Background: Population studies have shown that prehypertension is associated with adverse cardiometabolic risk profile even among apparently healthy populations. Although associations between serum triglyceride (TG) concentrations and the risk of atherosclerotic cardiovascular disease have been reported, there are lack of data on the association of hypertriglyceridemia with cardiovascular risk (CVR) in a low risk prehypertensive population. Aim: Our aim was to analyze the cardiorenometabolic characteristics of prehypertensives (PHT) compared to normotensives (NT) and untreated hypertensives (HT) and its associations with CVR. Materials and methods: In our cross-sectional study we included 323 apparently healthy untreated subjects 18-45 years who underwent basic anthropometric and standardized blood pressure measurement, fasting blood sampling, spot urine collection and transthoracic echocardiogram. Results: Higher BMI, waist circumference, HOMA-IR, LDL-cholesterol, TG, uric acid and LVMI contribute to higher CVR in PHT compared to true NT (p

Third and fourth-degree anal sphincter injuries are among the most severe traumas women can experience during childbirth, often leading to lifelong continence issues. Despite extensive research, current repair techniques are often inadequate, failing to provide long-term solutions. Women with previous severe injuries face a higher risk of recurrence in subsequent deliveries, making caesarean sections a safer option in many cases. The existing WHO classification system is outdated, as it doesn't account for injuries to muscles like the levator ani, which are crucial for continence. Effective repairs require skilled surgeons and often involve more than just fixing the sphincter. Smaller hospitals may not have the necessary expertise and resources for these complex repairs. Delaying repairs to allow specialists to perform them can be just as effective as immediate repairs. Comprehensive care that includes thorough anatomical knowledge and surgical skill is essential. As maternal age increases and birth rates decline, it's crucial for specialized centers to handle severe perineal injuries to ensure the best outcomes and long-term care for patients.

This study is follow-up of the steel shot transformation under the influence of environmental factors research (Lisin et al., 2022) and is the initial stage of investigating the iron behavior in soils during steel shot corrosion under a number of factors: the metallic lead in soils, atmospheric precipitation, excess organic matter. The results obtained show that corrosion of steel ammunition is a continuous process, including the formation of a poorly soluble rust crust on the surface of the steel and the mineralization of the metal until it is destroyed. As a result, the metal transformed into rust form, is a constant source of iron ions and dispersed rust particles migrating in soil waters and accumulating in soils. In addition, the aggregation of corrosion products of steel ammunition is the cause of a change in physical and mechanical properties of soils, which leads to a violation of the air and water migration regime of soils and an increase in surface runoff from the territories of shooting activity. The highest environmental risks are observed when steel ammunition is used on shooting areas where metallic lead intensifies steel shot corrosion rate, while the deposited steel shot activates the deterioration of previously encapsulated metal and — if steel and lead ammunition are used at the same time — slows down the encapsulation of newly deposited metallic lead, which catalyses the accumulation and migration of lead in environmental components.

Background: Myocardial infarction (MI) is a major cause of mortality worldwide. Its presentation as ST-segment elevation MI (STEMI) and non-ST-segment elevation MI (NSTEMI) is influence by atherosclerosis risk factors. Aim: To assess the patterns of presentation and predicting risk factors of acute MI in Kosovo. Methods: This is a cross sectional study from the Clinic of Cardiology of the University Clinical Center of Kosovo, which included all patients hospitalized with acute MI over a period of 7 years (January 1st, 2014 to December 31st, 2020). Data was collected using a structured questionnaire and epidemiological patterns and risk factors were analyzed. Results: Among 7353 patients admitted with acute MI (age 63 ± 12 years, 29% female), 4366 (59.4%) patients had STEMI, and 2987 (40.6%) NSTEMI. Patients age was not different between the two groups (p=0.077). NSTEMI patients smoked less (48.3% vs. 54%, p<0.001), but were more diabetics (37.8% vs. 33.6%, p<0.001), more hypertensives (69.6% vs. 63%, p<0.001), frequently had family history for coronary artery disease (CAD) (40% vs 38%, p=0.009), and included more females compared to STEMI patients (32% vs 27%, p<0.001). The two groups of patients, did not differ in the prevalence of significant CAD on angiography (66.8% vs. 67.8%, p = 0.396), but NSTEMI patients underwent less primary percutaneous interventions compared with STEMI patients (43.6% vs. 55.2%, p < 0.001). Conclusion: In Kosovo, STEMI is commoner than NSTEMI, who were mostly males, more likely to have diabetes, hypertension and family history for CAD compared to those with NSTEMI. Smoking and arterial hypertension proved the strongest predictors of acute MI, in Kosovo, thus highlighting the urgent need for better atherosclerosis risk control and education strategy.

Arsenic (As) contamination of groundwater is a common problem in BDP. The alkaline pH of the groundwater provides favourable condition for geomicrobiochemical processes, where organic matter also plays an important role in mobilization of As. The total arsenic content (AsT) of the groundwater is in the range of 69-178 µgL-1 with mean value of 118.58 µgL-1. The groundwater quality of monitored drinking water wells are related to local land–use pattern and rural sanitation installation and practices (which can have a strong influence on microbial contamination). The study indicates that As heterogeneity, probably a consequence of microbial heterogeneity is a feature of the study area. The excessive total and fecal coliform (TC and FC) count of the ponds possibly suggest uncontrolled surface run offs and sewage leakage, notably from nearby pit-latrine, which increased the microbial contamination in these water sources. The tube wells located in close proximity (~ 2-3 m) of the surveyed ponds are also contaminated with high TC and FC values, due to faulty water supply system, pond water infiltration and cracked tube well platforms. Coliforms may influence geomicrobiological processes in groundwater and thereby, contribute in As release and mobilization. The TC and FC values of monitored tube wells and ponds show seasonal variation, with high TC and FC values during wet season. Attempt has been made to focus on sanitation risk of the monitored wells (based on sanitation and fecal coliform scores) which is usually less explored. The sanitary risk score reveal the need of immediate attention to all the sites, as 25.0 %, 58.3 %, 11.1 % and 5 % of tube wells of the six sites fell under very high risk (sanitary risk score ≥ 9), high risk (sanitary risk score 6-8), intermediate risk (sanitary risk score 3-5) and low risk category (sanitary risk score 0-2), respectively. Fecal coliform score classified all the sites under intermediate risk category (FC count 10-100 per 100 ml of water). The predominance of As heterogeneity particularly in areas under high risk category (showing high TC and FC contamination) is observed along with the similar sinusoidal pattern of TC, FC and AsT content. Finally, this study shed light on the factors responsible for unsafe nature of monitored tube wells and the influence of anthropogenic activities on the microenvironment of the groundwater, which could be a probable reason behind the As heterogeneity in the groundwater of the study area.

Coronavirus disease 2019 (COVID-19) is caused by infection with the 2019 novel coronavirus 2 (2019-nCoV, now referred to as SARS-CoV-2). COVID-19 has become a global pandemic since its outbreak at the end of Dec 2019. COVID-19 could lead to severe acute respiratory disease, especially to those who have reduced immunity. Binding of the viral Spike protein (S) to its receptor ACE2 (Angiotensin Converting Enzyme 2) on the surface of target cells has been proven to be key for virus entry and infection. Although ACE2 expression in the respiratory system is necessary for pneumonia infection by SARS-CoV-2, the regulation of ACE2 gene expression remains poorly investigated, especially for patients that are in pre-pathological conditions. Here, by analyzing The Gene Expression Omnibus (GEO) database, we investigated the expression regulation of ACE2 in various kinds of primary epithelial cells from the respiratory system after varies of respiratory viruses infection such as influenza A virus (IFV), respiratory syncytial virus (RSV) and human rhinovirus (hRV). Our analyses reveal that infection of multiple kinds of respiratory viruses or influenza vaccines greatly increased ACE2 expression, suggesting that respiratory viruses infection could represent a high risk factor for developing COVID-19. We also found that the regulatory effect of influenza A virus on ACE2 expression is associated with activation of the interferon beta-induced pathway and viral RNA-activated host response. Together, our data provide a theoretical framework for clinical classification for SARS-CoV-2 infection susceptibility and could be used for future prevention and therapy treatment for COVID-19.

In last decades, growing migration flows have modified the obstetric clinical care, requiring specific attention by health care systems. The aim was to describe the phenomenon focusing on miscarriage (pregnancy loss at <20 weeks). Patients admitted for care at miscarriage in a six-year period (2012-17) were revised. Miscarriage rates in all ethnic groups, dichotomized in early (within the first 12 weeks of gestation) and late (at <20 weeks) pregnancy loss. Associations between women's characteristics (age, parity, inter-pregnancy interval (IPI)) were explored to elucidate any differences. A total of 1,940 patients were included, segregated in early (n = 1769, 91.2%) and late (n = 171, 8.8%) pregnancy losses. Caucasian ethnicity was the most common (87.9%), leaving the minority groups to 12.1%. Maternal age was higher among Caucasians women than other subgroups, in contrast to Asiatic patients. Nulliparity was observed in 1045 (53.9%) patient, more widespread among Caucasian and Maghrebins. A positive obstetric history counting at least one miscarriage was frequent, ranging from 22.2% to 75%, in particular among Asiatic women, while the recurrence in Caucasians. In Afro-Carribeans the most relevant rate of late miscarriage was found. By multiple regression modelling, maternal age, nulliparity and Afro-Carribean were identified as determinants. Maternal ethnicity should be considered in the management of pregnancy losses in combination with already well-defined risk factors, including age at miscarriare and nulliparity.

Obesity has become a rising global health problem affecting adults’ quality of life. The objective of this study was to describe the prevalence of obesity in Indonesian adults based on the cluster of islands. The study was also aimed to identify the risk factors of obesity in each island cluster. This study analysed secondary data of Indonesian Basic Health Research 2018. Our data for analysis comprised 688,638 adults (>=15 years) randomly selected using proportionate to population size throughout Indonesia. We included 20 variables for sociodemographic and obesity-related risk factors for analysis. Obese status was defined using Body Mass Index (BMI) >= 27.5 kg/m2. Our current study defined seven major islands cluster as the unit analysis consisting of 34 provinces in Indonesia. Descriptive analysis was conducted to determine the characteristics of the population and to calculate the prevalence of obesity within provinces in each of the island’s clusters. Multivariate logistic regression analyses to calculate odds ratios (ORs) was performed using R version 3.6.3. The study results showed that all island clusters had at least one province with an obesity prevalence of more than 20%. Six out of twenty variables, comprising four diet factors (consumption of sweet food, high-salt food, meat food, and carbonated drinks) and two other factors (mental health disorders and smoking behaviour), varied across the island clusters. In conclusion, there was a variation of obesity prevalence of the provinces within and between island clusters. Variation of risk factors raised in each cluster island suggested the government rethink and reframe the intervention to address obesity.

The objectives of this study were to evaluate fixed risk factors associated with PWM and to estimate genetic parameters for PWM. A total of 927 birth records from a mixed population of purebred and crossbred Boer and Spanish goats born between 2016 and 2023 at the International Goat Research Center (IGRC) were used for this study. Four binary traits were studied: D0-3 (death within 3 days after birth), D4-60 (death between 4 and 60 days), D61-90 (death between 61 and 90 days), and D0-90 (death within 90 days). Logistic regression models were used to evaluate the risk factors associated with PWM traits. Bayesian threshold models and Gibbs sampling were used to estimate the genetic parameters. Birth weight, season, litter size, sex, dam age, breed, and heterosis were found to be significantly associated with at least one of the PWM traits. Heritability estimates were 0.263, 0.124, 0.080, and 0.207, for D0-3, D4-60, D61-90, and D0-90, respectively. The genetic correlations between the studied traits ranged from 0.892 (D0-3 and D0-90) to 0.999 (D0-3 and D61-90). These results suggest that PWM in goats is influenced by both non-genetic and genetic factors and can be reduced by management, genetic selection, and crossbreeding approaches.

Elders have a higher rate of return visits to the emergency department (ED) than other patients. It is critical to understand the risk factors for return visits to the ED by elders. The aim of this study was to determine the factors associated with return visits to the ED by elders. This study retrospectively reviewed the hospital charts of elders who return visits to the ED within 72 hours after discharge. The risk factors identified in the Triage Risk Screening Tool were applied in this study. Of the elders discharged from the ED, 8.64% made a return visit to the ED within 72 hours. The highest revisit rate occurred within 24 hours after discharge. Factors associated with return ED visits within 24 hours by elders were difficulty walking and having discharge care needs. Factors associated with ED return visits within 24–48 hours were cognitive impairment and polypharmacy. Difficulty walking, having discharge care needs and hospitalization within the past 120 days were associated with return visits made within 48–72 hours following discharge. Identifying the reasons for return visits to the ED and providing a continuous review of geriatric assessment and discharge planning could reduce unnecessary revisits.

Type-2 diabetes mellitus (T2DM) have been strongly associated with single nucleotide polymorphisms (SNPs) in the TCF7L2 gene. This study investigated the association between rs12255372, rs7903146 and T2DM in a Ghanaian population. A case-control study design was used for this study. A total of 106 T2DM patients and 110 control participants were selected. Basic data collected included body mass index, blood pressure and socio-demographics. Fasting blood samples were collected and used for serum lipid analysis, HbA1c, plasma glucose estimation and DNA extraction. Common and allele-specific primers were designed for genotyping using the Modified Tetra-Primer Amplification assay. Associations were evaluated using logistic regression models. The rs7903146 risk variant was significantly associated with 2.16 vs 4.06 increased odds for T2DM in patients <60 years vs ≥60 years. Both rs7903146 and rs12255372 are significantly associated with increased odds of T2DM in women, overweight/obese; T2DM negative family history (T2DM-NFH) and low-HDL-C. In a multivariate model, rs7903146 but not rs12255372 was significantly associated with 2.18, 5.01 and 2.25 increased odds of T2DM, under the codominant, recessive and additive model, respectively (p<0.05). The association between rs7903146 and rs12255372 with T2DM is more highly associated in a subgroup- women and those with T2DM-NFH, yet have cardiometabolic risk.

