Pancreatic surgery is the most complex type of abdominal surgery,with high technical requirements and long learning curve,and the quality of surgery is directly related to the prognosis of the patients. In recent years,more and more indicators have been used to evaluate the quality of pancreatic surgery,such as operation time,intraoperative blood loss,morbidity,mortality, prognosis and so on,and different evaluation systems have been established,including benchmarking,auditing,outcome evaluation based on risk factor adjustment and textbook outcomes. Among them,the benchmark is the most widely used to evaluate surgical quality and is expected to become the standard for comparison among peers. This article reviews existing quality evaluation indicators and benchmarks for pancreatic surgery and anticipates its future application prospects.
Humans ; Benchmarking ; Digestive System Surgical Procedures ; Outcome Assessment, Health Care ; Blood Loss, Surgical ; Risk Factors

Objective: To externally validate and compare the accuracy of the China-PAR (Prediction for ASCVD Risk in China) model and the 2019 World Health Organization (WHO) cardiovascular disease risk charts for East Asian in predicting a 10-year cardiovascular disease in a general Chinese population. Methods: Participants aged 40-79 years without prior cardiovascular disease at baseline in the CHinese Electronic health Records Research in Yinzhou (CHERRY) were analyzed. The Kaplan-Meier analysis estimated the observed cardiovascular events (including non-fatal myocardial infarction, fatal coronary heart disease, and non-fatal or fatal stroke) rate within ten years. The expected risks were calculated using the WHO risk charts for East Asia (including the laboratory-based and non-laboratory-based models) and the China-PAR model. The expected-observed ratios were calculated to evaluate the overestimation or underestimation of the models in the cohort. Model accuracy was assessed by discrimination C-index, calibration χ² value, and calibration plots. Results: During a median of 7.26 years of follow-up, 13 301 cardiovascular events were identified among 225 811 participants. The C-index for the China-PAR model, WHO laboratory-based model and WHO non-laboratory-based model were 0.741 (0.735-0.747), 0.747 (0.740-0.753), and 0.739 (0.733-0.746) for men, and 0.782 (0.776-0.788), 0.789 (0.783-0.795), and 0.782 (0.776-0.787) for women, respectively. The WHO laboratory-based model and non-laboratory-based model underestimated the 10-year ASCVD risk by around 15% in women and underestimated by 0.8% and 4.4% in men, respectively. The China-PAR model underestimated the risks by 19.5% and 42.3% for men and women. Conclusions: The China-PAR and WHO models all have pretty good discriminations for 10-year cardiovascular risk assessment in this general Chinese population. However, the accuracy should be improved in the highest-risk groups, suggesting further specific models are still needed for those with the highest risk, such as patients with diabetes or older persons.
Adult ; Aged ; Cardiovascular Diseases/epidemiology* ; China/epidemiology* ; Female ; Humans ; Male ; Middle Aged ; Risk Assessment ; Risk Factors ; World Health Organization

Objective: To evaluate the occupational health risk of organic solvents in major posts of printing industry, and to provide technical reference to take targeted risk control measures. Methods: In January 2021, the contact ratio method was used to assess the occupational health risk of organic solvents in the major posts of 84 printing enterprises in Shantou, and Monte Carto method was used to estimate the probability distribution of risk levels in the majorpostsin January 2021. Results: The highest probability of risk assessment in printing and membranecovering post is Level 4 (high risk) , which are 76.2% and 67.6% respectively; the highest probability of simulation evaluation result in oil blending, dispensing and cleaning post is Level 3 (medium risk) ; and the simulation evaluation result in glueing post are mostly Level 3 (medium risk) and Level 4 (high risk) , the probability of which are 45.7% and 54.3% respectively. Conclusion: The occupational health risk of organic solvents in the major posts is generally middle-high risk level, and then the occupational health risk control of organic solvents in major posts of printing industry should be strengthened.
Air Pollutants, Occupational/analysis* ; Industry ; Occupational Exposure/analysis* ; Occupational Health ; Risk Assessment ; Solvents

Objective: To explore the applicability of three different kinds of noise occupational health risk assessment methods to the occupational health risk assessment of noise exposed positions in an automobile foundry enterprise. Methods: In July 2020, the occupational-health risk assessment of noise-exposed positions was conducted by using the Guidelines for risk management of occupational noise hazard (guideline method) , the International Commission on Mining and Metals Guidelines for Occupational Health Risk Assessment (ICMM) method and the Occupational-health risk index method (index method) respectively, and the results were analyzed and compared. Results: Through the occupational health field investigation, the noise exposure level of the enterprise's main workstations was between 80.3 and 94.8 dB (A) , among which the noise of the posts of shaking-sand, cleaning and modeling was greater than 85 dB (A) ; The noise risk of each position was evaluated by the three methods, and the adjustment risk level was between 2 and 5 assessed using the guideline method, between 2 and 3 assessed using the index method, and 5 evaluated using the ICMM model. Conclusion: Each of the three risk assessment methods has its own advantages and disadvantages. The ICMM model has a large difference in value assignment, and values in the results are larger than expected. The evaluation results of the guideline method and the index method are consistent in some positions, there is certain subjectivity in the evaluation using the index method, and the guideline method is more objective.
Automobiles ; Noise, Occupational/adverse effects* ; Occupational Exposure ; Occupational Health ; Risk Assessment/methods*

