BACKGROUND Laparoscopic distal pancreatectomy(LDP)has emerged as the preferred approach for both benign and malignant lesions located in the pancreatic body and tail.Nevertheless,a notable deficiency persists in the a...BACKGROUND Laparoscopic distal pancreatectomy(LDP)has emerged as the preferred approach for both benign and malignant lesions located in the pancreatic body and tail.Nevertheless,a notable deficiency persists in the absence of a standardized,procedure-specific metric for evaluating and comparing surgical quality.A composite measure termed“textbook outcome(TO)”,which encompasses key short-term endpoints,has been validated in laparoscopic pancreatoduodenectomy but has not yet been established in dedicated LDP cohorts.The definition and prediction of TO in this context could aid in facilitating cross-institutional benchmarking and fostering advancements in quality improvement.AIM To establish procedure-specific criteria for TO and identify independent predictors of TO failure in patients undergoing LDP.METHODS Consecutive patients who underwent LDP at a single high-volume pancreatic center between January 2015 and August 2022 were retrospectively analyzed.TO was defined as the absence of clinically relevant postoperative pancreatic fistula(grade B/C),post-pancreatectomy hemorrhage(grade B/C),severe complications(Clavien-Dindo≥III),readmission within 30 days,and in-hospital or 30-day mortality.Multivariable logistic regression was employed to identify independent predictors of TO failure,and a nomogram was constructed and internally validated.RESULTS Among 405 eligible patients,286(70.6%)attained TO.Multivariable analysis revealed that female sex[odds ratio(OR)=0.62,95%confidence interval(CI):0.39-0.99]conferred a protective effect,while preoperative endoscopic ultrasound-guided fine-needle aspiration(OR=2.66,95%CI:1.05-6.73),pancreatic portal hypertension(OR=2.81,95%CI:1.06-7.45),and cystic-solid(OR=2.51,95%CI:1.34-4.69)or solid lesions(OR=1.91,95%CI:1.06-3.44)were independently associated with TO failure(all P<0.05).The derived nomogram exhibited modest discrimination and calibration when assessed in both the training and validation datasets.CONCLUSION The proposed LDP-specific definition of TO is feasible and discriminative,and the developed nomogram provides an objective tool for individualized risk assessment.展开更多
BACKGROUND To investigate the preoperative factors influencing textbook outcomes(TO)in Intrahepatic cholangiocarcinoma(ICC)patients and evaluate the feasibility of an interpretable machine learning model for preoperat...BACKGROUND To investigate the preoperative factors influencing textbook outcomes(TO)in Intrahepatic cholangiocarcinoma(ICC)patients and evaluate the feasibility of an interpretable machine learning model for preoperative prediction of TO,we developed a machine learning model for preoperative prediction of TO and used the SHapley Additive exPlanations(SHAP)technique to illustrate the prediction process.AIM To analyze the factors influencing textbook outcomes before surgery and to establish interpretable machine learning models for preoperative prediction.METHODS A total of 376 patients diagnosed with ICC were retrospectively collected from four major medical institutions in China,covering the period from 2011 to 2017.Logistic regression analysis was conducted to identify preoperative variables associated with achieving TO.Based on these variables,an EXtreme Gradient Boosting(XGBoost)machine learning prediction model was constructed using the XGBoost package.The SHAP(package:Shapviz)algorithm was employed to visualize each variable's contribution to the model's predictions.Kaplan-Meier survival analysis was performed to compare the prognostic differences between the TO-achieving and non-TO-achieving groups.RESULTS Among 376 patients,287 were included in the training group and 89 in the validation group.Logistic regression identified the following preoperative variables influencing TO:Child-Pugh classification,Eastern Cooperative Oncology Group(ECOG)score,hepatitis B,and tumor size.The XGBoost prediction model demonstrated high accuracy in internal validation(AUC=0.8825)and external validation(AUC=0.8346).Survival analysis revealed that the disease-free survival rates for patients achieving TO at 1,2,and 3 years were 64.2%,56.8%,and 43.4%,respectively.CONCLUSION Child-Pugh classification,ECOG score,hepatitis B,and tumor size are preoperative predictors of TO.In both the training group and the validation group,the machine learning model had certain effectiveness in predicting TO before surgery.The SHAP algorithm provided intuitive visualization of the machine learning prediction process,enhancing its interpretability.展开更多
