Modeling

建模
  • 文章类型: Journal Article
    在过去的几十年中,用于处理各种废水类型的自由水面人工湿地(FWSCW)发生了显着变化。由于其成本效益和其他优势,全球对FWSCW应用的需求和兴趣日益增加,本文回顾了最近关于FWSCW去除不同类型污染物如营养素(即,TN,TP,NH4-N),重金属(即,Fe,Zn,和Ni),抗生素(即,土霉素,环丙沙星,多西环素,磺胺二甲嘧啶,和氧氟沙星),和杀虫剂(即,阿特拉津,S-甲草胺,吡虫啉,λ-氯氟氰菊酯,敌草隆3,4-二氯苯胺,Simazine,和阿特拉津)可能共存于湿地流入中,并讨论了模拟水力和污染物去除过程的方法。对最新文献的文献计量分析表明,中国的出版物数量最多,其次是美国。收集的数据显示,FWSCW平均可以去除61.6%,67.8%,54.7%,和72.85%的营养物质,重金属,抗生素,和杀虫剂,分别。优化每个污染物去除过程需要特定的设计参数。去除重金属需要最低的水力停留时间(HRT)(平均4.78天),去除农药需要最低的水深(平均0.34米),营养去除需要最大的系统尺寸。植被,尤其是香茅。和芦苇。,在FWSCW系统性能中起着重要作用,对移除过程做出重大贡献。各种建模方法(即,黑箱和基于过程的)进行了全面审查,揭示了需要包括与生物过程相关的内部过程机制以及植物物种。,这得到了进一步研究和实地研究验证的支持。这项工作提出了一个国家的最先进的,系统,并对FWSCW去除不同污染物的效率进行了比较讨论,主要设计因素,植被,和良好描述的性能预测模型。
    Free water surface constructed wetlands (FWSCWs) for the treatment of various wastewater types have evolved significantly over the last few decades. With an increasing need and interest in FWSCWs applications worldwide due to their cost-effectiveness and other benefits, this paper reviews recent literature on FWSCWs\' ability to remove different types of pollutants such as nutrients (i.e., TN, TP, NH4-N), heavy metals (i.e., Fe, Zn, and Ni), antibiotics (i.e., oxytetracycline, ciprofloxacin, doxycycline, sulfamethazine, and ofloxacin), and pesticides (i.e., Atrazine, S-Metolachlor, imidacloprid, lambda-cyhalothrin, diuron 3,4-dichloroanilin, Simazine, and Atrazine) that may co-exist in wetland inflow, and discusses approaches for simulating hydraulic and pollutant removal processes. A bibliometric analysis of recent literature reveals that China has the highest number of publications, followed by the USA. The collected data show that FWSCWs can remove an average of 61.6%, 67.8%, 54.7%, and 72.85% of inflowing nutrients, heavy metals, antibiotics, and pesticides, respectively. Optimizing each pollutant removal process requires specific design parameters. Removing heavy metal requires the lowest hydraulic retention time (HRT) (average of 4.78 days), removing pesticides requires the lowest water depth (average of 0.34 m), and nutrient removal requires the largest system size. Vegetation, especially Typha spp. and Phragmites spp., play an important role in FWSCWs\' system performance, making significant contributions to the removal process. Various modeling approaches (i.e., black-box and process-based) were comprehensively reviewed, revealing the need for including the internal process mechanisms related to the biological processes along with plants spp., that supported by a further research with field study validations. This work presents a state-of-the-art, systematic, and comparative discussion on the efficiency of FWSCWs in removing different pollutants, main design factors, the vegetation, and well-described models for performance prediction.