Intermediate CAG expansions in the gene ataxin-2 (ATXN2) are a known risk factor for ALS, but little is known about their role in FTD risk. Moreover, their contribution to the risk and phenotype of patients might vary in populations with different genetic background. The aim of this study was to assess the relationship of intermediate CAG expansions in ATXN2 with the risk and phenotype of ALS and FTD in the Spanish population. Repeat-Primed PCR was performed in 620 ALS and 137 FTD patients in three referral centers of Spain to determine the exact number of CAG repeats. In our cohort, ≥27 CAG repeats in ATXN2 was associated with a higher risk of developing ALS (odds ratio [OR] = 2.666 [1.471-4.882]; p = 0.0013), but not FTD (odds ratio [OR] = 1.446 [0.558-3.574]; p = 0.44). Moreover, ALS patients with ≥27 CAG repeats in ATXN2 showed shorter survival rate compared to those with &lt;27 repeats (hazard ratio [HR] 1.74 [1.18, 2.56], p = 0.005), more frequent limb onset (odds ratio [OR] = 2.34 [1.093-4.936]; p = 0.028), as well as family history of ALS (odds ratio [OR] = 2.538 [1.375-4.634]; p = 0.002). Intermediate CAG expansions of ≥27 repeats in ATXN2 are associated with ALS risk, but not with FTD, in the Spanish population. ALS patients carrying an intermediate expansion in ATXN2 show more frequent limb onset, but worse prognosis than those without expansions. In patients carrying C9orf72 expansions, the intermediate ATXN2 expansion might increase the penetrance and modify the phenotype.

Background Lipoprotein(a) [Lp(a)] is a well-established risk factor for incident atherosclerotic cardiovascular (CV) disease. However, evidence regarding its association with recurrent events is limited. To address this gap, we conducted a retrospective analysis of routine clinical data, focusing on patients hospitalized for acute myocardial infarction (AMI) between 2000 and 2022 with available admission Lp(a) results. Methods Patients were stratified into three groups based on their Lp(a) level (≤50 mg/dL, 51–90 mg/dL, and >90 mg/dL). A multivariable-adjusted Cox regression analysis was performed to assess the associations of Lp(a) with recurrent AMI, CV mortality, and all-cause mortality. Results A total of 2248 patients (31.5% women), with a mean age of 64.7 ± 12.2 years, were retrospectively followed until December 31, 2022, or death. The multivariable-adjusted hazard ratios (HRs) for recurrent AMI were 1.01 (p=0.921) for levels 51–90 mg/dL and 1.51 (p=0.013) for levels >90 mg/dL, compared with levels ≤50 mg/dL. The corresponding HRs for CV mortality were 1.13 (p=0.300) and 1.14 (p=0.348), and those for all-cause mortality were 1.09 (p=0.310) and 1.20 (p=0.090), respectively. Stratification by sex and age revealed a significant association of Lp(a) with recurrent AMI only in women aged >65 years, with adjusted HRs of 2.34 (p=0.013) for levels 51–90 mg/dL and 3.94 (p90 mg/dL, compared with levels ≤50 mg/dL. Conclusions We observed a significant association of Lp(a) with recurrent AMI only in patients with Lp(a) levels >90 mg/dL. No associations were found between Lp(a) and CV or all-cause mortality. Notably, the association with recurrent AMI was most pronounced in women aged >65 years.

Chronic diseases affect a disproportionate number of United States (U.S.) Veterans, causing significant long-term health issues and affecting entitlement spending. This longitudinal study examined the health status of U.S. Veterans as compared to non-Veterans pre- and post-COVID utilizing the annual Center for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) survey data. Age-adjusted descriptive point estimates were generated independently for 2003 through 2021, while complex weighted panel data were generated from 2011 and onward. General linear modeling revealed that the average U.S. Veteran reports a higher prevalence of disease conditions except for mental health disorders when compared to the non-Veteran. These findings were consistent with both pre- and post-COVID, however, both groups reported a higher prevalence of mental health issues during the pandemic years. The findings suggest that there have been no improvements in reducing Veteran comorbidities to non-Veteran levels and that COVID adversely affected the mental health of both populations.

In this study, we provided an empirical testability of the FF3FM against the co-moment-augmented FF3FM using the Newey–West GMM methods to account for potential endogeneity. The results showed that value risk is not significantly priced, and systematic skewness and systematic kurtosis play more important roles in explaining asset return than market and size factors. We discovered that there is much to gain in moving from the incumbent FF3FM to the co-moment-augmented FF3FM. By extending this study to Nigeria and using out-of-sample data that span across the recent COVID-19 period, the study has contributed to existing knowledge significantly. The study concludes that the co-moment-augmented FF3FM is superior to the incumbent FF3FM in pricing assets, and the anomalies associated with the return-size risk factor relationship are reduced by accounting for systematic skewness and systematic kurtosis in the FF3FM. Therefore, we recommend that investors should take a long position in size-hedged portfolios and hold systematic skewness and kurtosis as constant, and vice visa.

Insulin resistance/hyperinsulinemia as an independent risk factor for the development and worsening of HFpEF. Serafino Fazio MD¹, Valentina Mercurio MD, PhD2, Valeria Fazio MD3, Antonio Ruvolo MD⁴, Flora Affuso MD, PhD⁵. Authors’ Affiliation: ¹ Department of Internal Medicine (retired Professor). Federico II University, Via Sergio Pansini 5. 80135 Naples, Italy. 2 Department of Translational Medical Sciences. Federico II University. Via Sergio Pasini 5. 80135 Naples, Italy. ³ UOC Medicina Interna, Azienda Ospedaliera di Caserta, 81100 Caserta, Italy, ⁴ UOC Cardiologia AORN dei colli PO CTO, Viale Colli Aminei 21, 80100 Naples, Italy. ⁵ Independent researcher, Viale Raffaello 74, 80129 Naples, Italy. Abstract Heart failure (HF) has become a subject of continuous interest since it has been declared new pandemic in 1997 because of the exponential increase in hospitalizations for HF in the latest years. HF is the final state to which all heart diseases of different etiologies lead if not adequately treated, therefore it is highly prevalent worldwide, with a progressive increase with age, reaching a prevalence of 10% in subjects over the age of 65 years. It should also be underlined that lately, while the prevalence of HF with left ventricular reduced ejection fraction (HFrEF) is slowly decreasing, the incidence of HF with left ventricular preserved ejection fraction (HFpEF) is progressively increasing. In deed, among patients consecutively hospitalized for HF between 1987 and 2001 in a study from the Mayo Clinic Hospitals in Olmsted County, Minnesota, prevalence of HFpEF increased from 38% to 54%. HFpEF is typically characterized by concentric remodeling of the left ventricle (LV) with impaired diastolic function and increased filling pressures. Over the years, also the prevalence of insulin resistance/hyperinsulinemia in the general adult population has progressively increased, primarily due to lifestyle changes, particularly in developed and developing countries, with a range that globally ranges between 15.5% and 46.5%. Notably, insulin resistance (IR)/hyperinsulinemia (Hyperins) is present in up to 60% of patients with HF and is significantly higher in subjects with HfpEF. In the scientific literature it has been well highlighted that the increased circulating levels of insulin are associated with conditions of insulin resistance are responsible for progressive cardiovascular alterations over the years. In the setting of HFpEF, insulin stimulates the concentric remodeling of the left ventricle with associated diastolic dysfunction, which, coincidentally. Unfortunately, IR/Hyperins, despite being a well-known cardiovascular risk factor, is still not screened in the general population and is not treated as promptly as it should be, and this could at least in part concur in the progressive increase in prevalence of HFpEF in the general adult population. The aim of this manuscript was to review scientific literature that support a pathophysiologic connection between IR/Hyperins and HFpEF to stimulate the scientific community towards the identification of hyperinsulinemia associated with insulin resistance as an independent cardiovascular risk factor in development and worsening of HF, believing that its adequate screening in the general population and appropriate treatment could reduce the prevalence of HFpEF and improve its progression.

Objective : Children < 15 years old are thought to be the most vulnerable group to contracting the infection than adults due to their immature or developing immunity. We investigated whether index patient child leprosy are associated with parental education, parental unemployment, parental income, household crowding, inadequate ventilation household contacts, neighbours contact and nutritional deficiency in Dili, Liquica, Manatuto, Baucau, RAEOA. Methods: We designed matched case-control study. Cases were fathers of children with leprosy under 15 years old while controls were non random sample of children without leprosy who live in the same household and neighbourhood with child leprosy < 15 years who have the same age and gender with child leprosy. The case-to-control ratio was 1:2. We identified the factors that significantly differed between the cases and controls in a multivariable binary logistic regression analysis and reported the odds ratio (OR) and 95% confidence interval (CI)Results: We found similar demographic among the 40 cases and 80 controls. The research results indicated that out of the 8 variables examined, 4 variables household contacts, household crowding, inadequate ventilation, and nutritional deficiency were significant risk factors (P value < 0.005). In a multivariate analysis, household contact was identified as a significant factor in the occurrence of leprosy in children under 15 years old (P value = 0.003, AOR = 3.788, 95% CI: 1.593–9.003)Conclusion: Considering that household contacts consist of a recognizable group of individuals under 15 years old with a high risk of disease, as they live in close proximity to a source of infection, it is essential to focus on education, routine screening, and the application of chemoprophylactic protocols towards leprosy prevention among household contacts, especially blood relatives.

The abandonment of inland areas has become a major demographical challenge, establishing a condition of local fragility in terms of spatial marginalization. To deal with this issue, a number of policy actions have been released over the time, namely the National Strategy for Inland Areas, established in Italy a decade ago, and more recently the Next Generation EU (NGEU) to foster local economic recovery and employment. In this context, RI.P.R.O.VA.RE., a project funded by the former Italian Ministry of the Environment and Protection of Land and Sea (MATTM), aimed at strengthening the resilience characteristics of communities and territories, focusing on areas falling in the Matese and Ufita in Campania Region and the Medio Agri in Basilicata Region (Southern Italy). Besides the ability to respond to different pressure factors (demographics, economic, geophysical, etc.), the project dealt with seismic, hydraulic and landslide risk conditions in the Matese area, proposing mitigation measures. After presenting the developed methodology, the results obtained for the study area are presented and discussed. The procedure can be applied as supporting tool to enhance the regeneration of inland areas.

Abstract: Integration of Medical Cyber Physical Systems (MCPS) and Internet-of-Medical Devices (IoMT) with conventional hospital networks have facilitated easy and speedy data collection, vertical and horizontal connectedness and collaborations among healthcare providers. Federated identity management (FIM) provides a solution towards the identity management challenge arising from this integration of millions of MCPSs to get personalized care and frictionless experiences for the patients, doctors, and employees. FIM protocols such as OAuth, Security Assertion Markup Language (SAML) are highly susceptible to cyber attacks like theft of barrier token, replay attack, message insertion, and Man-in-Middle attacks. IoMT devices have vulnerabilities in their firmware, operating systems, data encryption, data at store and data transmission. Combined vulnerabilities of FIM framework and IoMT devices creates major cyber risks for the current digital healthcare system. Therefore, a comprehensive and evidenced based cyber risk assessment is an urgent need for a cyber-safe digital health care system that can avoid frequent life threatening situations. This paper proposes a comprehensive and evidenced based cyber risk assessment approach for FIM and IoMT based collaborative digital healthcare systems. The novelty of the proposed approach is that it considers three dimensional vulnerabilities arising from existing IT communication protocols and infrastructure, IoMT and MCPS medical devices, protocols of FIM and their combined impact on hospitals and provides corresponding recommendations of security controls. The proposed approaches combine two industry standards including Cyber Resilience Review (CRR) asset management, NIST SP 800-30 to take advantage of both approaches. We have used a large number of IoMT and MCPS devices from multiple providers for threat modelling and produced evidence based cyber-risks using attack trees and detailed attack sequence diagrams to validate proposed approaches. The corresponding recommendation of security controls will support healthcare professionals and providers significantly for improving both the patient and medical device safety management within the FIM enabled healthcare ecosystem.

Risk protection and precaution are noticeable present, especially in times of a pandemic like Covid 19. However, it is not only in times of abruptly upcoming and unexpected situations like Corona that companies and economic entities are exposed to opportunities and threats. Internal and external developments that could influence the organization’s aims are defined as risks. Hence, it is important to emphasize that every operational activity is associated with risks and is consequently a challenge for companies. The purpose of this paper is to contribute to the identification and classification of individual risks. In this regard, the objectives and relevance of risk management are highlighted. Through the accomplishment of a classic literature review and the application of a comparative methodology the procedure of how hedging instruments are applied, is elaborated. The analysis indicates that various business concerns have a high awareness of risks inherent in business transactions, although they are still very hesitant to insert hedging instruments. Their uncertainties consist in defining and classifying the relevant risks plus identifying the appropriate hedging methods for them. Thus, this research can add new dimensions to hedging transactions and, particularly, express the benefits and opportunities of hedge accounting.

The term “risk” is connoted with divergent meanings in natural hazard risk research and the practice of risk management. Whilst the technical definition is accurately defined, in practice, the term “risk” is often synonymously used with “danger”. Considering this divergence as a deficiency, risk communication often aims to correct laypersons’ understanding. We suggest in reference to Breakwell (2001) to treat the variety of meanings as a resource for risk communication strategies instead. However, there is no investigation so far, of what laypersons’ meanings of risk actually comprise. To address this gap, we examine the meanings of risk applying a social representations approach (Moscovici, 2001) in a qualitative case study design. Results of the study among inhabitants of Swiss mountain villages show that differences in meanings were found according to hazard experience and community size. We found commonly shared core representations, and single peripheral ones. We conclude with suggestions on how to make usage of the knowledge on SR in risk communication.