BACKGROUND: Need to a simple, available, accurate, comprehensive, and valid indicator is felt to assess thermal effects. Therefore, the present study was aimed to develop and validate the environmental heat strain risk assessment (EHSRA) index using structural equation modeling (SEM) based on empirical relations. METHODS: This cross-sectional study was performed on 201 male workers in environments with various climatic conditions. The heart rate and tympanic temperature of the individuals were monitored at times of 30, 60, and 90 min after beginning the work. At these times, values of dry temperature, wet temperature, globe temperature, and air velocity were also measured and metabolism rate and clothing thermal insulation value were estimated. At the end, a theoretical model was depicted in AMOS software and obtained coefficients were applied to develop a novel index. The scores of this indicator were categorized into four risk levels via ROC curves and validate using linear regression analysis. RESULTS: Indirect effect coefficients of the globe temperature, dry temperature, wet temperature, air velocity, metabolism, and clothing thermal insulation variables on the tympanic temperature were computed by 0.77, 0.75, 0.69, 0.24, 0.49, and 0.39, respectively. These coefficients were applied to develop the index. Optimal cut-off points of boundaries between risk levels included 12.02, 15.88, and 17.56. The results showed that the EHSRA index justified 75% of the variations of the tympanic temperature (R CONCLUSIONS The novel index possesses appropriate validity. It was suggested that this indicator is applied and validated in various environments in the next studies.
Adult ; Environmental Health/methods* ; Heat-Shock Response ; Hot Temperature/adverse effects* ; Humans ; Iran ; Latent Class Analysis ; Male ; Middle Aged ; Risk Assessment/methods* ; Young Adult

risk eyes according to preoperative diagnosis was also performed.RESULTS: A total of 140 eyes from 138 patients (age, 58 ± 18 years) were enrolled. Cox regression analysis revealed that the donor age of 65 years or older group presented an increased risk of both graft rejection and failure. Survival analysis revealed that rejection-free graft survival and graft survival rates were higher in eyes in the donor age of less than 65 years group. Finally, in the subgroup analysis, both rejection-free graft survival and graft survival rates were significantly higher in the donor age of less than 65 years group than in the donor age of 65 years or older group, but only in the low-risk subgroup.CONCLUSIONS: Donor age may correlate with graft survival in primary PK performed with imported donor corneas. Donor age could be a considerable factor in primary PK with imported donor corneas, especially in preoperatively low-risk patients.]]>
Cornea ; Corneal Transplantation ; Diagnosis ; Graft Rejection ; Graft Survival ; Humans ; Keratoplasty, Penetrating ; Methods ; Outcome Assessment (Health Care) ; Retrospective Studies ; Risk Factors ; Tissue Donors ; Transplants

Coronavirus Infections ; epidemiology ; prevention & control ; Elective Surgical Procedures ; statistics & numerical data ; Female ; Humans ; Infection Control ; methods ; Infectious Disease Transmission, Patient-to-Professional ; prevention & control ; Male ; Occupational Health ; statistics & numerical data ; Orthopedic Procedures ; methods ; statistics & numerical data ; Outcome Assessment, Health Care ; Pandemics ; prevention & control ; statistics & numerical data ; Patient Safety ; statistics & numerical data ; Pneumonia, Viral ; epidemiology ; prevention & control ; Risk Assessment ; Safety Management ; Singapore ; Wounds and Injuries ; diagnosis ; epidemiology ; surgery

