseius orientalis.