BACKGROUND Ampullary adenocarcinoma is a rare malignant tumor of the gastrointestinal tract.Currently,only a few cases have been reported,resulting in limited information on survival.AIM To develop a dynamic nomogram ...BACKGROUND Ampullary adenocarcinoma is a rare malignant tumor of the gastrointestinal tract.Currently,only a few cases have been reported,resulting in limited information on survival.AIM To develop a dynamic nomogram using internal and external validation to predict survival in patients with ampullary adenocarcinoma.METHODS Data were sourced from the surveillance,epidemiology,and end results stat database.The patients in the database were randomized in a 7:3 ratio into training and validation groups.Using Cox regression univariate and multivariate analyses in the training group,we identified independent risk factors for overall survival and cancer-specific survival to develop the nomogram.The nomogram was validated with a cohort of patients from the First Affiliated Hospital of the Army Medical University.RESULTS For overall and cancer-specific survival,12(sex,age,race,lymph node ratio,tumor size,chemotherapy,surgical modality,T stage,tumor differentiation,brain metastasis,lung metastasis,and extension)and 6(age;surveillance,epidemiology,and end results stage;lymph node ratio;chemotherapy;surgical modality;and tumor differentiation)independent risk factors,respectively,were incorporated into the nomogram.The area under the curve values at 1,3,and 5 years,respectively,were 0.807,0.842,and 0.826 for overall survival and 0.816,0.835,and 0.841 for cancer-specific survival.The internal and external validation cohorts indicated good consistency of the nomogram.CONCLUSION The dynamic nomogram offers robust predictive efficacy for the overall and cancer-specific survival of ampullary adenocarcinoma.展开更多
In this paper,we investigate three types of Feynman integrals up to any loop,including the massless banana integral,the one-mass banana integral,and the massless three-point multi-edge integral.Although these integral...In this paper,we investigate three types of Feynman integrals up to any loop,including the massless banana integral,the one-mass banana integral,and the massless three-point multi-edge integral.Although these integrals are simple in topology,they are involved in many interesting processes,like heavy quarks production and decay,as well as massless quark gluon form factors.By using one-loop integration formulas recursively,we obtain the analytic results at any loop order.It turns out that the results are quite simple and compact.The calculation method used in this work is straightforward,and may be generalized to more general cases.展开更多
In this paper,we consider the discrete boundary value problem of the type{∆u1=0=∆un-1,∇(t_(k)^(N-1))φ(∆uk))+t_(k)^(N-1)fk(t_(k),u_(k),∆_(uk))=0,2≤k≤n-1,whereφ:(-a,a)→R,0<a<∞,is an increasing homeomorphism ...In this paper,we consider the discrete boundary value problem of the type{∆u1=0=∆un-1,∇(t_(k)^(N-1))φ(∆uk))+t_(k)^(N-1)fk(t_(k),u_(k),∆_(uk))=0,2≤k≤n-1,whereφ:(-a,a)→R,0<a<∞,is an increasing homeomorphism withφ(0)=0,such aφis called singular,N≥1,n≥3 are integers,tk are the grid points,uk:=u(tk),k=1,2,...,n,∇is the backward difference operator defined by∆uk=uk-uk-1,△is the forward difference operator defined by△uk=uk+1-uk,fk(2≤k≤n-1)are continuous functions.We prove the existence of solutions to this problem by employing the sign condition,the continuation lemma and the upper and lower solutions,respectively.On this basis,we also establish the Ambrosetti-Prodi type results for it.展开更多
目的:探索在医院高质量发展背景下,引入疾病诊断相关分组(diagnosis related groups,DRGs)关键指标及目标与关键成果工作法(objectives and key results,OKR),建立岗位职责与护理价值相结合的薪酬分配体系,以综合评价方式激发护理活力,...目的:探索在医院高质量发展背景下,引入疾病诊断相关分组(diagnosis related groups,DRGs)关键指标及目标与关键成果工作法(objectives and key results,OKR),建立岗位职责与护理价值相结合的薪酬分配体系,以综合评价方式激发护理活力,提升管理效率,助力医院战略目标的实现。方法:于2023年1月—12月采用以资源为基础的相对价值比率(resource-based relative value scale,RBRVS)绩效考核方法,依托工作绩效点值的护理绩效管理方案;于2024年1月—12月利用DRGs+RBRVS绩效考核方法,测算不同护理单元护理直接、间接护理工作效益及绩效考核系数形成分层的月度考核基本机制;并基于OKR,以护理高质量发展为目标关键成果,量化护理安全、护理服务、护理质量、护理教研、护理素养5个考核点并设置权重占比,以考核分形式纳入月度考核,结余部分用于年度目标管理综合评比奖励。对比分析绩效改革前后护理工作情况、护士满意度及病人满意度。结果:实施护理绩效改革方案后,科室目标管理责任书得分为97.8分,较实施前的96.4分,提高了1.45%,各项护理工作情况明显改善;护士对绩效考核满意度及病人满意度较实施前有明显提升(P<0.05)。结论:基于DRGs及OKR建立护理绩效改革方案,通过精益化管理手段,在“多劳多得”的基础上强化“优绩优酬”,可实现护理工作与护理绩效的有机融合,促进护理高质量发展。展开更多
基金Supported by the Appropriate Technology Promotion Program in Chongqing,No.2023jstg005.