Against the dual background of deepening the construction of new liberal arts and implementing the"Double Ten Thousand Plan"for first-class undergraduate courses,local universities urgently need to explore d...Against the dual background of deepening the construction of new liberal arts and implementing the"Double Ten Thousand Plan"for first-class undergraduate courses,local universities urgently need to explore distinctive curriculum construction paths.Based on the requirements of the new liberal arts connotation,this paper constructs a three-dimensional integrated framework of"value guidance,ability driven,and knowledge foundation",and takes the construction of the"Finance"course at Yangtze University as a typical case for research.When systematically analyzing the"Finance"course in the school,a three-dimensional integrated curriculum reform practice is implemented by reshaping the three-level curriculum objectives of"state-society-individual",developing teaching content that integrates"modularization-localization-cutting-edge",using the"O-PRAISE"situational teaching method,and constructing a diversified collaborative evaluation system.A first-class curriculum construction model for local universities has been summarized,which involves five collaborative approaches:"localization"of target positioning,"integration"of content construction,"contextualization"of method implementation,"value-added"evaluation orientation,and"synergy"of resource guarantee.The aim is to provide theoretical paradigms and practical solutions for similar universities to learn from,effectively solving practical difficulties such as the disconnect between value shaping and knowledge transmission,and the mismatch between talent cultivation and local needs in curriculum construction.展开更多
This paper aims to explore the development strategies for subject services in university libraries within the context of the“double first-class”initiative.By examining the relationship between“double first-class”c...This paper aims to explore the development strategies for subject services in university libraries within the context of the“double first-class”initiative.By examining the relationship between“double first-class”construction and university library subject services,the study analyzes the current state of subject services,including resource development,service models,and team building.Drawing on domestic and international case studies,the paper proposes a series of targeted and practical strategies to enhance the quality of subject services in university libraries,thereby providing robust support for the advancement of the“double first-class”initiative.展开更多
The“Double First-Class”construction focuses on the development of disciplinary connotations and the improvement of talent cultivation quality,posing higher demands on the teaching mode and talent supply of public he...The“Double First-Class”construction focuses on the development of disciplinary connotations and the improvement of talent cultivation quality,posing higher demands on the teaching mode and talent supply of public health and preventive medicine disciplines.Environmental health,as a core course in public health and preventive medicine,directly relates to the cultivation of effective composite public health talents.Based on the core orientation of the“Double First-Class”construction and combining the talent cultivation and course characteristics of environmental health,this paper explores the significance of teaching reform and talent cultivation in environmental health from the perspective of“Double First-Class”construction.It also investigates the paths for teaching reform and talent cultivation from multiple dimensions,aiming to provide references for cultivating high-quality professionals who meet the needs of national public health development and ecological environmental protection.展开更多
This article analyzes the application strategies of Building Information Modeling(BIM)support technology in a first-class highway reconstruction and expansion project based on its actual situation.According to the bas...This article analyzes the application strategies of Building Information Modeling(BIM)support technology in a first-class highway reconstruction and expansion project based on its actual situation.According to the basic situation of BIM technology and its application goals in this project,it explores application strategies such as BIM model construction,BIM prefabricated structural model deepening and schedule simulation,BIM collision detection,and BIM tunnel pre-construction simulation.Through this analysis,it is hoped to provide a reference for the rational application of BIM support technology and ensure the high-quality and efficient completion of first-class highway reconstruction and expansion projects.展开更多
