The Pre-Operative GRADE Score Is Associated with 5-Year Survival among Older Patients with Cancer Undergoing Surgery

We aimed to assess the prognostic value of the pre-operative GRADE score for long-term survival among older adults undergoing major surgery for digestive or non-breast gynaecological cancers. Between 2013 and 2019, 136 consecutive older adults with cancer were prospectively recruited from the PF-EC cohort study before major cancer surgery and underwent a geriatric assessment. The GRADE score includes weight loss, gait speed at the threshold of 0.8 m/s, cancer site and cancer extension. The primary outcome was post-operative 5-year mortality. Patients were classified as low risk (GRADE ≤ 8) or high risk (GRADE > 8) on the basis of the median score. A Cox multivariate proportional hazards regression model was performed to assess the association between pre-operative factors and 5-year mortality expressed by adjusted hazard ratio (aHR) and 95% CI. The median age was 80 years, 52% were men, 73% had colorectal cancer. The 30-day post-operative severe complication rate (Clavien-Dindo ≥ 3) was 37%. The 5-year post-operative mortality rate was 34.5%. A GRADE score ≥ 8 (aHR = 2.64 [1.34–5.21], p = 0.0002) was associated with post-operative mortality after adjustment for Body Mass Index < 21 kg/m2 and Instrumental Activities of Daily Living <3/4. By combining very simple geriatric and cancer parameters, the pre-operative GRADE score provides a discriminant prognosis and could help to choose the most suitable treatment strategy for older cancer patients, avoiding under or over-treatment.

Research on Security Risk Assessment Mechanism of Important Event Based on Multi-Source Data

In order to effectively assess all types of security risks in the important event, the important decision-making basis for security risk warning and emergency management of important event is provided by analyzing the coupling relationship and evolution mechanism between various risks. The criminal causes, management defects, security and emergency system construction are analyzed from the possibility of accidents and risks. The multi-source data risk assessment system based on five subsystems and its index set of human factors, management factors, site factors, event factors and audit factors are proposed. The weight of each index in the assessment system is determined by the method of information entropy, and then the risk grade of important event is determined according to the weight calculation function and the improved fuzzy matter element model. The verification with an example shows that: the risk assessment model is optimized by combining entropy weight with fuzzy matter-element model，the influence of weight data extreme value was weakened，the qualitative description and quantitative analysis of multi-source data could be combined，and the subjective error was reduced. The risk grade of important event is reasonably evaluated, and the assessment effect is basically consistent with the expert inspection analysis, which shows that the method had certain application value.

Risk Decision-Making Technology in Gas Reservoir Development at Sichuan Basin

During the development of complex gas reservoirs, the risk decision-making problem often emerges. Thus, the study on risk assessment is an important tool used to identify potential hazards and create appropriate avoidance measures accordingly. Based on the analysis of seven types of risk factors in gas reservoir development planning, this paper aims to clarify the logical relationship between the risk factors in the strategic planning of natural gas development. The comprehensive research on target risks in the gas reservoir development planning based on stochastic simulation was carried out. The “probability curve scanning method” was used to evaluate objective risk factors, while the decision-making risk factors were evaluated using the “probability curve displacement method.” According to the realization probability and dispersion degree of the planned target combined with the risk grade evaluation matrix, the planning target evaluation risk grade was implemented. Moreover, the planning unit risk grade evaluation was obtained at different stages. Regarding the specific production capacity conditions in gas wells (horizontal and vertical wells) and gas reservoir water invasion, the probability method with Monte Carlo stochastic simulation was used to calculate the production and water invasion volumes. The established decision-making risk technology for gas reservoir development, along with the associated supporting procedures, can be used to evaluate the risks of reservoir development planning, production, and water invasion.