文摘BACKGROUND Ampullary adenocarcinoma is a rare malignant tumor of the gastrointestinal tract.Currently,only a few cases have been reported,resulting in limited information on survival.AIM To develop a dynamic nomogram using internal and external validation to predict survival in patients with ampullary adenocarcinoma.METHODS Data were sourced from the surveillance,epidemiology,and end results stat database.The patients in the database were randomized in a 7:3 ratio into training and validation groups.Using Cox regression univariate and multivariate analyses in the training group,we identified independent risk factors for overall survival and cancer-specific survival to develop the nomogram.The nomogram was validated with a cohort of patients from the First Affiliated Hospital of the Army Medical University.RESULTS For overall and cancer-specific survival,12(sex,age,race,lymph node ratio,tumor size,chemotherapy,surgical modality,T stage,tumor differentiation,brain metastasis,lung metastasis,and extension)and 6(age;surveillance,epidemiology,and end results stage;lymph node ratio;chemotherapy;surgical modality;and tumor differentiation)independent risk factors,respectively,were incorporated into the nomogram.The area under the curve values at 1,3,and 5 years,respectively,were 0.807,0.842,and 0.826 for overall survival and 0.816,0.835,and 0.841 for cancer-specific survival.The internal and external validation cohorts indicated good consistency of the nomogram.CONCLUSION The dynamic nomogram offers robust predictive efficacy for the overall and cancer-specific survival of ampullary adenocarcinoma.
基金supported in part by the National Natural Science Foundation of China(NSFC)under Grants Nos.12175048 and 12205061supported by the Guangdong Basic and Applied Basic Research Foundation under Grant No.2022A1515010041.
文摘In this paper,we investigate three types of Feynman integrals up to any loop,including the massless banana integral,the one-mass banana integral,and the massless three-point multi-edge integral.Although these integrals are simple in topology,they are involved in many interesting processes,like heavy quarks production and decay,as well as massless quark gluon form factors.By using one-loop integration formulas recursively,we obtain the analytic results at any loop order.It turns out that the results are quite simple and compact.The calculation method used in this work is straightforward,and may be generalized to more general cases.
基金Supported by the National Natural Science Foundation of China(Grant Nos.1236104012461035)+1 种基金the Outstanding Youth Fund of Gansu Province(Grant No.24JRRA121)the Scientific Research Ability Improvement Program for Young Teachers of Northwest Normal University(Grant No.NWNU-LKQN2021-17)。
文摘In this paper,we consider the discrete boundary value problem of the type{∆u1=0=∆un-1,∇(t_(k)^(N-1))φ(∆uk))+t_(k)^(N-1)fk(t_(k),u_(k),∆_(uk))=0,2≤k≤n-1,whereφ:(-a,a)→R,0<a<∞,is an increasing homeomorphism withφ(0)=0,such aφis called singular,N≥1,n≥3 are integers,tk are the grid points,uk:=u(tk),k=1,2,...,n,∇is the backward difference operator defined by∆uk=uk-uk-1,△is the forward difference operator defined by△uk=uk+1-uk,fk(2≤k≤n-1)are continuous functions.We prove the existence of solutions to this problem by employing the sign condition,the continuation lemma and the upper and lower solutions,respectively.On this basis,we also establish the Ambrosetti-Prodi type results for it.
文摘目的:探索在医院高质量发展背景下,引入疾病诊断相关分组(diagnosis related groups,DRGs)关键指标及目标与关键成果工作法(objectives and key results,OKR),建立岗位职责与护理价值相结合的薪酬分配体系,以综合评价方式激发护理活力,提升管理效率,助力医院战略目标的实现。方法:于2023年1月—12月采用以资源为基础的相对价值比率(resource-based relative value scale,RBRVS)绩效考核方法,依托工作绩效点值的护理绩效管理方案;于2024年1月—12月利用DRGs+RBRVS绩效考核方法,测算不同护理单元护理直接、间接护理工作效益及绩效考核系数形成分层的月度考核基本机制;并基于OKR,以护理高质量发展为目标关键成果,量化护理安全、护理服务、护理质量、护理教研、护理素养5个考核点并设置权重占比,以考核分形式纳入月度考核,结余部分用于年度目标管理综合评比奖励。对比分析绩效改革前后护理工作情况、护士满意度及病人满意度。结果:实施护理绩效改革方案后,科室目标管理责任书得分为97.8分,较实施前的96.4分,提高了1.45%,各项护理工作情况明显改善;护士对绩效考核满意度及病人满意度较实施前有明显提升(P<0.05)。结论:基于DRGs及OKR建立护理绩效改革方案,通过精益化管理手段,在“多劳多得”的基础上强化“优绩优酬”,可实现护理工作与护理绩效的有机融合,促进护理高质量发展。