BACKGROUND: We aimed to investigate whether various immune-related plasma proteins, alone or in combination with conventional clinical risk factors, can predict spontaneous preterm delivery (SPTD) and intra-amniotic infection in women with premature cervical dilation or a short cervix (≤ 25 mm).METHODS: This retrospective study included 80 asymptomatic women with premature cervical dilation (n = 50) or a short cervix (n = 30), who underwent amniocentesis at 17–29 weeks. Amniotic fluid (AF) was cultured, and maternal plasma was assayed for interleukin (IL)-6, matrix metalloproteinase (MMP)-9, tissue inhibitor of metalloproteinases (TIMP)-1, and complements C3a and C5a, using enzyme-linked immunosorbent assay (ELISA) kits. The primary outcome measures were SPTD at < 32 weeks and positive AF cultures.RESULTS: The plasma levels of IL-6, C3a, and C5a, but not of MMP-9 and TIMP-1, were significantly higher in women with SPTD at < 32 weeks than in those who delivered at ≥ 32 weeks. The women who delivered at < 32 weeks had more advanced cervical dilatation, and higher rates of antibiotic and tocolytic administration and were less likely to be given vaginal progesterone than those who delivered at ≥ 32 weeks. Using a stepwise regression analysis, a combined prediction model was developed, which included the plasma IL-6 and C3a levels, and cervical dilatation (area under the curve [AUC], 0.901). The AUC for this model was significantly greater than that for any single variable included in the predictive model. In the univariate analysis, plasma IL-6 level was the only significant predictor of intra-amniotic infection.CONCLUSION: In women with premature cervical dilation or a short cervix, maternal plasma IL-6, C3a, and C5a levels could be useful non-invasive predictors of SPTD at < 32 weeks. A combination of these biomarkers and conventional clinical factors may clearly improve the predictability for SPTD, as compared with the biomarkers alone. An increased plasma level of IL-6 predicted intra-amniotic infection.
Amniocentesis ; Amniotic Fluid ; Area Under Curve ; Biomarkers ; Blood Proteins ; Cervix Uteri ; Complement System Proteins ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Interleukin-6 ; Interleukins ; Labor Stage, First ; Outcome Assessment (Health Care) ; Plasma ; Pregnancy ; Progesterone ; Retrospective Studies ; Risk Factors ; Tissue Inhibitor of Metalloproteinase-1 ; Tissue Inhibitor of Metalloproteinases

Objectives: This study aims to (1) determine the cardiovascular risk of persons with hypertension and diabetes attending hypertension/diabetic clinics or hypertension/health club meetings in the AMIGA (Alfonso, Mendez, Indang, General Emilio Aguinaldo and Amadeo) municipalities of Cavite; (2) suggest measures to improve the cardiovascular disease (CVD) program in these municipalities using the results of the study. Methods: A cross-sectional study was performed on patients diagnosed with hypertension and/or diabetes who are attending clinics or club meetings in the barangays of the five AMIGA municipalities of Cavite. Participants were interviewed using an abbreviated version of the World Health Organization (WHO) STEPS questionnaire on risk factors. The participants’ anthropometric measurements were obtained and their total blood cholesterol levels determined. CVD risk was then estimated using the WHO / International Society of Hypertension (ISH) risk prediction chart for the Western Pacific Region B. Results: 1,032 participants from 27 barangays qualified for the study. Participants were predominantly female (74%); over-all mean age was 58.43 years. The majority of the participants (79.17%) were found to be in the low-risk group; 11.34% were in the moderate risk group; 4.46% were in the high-risk group; while 5.05% were in the very high-risk group. Majority of the participants were also found to be obese. Mean total cholesterol was 207.02 mg/dl. Conclusion Majority of participants were stratified in the low-risk category (<10% chance to have cardiovascularevents in the next 10 years), while 9.5% were in the high-risk category (≥20% risk). Obesity is a major risk factor that could be addressed in this population.
Cardiovascular Diseases ; Risk Assessment ; World Health Organization

PURPOSE: Amendment to the Act on Decisions on Life-sustaining Treatment was recently enacted to designate long-term care hospitals as providers of hospice and palliative care. Despite its benefit of providing improved accessibility to end-of-life care, the amendment has raised concerns about its effect on quality of service. This study aimed to use information obtained from an expert group interview and previous studies to compare how cancer patients, family caregivers, physicians, and the general Korean population perceive the potential benefits and risks of this amendment.METHODS: We conducted a multicenter cross-sectional study from July to October 2016. The included participants answered a structured questionnaire regarding the extent to which they agree or disagree with the questionnaire items indicating the potential benefits and risks of the amendment. Chi-square tests and univariate and multivariate logistic regression analyses were performed.RESULTS: Compared with the general population, physicians agreed more that long-term care hospitals are currently not adequately equipped to provide quality hospice and palliative care. Family caregivers found improved access to long-term care hospitals more favorable but were more likely to agree that these hospitals might prioritize profits, thereby threatening the philosophy of hospice care, and that families might cease to fulfill filial responsibilities. Compared with the general population, cancer patients were more concerned about the potentially decreased service quality in this setting.CONCLUSION: Although potential service beneficiaries and providers expected improved accessibility of hospice and palliative care services, they were also concerned whether the system can provide adequate quality of end-of-life care.
Caregivers ; Cross-Sectional Studies ; Health Personnel ; Hospice Care ; Hospices ; Humans ; Interviews as Topic ; Logistic Models ; Long-Term Care ; Palliative Care ; Philosophy ; Risk Assessment ; Terminal Care