CTNI-34. TOXICITY PROFILE AND COMPLIANCE OF PATIENTS WITH HIGH RISK GRADE 2 OR GRADE 3 GLIOMAS RECEIVING ADJUVANT PCV VERSUS ADJUVANT TEMOZOLOMIDE

INTRODUCTION The NCCN recommends either PCV (Procarbazine, CCNU and vincristine) or Temozolomide (TMZ) as adjuvant therapy in high-risk grade 2 & grade 3 gliomas. In this ongoing study we are comparing PCV with TMZ as adjuvant therapy in this setting. METHODS This is a randomised phase 3 study that includes patients with high risk (as per RTOG) grade 2 gliomas and grade 3 gliomas after surgery. Patient are randomly assigned in 1: 2 to receive either adjuvant PCV or TMZ after adjuvant RT. The primary end-point is progression-free survival & key secondary end points are overall survival, toxicity and quality of life. The current analysis focuses on the compliance and adverse events seen in patients enrolled till 30th April 2020. RESULTS 46 patients were enrolled, with 30 patients in TMZ arm. The median age of patients was 37 years (range 23-64). The ECOG PS was 1 in 45 (97.8%) patients and 2 in 1(2.2%) patient at enrolment. The number of patients who have completed all planned cycles of chemotherapy in the PCV arm is 62.5% (10, n=16) as compared to 90% (27, n=30) in the TMZ arm (P=0.047). The incidence of grade 3 or higher adverse events is 68.8% (n=11) in the PCV arm and 16.7% (n=5) in the TMZ arm (P=0.001). The most common grade 3 or higher toxicities noted are lymphopenia in 50% (n=8), neutropenia in 37.5% (n=6), and thrombocytopenia in 25% (n=4) in the PCV arm; while the corresponding numbers in the TMZ arm are 13.3% (n=4), 3.3% (n=1) and 10% (n=3) respectively. CONCLUSION In the current study the chemotherapy completion rates are higher with TMZ and it is associated with lower grade 3-4 events, whether this will lead to an improvement in outcomes remains to be seen.

Risk Assessment of Wave Energy Converter At Kuantan Port, Pahang

Harvesting energy from ocean waves remains an untapped resource, and it is considered a new methodology in renewable energy, especially in Malaysia. This research is based on a project at Kuantan Port that used Wave Energy Converter (WEC) as a platform to generate energy from waves and convert it into electricity. The purpose of this research is to conduct a risk assessment before the execution of the project by referring to the International Organization for Standardization (ISO) 31000 and Risk Management Guidelines: Companion to AS/NZS 4360:2004. It started from risk identification and planned a mitigation way to reduce the grade of risk. These mitigations will be monitored throughout the project to avoid any accidents or harm during construction and installation in the future. The assessment will be using a qualitative analysis method that will gather all the possible risks that impact the project and propose the actions to mitigate the risk. The assessment will also consider the likelihood, seriousness, and weightage to determine the risk level. The risk assessment is divided into six clusters: project management, hydrography, mechanical, electrical, civil, and safety and security. After analysis, each cluster has given their feedback on the risk assessment and their cluster-s risk grade. This research has found that the risk grade is at grade C, which needs the risk assessment of this project to reduce the likelihood, seriousness, and required mitigation actions. Eventually, after the mitigation plan is applied to each risk, the grade of risk is reduced to N.

Phosphohistone H3 Immunohistochemical Labeling: a Potentially Useful Tool for Risk Stratification and Prognostic Analysis in Gastrointestinal Stromal Tumors.