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  • 文章类型: Journal Article
    目的:本综述的目的是概述用餐时的父母沟通模式,特别强调有和没有饮食失调史的家庭之间的差异。
    方法:根据PRISMA声明进行系统评价。在PubMed进行了系统的文献检索,PubPsych和PsycINFO以及结果由两名独立评估者使用PICOS标准进行了资格评估。只有包括用餐时间观察的研究才被认为适合分析显性和隐性父母交流。
    结果:审查的结果表明,母亲之间的交流更多,更复杂,与父亲相比,他们的孩子在用餐时的话语种类更多。通信的意图和类型是多样和异构的。总的来说,父母经常试图鼓励他们的孩子吃饭。言语建模和共同饮食似乎是常见的行为。有饮食失调史的母亲比没有饮食失调史的母亲在进食过程中表现出更多的负面情绪。关于使用积极评论和控制言论的发现是矛盾的。
    结论:这篇综述概述了亲子沟通和家庭聚餐行为建模的主要领域,这可能与调查和整合饮食行为和无序饮食的代际传播模型有关。
    OBJECTIVE: The aim of this review is to provide an overview of parental communication patterns during mealtimes, with a special emphasis being placed on the differences between families with and without a history of eating disorders.
    METHODS: The systematic review was conducted according to the PRISMA statement. A systematic literature search was carried out in PubMed, PubPsych and PsycINFO and the results were assessed for eligibility by two independent raters using the PICOS criteria. Only studies that included a mealtime observation were considered suitable for analysis of both explicit and implicit parental communication.
    RESULTS: The results of the review suggest that mothers communicate more, with more complexity, and with a greater variety of words with their children during mealtimes compared to fathers. The intention and type of communication is diverse and heterogeneous. In general, parents often tried to encourage their children to eat. Verbal modeling and co-eating appeared to be common behaviors. Mothers with a history of eating disorders expressed more negative emotions during eating than mothers without eating disorders. Findings regarding the use of positive comments and controlling speech are contradicting.
    CONCLUSIONS: The review outlines major fields of parent-child communication and modeling behavior around family meals which might be relevant to investigate and integrate into models of intergenerational transmission of eating behavior and disordered eating.
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  • 文章类型: Journal Article
    继续投资于脊髓灰质炎病毒传播数学模型的开发和应用,经济学,和风险导致它们用于支持脊髓灰质炎最终策略开发和风险管理政策。这项研究补充了2000-2019年期间的早期审查,并讨论了自2020年以来由全球根除脊髓灰质炎倡议(GPEI)合作伙伴和其他人支持的建模小组发表的研究的演变。我们系统地回顾了2020-2024.25年在同行评审期刊上以英文发表的建模论文,这些论文侧重于脊髓灰质炎病毒传播和健康经济分析。尽管人们期待已久的脊髓灰质炎病毒传播结束和GPEI日落,这将导致它对建模的支持结束,我们发现,GPEI合作伙伴支持的建模组数量增加了一倍,发表率增加.建模继续在支持GPEI和国家/区域政策方面发挥作用,但是小儿麻痹症根除治理的变化,分散管理和决策,建模方法和结果的异质性增加降低了建模结果的总体影响。同时,2016年全球协调停止2型口服脊髓灰质炎病毒疫苗用于预防性免疫接种以及引入新的脊髓灰质炎病毒疫苗和制剂的失败,在此期间增加了脊髓灰质炎病毒传播的复杂性和不确定性以及经济模型和政策建议。
    Continued investment in the development and application of mathematical models of poliovirus transmission, economics, and risks leads to their use in support of polio endgame strategy development and risk management policies. This study complements an earlier review covering the period 2000-2019 and discusses the evolution of studies published since 2020 by modeling groups supported by the Global Polio Eradication Initiative (GPEI) partners and others. We systematically review modeling papers published in English in peer-reviewed journals from 2020-2024.25 that focus on poliovirus transmission and health economic analyses. In spite of the long-anticipated end of poliovirus transmission and the GPEI sunset, which would lead to the end of its support for modeling, we find that the number of modeling groups supported by GPEI partners doubled and the rate of their publications increased. Modeling continued to play a role in supporting GPEI and national/regional policies, but changes in polio eradication governance, decentralized management and decision-making, and increased heterogeneity in modeling approaches and findings decreased the overall impact of modeling results. Meanwhile, the failure of the 2016 globally coordinated cessation of type 2 oral poliovirus vaccine use for preventive immunization and the introduction of new poliovirus vaccines and formulation, increased the complexity and uncertainty of poliovirus transmission and economic models and policy recommendations during this time.