This study first analyzes four distinct forms of Fujian folk dance,highlighting the notable differences in their cultural characteristics and dance qualities.It then categorizes these dance forms to align with textboo...This study first analyzes four distinct forms of Fujian folk dance,highlighting the notable differences in their cultural characteristics and dance qualities.It then categorizes these dance forms to align with textbook construction,discussing in depth the principles guiding the development of textbooks that correspond to these classifications.展开更多
“Five education”is pivotal for students’all-round development.However,primary English teaching currently faces challenges including the superficial implementation of“Five education”.This study employed action res...“Five education”is pivotal for students’all-round development.However,primary English teaching currently faces challenges including the superficial implementation of“Five education”.This study employed action research to explore practical methods for integrating English picture book with textbook to implement“Five education”.Through two rounds of iterative action research,a three-stage activity-based teaching path was developed and refined,enabling the progressive infusion of“Five education”objectives across the learning cycle.Findings demonstrated that this integrated approach-particularly when supported by strategies such as picture book background videos and audio-edited narrative connections-effectively deepened the implementation of“Five education”,mitigated student reading fatigue,and significantly improved students’reading fluency and labor initiative,thus provided a replicable practical paradigm for realizing“Five education simultaneously”.展开更多
BACKGROUND Textbook outcome(TO),an emerging composite metric for surgical quality assessment,has recently gained recognition for evaluating perioperative results.Laparoscopic transcystic common bile duct exploration(L...BACKGROUND Textbook outcome(TO),an emerging composite metric for surgical quality assessment,has recently gained recognition for evaluating perioperative results.Laparoscopic transcystic common bile duct exploration(LTCBDE)has become a widely adopted minimally invasive technique for treating cholecystolithiasis with choledocholithiasis.Despite its growing clinical application,TO has not yet been formally defined for LTCBDE,nor have its failure-associated risk factors been systematically examined.AIM To define TO for LTCBDE,establish standardized criteria,and identify risk factors for TO failure via logistic regression.METHODS A retrospective cohort of 388 patients who underwent LTCBDE in combination with laparoscopic cholecystectomy at the Department of Biliopancreatic Surgery,Tongji Hospital,from January 2018 to October 2024,was analyzed.The study delineated TO criteria for LTCBDE,calculated the rate of TO achievement,and employed logistic regression to determine independent predictors of TO failure.RESULTS TO was defined as the absence of the following seven criteria:Conversion to open surgery,postoperative complications(Clavien-Dindo grade≥2),biliary leakage(International Study Group of Pancreatic Surgery/International Study Group of Liver Surgery grade B/C),delayed removal of drainage tube(>4 days),postoperative interventions,prolonged length of stay(>7 days),and 30-day readmission or mortality.Among 388 patients,276(71.1%)achieved TO.The primary causes of TO failure included delayed removal of drainage tube(94 cases,83.9%),prolonged length of stay(50 cases,44.6%).Multivariate analysis revealed four independent risk factors for TO failure:Preoperative endoscopic retrograde cholangiopancreatography(P=0.022),advanced age(P=0.010),prolonged anesthesia time(P<0.001),and elevated preoperative alkaline phosphatase levels(P=0.048).These findings suggest that applying the concept of TO to LTCBDE enhances surgical quality evaluation and supports early identification of high-risk patients,facilitating personalized clinical decisions and optimizing individual management.展开更多
Based on the ADDIE model,we explored the integration path between Understanding Contemporary China:An English Reading and Writing Textbook and the main textbook of college English reading.Firstly,the basis of textbook...Based on the ADDIE model,we explored the integration path between Understanding Contemporary China:An English Reading and Writing Textbook and the main textbook of college English reading.Firstly,the basis of textbook integration was analyzed,followed by an explanation of the overall design scheme of textbook integration,and then a series of teaching resources were initially developed and used in teaching practice.Through testing,it was found that the integrative teaching of the two sets of textbooks under the ADDIE model achieved good teaching results,and promoted the three aspects of reading literacy,disciplinary literacy,and value leadership.展开更多