BackgroundIt is well recognized that risk stratification of gastrointestinal stromal tumors (GISTs) is closely related to tumor size, mitotic index (MI), and primary location. Among these three parameters, tumor size and primary location are easily established, while MI is subjective and its repeatability is poor. It is thus necessary to identify a biomarker to represent the true MI. Expression status and biological or prognostic significance of mitotic marker phosphohistone H3 (PHH3) and cell proliferation marker Ki67 in GIST have not been clearly understood until now. MethodsAn immunohistochemistry experiment was performed to detect the expression status of PHH3 and Ki67 in 125 paraffin-embedded GIST samples. All of the patients were followed up until September 30, 2019. ResultsThe MI determined using stained hematoxylin and eosin (H&E) sections (MI-H&E) and immunohistochemically positive PHH3 index (PHH3-IHC) was compared among groups of different genders, ages, primary locations, and histological subtypes, showing that the difference was not statistically significant (P>0.05). MI-H&E and the immunohistochemically positive Ki67 index were positively correlated (r=0.273, P=0.001), but the correlation was lower than that with the PHH3-positive index (r=0.705, P=0.000). The PHH3-positive index was also positively correlated with the Ki67 index (r=0.224, P=0.006). MI-H&E were positively correlated with MI quantified using immunohistochemically stained PHH3 sections (MI-PHH3) (P<0.05). After using PHH3 to perform MI quantification, the risk stratification of five GIST cases was changed, where two cases were given a higher risk grade and three cases were given a lower risk grade. Follow-up data were obtained from 98 cases (98/125, 78.4%), including two cases of metastasis and one death. Both metastatic and death cases had high MI-H&E. One metastatic case and one death case had high PHH3-positive indexes, while the remaining metastatic case had a low PHH3-positive index. ConclusionImmunohistochemical PHH3 labeling is a potentially useful tool for risk stratification and prognostic analysis in GIST. Using immunohistochemical PHH3 labeling makes it more convenient for pathologists to determine the MI for GIST. MI quantification with immunohistochemical PHH3 sections can be used as an adjunct tool for risk stratification and prognostic analysis of GIST, but cannot completely replace MI quantification using stained H&E sections. The Ki67 index is positively correlated with MI-H&E, although the efficiency of tumor risk stratification is lower than that of PHH3.

Fungsi Jaminan Sebagai Penentu Credit Scoring Dalam Layanan Pinjam Meminjam Uang Berbasis Teknologi Informasi

The growth of information technology or commonly referred to as Industrial Revolution 4.0 has given birth to a new idea namely Money Lending and Borrowing Services based on Information Technology. Peer to Peer Lending (P2P) Lending is a service that is much in demand by the public. The majority of P2P Lending financial technology providers do not require collateral. With this condition, OJK has issued a special regulation, namely POJK No. 77 / POJK.01 / 2016 concerning Money Lending and Borrowing Services based on Information Technology. Article 21 POJK No.77 / POJK.01/2016 states that the Operator is required to manage credit risk and operational risk. One risk management undertaken by the Provider is to use Credit Scoring to classify Debtors into certain risk grades. However, because the majority of P2P Lending does not require a material guarantee, the Credit Scoring factor other than collateral becomes very important. In practice, the Operator is often less selective about the classification of Debtors in Credit Scoring, resulting in many defaults.Keywords: Peer to Peer Lending; Financial Technology; Credit Scoring; Risk Grade.AbstrakPerkembangan teknologi informasi informasi atau yang biasa disebut dengan Revolusi Industri 4.0 telah melahirkan gagasan baru yaitu Layanan Meminjam Uang Berbasis Teknologi Informasi. Peer to Peer Lending (P2P) Lending menjadi layanan yang banyak diminati oleh masyarakat. Dari beragam Penyelenggara teknologi finansial P2P Lending mayoritas tidak mensyaratkan adanya jaminan kebendaan. Dengan adanya kondisi tersebut OJK telah mengeluarkan aturan khusus yaitu POJK No. 77/POJK.01/2016 tentang Layanan Pinjam Meminjam Uang Berbasis Teknologi Informasi. Pasal 21 POJK No.77/POJK.01/2016 menyatakan Penyelenggara wajib melakukan manajemen risiko kredit dan risiko operasional. Salah satu manajemen risiko yang dilakukan Penyelenggara adalah menggunakan Credit Scoring untuk mengklasifikasi Debitor ke dalam risk grade tertentu. Meskipun demikian karena mayoritas P2P Lending tidak mensyaratkan adanya jaminan kebendaan, maka faktor Credit Scoring selain jaminan menjadi sangat penting. Pada prakteknya Penyelenggara seringkali kurang selektif terhadap klasifikasi Debitor dalam Credit Scoring sehingga banyak terjadi wanprestasi. Kata Kunci: Peer to Peer Lending; Teknologi Finansial; Credit Scoring; Risk Grade.