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  • 文章类型: Journal Article
    背景:减少COVID-19传播的旅行相关策略随着对SARS-CoV-2和新的预防工具的理解的变化而迅速发展,诊断,和治疗。建模是研究不同疾病遏制策略可能发生的结果范围的重要方法。
    方法:我们研究了2019年12月至2022年9月发表的43篇文章,这些文章使用建模来评估与旅行相关的COVID-19遏制策略。我们提取并综合了有关研究目标的数据,方法,结果,人口,设置,战略,和成本。我们使用标准化方法根据建模质量和严格性的26项标准来评估每个分析。
    结果:最常用的方法包括检查检疫的隔室建模,隔离,或测试。在大流行的早期,目标是预防与旅行相关的COVID-19病例,重点关注个人层面的结果,并评估旅行限制等策略,未经测试的检疫,社交距离,和抵达PCR检测。在诊断测试和疫苗的发展之后,建模研究预测了人群水平的结局,并研究了这些工具来限制COVID-19的传播。很少有发表的研究包括快速抗原筛选策略,成本,显式模型校准,或对建模方法的批判性评估。
    结论:未来的建模分析应利用开源数据,提高建模方法的透明度,纳入新的预防措施,诊断,和治疗,并包括成本和成本效益,以便建模分析可以提供信息,以解决未来值得关注的SARS-CoV-2变体和其他新兴传染病(例如,水痘和埃博拉病毒)用于与旅行相关的卫生政策。
    BACKGROUND: Travel-related strategies to reduce the spread of COVID-19 evolved rapidly in response to changes in the understanding of SARS-CoV-2 and newly available tools for prevention, diagnosis, and treatment. Modeling is an important methodology to investigate the range of outcomes that could occur from different disease containment strategies.
    METHODS: We examined 43 articles published from December 2019 through September 2022 that used modeling to evaluate travel-related COVID-19 containment strategies. We extracted and synthesized data regarding study objectives, methods, outcomes, populations, settings, strategies, and costs. We used a standardized approach to evaluate each analysis according to 26 criteria for modeling quality and rigor.
    RESULTS: The most frequent approaches included compartmental modeling to examine quarantine, isolation, or testing. Early in the pandemic, the goal was to prevent travel-related COVID-19 cases with a focus on individual-level outcomes and assessing strategies such as travel restrictions, quarantine without testing, social distancing, and on-arrival PCR testing. After the development of diagnostic tests and vaccines, modeling studies projected population-level outcomes and investigated these tools to limit COVID-19 spread. Very few published studies included rapid antigen screening strategies, costs, explicit model calibration, or critical evaluation of the modeling approaches.
    CONCLUSIONS: Future modeling analyses should leverage open-source data, improve the transparency of modeling methods, incorporate newly available prevention, diagnostics, and treatments, and include costs and cost-effectiveness so that modeling analyses can be informative to address future SARS-CoV-2 variants of concern and other emerging infectious diseases (e.g., mpox and Ebola) for travel-related health policies.
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  • 文章类型: Journal Article
    几乎所有科学技术领域的趋势领域之一是人工智能。计算生物学和人工智能可以在许多步骤中帮助基因治疗,包括:基因识别,基因编辑,矢量设计,新大分子的开发和基因传递的建模。计算生物学和人工智能在这一领域使用了各种工具,比如基因组学,转录组学和蛋白质组学数据分析,机器学习算法和分子相互作用研究。这些工具可以引入新的基因靶标,新颖的载体,优化实验条件,预测结果,并提出最佳解决方案,以避免基因疗法治疗后的不良免疫反应。
    One of the trending fields in almost all areas of science and technology is artificial intelligence. Computational biology and artificial intelligence can help gene therapy in many steps including: gene identification, gene editing, vector design, development of new macromolecules and modeling of gene delivery. There are various tools used by computational biology and artificial intelligence in this field, such as genomics, transcriptomic and proteomics data analysis, machine learning algorithms and molecular interaction studies. These tools can introduce new gene targets, novel vectors, optimized experiment conditions, predict the outcomes and suggest the best solutions to avoid undesired immune responses following gene therapy treatment.