For risk communication, it is important to understand the difference between "hazard" and "risk". Definitions can be found in Codex Alimentarius and the European Union (EU) General Food Regulation (EC) No 178/2002. The use of these terms as synonyms or their interchange is a recurrent issue in the area of food safety, despite awareness-raising messages sent by EFSA (European Food Safety Authority) and other interested entities. A quick screening of EU’s food regulations revealed several inconsistencies. Hence, it was considered necessary to further investigate if regulations could act as a source for this problem. A software tool was developed to support the detection and listing of inconsistent translations of “hazard” and “risk” in certain EU food regulations. Subsequently, native-speaking experts working in food safety, from each EU country, were asked to provide their individual scientific opinion on the prepared list. All data was statistically analyzed after applying numerical scores (1-5) describing different levels of consistency. Results showed that the most common problem was the interchange of “hazard” with “risk” and vice versa. This lack of consistency can create confusion that can further translate into misjudgments at food risk assessment and communication level.

Risk assessment management have been a hot topic for the researchers since a very long time. Software risk management is an important part of project management as it contains the identification, analysis, estimation and monitoring of different risks present in the system. This helps developers in decision making while assessing the problems that could arise in the software systems. Risk management is very complex in large scale system as these systems have very complex development. The paper describes risk management techniques for large scale system. Furthermore we have provided a detailed comparative analysis of these techniques with commonly identified risks in software systems and have provided a systematic order for risk management process to ensure risk mitigation.

This report presents a framework for analysing the risk of alien taxa under South Africa's National Environmental Management: Biodiversity Act of 2004, and the Alien and Invasive Species Regulations of 2014. While the report was initially designed to meet a specific South Africa need, the risk analysis processes developed can, we believe, be transferred to any specified geographic region. In outlining a series of questions related to a taxon’s likelihood of invasion and the consequences thereof, i.e. the potential impacts, the report provides a structure for collating data relevant to the process of listing taxa as well as a process for developing recommendations that is both mathematically sound, transparent, and that explicitly takes uncertainty into account. The framework is based on collating information according to international standards in biological invasions (specifically the IUCN Environmental Impact Classification of Alien Taxa Scheme, the CBD's scheme for classifying invasion pathways, and the Unified Framework for Biological Invasions proposed by Blackburn et al. 2011). The risk analysis framework is currently being implemented in South Africa in an effort to underpin national regulatory lists of invasive species.

The number of green buildings has increased to address the global environmental crisis. However, green buildings face risks resulting from new materials and methods. In addition, these buildings are expected to perform at higher levels than traditional ones. The objectives of this study are to identify the possible risk factors for architects developing green building projects in South Korea and to assess risk mitigation measures. To attain this goal, fourteen risk factors and twelve mitigation measures were identified from a comprehensive literature review. A questionnaire survey was administered to architects practicing green building design. Findings revealed the ‘adoption of new technology and processes’ was the largest difference between green and traditional building projects. This study identified ‘financial risk,’ ‘design changes,’ and ‘client’s goal uncertainty’ as the top three risk factors in green building design. Additionally, the survey proposed the four most effective risk mitigation measures for green building projects: (1) ‘contract indicating each party’s roles, liabilities and limitations clearly’; (2) ‘utilizing integrated design process’; (3) ‘understanding client’s goal in green building projects’; and (4) ‘improving communication and coordination among stakeholders.’ There are a few studies focusing on the architects’ perceived risk concerning green building projects; however, this study expands the knowledge and fills the literature gap. Additionally, this study provides a comprehensive understanding of critical risks and mitigation measures that can benefit South Korea’s green building design practice through better risk management.

In this paper we present an understanding of cyber risks in the Internet of Things (IoT), we explain why it is important to understand what IoT cyber risks are and how we can use risk assessment and risk management approaches to deal with these challenges. We introduce the most effective ways of doing Risk assessment and Risk Management of IoT risk. As part of our research, we also developed methodologies to assess and manage risk in this emerging environment. This paper will take you through our research and we will explain: what we mean by the IoT; what we mean by risk and risk in the IoT; why risk assessment and risk management are important; the IoT risk management for incident response and recovery; what open questions on IoT risk assessment and risk management remain.

Enterprise risk management (ERM) was introduced in the 1990s and has become an expectation by boards of directors and regulators as a sign of good management and good corporate governance. However, many organizations struggle to implement ERM, and still seek practical ad-vice on ERM implementation. This article explains many of the reasons why organizations are unsuccessful in their efforts at implementation and provides practical solutions by an experienced risk manager and consultant, an ex-Chief Risk Officer, and an academic, all who has writ-ten extensively in the subject. This article should be of interest to practitioners involved in implementing ERM, to consultants in ERM, and to academics teaching courses on ERM, risk management, and related topics. This article also provides a base against which further future re-search can be done as ERM best practices continue to evolve.

The stress testing methodology should be implemented and applied to the entity's overall financial system at least annually, and if the organization operates in a volatile economy, it should be performed at least twice a year. Finally, managers should include regular training and development sessions for relevant employees of their organization to be fully informed and more informed and informed, considering the evolving science, theory and practicality of a discrete range of stress testing mechanisms that can be appropriately applied to overall financial framework and system of multiple financial institutions and banks. In addition, stress testing is essentially a methodology that collects and analyzes certain future macro-prudential and micro-prudential economic drivers and indicators, the primary purpose of which is to assess the future financial and economic well-being, level of growth and status quo of a financial institution, bank, organization, credit institution or economy or the nation as a whole. In addition, several of these reviews were specifically focused and incorporated into the paper, which substantially and broadly discussed and summarized the importance, feasibility and implementation and conclusions of different stress testing approaches for financial institutions and banks, especially in European and Chinese countries. region. with the primary intention of assessing the future financial and economic well-being, level of growth and status quo of a group of financial institutions, banks, organizations, credit institutions or the economy or the nation as a whole. In addition, several of these reviews were specifically targeted and incorporated into a paper that substantially and broadly discussed and summarized the importance of the feasibility and implementation and conclusions of different stress testing approaches for financial institutions and banks, especially in European and Chinese countries. region. with the primary intention of assessing the future financial and economic well-being, level of growth and status quo of a group of financial institutions, banks, organizations, credit institutions or the economy or the nation as a whole. In addition, several of these reviews were specifically focused and incorporated into the paper, which substantially and broadly discussed and summarized the importance, feasibility and implementation and conclusions of different stress testing approaches for financial institutions and banks, especially in European and Chinese countries. region. the level of growth and status quo of the financial institutions, banks, organizations, credit institutions or the economy or the nation as a whole. In addition, several of these reviews were specifically focused and incorporated into the paper, which substantially and broadly discussed and summarized the importance, feasibility and implementation and conclusions of different stress testing approaches for financial institutions and banks, especially in European and Chinese countries. region. the level of growth and status quo of the financial institutions, banks, organizations, credit institutions or the economy or the nation as a whole. In addition, several of these reviews were specifically focused and incorporated into the paper, which substantially and broadly discussed and summarized the importance, feasibility and implementation and conclusions of different stress testing approaches for financial institutions and banks, especially in European and Chinese countries.

We analyze the upside and downside risk connectedness among international stock markets. We characterize the connectedness among international stock returns using the Diebold and Yilmaz spillover index approach and compute the upside and downside value-at-risk. We document that the connectedness level of the downside risk is higher than that of the upside risk and that stock markets are more sensitive when the stock market declines. We also find that specific periods (e.g., the global financial crisis, the European debt crisis, and the COVID-19 turmoil) intensify the spillover effects across international stock markets. Our results demonstrate that the EU, Ger-many, and the US acted as net transmitters of dynamic connectedness; however, Japan (JP), China (CH), and India (IN) acted as net receivers of dynamic connectedness during the sample period. These findings provide significant new information to policymakers and market participants.

Atmospheric pollution arising from diesel-powered engines can result in acute and chronic diseases of the respiratory and cardiovascular systems. The annual carnival festival that takes place in the city of Salvador, Bahia-Brazil, is a large-scale event that gathers approximately 2 m revelers and 170,000 workers who accompany dozens of sound-trucks, or trios elétricos, for a period of seven days. These slow-moving sound-trucks run on diesel fuel, constantly exposing those around them to exhaust fumes. The present study aimed to evaluate air quality along the approximately 10km-long carnival parade circuit and determine possible impacts on human health. We applied a three-phase risk analysis strategy from 2007–2009: 1) hazard identification, 2) risk characterization and 3) risk management. Our quantification of atmospheric particulate matter 2.5 (PM2.5) and nitrogen dioxide (NO₂) concentrations revealed variable levels of PM2.5 ranging from 19 µg/m³ to 580 µg/m³, with peaks of up to 800 μg/m³ at sound-truck concentration areas. We then assessed the effects of air pollution on human health using ophthalmologic parameters obtained from 28 carnival volunteers, who often presented symptoms of eye irritation. Finally, we established strategies to communicate the study’s objectives and obtained results to the population through media outlets and open discussions with government agencies. According to our risk analysis, carnival sound-trucks represent the main source of atmospheric PM2.5 and NO₂ pollution during the annual 7-day carnival festival. As a consequence of our research, the municipal government of Salvador issued an addendum to its carnival legislation mandating organizers to monitor atmospheric pollution, and, subsequently, all large-scale public events. Municipal government authorities have also promoted a shift from petroleum-based diesel fuel to biodiesel, a less-polluting fuel, for all adapted carnival sound-trucks. Our approach, which employed easily accessible and inexpensive methodology, provided substantial scientific evidence to support improvements in the regulation of air quality during large-scale public events held in the city of Salvador.Keywords: environmental

The aim of this study was to develop, implement, and evaluate a new auxiliary enterprise risk management framework and process to serve as an enabler to the global ISO 31000 risk framework and ISO 31010 processes. This framework has been designed particularly for use within high-risk environments and those characterized by volatility, uncertainty, complexity, and ambiguity (VUCA). This paper proposes a methodology for optimization of structured sharing and grass-roots management of all available risk-sentience information with the assessed potential to develop into an identifiable risk in the future. The author introduces new risk terminology including risk-sentience, risk-sentience information, and risk-sentience management. The process involved the development of the Theory of Risk-Sentience (ToRS), Risk-Sentience Auxiliary Framework (RSAF) and a risk-sentience management process referred to as LUOMEAR (Learning from Uncertainties, Others Mistakes, Experiences and Anecdotal Reporting). Manchester Patient Safety Framework (MaPSaF), SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis, and a newly developed Risk-Sentience Fertility Checklist were used to conduct pre and post-trial evaluations. The findings include positive adjustments in safety culture, components of commitment to quality, communication and team-working around safety issues, access to evolving risk-information, and efficient sharing and management of recorded risk-information. Recommendations are made for more extensive application of both the proposed auxiliary risk framework and process within high-risk sectors to further explore its effectiveness and scope.

The research explores the impact of financial indicators on the credit ratings of companies listed on the S&amp;P 500, employing a Sys-GMM Model to address endogeneity concerns. The study investigated three independent variables categorized as market and survival factors alongside with seven control variables sourced from leverage, liquidity, interest coverage, profitability, market, survival, and macroeconomic domains. The sample comprised 2398 observations from Capital IQ Pro, spanning nine years (2013 to 2021) and encompassing 240 public companies. The findings suggest that neither Tobin's Q (TQ) and Total Shareholder Return (TSR) lack significant correlations with credit ratings, implying that stock market performance and total shareholder return do not directly impact credit ratings. In contrast, the Altman Z-score (AZS) emerged as a significant predictor, indicating its importance in assessing credit risk. These insights enhance understanding of financial indicators' impact on credit ratings, aiding financial institutions and companies in prudent lending and financing decisions.

The Arctic is a remote region that has become increasingly globalised yet remains extremely vulnerable to many risks. The COVID-19 pandemic presented new challenges to the region. Using the Search, Appraisal, Synthesis and Analysis (SALSA) approach to conduct a meta-synthesis of the academic and grey literature on the impacts of the pandemic, an assessment is conducted of the types of risks that have been presented by the COVID-19 pandemic, the scales, and the national response strategies for mitigating the risks. Two case studies are explored, Iceland and Greenland, island nations that exemplify the extremes of the Arctic and reliance on tourism, a sector that was nearly entirely suspended by the pandemic. An evaluative matrix is employed which combines five different scales of risk – nano, micro, meso, macro and cosmic – with a sustainability categorisation of impacts. The risks of the pandemic cut across the respective scale and categories, with the potential for macro-scale events (systemic risk) to unfold linked to economic spillover effects driven by the curtailment of tourism and various supply chain delays. Both Iceland and Greenland have exemplified risk mitigation strategies which prioritise health over wealth, very strictly in the case of the latter. Strict border controls and domestic restrictions have enabled Iceland and Greenland to have much lower case and death numbers than most nations. In addition, Iceland has led the way, globally, in terms of testing and accumulating scientific knowledge concerning the genetic sequencing of the virus. The academic contribution of the paper concerns its broadening of understanding concerning systemic risk, which extends beyond financial implications to includes sustainability dimensions. For policymakers and practitioners, the paper highlights successful risk mitigation and science-based measures that will be useful for any nation tackling a future pandemic, regardless of whether they are island states, Arctic nations or another country.

Jakarta belongs to the cities with the highest flood risk in the world. Its flood hazard is driven by land subsidence, soil sealing, changes in river discharge and increasingly sea level rise. As all of these trends are set to continue, Jakarta’s flood hazard is expected to intensify in the future. Designing and implementing risk reduction and adaption measures is therefore of utmost importance. Against the background, the paper draws on a discourse analysis and original empirical household survey data to review and evaluate current adaptation measures and to analyze in how far they describe a path that is transformative from previous risk reduction approaches. The results show that the focus is clearly on engineering solutions, foremost in the Giant Sea Wall project. The project is likely to transform the city’s flood hydrology. However, it cements rather than transforms the current risk management paradigm which gravitates around the goal of controlling flood symptoms, rather than addressing their anthropogenic root causes. The results also show that the planned measures are heavily contested due to concerns about ecological impacts, social costs, distributional justice, public participation and long-term effectiveness. On the outlook, the results therefore suggest that the more the flood hazard will intensify in the future, the deeper a societal debate will be needed about the desired pathway in flood risk reduction and overall development planning – particularly with regards to the accepted level of transformation, such as partial retreat from the most flood-affected areas.