文摘BACKGROUND Laparoscopic distal pancreatectomy(LDP)has emerged as the preferred approach for both benign and malignant lesions located in the pancreatic body and tail.Nevertheless,a notable deficiency persists in the absence of a standardized,procedure-specific metric for evaluating and comparing surgical quality.A composite measure termed“textbook outcome(TO)”,which encompasses key short-term endpoints,has been validated in laparoscopic pancreatoduodenectomy but has not yet been established in dedicated LDP cohorts.The definition and prediction of TO in this context could aid in facilitating cross-institutional benchmarking and fostering advancements in quality improvement.AIM To establish procedure-specific criteria for TO and identify independent predictors of TO failure in patients undergoing LDP.METHODS Consecutive patients who underwent LDP at a single high-volume pancreatic center between January 2015 and August 2022 were retrospectively analyzed.TO was defined as the absence of clinically relevant postoperative pancreatic fistula(grade B/C),post-pancreatectomy hemorrhage(grade B/C),severe complications(Clavien-Dindo≥III),readmission within 30 days,and in-hospital or 30-day mortality.Multivariable logistic regression was employed to identify independent predictors of TO failure,and a nomogram was constructed and internally validated.RESULTS Among 405 eligible patients,286(70.6%)attained TO.Multivariable analysis revealed that female sex[odds ratio(OR)=0.62,95%confidence interval(CI):0.39-0.99]conferred a protective effect,while preoperative endoscopic ultrasound-guided fine-needle aspiration(OR=2.66,95%CI:1.05-6.73),pancreatic portal hypertension(OR=2.81,95%CI:1.06-7.45),and cystic-solid(OR=2.51,95%CI:1.34-4.69)or solid lesions(OR=1.91,95%CI:1.06-3.44)were independently associated with TO failure(all P<0.05).The derived nomogram exhibited modest discrimination and calibration when assessed in both the training and validation datasets.CONCLUSION The proposed LDP-specific definition of TO is feasible and discriminative,and the developed nomogram provides an objective tool for individualized risk assessment.
基金Supported by National Key Research and Development Program,No.2022YFC2407304Major Research Project for Middle-Aged and Young Scientists of Fujian Provincial Health Commission,No.2021ZQNZD013+2 种基金The National Natural Science Foundation of China,No.62275050Fujian Province Science and Technology Innovation Joint Fund Project,No.2019Y9108Major Science and Technology Projects of Fujian Province,No.2021YZ036017.
文摘BACKGROUND To investigate the preoperative factors influencing textbook outcomes(TO)in Intrahepatic cholangiocarcinoma(ICC)patients and evaluate the feasibility of an interpretable machine learning model for preoperative prediction of TO,we developed a machine learning model for preoperative prediction of TO and used the SHapley Additive exPlanations(SHAP)technique to illustrate the prediction process.AIM To analyze the factors influencing textbook outcomes before surgery and to establish interpretable machine learning models for preoperative prediction.METHODS A total of 376 patients diagnosed with ICC were retrospectively collected from four major medical institutions in China,covering the period from 2011 to 2017.Logistic regression analysis was conducted to identify preoperative variables associated with achieving TO.Based on these variables,an EXtreme Gradient Boosting(XGBoost)machine learning prediction model was constructed using the XGBoost package.The SHAP(package:Shapviz)algorithm was employed to visualize each variable's contribution to the model's predictions.Kaplan-Meier survival analysis was performed to compare the prognostic differences between the TO-achieving and non-TO-achieving groups.RESULTS Among 376 patients,287 were included in the training group and 89 in the validation group.Logistic regression identified the following preoperative variables influencing TO:Child-Pugh classification,Eastern Cooperative Oncology Group(ECOG)score,hepatitis B,and tumor size.The XGBoost prediction model demonstrated high accuracy in internal validation(AUC=0.8825)and external validation(AUC=0.8346).Survival analysis revealed that the disease-free survival rates for patients achieving TO at 1,2,and 3 years were 64.2%,56.8%,and 43.4%,respectively.CONCLUSION Child-Pugh classification,ECOG score,hepatitis B,and tumor size are preoperative predictors of TO.In both the training group and the validation group,the machine learning model had certain effectiveness in predicting TO before surgery.The SHAP algorithm provided intuitive visualization of the machine learning prediction process,enhancing its interpretability.