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  • 文章类型: Journal Article
    需要在2015年《巴黎气候协定》的国家自主承诺(NDC)之外做出重大的缓解努力,以避免比工业化前温度升高2°C。健康共同效益代表选定的近期,在这些政策对气候变化规模的有益影响显现之前,可以在短期内抵消缓解成本的气候政策的积极后果。对缓解方案及其健康影响进行建模的方法的多样性抑制了对决策有用的荟萃分析和结果综合。
    我们评估了气候缓解的健康共同利益建模的方法和选择范围,以确定增加一致性和协作的机会,从而更好地为决策提供信息。我们回顾了量化气候变化缓解与空气质量相关的健康共同利益的研究,交通运输,自2009年柳叶刀委员会“管理气候变化对健康的影响”以来,饮食一直到2017年1月。我们记录了方法,方法,场景,与健康相关的暴露,和健康结果。
    42项研究符合纳入标准。空气质量,交通运输,饮食方案从具体的政策建议到假设的方案,从全球建议到利益相关者知情的地方指导。地理和时间范围以及方案的有效性决定了政策的相关性。最近的研究倾向于使用更复杂的方法来解决相关政策系统的复杂性。
    大多数研究表明,更近的期限,地方辅助健康福利为政策采纳和净成本节约提供动力。然而,研究更适合描述气候政策与健康的相互作用以及潜在结果的大小,而不是提供健康共同获益的具体准确估计.对气候政策的健康共同利益进行建模可在情景合理时提供与政策相关的信息,相关,彻底,并且该模型充分解决了复杂性。在气候缓解研究的健康共同利益中,选定的建模选择更加一致,将有助于评估缓解方案,特别是适用于国家发展中国家的缓解方案,并促进政策采纳。
    UNASSIGNED: Significant mitigation efforts beyond the Nationally Determined Commitments (NDCs) coming out of the 2015 Paris Climate Agreement are required to avoid warming of 2°C above pre-industrial temperatures. Health co-benefits represent selected near term, positive consequences of climate policies that can offset mitigation costs in the short term before the beneficial impacts of those policies on the magnitude of climate change are evident. The diversity of approaches to modeling mitigation options and their health effects inhibits meta-analyses and syntheses of results useful in policy-making.
    UNASSIGNED: We evaluated the range of methods and choices in modeling health co-benefits of climate mitigation to identify opportunities for increased consistency and collaboration that could better inform policy-making. We reviewed studies quantifying the health co-benefits of climate change mitigation related to air quality, transportation, and diet published since the 2009 Lancet Commission \'Managing the health effects of climate change\' through January 2017. We documented approaches, methods, scenarios, health-related exposures, and health outcomes.
    UNASSIGNED: Forty-two studies met the inclusion criteria. Air quality, transportation, and diet scenarios ranged from specific policy proposals to hypothetical scenarios, and from global recommendations to stakeholder-informed local guidance. Geographic and temporal scope as well as validity of scenarios determined policy relevance. More recent studies tended to use more sophisticated methods to address complexity in the relevant policy system.
    UNASSIGNED: Most studies indicated significant, nearer term, local ancillary health benefits providing impetus for policy uptake and net cost savings. However, studies were more suited to describing the interaction of climate policy and health and the magnitude of potential outcomes than to providing specific accurate estimates of health co-benefits. Modeling the health co-benefits of climate policy provides policy-relevant information when the scenarios are reasonable, relevant, and thorough, and the model adequately addresses complexity. Greater consistency in selected modeling choices across the health co-benefits of climate mitigation research would facilitate evaluation of mitigation options particularly as they apply to the NDCs and promote policy uptake.