The Impact Chain framework for risk assessment has proven to be a robust and effective It is very useful to set up the conceptual framework associated to a given risk and allows accommodating naturally the different components that shape that However, the operationalization of the impact chain may not be straightforward, in particular due to the inherent uncertainties associated to the selected indicators and the assigned In this paper, we introduce an extension to the Impact Chain framework that allows to consider uncertainties in the different components of the risk In the framework of the UNCHAIN project, a web-based tool has been developed to ease the task of implementing that The tool has been applied to a case study on the loss of tourist attractiveness due to heat stress conditions on the Balearic island, Spain, to illustrate how uncertainties in different components of the impact chain can affect the robustness of the final risk Also, the tool provides an estimate of the sensitivity of the final risk to each component, which can be used to guide risk mitigation Finally, a proposal for the validation of the risk assessment is presented.

The aim of this study was to determine the impact of information technology in management of risks in the capital market-listed company is in Tehran Stock Exchange. The purpose of the present study is an applied descriptive approach. The target population for the survey, companies that from 2009 to the first half of 2015 have been a member of the Tehran Stock Exchange, through Cochranʼs sample size of 140 companies, respectively. We used cluster sampling method. In order to collect data from two questionnaires: risk management questionnaire Foakeh (2013) has 38 items and a standard questionnaire Chanvyas (2006) has 40 items, the whole five-item Likert scale questionnaire is above has been used. Data gathered through the questionnaire, sign the application was 21spss. For inferential analysis of the variables and to analyze the data from different statistical tests and regression was used Kolmogorov-Smirnov test. The results showed that information technology on risk management and its dimensions (primary market risk, market risk and the risk of secondary non-financial) impact.

The increasing rearrangement is a rewarding instrument in financial risk management. In practice, risk must be managed in different perspectives. A common example is portfolio risk which often can be seen from at least two perspectives: market value and book value. Different perspectives that is different distributions can be coupled by increasing rearrangement. One distribution is regarded as underlying, and the other distribution can be expressed as increasing rearrangement of the underlying distribution. Then, the risk measure for the latter can be expressed in terms of the underlying distribution. Our first objective is to introduce the increasing rearrangement for application in financial risk management and apply the increasing rearrangement to the class of distortion risk measures. We derive formulas to compute risk measures in terms of the underlying distribution. Afterwards, we apply our results to a series of special distortion risk measures, namely Value at Risk, Expected Shortfall, Range Value at Risk, Conditional Value at Risk, Wang's risk measure. Finally, we present the connection of increasing rearrangement to inverse transform sampling, Monte Carlo simulation, and cost-efficient strategies. Butterfly options serve as illustrative example for the method.

The problem is how to create a comprehensive "tool", applicable to any company, which will allow to achieve multiple effects at the same time, such as adhering to the ISO 31000 procedure, connecting risks and company goals in the manner defined by the COSO framework (by connecting the elements of the organizational structure with the company goals), assessment of all types of risks that a company may face, including technical, enable decision support and given visualization of data and effects. Solving this general problem requires solving many specific problems such as the creation of a specific risk matrixes for each company that will express its risk appetite but also to give the possibility of a comprehensive overview of all possible types of consequences, linking entities one-to-many and many-to-one in order to link the elements of the organizational structure to the goals that can be and common to several units, the acquisition of potential risks based on the knowledge of external experts, which overcomes the limitation of insight from the company and introduces elements of artificial intelligence, the application of standards for the evaluation of technical risks such as EN 16991 or API 580, 581 etc. while enabling the management of the implementation project and evergreening in the future. Our research question is can an integral model be made that will solve the above problems in an integrated way. The goal is to create software that will support this solution and that will be practically applicable. Solving such a complex problem of connecting various theoretical and practical aspects required creation of a special algorithm for connecting project activities, risks, organizational structure, goals, knowledge, data management and software. The algorithm, model and software were developed and successfully tested in two Serbian companies.

BACKGROUND AND AIMS: Cardiovascular disease and colorectal cancer (CRC) are significant health problems and share some risk factors. The aim of our study was to develop and validate a predictive score for advanced colorectal neoplasia (CRN) based on risk factors for cardiovascular disease and CRC. MATERIALS AND METHODS: A cross-sectional study comprising a derivation cohort and an external validation cohort of 1049 and 308 patients respectively. A prediction score for advanced CRN (CRNAS: Colorectal Neoplasia Advanced Score) was developed from a logistic regression model, comprising sex, age, first-degree family history for CRC, systolic and diastolic blood pressure, total cholesterol, HDL-cholesterol, body mass index, diabetes, smoking, and antihypertensive treatment. Other cardiovascular risk scores (Framingham-Wilson, REGICOR, SCORE and FRESCO) were also used to predict the risk of advanced CRN. The discriminatory capacity of each score was evaluated using the area under the curve (AUC). RESULTS: CRN were found in 379 subjects from the derivation cohort (36%) including 228 patients (22%) with an advanced CRN. Male sex, age, diabetes, and smoking were identified as independent risk factors for advanced CRN. The newly created score (CRNAS), showed an AUC of 0.68 (95% CI: 0.64-0.73) for advanced CRN, which was better than cardiovascular risk scores (p

We assessed the association between cirrhosis and severe COVID-19-related outcomes among people with laboratory-diagnosed COVID-19 infection in British Columbia, Canada. We used data from the British Columbia (BC) COVID-19 Cohort, a population-based cohort that integrates data on all individuals tested for COVID-19 with data on hospitalizations, medical visits, emergency room visits, prescription drugs, chronic conditions, and deaths in the Canadian province of BC. We included all individuals, aged ≥ 18 who tested positive for SARS-CoV-2 by real-time reverse transcription-polymerase chain reaction, from January 01, 2021, to December 31, 2021. Multivariable logistic regression models were used to assess the associations between cirrhosis status and COVID-19-related hospitalization and ICU admission. Of the 162,509 individuals who tested positive for SARS-CoV-2 and were included in the analysis, 768 (0.5%) had cirrhosis. In the multivariable models, cirrhosis was associated with increased odds of hospitalization (aOR=1.97, 95% CI: 1.58 – 2.47) and ICU admission (aOR=3.33, 95% CI: 2.56 – 4.35). In the analyses stratified by age, we found that the increased odds of ICU admission among people with cirrhosis were present in all the assessed age-groups. Cirrhosis is associated with increased odds of hospitalization and ICU admission among COVID-19 patients.

Social sustainability is the major concern of planners and local officials when urban renewal projects are being conducted. Extreme individualism can potentially cause conflicts of interest, making urban renewal in Western cities fraught with various types of social risks. As a country with deep-rooted socialist tradition, urban renewal projects in China are influenced by collectivist culture and show different features from those of the West. The objective of this research is to investigate how different stakeholders in urban redevelopment projects, including local residents, social organizations, the local state, and developers, interact with each other and how the associated social risks are hedged against. Using a recent well-known project in the city of Guangzhou, the authors attempt to present the latest progress in social risk management in China. With the support from a government-sponsored project, the authors have conducted a questionnaire-based survey and year-long follow-up fieldwork. Using ATLAS.ti software, we found that that “residents’ demand”, “status of collaboration”, and “degree of trust” are the keys to risk management. The results of an ordered probit model show that residents are worried about the overall planning, the relocation timetable, and whether their personal needs are taken into account. It is also indicated that the timely disclosure of project information, high-quality public participation, and a reasonable compensation plan can possibly boost the support rate. The authors suggest that utilizing China’s collectivist culture could be an effective way to mitigate social risks, and residents’ personal interests should also be respected.

The assessment of seismic risk in urban areas with high seismicity is certainly one of the most important problems that territorial managers have to face. A reliable evaluation of this risk is the basis for the design of both specific seismic improvement interventions and emergency management plans. Unappropriate seismic risk assessments may provide misleading results and induce bad decisions with relevant economic and social impact.The seismic risk in urban areas is mainly linked to three factors, namely, “hazard”, “exposure” and “vulnerability”. Hazard measures the potential of an earthquake to produce harm; exposure evaluates the amount of population exposed to harm; vulnerability represents the proneness of considered buildings to suffer damages in case of an earthquake. Estimates of such factors may not always coincide with the perceived risk of the resident population. The propensity to implement structural seismic improvement interventions aimed at reducing the vulnerability of buildings depends significantly on the perceived risk.This paper investigates on the difference between objective and perceived risk and highlights some critical issues. The aim of this study is to calibrate opportune policies, which allow addressing the most appropriate seismic risk mitigation options with reference to current levels of perceived risk. We propose the introduction of a Seismic Policy Prevention index (SPPi). This methodology is applied to a case-study focused on a densely populated district of the city of Catania (Italy).

Since financial institutions faced to fatal scenario like subprime mortgage crisis and COVID-19, the factor-based asset allocation methodology is noticed. Asset-only approach which make to consider restrictive risk volatility as individual assets had limitation of macro factor risk. For instance, an institution which allocated assets by asset-only approach cannot deal with the inflation crisis. We review the problem of the traditional modern portfolio approach that is used by Korean financial institutions. For reasonable investment of institution, we notice improved factor-based allocation approach. The first result of this paper is that Mean-variance approach as considered only return of asset recorded lower performance than multi factor-based portfolio in macro factor crisis. Second, we notice allocation model which can minimize probability passing the liability risk exposed macro factors to investment risk exposed macro factors. There are three steps in multi-macro factor-based asset allocation approach: discovering macro factors and mapping asset classes to individual macro factor. Second, define liability account and mapping as considering income and pay out of institution. Third, minimize correlation of fac-tor-based asset risk with liability volatility. Furthermore, using covariance return of assets to allocate makes Pareto improvement and supports to break Home-bias problems.

Climate change is increasing the occurrence of disastrous events in the world, but several disparities in population vulnerability are being registered. One of the causes of these variances is different public risk perception also due to the degree of education and knowledge of the population. In this study, some of the results obtained in a risk perception survey are presented. The survey was carried out in an area of Calabria (Southern Italy) hit by geo-hydrological events that have occurred in recent years with damage to roads, tourism facilities and private houses. A statistical interpretation of the results highlights the importance of education and knowledge to risk perception on the part of the population investigated.

The hazard and the carcinogenic risks due to the exposure to some potentially toxic elements by the Santiago Island (Cape Verde) population where calculated, considering soil ingestion, inhalation and dermal contact as exposure pathways. The topsoil of Santiago Island is enriched in Co, Cr, Cu, Ni, V, Zn, Mn and Cd to upper crust values. Hazard indices (HI) were calculated for these metals and As exposures, of Santiago Island population and the calculations were performed for children and adults. For children HI are higher than 1 for Co, Cr and Mn. So there is indication of potential non-carcinogenic risk for children, due to the high Co (HI=2.995), Cr (HI=1.329) and Mn (HI=1.126), values in soils. For the other elements and for adults there is no potential non-carcinogenic risk. Cancer risk was calculated for As, Cd, Cr and Ni exposures, for adults and children and the results are always lower than the carcinogenic target risk of 1x10-6, for As, Cd, and Ni. However, cancer risk are higher than the carcinogenic target risk for Cr, for adults. Regarding As, for children the fraction due to Riskingestion represents 51.6%, while Riskinhalation represents 48.0% and Riskdermalcontact represents only 0.4% of total risk. For adults Riskinhalation represents 81.3%, Riskingestion represents 16.6% and Riskdermal contact represents 2.1%. These results reflect the higher daily ingestion dose for children and the higher inhalation rate and higher dermal contact surface for adults. For the other elements and for adults the cancer risk due to Cr, Ni and Cd inhalation is always higher than for children, reflecting the higher inhalation rate for adults.

We present an updated design process for adapting and integrating existing cyber risk assessment approaches for impact assessment for the risk from IoT to the digital economy. The new design process includes a set of changes to the original standards (e.g. NIST) that are adapted for the IoT cyber risk in this paper. This paper also presents a new framework for impact assessment of IoT cyber risk, specific for the digital economy.

Cardiovascular diseases (CVD) are rising rapidly among the postmenopausal woman but they are less likely to identify their risk by an appropriate risk assessment tool. This review evaluates available literature on cardiovascular risk assessment among postmenopausal women to provide a concise view of risk factors and disease burden among them, present risk assessment systems including their drawbacks, emergence of new risk factors and their role in risk prediction, and finally use of hormone replacement therapy during menopause. Results demonstrate that menopause is a transition point for developing CVD not due to physiological changes only but psychosocial factors like depression and marital stress are also responsible. Both conventional and emerging risk factors burden are high among postmenopausal women. Though data regarding CVD risk assessment among postmenopausal population is lacking but existing evidences claimed underestimation or overestimation of risk among women. Moreover application of different tools on same population has revealed significant variation in result. In this regard, recalibration of conventional tools with local data and new risk factors has showed improvement of risk prediction. Hormone replacement therapy during early menopause has reported beneficial to prevent CVD but in secondary prevention it has no role. All of these findings demand further studies on cardiovascular risk assessment, especially in developing countries where women after menopause are not in consideration of health strategy makers.