基金Supported by Yangtze University School-level Teaching Research Project(JY2021038,JY2022009,JY2024059)。
文摘Against the dual background of deepening the construction of new liberal arts and implementing the"Double Ten Thousand Plan"for first-class undergraduate courses,local universities urgently need to explore distinctive curriculum construction paths.Based on the requirements of the new liberal arts connotation,this paper constructs a three-dimensional integrated framework of"value guidance,ability driven,and knowledge foundation",and takes the construction of the"Finance"course at Yangtze University as a typical case for research.When systematically analyzing the"Finance"course in the school,a three-dimensional integrated curriculum reform practice is implemented by reshaping the three-level curriculum objectives of"state-society-individual",developing teaching content that integrates"modularization-localization-cutting-edge",using the"O-PRAISE"situational teaching method,and constructing a diversified collaborative evaluation system.A first-class curriculum construction model for local universities has been summarized,which involves five collaborative approaches:"localization"of target positioning,"integration"of content construction,"contextualization"of method implementation,"value-added"evaluation orientation,and"synergy"of resource guarantee.The aim is to provide theoretical paradigms and practical solutions for similar universities to learn from,effectively solving practical difficulties such as the disconnect between value shaping and knowledge transmission,and the mismatch between talent cultivation and local needs in curriculum construction.
基金Heilongjiang Provincial Library Work Committee Project“Double First-Class Construction Research on the Development Strategy of Subject Services in University Libraries”(2024-016-B)。
文摘This paper aims to explore the development strategies for subject services in university libraries within the context of the“double first-class”initiative.By examining the relationship between“double first-class”construction and university library subject services,the study analyzes the current state of subject services,including resource development,service models,and team building.Drawing on domestic and international case studies,the paper proposes a series of targeted and practical strategies to enhance the quality of subject services in university libraries,thereby providing robust support for the advancement of the“double first-class”initiative.
文摘The“Double First-Class”construction focuses on the development of disciplinary connotations and the improvement of talent cultivation quality,posing higher demands on the teaching mode and talent supply of public health and preventive medicine disciplines.Environmental health,as a core course in public health and preventive medicine,directly relates to the cultivation of effective composite public health talents.Based on the core orientation of the“Double First-Class”construction and combining the talent cultivation and course characteristics of environmental health,this paper explores the significance of teaching reform and talent cultivation in environmental health from the perspective of“Double First-Class”construction.It also investigates the paths for teaching reform and talent cultivation from multiple dimensions,aiming to provide references for cultivating high-quality professionals who meet the needs of national public health development and ecological environmental protection.
文摘This article analyzes the application strategies of Building Information Modeling(BIM)support technology in a first-class highway reconstruction and expansion project based on its actual situation.According to the basic situation of BIM technology and its application goals in this project,it explores application strategies such as BIM model construction,BIM prefabricated structural model deepening and schedule simulation,BIM collision detection,and BIM tunnel pre-construction simulation.Through this analysis,it is hoped to provide a reference for the rational application of BIM support technology and ensure the high-quality and efficient completion of first-class highway reconstruction and expansion projects.
文摘This study first analyzes four distinct forms of Fujian folk dance,highlighting the notable differences in their cultural characteristics and dance qualities.It then categorizes these dance forms to align with textbook construction,discussing in depth the principles guiding the development of textbooks that correspond to these classifications.