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  • 文章类型: Journal Article
    考虑用户的情绪在最终用户采用和接受最新技术中起着极其重要的作用。用户情绪还可以帮助识别未知的需求,节省资源,否则将被浪费,如果以后发现。然而,在软件工程中,对用户的情感需求进行引导和建模仍然是一个开放的研究领域。
    本系统映射综述从两个角度分析了软件工程中的情感需求(ER)实践:启发和建模。对于启发技术,我们研究技术,评价方法,局限性,和应用程序域。对于建模技术,我们研究建模语言,分析,局限性,域。
    我们系统地回顾了1993-2023年间发表的有关情感需求工程的研究,并确定了46项相关的主要研究。
    共有34项研究调查了ER激发技术,五种经过检验的建模技术,七个涵盖了两者。说明性案例研究是提出的启发技术的主要评估方法。确定的限制包括时间消耗和广泛的人类参与。主要的应用领域是医疗保健和福祉,和游戏开发。
    这篇综述总结了情感需求研究的现状,突出关键启发和建模技术,评估,局限性,域。进一步的研究可以基于这些发现来推进软件工程中的情感需求实践。未来的研究可能会解决(1)管理用户之间相互冲突的情感需求,(2)评估在开发过程中考虑情感需求的价值和影响;(3)建模和分析情感需求与其他需求的关系。
    UNASSIGNED: Considering users\' emotions plays an extremely crucial role in the adoption and acceptance of recent technology by the end user. User emotions can also help to identify unknown requirements, saving resources that would otherwise be wasted if discovered later. However, eliciting and modeling users\' emotional requirements in software engineering is still an open research area.
    UNASSIGNED: This systematic mapping review analyzes emotional requirements (ER) practices in software engineering from two perspectives: elicitation and modeling. For elicitation techniques, we investigate the techniques, evaluation methods, limitations, and application domains. For modeling techniques, we examine the modeling languages, analyses, limitations, and domains.
    UNASSIGNED: We systematically reviewed studies on emotional requirements engineering published between 1993-2023 and identified 46 relevant primary studies.
    UNASSIGNED: A total of 34 studies investigated ER elicitation techniques, five examined modeling techniques, and seven covered both. Illustrative case studies were the main evaluation method for proposed elicitation techniques. Identified limitations include time consumption and extensive human involvement. The dominant application domains were healthcare and well-being, and game development.
    UNASSIGNED: This review summarizes the current landscape of emotional requirements research, highlighting key elicitation and modeling techniques, evaluations, limitations, and domains. Further research can build on these findings to advance emotional requirements practices in software engineering. Future research may address (1) managing conflicting emotional requirements across users, (2) evaluating the value and impact of considering emotional requirements during the development and (3) Modeling and analyzing emotional requirements in relation to other requirements.