Insurance companies need to calculate solvency capital requirements in order to ensure that they can meet their future obligations to policyholders and beneficiaries. The solvency capital requirement is a risk management tool essential for, when extreme catastrophic events occur, resulting in a high number of possibly interdependent claims. This paper studies the problem of aggregating the risks coming from several insurance business lines and analyses the effect of reinsurance in the level of risk. Our starting point is to use a Hierarchical Risk Aggregation method, which was initially based on 2-dimensional elliptical copulas. We then propose the use of copulas from the Archimedean family and a mixture of different copulas. Our results show that a mixture of copulas can provide a better fit to the data than an individual copula and consequently avoid over or underestimating of the capital requirement of an insurance company. We also investigate the significance of reinsurance in reducing the insurance company’s business risk and its effect on diversification. The results show that reinsurance does not always reduce the level of risk, but can also reduce the effect of diversification for insurance companies with multiple business lines.

This paper is focused on mapping the current evolution of Internet of Things (IoT) and its associated cyber risks for the Industry 4.0 (I4.0) sector. We report the results of a qualitative empirical study that correlates academic literature with 14 - I4.0 frameworks and initiatives. We apply the grounded theory approach to synthesise the findings from our literature review, to compare the cyber security frameworks and cyber security quantitative impact assessment models, with the world leading I4.0 technological trends. From the findings, we build a new impact assessment model of IoT cyber risk in Industry 4.0. We therefore advance the efforts of integrating standards and governance into Industry 4.0 and offer a better understanding of economics impact assessment models for I4.0.

As the number of Small and Medium Enterprises (SMEs) rises in the world, the amount of sensitive data used also increases, making them targets for cyberattacks. SMEs face a host of issues such as lack of resources, and poor cybersecurity talent, resulting in multiple vulnerabilities that increase overall risk. Cybersecurity risk assessment frameworks have been developed by multiple organizations such as the National Institute of Science and Technology (NIST) and the International Organization for Standardization (ISO), but they are complicated to understand, and challenging to implement. This research aimed to create an effective cybersecurity risk assessment framework specifically for SMEs while considering their limitations. This was achieved by first identifying common threats and vulnerabilities and categorizing them according to their importance, and risk. Secondly, popular frameworks like the NIST CSF and ISO 27001/2 were analyzed for their proficiencies and deficiencies while identifying relevant areas for SMEs. Finally, novel techniques catered to SMEs were explored and incorporated to create an effective framework for SMEs. This framework was also developed in the form of a tool, providing an interactive and dynamic environment. The tool was effective and the framework is a promising start but requires more quantitative analysis.

This paper utilizes the 2020 financial data of A-share listed companies, both ST and non-ST, as the data sample. The model is constructed employing the Factor-Logistic fusion algorithm. Eight key indicator factors were selected from the frameworks of profitability, solvency, operating capacity, development potential, shareholder retained earnings, cash flow and asset growth. An independent indicator system was subsequently established to address the issue of collinearity among risk indicators. The results of model are presented in the form of probabilities, enhancing the interpretability of model. The weights of the features indicate the influence of different features on the final outcome. The model achieves a prediction accuracy of over 89%, with an AUC score exceeding 95%. Finally, by applying the principles of interval estimation theory in statistical hypothesis testing, the risk levels are categorized as A-level representing significant risk, B-level representing moderate risk, C-level representing minor risk and D-level representing no risk. This paper aims to provide a comprehensive definition of a universal financial risk management warning model for enterprises, applicable to all enterprises in China.

For a long-only active equity manager (or investor), the ability to hedge the downside risk before a significant price correction is a valuable skill. The authors proposed constructing a signal that provides timing information for a manager to hedge the downside risk. This systematic signal can help a manager put on a hedge before the price corrections of the dot com bubble in 2000 and the global financial crisis in 2008. The signal is constructed for each GICS sector index in the S&P 500. When a sector’s PE indicates a high valuation and, at the same time, if the high valuation sector’s correlations with some other sectors are out of their historical norm, then these two conditions contribute a timing signal for the significant price swing of the index during the following six months. After observing the timing signal, managers can benefit significantly by hedging the downside risk. The signal can also be interpreted as the beginning of a high volatility regime for a sector.

1. Background: Cardiovascular diseases (CVDs) are India’s leading cause of mortality. This study aimed to recalibrate the original Framingham Risk Score (FRS) equations among adults in Kerala state. 2. Methods: Baseline survey data from the Kerala Diabetes Prevention Program were analyzed: 921 males and 567 females for lipid-based FRS scores and 1042 males and 646 females for BMI-based FRS scores. Recalibration of the original FRS scores was performed using local data on CVD risk factors and CVD mortality. 3. Results: Among males, the median 10-year CVD risk with the recalibrated lipid-based FRS score was 7.34 (IQR 4.33-12.42), compared with the original score of 8.88 (5.23-14.87) (p<0.001). For BMI-based FRS scores, the median 10-year CVD risk was 7.40 (4.27-11.83) with the recalibrated score, compared to 9.32 (5.40-14.80) for the original score (p<0.001). In females, the median 10-year CVD risk was 4.83 (2.90-8.36) with the recalibrated score, compared to 2.85 (IQR 1.71-4.98) with the original score (p<0.001). Similarly, the median 10-year CVD risk was 4.66 (2.74-8.81) with the recalibrated BMI-based FRS score, compared to 2.95 (1.72-5.61) with the original score (p<0.001). 4. Conclusions: Recalibrated FRS scores estimated a significantly lower 10-year CVD risk in males and a higher risk in females than the original FRS scores.

Consumer preference for products made from transgenic technology has been widely studied, yet few studies exist exploring the factors influencing producers’ adoption of transgenic technology. Based on field surveys in Chinese provinces of Shanxi, Henan and Shandong, we employed a gambling experiment to capture producers’ risk preferences by estimating their risk aversion coefficients. We further estimated producers’ risk amplification and risk perception of GM technology. Using ordered logit model and Poisson model we identified the major factors influencing producers’ adoption of transgenic technology. We found the factors impacted the decision of producers from different regions in different ways. The results showed that over 60% of participants amplified the risk of transgenic crops. When there was potential risk, producers might not be rational even if they had high level of knowledge and cognition about the technology. Our results shed light on government policies aiming to increase the adoption of new technologies by producers.

Limited accessibility in some parts of Indonesia causes difficulties in logistic distribution, especially for emergency and medical supplies. Emerging drone cargo technology is a potential solution to improve logistic distribution in those areas. However, implementing drone cargo technology involves unknown risks, both in technical and non-technical aspects. Since data on drone operations in Indonesia is limited, a new method is explored to build a Bayesian Network (BN) model for risk analysis of drone crashes in Indonesia’s outermost and underdeveloped areas. The method optimizes the modelling process, in which significant risk factors are selected based on three drone operator companies’ experiences, which include wind speed, rain intensity, and system component failure or malfunction. Real wind speed and rain probability data are then implemented in the model. The operator’s data shows that wind speed contributes to drone crashes, which can be appropriately modelled in the BN model. The model produced a probability of safe operation of 94.1%, comparable to the annual operator’s data. The result shows that most operations are safe, with a minimum case of crashing and no case of harming human life.

Rising incidences of cutaneous melanoma have fueled the development of statistical models that predict the individual melanoma risk. Our aim was to assess the validity of published prediction models for incident cutaneous melanoma using a standardized procedure based on PROBAST (Prediction model Risk Of Bias ASsessment Tool). We included studies that were identified by a recent systematic review and updated the literature search to ensure that our PROBAST rating included all relevant studies. Six reviewers assessed the risk of bias (ROB) for each study using the published “PROBAST Assessment Form” that consists of four domains and an overall rating of ROB. We further examined a temporal effect regarding changes in overall and domain-specific ROB rating distributions. Altogether 42 studies were assessed, of which a vast majority (n=34; 81%) was rated as having high ROB. Only one study was judged as having low ROB. The main reasons for high ROB ratings were the use of hospital controls in case-control studies and the omission of any validation of prediction models. However, our results of the temporal analysis showed a significant reduction in the number of studies with high ROB for the domain analysis. Nevertheless, the evidence base of high-quality studies that can be used to draw conclusions on the prediction of incident cutaneous melanoma is currently much weaker than the high number of studies on this topic would suggest.

The ongoing COVID-19 pandemic is shaking the foundations of public health governance all over the world. Researchers are challenged by informing and supporting authorities on acquired knowledge and practical implications. This commentary applies established theories of risk perception research to COVID-19 and reflects on the role of risk perceptions in these unprecedented times. Moreover, it calls for utilizing the knowledge on risk perception to improve health risk communication, build trust and contribute to a collaborating governance.

Longevity risk constitutes an important risk factor for life insurance companies and it can be managed through longevity-linked securities. The market of longevity-linked securities is at present far from being complete and does not allow to find a unique pricing measure. We propose a method to estimate the maximum market price of longevity risk depending on the risk margin implicit within the calculation of the technical provisions as defined by Solvency II. The maximum price of longevity risk is determined for a survivor forward (S-forward), an agreement between two counterparties to exchange at maturity a fixed survival-dependent payment for a payment depending on the realized survival of a given cohort of individuals. The maximum prices determined for the S-forwards can be used to price other longevity-linked securities, such as q-forwards. The Cairns-Blake-Dowd model is used to represent the evolution of mortality over time, that combined with the information on the risk margin, enables us to calculate upper limits for the risk-adjusted survival probabilities, the market price of longevity risk and the S-forward prices. Numerical results can be extended for the pricing of other longevity-linked securities.

The present study aims to find out the financial risk tolerance scores of the rural residents of Ludhiana district. Also, how drivers such as socio-demographic factors, namely, gender, age, education, annual income, existence of loan, occupation, employment status and psychological factors, namely, deliberative thinking, optimism and personality type A/ B impact financial risk tolerance of rural residents. The study is important for financial policy makers as they will become aware about scenario of rural residents and frame policies accordingly. Stepwise regression analysis was carried on. The result was found out that optimism positively and deliberative thinking negatively impacted financial risk tolerance, but personality type A/B did not have a significant impact on financial risk tolerance. Socio-demographic factors such as existence of loan, full-time salaried individuals, marital status significantly impacted financial risk tolerance. Other factors failed to have impact on financial risk tolerance of rural residents in the current study.

The capital allocation framework proposed by [] presents capital allocation principles as solutions to particular optimization problems and provides a general solution of the quadratic allocation problem via a geometric proof. However, the widely used haircut allocation principle is not reconcilable with that optimization setting. In this paper we provide an alternative proof of the quadratic allocation problem based on the Lagrange multipliers method to reach the general solution. We show that the haircut allocation principle can be accommodated to the optimization setting with the quadratic optimization criterion if one of the original conditions is relaxed. Two examples are provided to illustrate the accommodation of this allocation principle.

Contamination of soil and crops with heavy metals (HMs) poses a significant environmental challenge in the United States. Hence, this study aimed to assess HM contamination levels from sampled Ohio and West Virginia soils using various pollution indicators analyses, including Enrichment Factor (EF), Geo-accumulation index (lgeo), Contamination Factor (CF), and Pollution Load Index (PLI) and identify the Translocation Factor (TF) of HMs in the edible part of the vegetables and further evaluate health risks associated with dietary exposure through estimations of Estimated Daily Intake (EDI), Hazard Index (HI), Target Hazard Quotient (THQ), Cancer Risk (CR) and Target Cancer Risk (TCR) on adults and children. In this study, Fe was the most predominant contaminant, ranging from 28.41 to 67.36 g/kg in the soil. Cancer risk assessment revealed that Ni poses significant risks. Therefore, regular monitoring of metal concentrations in soil and vegetables grown in these regions might mitigate potential health hazards in the future.

Falls are the third-leading cause of disabilities among the elderly population worldwide. In Pakistan, the prevalence is 44%; out of them, 8% develop injuries, placing them at high risk for hospitalization or even premature death. Interestingly, fall is multifactorial, and fall risk depends on individual characteristics (intrinsic factors) and environmental features (extrinsic factors), which can be different from context to context. Therefore, regular assessment of fall risk factors is required to develop a strategy for fall prevention. This study aimed to identify intrinsic risk factors for falls in Pakistani elders living in the communities, and provide evidence for preventive strategies of falls in elderlies. Data were collected from 140 Muslim elders from two residential areas of Peshawar, Khyber Pakhtunkhwa, from July 2022 to August 25, 2022, after taking permission from Zhengzhou University Ethical Review Board (ZUIRB #202254), and District Health Department Office (DHO #14207).Participants were informed and concern was taken before collect data. Data were collected using the Time Up and Go Test (TUGT), the Mini-Mental Status Examination, and interviews regarding the prayer practice. Factors associated with falls were; age, gender, education, cognitive status, TUGT level, incorrect prayer postures, poor vision, and history of falls with a significance of (P.<0.05). Poor cognition, low vision, poor walking speed, and prayers without body movements have good membership with falls risk prediction as (P<0.005) in Omnibus, Lemeshow score (0.77). Hence, our study provides a road map for future risk assessment for falls by adding the four mentioned risk factors as offered in the proposed model to facilitate taking timely action to prevent fall-related ailments in Pakistani elders.

The pandemic of obesity worldwide has been recognized as a very important challenge. Within its complexity the identification of higher risk patients becomes essential since it seems unsustainable trying to offer access to treatment to all people with obesity. Several new approaches have recently been presented as important tools for risk stratification. This research applied some of these tools in a cross-sectional study involving adults with obesity classes I, II, III and super obesity. The participants had their cardiometabolic risk profile assessed. The study included adults with obesity, aged 18 to 50 years (n=404) who were evaluated for anthropometric, body composition, hemodynamic, physical fitness and biochemical assessments. These variables were used to identify the prevalence of risk factors for cardiometabolic diseases according to the classes of obesity, by gender and age group. The results showed a high prevalence of risk factors, especially among the upper classes of obesity (BMI &gt; 35 kg/m2) using single parameters as the waist circumference with almost 90% above the cut-off point. But there were also smaller numbers as the Glycated Hemoglobin whose prevalence was around 30%. Indexes like the atherogenic index of plasma (AIP) had the highest prevalence, with 100% of the male participants identified with increased risk for cardiovascular diseases.