基金this paper is funded by Project Information:2023 Guangdong Undergraduate Colleges and Universities Teaching Quality and Teaching Reform Project Construction Project,Project Name:Action Research on Whole-area Nurturing of English Reading Teaching in Universities,Secondary and Primary Schools under the Perspective of Discipline Nurturing.Project serial number:895.
文摘“Five education”is pivotal for students’all-round development.However,primary English teaching currently faces challenges including the superficial implementation of“Five education”.This study employed action research to explore practical methods for integrating English picture book with textbook to implement“Five education”.Through two rounds of iterative action research,a three-stage activity-based teaching path was developed and refined,enabling the progressive infusion of“Five education”objectives across the learning cycle.Findings demonstrated that this integrated approach-particularly when supported by strategies such as picture book background videos and audio-edited narrative connections-effectively deepened the implementation of“Five education”,mitigated student reading fatigue,and significantly improved students’reading fluency and labor initiative,thus provided a replicable practical paradigm for realizing“Five education simultaneously”.
文摘BACKGROUND Textbook outcome(TO),an emerging composite metric for surgical quality assessment,has recently gained recognition for evaluating perioperative results.Laparoscopic transcystic common bile duct exploration(LTCBDE)has become a widely adopted minimally invasive technique for treating cholecystolithiasis with choledocholithiasis.Despite its growing clinical application,TO has not yet been formally defined for LTCBDE,nor have its failure-associated risk factors been systematically examined.AIM To define TO for LTCBDE,establish standardized criteria,and identify risk factors for TO failure via logistic regression.METHODS A retrospective cohort of 388 patients who underwent LTCBDE in combination with laparoscopic cholecystectomy at the Department of Biliopancreatic Surgery,Tongji Hospital,from January 2018 to October 2024,was analyzed.The study delineated TO criteria for LTCBDE,calculated the rate of TO achievement,and employed logistic regression to determine independent predictors of TO failure.RESULTS TO was defined as the absence of the following seven criteria:Conversion to open surgery,postoperative complications(Clavien-Dindo grade≥2),biliary leakage(International Study Group of Pancreatic Surgery/International Study Group of Liver Surgery grade B/C),delayed removal of drainage tube(>4 days),postoperative interventions,prolonged length of stay(>7 days),and 30-day readmission or mortality.Among 388 patients,276(71.1%)achieved TO.The primary causes of TO failure included delayed removal of drainage tube(94 cases,83.9%),prolonged length of stay(50 cases,44.6%).Multivariate analysis revealed four independent risk factors for TO failure:Preoperative endoscopic retrograde cholangiopancreatography(P=0.022),advanced age(P=0.010),prolonged anesthesia time(P<0.001),and elevated preoperative alkaline phosphatase levels(P=0.048).These findings suggest that applying the concept of TO to LTCBDE enhances surgical quality evaluation and supports early identification of high-risk patients,facilitating personalized clinical decisions and optimizing individual management.
基金funded by Project Information:2022 Guangzhou Municipal Higher Education Teaching Research and Reform Key Research Project:“Innovation and Practice of English Reading Curriculum Ideological and Political in Colleges and Universities:A Study on the Integration of Understanding Contemporary China:An English Reading and Writing Textbook and English Reading Teaching”(2023JGZDXM001).
文摘Based on the ADDIE model,we explored the integration path between Understanding Contemporary China:An English Reading and Writing Textbook and the main textbook of college English reading.Firstly,the basis of textbook integration was analyzed,followed by an explanation of the overall design scheme of textbook integration,and then a series of teaching resources were initially developed and used in teaching practice.Through testing,it was found that the integrative teaching of the two sets of textbooks under the ADDIE model achieved good teaching results,and promoted the three aspects of reading literacy,disciplinary literacy,and value leadership.