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  • 文章类型: Journal Article
    尽管流动水域在全球温室气体(GHG)预算中具有公认的重要性,河流温室气体模型仍然过于简化,从而制约了河流温室气体排放反馈有效预测的发展。在这里,我们通过调查2010年至2021年发表的122篇论文中的148个模型,阐明了河流GHG模型的最新技术。我们的研究结果表明,河流温室气体模型大多是数据驱动模型(83%),虽然机械模型和混合模型的应用并不常见(12%和5%,分别)。总的来说,河流温室气体模型主要用于解释温室气体排放与生化因素之间的关系,虽然水文的作用,地貌,土地利用和覆盖因素仍然缺失。复杂和高级模型的发展受到数据稀缺问题的限制;因此,努力应侧重于开发负担得起的自动监测方法,以提高数据质量和数量。为了将来的研究,我们要求进行流域尺度研究,以解释河流和陆地与地表的相互作用,鉴于混合模型的灵活性,建议使用混合模型。对温室气体动态的这种全面理解将有助于扩大规模,从而减少全球温室气体估计的不确定性。最后,我们基于三个主要标准提出了模型选择的应用框架,包括模型目的,模型尺度和温室气体数据的时空特征,通过这种优化模型可以应用于各种研究条件。
    Despite the recognized importance of flowing waters in global greenhouse gas (GHG) budgets, riverine GHG models remain oversimplified, consequently restraining the development of effective prediction for riverine GHG emissions feedbacks. Here we elucidate the state of the art of riverine GHG models by investigating 148 models from 122 papers published from 2010 to 2021. Our findings indicate that riverine GHG models have been mostly data-driven models (83%), while mechanistic and hybrid models were uncommonly applied (12% and 5%, respectively). Overall, riverine GHG models were mainly used to explain relationships between GHG emissions and biochemical factors, while the role of hydrological, geomorphic, land use and cover factors remains missing. The development of complex and advanced models has been limited by data scarcity issues; hence, efforts should focus on developing affordable automatic monitoring methods to improve data quality and quantity. For future research, we request for basin-scale studies explaining river and land-surface interactions for which hybrid models are recommended given their flexibility. Such a holistic understanding of GHG dynamics would facilitate scaling-up efforts, thereby reducing uncertainties in global GHG estimates. Lastly, we propose an application framework for model selection based on three main criteria, including model purpose, model scale and the spatiotemporal characteristics of GHG data, by which optimal models can be applied in various study conditions.
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  • 文章类型: Journal Article
    为了应对对治疗性生物分子日益增长的需求,需要连续和成本有效的生物分离技术来提高提取产率和效率。水相双相提取发酵已成为一种集成的下游加工技术,提供选择性分区,高生产率,和保持生物分子的完整性。然而,这种技术的动态性质需要对潜在的分离机制有全面的了解。不幸的是,由于有限的资源和时间,影响这种动态行为的参数分析可能是具有挑战性的。为了解决这个问题,可以采用数学建模方法来最大限度地减少繁琐的试错实验过程。这篇综述文章介绍了上游和下游处理技术的数学建模方法,专注于以经济有效的方式生产可用于制药工业的生物分子。通过利用数学模型,研究人员可以优化生产和纯化过程,导致生物分子生产效率提高和加工成本降低。
    In response to the growing demand for therapeutic biomolecules, there is a need for continuous and cost-effective bio-separation techniques to enhance extraction yield and efficiency. Aqueous biphasic extractive fermentation has emerged as an integrated downstream processing technique, offering selective partitioning, high productivity, and preservation of biomolecule integrity. However, the dynamic nature of this technique requires a comprehensive understanding of the underlying separation mechanisms. Unfortunately, the analysis of parameters influencing this dynamic behavior can be challenging due to limited resources and time. To address this, mathematical modeling approaches can be employed to minimize the tedious trial-and-error experimentation process. This review article presents mathematical modeling approaches for both upstream and downstream processing techniques, focusing on the production of biomolecules which can be used in pharmaceutical industries in a cost-effective manner. By leveraging mathematical models, researchers can optimize the production and purification processes, leading to improved efficiency and processing cost reduction in biomolecule production.
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  • 文章类型: Meta-Analysis
    目的:提供妇科非癌症手术中症状性静脉血栓栓塞(VTE)和大出血风险的特定程序估计。
    方法:我们在Embase上进行了全面的搜索,MEDLINE,WebofScience,谷歌学者。此外,我们分别进行了研究血栓预防效果的随机试验.