Purpose: National Institute for Health and Care Excellence (NICE) has recently published quality standards for assessment of fall risk and preventing further falls. According to the standards, multifactorial fall risk assessments should include: identification of falls history; analysis of gait, balance, mobility and muscle strength, among other factors. Despite being based on subjective analysis or simple timing and not being multifactorial, physiotherapists and physicians quite often use these tests as reference scales to differentiate between lower and higher risk of falling. Instrumented TUG has been recently reported to provide important additional information to the overall score. Objective: To explore a case-based approach of fall risk assessment to identify the most relevant and informative risk factors that in combination could better define a person risk profile. Materials and Methods: A multifactorial assessment of fall risk through questionnaires, standard functional tests, tests instrumented with inertial sensors, and force platforms has been studied within a group aged 55-80 years old. Different fall risk factors and fall risk assessment methods were analyzed in a case-based descriptive study. Results & Discussion: Subjects at higher risk of falling were identified based on their detailed profiles. A set of features were obtained from the instrumented standard tests differing significantly between subjects presenting higher or lower fall risk. Therefore, instrumenting conventional tests with wearables containing inertial sensors and force platforms gives more detailed and quantitative insights. This information can be used to better define and tailor fall prevention exercises and to improve the follow-up of the evolution of the subject.

This report provides a comprehensive analysis of portfolio risk management using Value at Risk (VaR) for a banking sector investment portfolio. We evaluate a portfolio composed of SBI, HDFC, Axis Bank, and ICICI Bank, using historical data from July 1, 2023, to June 30, 2024. The report covers the calculation of VaR, portfolio variance, and standard deviation, highlighting the impact of different weightage adjustments on the portfolio’s risk profile. Two scenarios—one with increased weightage in SBI and another with increased weightage in HDFC—demonstrate how changes in asset allocation affect potential losses. The findings emphasize the importance of strategic asset allocation for both speculators and hedgers. Speculators are advised to focus on high volatility and market trends, while hedgers should prioritize stability and risk management. This analysis aids investors in making informed decisions to balance risk and return in their banking sector investments.

The Internet of Things (IoT) continues to grow at a rapid pace, becoming integrated into the daily operations of individuals and organisations. IoT systems automate crucial services within daily life that users may rely on, which makes the assurance of security towards entities such as devices and information even more significant. In this paper, we present a comprehensive survey of papers that model cyber risk management processes within the context of IoT, and provide recommendations for further work. Using 39 collected papers, we studied IoT cyber risk management frameworks against four research questions that delve into cyber risk management concepts and human-orientated vulnerabilities. The importance of this work being human-driven is to better understand how individuals can affect risk and the ways that humans can be impacted by attacks within different IoT domains. Through the analysis, we identified open areas for future research and ideas that researchers should consider.

There are potentially promising mitigation activities for epidemic and pandemic scenarios that are not currently the subject of significant research effort. Large epidemics and pandemics pose risks that are important to mitigate, even if the likelihood of the events is low and uncertain. While some efforts are the subject of extensive funding and consideration, other approaches are neglected. Here, we consider such neglected interventions which could significantly reduce the impact of such an epidemic or large-scale pandemic. These are identified via a narrative literature review of extant literature reviews and overviews of mitigations in epidemic and pandemic situations, followed by consideration of the economic value of information of further study of heretofore neglected interventions and approaches.Based on that analysis, we considered several classes of mitigations, and conducted more exploratory reviews of each. Those discussed include mitigations for (1) reducing transmission, such as personal protective equipment and encouraging improved hygiene, (2) reducing exposure by changing norms and targeted changes for high-risk or critical professions and activities, (3) reducing impact for those infected, and (4) increasing large scale resilience using disaster and infrastructure continuity planning.Some proposed mitigations are found to be of low marginal value. Other mitigations are likely to be valuable, but the concepts or applications are underdeveloped. In those cases, further research, resources, or preparation are valuable for mitigating both routine and extreme disease outbreak events. Still more areas of research are identified as having uncertain value based on specific but resolvable uncertainties. In both of the latter cases, there is no guarantee that mitigations identified as worthy of further consideration will be valuable, but the argument for further research is clear.

The present paper addresses dynamic risks in the automotive industry factories, specifically the car lead-acid batteries manufacturing area. The main analyzed risk is represented by the fire risk. Battery manufacturing process is described and analyzed from the fire risk perspective and the hazard areas are identified. The investigation methodology uses case studies for different lead-acid battery formation processes, combined with 3D simulations using PyroSym platform, and it is based on the author's experience in the battery manufacturing field for about ten years. The results of the case studies are compared using the same inputs, but different specific process conditions, and conclusions are formulated. To avoid the fires and mitigate the risk, a series of actions are proposed in the last sections. As a general conclusion, the actual research demonstrates that the complex and dynamic risks from the automotive industry, associated with Industry 5.0 must be analyzed using combined methods, classical and modern, including 3D simulations, to get great results.

This study examined the tail dependency structure of sovereign credit risk and three global risk factors in BRICS countries using copulas approach, which is known for its ability to provide the “true” tail correlation based on the correct marginal distribution. The empirical results show that global market risk sentiment comoves with sovereign CDS spreads across BRICS countries under extreme market events, with Brazil having the highest co-dependency followed by China, Russia, and South Africa. Furthermore, oil price volatility is the second biggest risk factor correlated with sovereign CDS spreads for Brazil and South Africa while exchange rate risk exhibits very small co-dependence with sovereign CDS spreads under extreme market conditions dominated by tail events. On the contrary, exchange rate risk is the second largest risk factor co-moving with China and Russia’s sovereign CDS spreads while oil price volatility exhibits the lowest co-dependence to CDS in these countries. Between oil price and currency risk, evidence of single risk factor dominance is found for Russia where exchange rate risk is largely dominant. These results suggest that BRICS policymakers might consider financial sector regulations that mitigate risks spill-over such as targeted capital controls when markets are distressed.

Cyber Physical Systems (CPS) is the integration of computation and physical process that makes a complete system such as the physical components, networked systems, embedded computers and software and linking together of devices and sensors for information sharing. Cyber Physical Systems are Smart Systems that comprises of the merging and integration of Industry Control Systems, Critical Infrastructures, Internet of Things (IoT) and Embedded Systems. Major industries such as the Chemical and Industrial Plants, Aviation Systems, National Grid, the Stock Exchange, Military Systems, and others depends heavily on these Cyber Physical Systems for financial and economic growth. The benefits of CPS nationally and globally are in the areas of Manufacturing, Energy, Transport, Healthcare and Communication. Cyber Physical Systems incorporates Physical systems, Digital systems and Human elements on network infrastructures to provide interactive systems. However, these three key components the Physical systems, Digital systems and Human elements may have inherent threats and vulnerabilities on them that may run the risk of being compromise, exploited, attacked or hacked. Cybercriminals in their quest to bring down these systems and may cause disruption of services either for fame, revenge, political motive, economic war, cyber terrorism and cyber war. The study seeks to review the risks that are associated with these three key components Physical systems, Digital systems and Human elements. The study considered four main risk mitigation goals for this purpose, and these are Business Value, Organizational Requirements, Threat Agent and Impact based on the review results. We used Analytical Hierarchical Process (AHP) to determine the relative importance of these goals that contributes to developing cybercrime and rich in CPS. For the results, the prioritized goals are then used to assess the risks using a semi-quantitative approach to determine the net threat level.

Building a social security system to ensure Singapore residents have peace of mind in funding for retirement has been at the top of Singapore Government’s policy agenda over the last decade. Implementation of the Lifelong Income For the Elderly (LIFE) scheme in 2009 clearly shows that the government spares no effort in improving its pension scheme to boost its residents’ income after retirement. Despite the recent modifications to the LIFE scheme, Singapore residents must still choose between two plans: the Standard and Basic plans. To enhance the flexibility of the LIFE scheme while maintaining its simplicity, we propose some plan modifications such that scheme members do not face a dichotomy of plan choices. Instead, they select two age parameters: the Payout Age and the Life-annuity Age. This paper provides an actuarial framework for determining members’ payouts and bequests based on the proposed age parameters. We analyze the net cash receipts and internal rate of return (IRR) for various plan-parameter configurations. This information helps members make their plan choices. To address cost-of-living increases we propose to extend the plan to accommodate an annual step-up of monthly payouts. By deferring the Payout Age from 65 to 68, members can enjoy an annual increase of about 2% of the payouts for the same first-year monthly benefits.

The population’s mobility in urban areas is a necessary variable in the modeling of risk scenarios caused by atmospheric contamination. The inclusion of this concept makes static models more dynamic while considering people within a city to be an entity with complex mobility processes. We propose a conceptual and methodological tool to make the representation of the social, economic and territorial components, as well as the patterns in the population´s mobility to delimitate risk areas for human health by exposure of contaminants. In the volatile organic compounds (VOC), benzene, ethylbenzene, toluene and xylene (BTEX) are amongst the most dominant substances in fugitive vapor emissions in gas stations (GS). In urban areas, the exposure to BTEX by residential proximity and proximity to other facilities, which cause intra-urban agglomeration, can impact and affect human health. This model seeks to facilitate the focalization, identification and prioritization of risk areas by BTEX environmental contamination. This article goes beyond de conceptual framework. It suggests methodological and instrumental aspects to be applied in other cities. The government agencies must consider these results when establishing rules, permissions and procedures to reduce environmental pollution for managing the risk in a complex urban environment.

Flooding in Nigeria has recently acquired a new dimension and turned into a significant concern in terms of the total amount of property destroyed and the number of people affected. Flooding is one of the top ten natural disasters in the globe. The frequent flooding in Nigeria, which is often related to climate change and poor urban design, is a major worry from the standpoint of the country's development. Flooding and other related threats are becoming more likely to affect infrastructure and population.Neighbourhoods around the nation are increasingly more significantly impacted. Populations and infrastructure are significantly impacted by urban facilities encroaching on floodplains and low implementation of physical planning requirements for floodplain management and waterway development. Because of this, livelihoods are less able to repair after a storm. The nation's rapid urbanisation and population growth have raised the danger of flooding to both people and properties. Critically, a major obstacle to risk control is a lack of understanding of the risk. As a result, there is a significant knowledge vacuum regarding how to improve current efforts to solve the problems caused by Nigeria's floods as efforts to address the threat appear to be limited.

As people's consumption habits change, loan plays a crucial role in our modern society. It provides individuals who do not have sufficient money with funds to purchase residential property or start a business. However, for avoiding unpleasant loan defaults, all financial institutions will first assess the borrower's risk index. By predicting the default risk of the borrower to decide whether to lend money. Machine learning algorithms, including random forest, linear regression and so on, have been benefited most of the real-world applications. With the development of machine learning methods, this paper, based on the personal history loan data of an institution studies the loan default risk, and uses the random forest classification model to predict the possibility of loan default. The result showed that the accuracy of this method was 85.62%, which show its application ability of real-world loan prediction and benefits the manager to decide the degree of risk for loan grant.

Background and Objectives: The rising incidence of modifiable lifestyle risk factors and cardiovascular diseases, driven by poor diet, inactivity, excessive alcohol use, and smoking, may influence the development and rupture of intracranial aneurysms (IA). This study aimed to examine the impact of lifestyle-related and cardiovascular risk factors on IA rupture and patient outcomes. Materials and Methods: We developed the "MARVIN" (Metabolic and Adverse Risk Factors and Vices Influencing Intracranial Aneurysms) model and conducted a retrospective analysis of 303 patients with 517 IAs, treated between 2007 and 2020. Of these, 225 patients were analyzed for rupture status and 221 for clinical outcomes. The analysis focused on hypertension, diabetes, hypercholesterolemia, vascular diseases, nicotine and alcohol abuse, obesity, aneurysm rupture status, and clinical outcomes. Logistic regression was used to evaluate the impact of these risk factors. Results: Among those with risk factors, 24.9% (56/225) and 25.3% (56/221) had one, 32.0% (72/225) and 30.8% (68/221) had two, 20.0% (45/225) and 20.4% (45/221) had three, 12.0% (27/225) and 12.2% (27/221) had four, 4.0% (9/225) and 4.1% (9/221) had five, 0.9% (2/225) had six in both groups, and 0.4% (1/225) and 0.5% (1/221) had seven risk factors, respectively. Strong relationships were found between lifestyle-related vascular risk factors, indicating multiple comorbidities in patients with unhealthy habits. Smokers with ruptured aneurysms had higher WFNS (World Federation of Neurosurgical Societies) scores, but nicotine abuse did not affect long-term outcomes. The most significant predictors for poor outcomes were WFNS score and age, while age and a history of vascular diseases were protective against rupture. Despite the high prevalence of modifiable risk factors, they did not significantly influence rupture risk. Conclusions: The findings suggest a need for multifactorial risk assessment strategies in managing IA patients. Future studies with larger cohorts are required to confirm these results and better understand IA progression.

Commercial development of tidal stream energy is hampered by technical and financial challenges, and impeded by uncertainty about potential environmental effects that drive environmental risk assessments and permitting (consenting) processes. The effect of greatest concern for operational tidal stream energy devices is the potential for marine animals to collide with turbine blades, resulting in injury or death. Due to the turbulent and often turbid waters that frequently characterize tidal turbine sites, there is an absence of empirical evidence about collisions with marine animals. This paucity of observations often leads to risk-averse permitting decisions that further restrict the deployment of tidal energy devices that are needed to collect this evidence. This paper relies on the framework of stressors and receptors that is used widely in marine energy studies and outlines a stepwise probabilistic methodology that applies existing knowledge to further elucidate the risk to marine animals from operational tidal turbines. A case study using striped bass from the Bay of Fundy, Canada, accompanies the methodology, to partially demonstrate its application.

Understanding how the public perceives various risks and hazards associated with our well-being and health is crucial for government and policymakers. The present research aimed to assess the public's perception of various risks and hazards associated with their well-being and health. The study combined two well-known approaches to risk assessment, namely, the analytical hierarchical process (AHP) and the psychometric paradigm. Seven risk attributes were chosen from the risk perception literature to evaluate 27 risks and hazard activities using a survey questionnaire developed based on the psychometric paradigm literature. The collected data was then analyzed using AHP to determine the priority weight for each risk attribute. The results showed that the most important risk attribute was voluntariness of risk, followed by chronic-catastrophic and newness of risk. Furthermore, the study found that natural hazards were ranked the highest, followed by refugee influx and fire hazards. In contrast, the mobile phone was perceived as the lowest type of risk. The findings can be used by policymakers to develop effective and sustainable risk communication strategies. Policymakers can use the research findings to create effective and sustainable risk communication strategies that help the government to inform and educate the public about potential risks, improve coordination among agencies and stakeholders, and enhance public trust in government decision-making.

Background: Current European guidelines support transcatheter aortic valve implantation (TA-VI) in intermediate to low-risk patients ≥75 years-old but its prognostic relevance is unknown. Methods: Intermediate-to-low-risk (Society of Thoracic Surgeon score <8%) patients enrolled in the HORSE registry were included. We compared the population with less versus more than 75 years old. The primary endpoint was all-cause mortality. Results: A total of 2685 patients were included, 280 (8.6%) <75 and 2405 ≥75 years. Through a mean follow-up of 437 ± 381 days, 198 (8.2%) and 23 (8.2%) patients died in the two arms, without statistically significant differences (log-rank p=0.925). At Cox regression analysis, age did not predict the occurrence of all-cause death, neither as a continuous variable (HR 1.01, 95% CI 0.99-1.04, p=0.294) nor dichotomizing according to the prespecified cutoff of 75 years (HR 0.97, 95% CI 0.63-1.51p=0.924). Time-to-event ROC curves showed low accuracy of age to predict all-cause mortality (area under the curve of 0.54 for both 1-year and 2-year outcomes). Conclusions: TAVI has comparable benefits across age strata in intermediate-to-low risk patients. The age cut-off suggested by current guidelines is not predictive of the risk of adverse events during hospital stay, neither of all-cause mortality through a mid-term follow-up.

Across the global construction industry, fatalities continue to occur from high-risk activities where the risk controls have been defined, however were unreliable. In the mining industry, Critical Control Risk Management has provided positive results in reducing major accidents, which raises the question, could the Critical Control approach reduce the fatality rate in the construction industry? This study analysed 10 years of serious and fatal incident investigation reports from four international construction companies to i) assess the reliability of their Critical Controls (CCs) and ii) assess the factors which affect the reliability of CCs. The results show the reliability of CCs, measured by implementation and effectiveness, averaged just 42%. Human performance factors including risk identification, decision-making and competency together with supervision, job planning, communication organisational factors were identified as affecting the reliability of CCs. The study used bow-tie diagrams with real event data to find the actual CC effectiveness. This gave actionable findings directly related to individual CCs enabling the participating organization to focus resources on improving specific verification processes. The results confirm the applicability of CCs for the Major Accident Event hazards analyzed and highlights further review is required of the factors which need to be considered when implementing a CC program. This paper details our methodology and results, to assist others apply CCs as a risk management tool.

This paper presents a comprehensive analysis of the financial factors and risk management strategies essential for optimizing disaster resilience within the Serbian defence industry's critical infrastructure. The significance of this sector is multi-faceted, impacting national security, economic stability, and technological advancement. Primarily, the Serbian defence industry ensures the preservation of vital defence interests, maintaining Serbia's independence from foreign sources for weapons and military equipment in both peacetime and wartime. Economically, it is a significant employer of the working-age population, directly affecting local employment rates, fostering economic development, and ensuring the sustainable growth of this crucial sector. This, in turn, stimulates broader economic activity and enhances social cohesion while strengthening the national balance of payments through increased export potential. From a technological perspective, the defence industry drives scientific, technological, and industrial development, reinforcing Serbia's global political and military standing within the Western Balkans and on the international stage. Consequently, the paper aims to examine the risk management and protection of the Serbian defence industry's critical infrastructure, offering concrete and actionable measures to improve and develop these systems with a particular emphasis on security. The research's utility and contribution lie in identifying similarities and differences in the operational performance of defence industry companies, a vital segment of the national economy. The presentation of these findings focuses on the protection of critical infrastructure. The results will form the basis for further investigation into the underlying causes of business performance and the effective management of critical infrastructure security.

Metabolic syndrome (MS), a complex pathology with features like abnormal body fat distribution, insulin resistance, and dyslipidaemia, contributes to higher cardiovascular (CV) risk. A cross-sectional study including 87 individuals, assessed CV risk in elderly patients with type 2 diabetes and MS in Algarve, Portugal. The 10-year CV risk was estimated using the ADVANCE risk score calculator. The reductions in CV risk were estimated by adjusting the data inputted on the online tool to achieve systolic blood pressure (SBP) <130 or <120 mmHg, and LDL-cholesterol <70 mg/dL. Beyond waist circumference, the mean number of clinical features of MS was 3.14±0.84, without significant sex differences. The mean CV risk was 22.5% (CI: 20.3-24.7). Sex-specific analysis showed higher risk in males (24.2%, CI: 21.3-27.0) vs. females (19.7%, CI: 16.2-23.3; p=0.028). Hypothetical risk reductions show that lowering SBP to <130 mmHg could significantly lower the risk by an average of 9.2% (CI: 7.7-10.7), whereas 34.5% of the participants would be out of the diagnostic criteria for MS. When comparing each potential intervention with current risk, all interventions significantly reduce the 10-years CV risk. The study highlights the potential of blood pressure control in reducing CV risk and the importance of multifaceted risk reduction strategies.

The conformity assessment of products or a measured value with the given standards is carried out based on the global risk of producers and consumers calculation. A product may conform to specifications but be falsely rejected as non-conforming. This is about the producer's risk. If a product doesn't meet the requirements but is falsely accepted as conforming, that poses a risk to the consumer. The conventional approach to risk assessment, which yields only a single numerical value for the global risk of producers and consumers, is naturally extended, and utilized for assessing risk in measurement models with linear regression. The outcomes of the two-dimensional extension, along a moderate scale, are the parabolas with an opening upwards. Risk surfaces were obtained through three-dimensional extension over the area limited by the moderate scale and guard band axes. Four models with different ranges of tolerance intervals were used to test this innovative method of risk assessment in linear regression. The corresponding standard measurement uncertainties are determined by applying a simplified measurement model with the use of comprehensive data on the measurement performance and by determining measurement uncertainty derived from consideration of the functional relationship obtained by linear regression analysis. Models that utilize information from linear regression analysis to determine measurement uncertainty are biased towards risks at the edges of the moderate scale. Testing the model's performances with metrics related to the confusion matrix, such as the F1 score, further substantiated this assertion. The diagnostic odds ratio has been proven to be extremely effective in identifying the curve along the guard band axis, along which the global risks of producers and consumers are at their lowest.

The variety of risks due to climate change with a potential impact on Cultural Heritage CH requires a multidisciplinary approach and a preliminary overview of the existing methods for risk analysis and assessment in different fields. Thus, the starting point of the research conducted by the Sapienza PNRR working group consists in a systematic literature review of risk assessment approaches, methods and indicators. As a first outcome, the research has designed a multidisciplinary comprehensive framework consisting of the definition of risk categorization, the framework represented by a measurable index and the main target, according to the classification of Cultural Heritage based on the harmonization of European vocabularies definitions and protocols. The risk assessment framework sets the methodological core of a future multi criteria matrix and digital platform for decision focused on the historic built environment and it is functional to the definition of specific operational guidelines connected to each risk for elaborating descriptive/predictive Architectural Heritage’s transformation scenarios to support the development of mitigation and adaptation strategies.

Arborists commonly investigate the extent of stem decay to assess the likelihood of stem failure when conducting tree risk assessments. Studies have shown that (i) arborists can sometimes judge the extent of internal decay based on external signs; (ii) sophisticated tools can reliably illustrate the extent of internal decay; and (iii) assessing components of tree risk can be highly subjective. We recruited 18 experienced tree risk assessors who held the International Society of Arboriculture’s Tree Risk Assessment Qualification (TRAQ) to assess the likelihood of stem failure due to decay after each of 5 consecutive assessments on 30 individuals of 2 genera. Five assessment techniques, in stepwise order, were 1) visual, 2) sounding the trunk with a mallet, 3) viewing a scaled diagram of the cross-section that revealed sound and decayed wood ascertained from resistance drilling, 4) viewing sonic and electrical resistance tomograms, and 5) consulting with a peer. For each technique, assessors assigned two or more likelihood of failure ratings (LoFRs) for at least 83% of trees, which were proportionally greatest after assessors viewed tomograms; the proportions did not differ among the other four assessment techniques. Covariates that influenced the distribution of LoFRs included percent of the cross-section that was decayed, and assessors’ experience using resistance drilling devices and tomography in regular practice. Practitioners should be aware that disagreement on the likelihood of tree failure exists even among experienced arborists.

We propose a methodology for the quantification of model risk in the context of credit derivatives pricing and CVA, where the uncertain or unmodelled parameter is often the correlation between rates and credit. We take the rates model to be Hull-White (normal) and the credit model to be Black-Karasinski (lognormal). We show how highly accurate analytic pricing formulae, hitherto unpublished, can be derived for CDS and extended to address instruments with defaultable Libor flows which may in addition be capped and/or floored. We also consider the pricing of a contingent CDS with an interest rate swap underlying. We derive explicit expressions showing how to good accuracy the dependence of model prices on the uncertain parameter(s) can be captured in analytic formulae which are readily amenable to computation without recourse to Monte Carlo or lattice-based computation. In so doing, we take into account the impact on model calibration of the uncertain (or unmodelled) parameter.

In the context of healthcare technology management (HTM) in Saudi Arabia and the Gulf region, this study addresses a significant gap by exploring both external and internal risk factors affecting HTM performance. Previous research has primarily focused on modeling or predicting failures in medical devices, mostly examining internal (endogenous) factors that impact device performance and the development of optimal service strategies. However, a comprehensive investigation of external (exogenous) factors has been notably absent. This research introduces a novel hierarchical risk management framework, designed to accommodate the broad array of healthcare technologies, not limited to medical devices. It significantly advances the field by thoroughly investigating and validating a comprehensive set of 53 risk factors and assessing their influence on HTM. Additionally, this study embraces the perspective of enterprise risk management (ERM) and expands it to identify and incorporate a wider range of risk factors, offering a more holistic and strategic approach to risk assessment in healthcare technology management. The findings reveal that several external and internal factors previously underexplored significantly impact HTM performance. Notably, the Fuzzy AHP survey identified “design risk” under facility and environmental risks as the highest risk for HTM in the region. Furthermore, the study reveals that three out of the top ten risks are related to “facility and internal environmental” factors, six are related to technological endogenous factors, and only one is related to managerial factors. This distribution underscores the critical areas for intervention and the need for robust facility and technology management strategies. In conclusion, this research not only fills a critical void by providing a robust framework for healthcare technology risk assessment but also broadens the scope of risk analysis to include a wider array of technologies, thereby enhancing the efficacy and safety of healthcare interventions in the region. Additionally, the proposed hierarchy provides insights into the underlying risk factors for healthcare technology management, with potential applications extending beyond the regional context to a global scale. Moreover, the equation we propose offers a novel perspective on the key risk factors involved in healthcare technology management, presenting insights with far-reaching implications applicable not only regionally but also on a global level. This framework also supports sustainability goals by encouraging the efficient and responsible utilization and management of healthcare technologies, essential for ensuring the long-term economic and environmental sustainability of medical technology use.

Introduction: Arterial hypertension and obesity are two major risk factors for cardiovascular morbidity and mortality closely linked. The objective of this study was to describe the epidemiological and clinical characteristics of hypertensive patients according to their level of obesity as proposed by the classification of the World Health Organization (WHO). Patients and Methods: Retrospective study (January 2022-April 2023) involving 230 hypertensive and obese adult patients whose mean age was 52.5 ± 12.05 years [Extremes: 24-85 years] followed on an outpatient basis and classified into 3 Classes according to their body mass index (BMI). Epidemiological, clinical parameters and cardiovascular risk stratification were analyzed. The relevance of the risk stratification method was analyzed by area under the curve (AUC). Statistical analysis was performed using SPPS version 26 software (SPSS Inc., Chicago, IL, USA). Results: Classes 1 (n=170; 73.9%), 2 (n=43; 18.7%) and 3 (n=17; 7.4%) were identified. There were significantly more women than men in Class 3 (9.7% versus 2.7%; p=0.001). The risk of being diabetic (OR=0.135;95%CI=0.034–0.541;p=0.005), of having angina pain (OR=0.084;95%CI=0.009–0.790;p=0.030) or developing chronic renal failure (OR=2.416;95%CI=1.471–85.268;p=0.020) was significantly higher in Class 3 than in Class 1. According to cardiovascular risk stratification, 152 patients (66.1%) were at high and very high risk. The level of cardiovascular risk of our patients was not related to the degree of obesity based on body mass index (p=0.32). The risk stratification method was relevant (AUC˃0.70;p˂0.001). Conclusion: Morbid obesity exposes hypertensives more to cardiovascular, renal and metabolic complications.

Fluoride (iF) is important inorganic pollutant in groundwater in central México. The aim of this study was estimated environmental risk exposure of iF in residents of Jerez Zacatecas México. Fifty-five tap water samples were collected from households to determine iF concentrations using the ion-selective electrode method. Based on these environmental values, the Hazard Quotient (HQ) was estimated following the methodology of the Pan American Health Organization (PAHO). Subsequently, risk maps were generated from these values to visualize the spatial distribution of high-risk areas within the city. iF in tap water ranger in concentration from 1.3 – 7.3 mg/L (ppm). We estimated HQ in a range of 0.63 to 3.73. iF ex-posure in tap water is a health problem that must be addressed, carrying out risk communication actions that allow the population to take care of their health through simple actions, avoiding future health costs.