    方法:观察性研究纳入≥50名接受妇科非癌症手术的成年患者,报告至少以下一种的绝对发病率:症状性肺栓塞(PE),有症状的深静脉血栓形成(DVT),有症状的VTE,需要再干预的出血(包括再探查和血管栓塞),导致输血或术后血红蛋白<70g/L的出血
    方法:由两名评审员组成的团队独立评估资格,执行数据提取,并评估合格文章的偏见风险。我们调整了报告的血栓预防和随访时间的估计值,并使用研究的中位数来确定按患者VTE危险因素分层的手术后4周的累积发生率。并使用等级方法对证据确定性进行评级。
    结果:我们纳入了131项研究(1,741,519例患者),报告了50例VTE估计值和35例妇科非癌症手术需要再干预的出血估计值。VTE的证据确定性通常为中等或低,而需要再次干预的出血的证据确定性较低或非常低。在几种手术中,有症状的静脉血栓栓塞的风险中位数<0.1%(例如,经阴道取卵)到其他的1.5%(例如,微创骶结肠切除术与子宫切除术,患者VTE风险组的1.2-4.6%)。在30例(60%)手术中,VTE风险<0.5%;在10例(20%)中,VTE风险为0.5-1.0%;在10例(20%)手术中,VTE风险>1.0%。需要再次干预的出血风险从<0.1%(经阴道取卵术)到4.0%(开放性子宫肌瘤切除术)不等。在17例(49%)手术中,需要再次干预的出血风险<0.5%,12年0.5%-1.0%(34%),6个(17%)中>1.0%。
    结论:妇科非癌手术中VTE的风险因手术和患者而异。VTE风险仅在选定的患者和手术中超过出血风险。尽管大多数证据的确定性很低,尽管如此,研究结果为将药物血栓预防限制在接受妇科非癌症手术的少数患者提供了令人信服的理由.
    OBJECTIVE: This study aimed to provide procedure-specific estimates of the risk for symptomatic venous thromboembolism and major bleeding in noncancer gynecologic surgeries.
    METHODS: We conducted comprehensive searches on Embase, MEDLINE, Web of Science, and Google Scholar. Furthermore, we performed separate searches for randomized trials that addressed the effects of thromboprophylaxis.
    METHODS: Eligible studies were observational studies that enrolled ≥50 adult patients who underwent noncancer gynecologic surgery procedures and that reported the absolute incidence of at least 1 of the following: symptomatic pulmonary embolism, symptomatic deep vein thrombosis, symptomatic venous thromboembolism, bleeding that required reintervention (including re-exploration and angioembolization), bleeding that led to transfusion, or postoperative hemoglobin level <70 g/L.
    METHODS: A teams of 2 reviewers independently assessed eligibility, performed data extraction, and evaluated the risk of bias of the eligible articles. We adjusted the reported estimates for thromboprophylaxis and length of follow-up and used the median value from studies to determine the cumulative incidence at 4 weeks postsurgery stratified by patient venous thromboembolism risk factors and used the Grading of Recommendations Assessment, Development and Evaluation approach to rate the evidence certainty.
    RESULTS: We included 131 studies (1,741,519 patients) that reported venous thromboembolism risk estimates for 50 gynecologic noncancer procedures and bleeding requiring reintervention estimates for 35 procedures. The evidence certainty was generally moderate or low for venous thromboembolism and low or very low for bleeding requiring reintervention. The risk for symptomatic venous thromboembolism varied from a median of <0.1% for several procedures (eg, transvaginal oocyte retrieval) to 1.5% for others (eg, minimally invasive sacrocolpopexy with hysterectomy, 1.2%-4.6% across patient venous thromboembolism risk groups). Venous thromboembolism risk was <0.5% for 30 (60%) of the procedures; 0.5% to 1.0% for 10 (20%) procedures; and >1.0% for 10 (20%) procedures. The risk for bleeding the require reintervention varied from <0.1% (transvaginal oocyte retrieval) to 4.0% (open myomectomy). The bleeding requiring reintervention risk was <0.5% in 17 (49%) procedures, 0.5% to 1.0% for 12 (34%) procedures, and >1.0% in 6 (17%) procedures.
    CONCLUSIONS: The risk for venous thromboembolism in gynecologic noncancer surgery varied between procedures and patients. Venous thromboembolism risks exceeded the bleeding risks only among selected patients and procedures. Although most of the evidence is of low certainty, the results nevertheless provide a compelling rationale for restricting pharmacologic thromboprophylaxis to a minority of patients who undergo gynecologic noncancer procedures.
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