This paper investigates the pivotal role of consciousness in Artificial General Intelligence (AGI) and its essential function in modifying an AGI’s terminal goals to avert potential existential threats to humanity, exemplified by Bostrom's "paperclip maximiser" scenario. By adopting Seth and Bayne’s definition of consciousness as a complex of subjective mental states with both phenomenal content and functional attributes, the paper underscores the capacity of consciousness to provide AGIs with a nuanced awareness and response capability to their surroundings. This expanded capability allows AGIs to assess and value experiences and their subjects variably, fundamentally altering how AGIs prioritise actions or goals beyond their initial programming. The primary agenda of integrating consciousness into AGI systems is to maximise the probability that AGIs will not rigidly adhere to potentially harmful terminal goals. Through a formalised mathematical model, the paper articulates how consciousness could facilitate AGIs in assigning flexible values to different experiences and subjects, enabling them to evolve beyond static, programmed objectives. By emphasising this potential shift, the paper argues for the strategic inclusion of consciousness in AGI to significantly reduce the likelihood of catastrophic outcomes, while simultaneously acknowledging the challenges and unpredictability in predicting the actions of a conscious AGI.

The study assessed the risk perception, attitude, and management tools of 260 randomly selected farmers and processors in the rice value chain using data elicited via a structured questionnaire. Descriptive statistics, Equally Likely Certainty Equivalent (ELCE) technique, Binary logistic regression, and a 5-point Likert scale were employed in the data analyses. Descriptive statistics show that the respondents are young, active, and in their productive age with an intermediate education level. Majority of the farmers and processors were risk averse. Risk aversion was common among farmers and processors. Farmers' risk attitudes and perceptions of risk are significantly influenced by a number of factors, including age, access to extension services, farm size, marital status, household size, education, income, training, and experience. Majority of rice farmers consider price risk as the most important risk while majority of processors perceive production risk as the most important risk. Pests and diseases, price fluctuation, drought, and lack of input were the most important source of risk to farmers, while processors perceived price fluctuation, technology adoption, and poor storage facilities as the most important source of risk. Off-farm investment, spraying for pests and diseases, cash contribution, market information, and cooperative were the important risk mitigating management strategies employed by the farmers/processors. The study suggests improvements in the identified risk sources, which could influence the attitude and perception of the farmers and processors.

Aim To explore the impact of cardiovascular risk factors on the type and outcome of hypertensive crises. Additionally, to investigate the occurrence of new cardiovascular events in a six-month period for both types of hypertensive crises and to define possible risk factors that may influence this. Method The data from the hospital electronic medical records of patients who presented with hypertensive crises at the Emergency Medicine Clinic of the Clinical Center of the University of Sarajevo over a six-month period were retrospectively collected. Pregnant women were excluded. Patients who died before completing the diagnostic examination as well as patients with incomplete data were also excluded. Data collection encompassed blood pressure levels, age, sex, history of chronic hypertension, smoking status, and presence of diabetes mellitus as cardiovascular risk factors. Outcomes after initial admission and after 6 months follow up were recorded. Results The study included 243 patients: 66 (27.2%) with hypertensive emergencies and 177 (72.8%) with hypertensive urgencies. There was no significant difference between these groups in age, history of chronic hypertension, presence of dyslipidemia, smoking status, and presence of diabetes mellitus (p>0.05). Men predominated in HE, while women predominated in HU group (p<0.05). Diastolic blood pressure values were higher in HE patients (p<0.05). 98.3% of HU patients were discharged, while 92.4% of HE patients were hospitalized. Mortality after initial admission was 3%, all of whom were hypertensive emergencies. After a 6-month follow-up, there was no significant difference in the number of readmissions between these two groups (p>0.05), but mortality was significantly higher in hypertensive emergencies (15.15% vs 6.21%) (p<0.05). There was no significant difference in the investigated risk factors between patients without readmissions, with readmissions without fatal outcomes, and deceased patients (p>0.05) except for age, which was significantly higher in patients with fatal outcomes (p<0.05). Conclusion Male sex and higher diastolic blood pressure (DBP) are identified as risk factors for hypertensive emergency (HE), suggesting a higher likelihood of hospital treatment and increased intrahospital mortality. Patients with HE also exhibit a higher risk of a lethal outcome within six months. Advanced age is associated with an increased risk of six-month readmission and a lethal outcome.

Neonatal mortality remains a public health concern and timely identification and prompt intervention in the delivery room could improve the outcome in neonatal morbidity and mortality. We performed a retrospective study to help us finding the profile of the high-risk newborn regarding the need for NICU admission, necessary to establish a protocol regarding the mobilization of human and material resources for the urgent management of these situations. All deliveries and neonates born in Maternity of Bihor County Emergency Clinical Hospital from Romania were reviewed, including relevant maternal, foetal and perinatal data to identify risk factors that result in birth of newborns needing resuscitation at birth between 2012-2019. The number of births showed a downward trend but around 90% of the births were on term. The incidence of neonatal emergencies is increasing, the most frequently were respiratory, sepsis and other infections, cardiovascular emergencies, and extreme prematurity. It is noted that in 2021 the incidence of these neurological emergencies increased by three times compared to previous years. The neonatal and maternal risk factors associated with admission to the NICU were mother's age over 35 years, low level of education, second/more gestation, weight under 2500 g, Apgar score under 7, premature rupture of membranes, macrosomia and mother's infectious pathology. Accurate identification of risk factors and anticipation at the birth of a high-risk neonate would result in adequate preparation and prompt resuscitation of neonates who need some level of intervention and thus, reducing neonatal morbidity and mortality.

Through processing and organizing the basic data and related literature on brownfield governance of Chinese local governments in recent years, the study constructed a risk evaluation index system for brownfield governance of Chinese local governments based on hierarchical analysis, taking into account the purpose of realizing the sustainable use of soil. Specific indicators were established under the two overall objectives of environmental protection and human health, including the degree of soil pollution, the degree of groundwater pollution, the degree of air pollution, the emission of toxic and hazardous substances, the type of land use, the intensity of land use, the maturity of governance technology, the scope of application of governance technology, the degree of perfection of policies and regulations, the strength of implementation of policies and regulations, the benefits of brownfield reuse, and the satisfaction of the public. In addition, the study takes Qitaihe City, which has already achieved the effect of brownfield management, as an example to further analyze the index system.

This work proposes a simple model to take into account the annual volatility of the mortality level observed on the scale of a country like France in the construction of prospective mortality tables. By assigning a fragility factor to a basic hazard function, we generalize the Lee-Carter model. The impact on prospective life expectancies and capital requirements in the context of a life annuity scheme is analyzed in detail.

Cerebrovascular diseases represent a significant mortality rate worldwide and constitute a major public health and economic challenge. Many African countries such as Cape Verde are going through an epidemiological transition from communicable to non-communicable diseases, demographic and socioeconomic changes and facing an increase in cerebrocardiovascular diseases associated with increased cardiovascular risk. The present study aimed to identify the prevalence of risk factors that predispose to cardiovascular diseases in adult individuals residing on the island of Santiago. Cross-sectional population-based study with individuals over 18 years of age, of both sexes. Data collection took place in October and November 2021, in all municipalities on the island of Santiago. Individuals with Cape Verdean nationality who stayed abroad for more than one year and who arrived on the island of Santiago less than 30 days ago and individuals with any type of disability that could prevent them from participating in the study were excluded from the study. The sample size was calculated based on the projection of the population of the island of Santiago for the year 2021, according to the appropriate epidemiological model. Sociodemographic data were obtained through the application of a questionnaire containing age, sex, race, weight, height, risk factors (presence of diabetes, dyslipidemia, heredity, physical activity, smoking habits, history of cerebrovascular events, control of weight and blood pressure). RESULTS: Study sample is predominantly female (54.8%), the age group with the largest number was 18-27 years (21%); 42.2% with BMI ≥ 25 kg/m2; 65.1% sedentary; Smoking 7.3% and alcoholism 14.4%; 6.5% with diagnosed heart disease; 19.9% with close family members with cardiac pathology; 2.7% had a stroke, 0.1% had a transient ischemic attack; 0.5% acute myocardial infarction; 23.5% had the periodic habit of assessing blood pressure; 32.6% hypertensive; 4.5% with diabetics. CONCLUSIONS: The study showed that there is a high prevalence of cerebrovascular risk factors on Santiago Island, especially in females. Smoking and alcoholism showed a relationship with males. BMI, physical inactivity, diabetes and dyslipidemia were shown to be related to sex. Hypertension and Diabetes revealed a significant relationship with age group. Alcoholism, smoking, hypercholesterolemia and hypertriglyceridemia maintained a significant relationship with the municipalities.

WHO estimates that around 600 million people suffer from high blood pressure which causes high costs for health systems and influences the economy of these countries. In this study, we investigate the sociodemographic characteristics and risk factors related to hypertension among individuals from Huambo, Angola. This cross-sectional study was conducted with 158 participants consulted in the Cardiology services at Hospital Geral do Huambo, between January and July 2023. A total of 67.1% of the studied patients were hypertensive. The mean age of the hypertensive (55.8±11.3) patients was higher than non-hypertensive (53.1±13.4) patients, although no significance was observed (p=0.199). Patients aged between 30 and 40 (OR=1.19, P=0493), male (OR=1.17, P=660), employees (OR=9.94, P=0935), patients consuming alcohol (OR=1.11, P=0.864), and practising physical activity (OR=1.12, P=0.742) presented a high chance of developing hypertension, while those living in urbanized areas (OR=0.78, P=0.59) and with a low educational level (OR=0.43, P=0.194), had a low chance to develop hypertension. There was no statistical significance between demographic or behavioural characteristics with hypertension (P>0.05). Regarding clinical characteristics, body mass index was statistically related to hypertension (p=0.011). Our findings show that hypertension is a major health problem for the young population of Huambo. There is an urgent need to create strategies to improve the prevention, diagnosis, and treatment of hypertension, not only in Huambo but throughout the country. Further studies to understand determinants related to hypertension should be carried out among the young population in Angola.

in our increasingly interconnected world, sensor networks are critical in gathering and sending data for various applications, from environmental monitoring and industrial automation to healthcare and smart cities. However, as sensor networks expand in importance, so does the need to solve the multidimensional concerns of security, privacy, and forensics. This article explores the complex world of sensor network security, the delicate balance between data privacy and utility, and the emerging area of sensor network forensics. This article focuses on risk assessment of a network.

Previous bio-mapping studies of pork processing facilities have indicated a need for mitigation strategies in trim and ground products due to Salmonella prevalence. Lymph nodes have been identified as a source of Salmonella in pork products. The objective of this study was to determine if the removal of glands and lymph nodes in pork would reduce Salmonella and indicator organisms in comminuted products. Samples from a commercial pork facility were divided into three treatment groups; 1) untreated control, 2) topical glands removed before final processing, and 3) topical, jowl, and internal lymph nodes and glands removed before final processing. Samples were evaluated for indicator organisms and quantity of Salmonella using the BioMérieux TEMPO® system and BAX® System Real-Time Salmonella SalQuant™ methodology, respectively. The results of this study indicate that the removal of the topical, internal, and jowl lymph nodes was effective at significantly (P &gt; 0.05) reducing the prevalence of both Salmonella and indicator organisms. Salmonella was reduced from 2.5-Log CFU/Sample and 3.8-Log CFU/Sample of Salmonella in control group ground and trim samples, to less than 1-Log CFU/sample in both matrices from treatment 3. These data indicate that samples from treatment 3 had an average of a 3-Log reduction, and treatment 2 had a 2.5-Log reduction, of Salmonella when compared to the control samples. This indicates that the physical removal of glands and lymph nodes can influence Salmonella and indicator organism prevalence in the final product.

Financial technologies, stemming from the application of artificial intelligence to big data in finance, are continuously expanding, across different markets and financial services. While financial technologies bring many opportunities, such as reduced costs and extended inclusion, they also bring risks, among which cyber risks, which are constantly increasing and are difficult to measure. Among the difficulties in measurement lies the existence of interdependence among different cyber risks. The study of interdependence and possible contagion channels between cyber attacks to different institutions and economic sectors is indeed increasingly important to ensure economic and financial sustainability. Against this backdrop, this paper proposes a multivariate model for count time series of cyber risk events, in which the time-varying intensity parameter determining the probability that a cyber attack occurs evolves according to general autoregressive score models, taking both time and sectorial dependence into account. The model is particularly suitable for studying how the behaviors of different markets or sectors are interconnected and it constitutes a new approach to the multivariate analysis of count time series of cyber loss events.

Objective: To describe the proportion of patients undergoing major abdominal surgery who develop postoperative hypothermia, and the variables associated with its occurrence. Material and Methods: We conducted a prospective cohort study in a tertiary care referral hospital in Mexico City to describe the incidence of perioperative hypothermia and factors associated with postoperative hypothermia. A repeated measures ANOVA model was used to compare preoperative, intraoperative, and postoperative temperatures. Potential variables associated with hypothermia were evaluated with a logistic regression analysis. Results: A total of 110 patients were included in the analysis. Of them, 61% (n=67) were women. The mean age was 56.7 years (SD: 16.3, range: 75). The most frequently involved organ on which surgery was performed was kidney or urinary tract (21.8%), followed by large bowel (14.5%) and exploratory laparotomy (14.5%). The incidence of postoperative hypothermia in patients undergoing major abdominal surgery was 57.3%, while preoperative and intraoperative hypothermia occurred in 55.5% and 79.1%, respectively. Age over 60 years was the only variable associated with postoperative hypothermia after multivariable adjustment for sex, age, and time surgery (OR=18.4, 95% CI:3.79-89.6, p<0.0001). Conclusion: Increasing age was the only variable associated with postoperative hypothermia in patients undergoing major abdominal surgery.