Nigeria is the most populous country in the African continent. The aim of this study was to analyze risk factors for COVID-19 prevalence and deaths in all 6 geopolitical regions and 37 states in Nigeria. We analyzed the data retrieved from various sources, including Nigeria CDC, Nigeria National Bureau of Statistics, Unicef-Nigeria multiple indicator cluster survey and the Institute of Health Metrics and Evaluation, University of Washington. We examined 4 clinical risk factors (prevalence of TB, HIV, smoking and BCG vaccination coverage) and 5 sociodemographic factors (age ≥65, population density, literacy rate, unemployment and GDP per capita). Multivariate modeling was conducted using generalized linear model. Our analysis showed that the incidence of confirmed COVID-19 cases differed widely across the 37 states, from 0.09 per 100,000 in Kogi to 83.7 in Lagos. However, more than 70% of confirmed cases were concentrated in just 7 states: Lagos, Abuja, Oyo, Kano, Edo, Rivers and Delta. Case mortality rate (CMR) per million population also varied considerably, with Lagos, Abuja and Edo having CMR above 9. On bivariate analysis, higher CMR correlated positively with GDP and to a lesser extent with TB and population density. On multivariate analysis, which is more definitive, states with higher HIV prevalence and BCG coverage had lower CMR, while high GDP states had a greater CMR. This study indicates that COVID-19 has disproportionately affected certain states in Nigeria. Population susceptibility factors include higher economic development but not literacy or unemployment. Death rates were mildly lower in states with higher HIV prevalence and BCG vaccination coverage.

Prediction of the likely evolution in the traffic scenes is a challenging task because of high uncertainty of sensing technology and dynamic environment. It leads to failure of planning for intelligent agents like autonomous vehicles. In this paper, we propose a fluid-based physical model to present the influence of surrounding object's motion on driving safety. In our pipeline, the input sensor could be LiDAR, camera, or multi-modal data. We use a Kalman filter to estimate the state space of each detected object, and adopt the properties of stable fluid to build a riskmap based on the density field. The noisy state space are then modeled as the boundary conditions in the simulation of advection and diffusion process. We test our approach on the public KITTI dataset and find this model could handle the short-term prediction in case of misdetection and tracking failure caused by object occlusion, which shows promising in collision risk assessment on road scenes.

This study addresses the peculiarities of the generation of slope movements in the context of road infrastructures and provide a predictive mapping of susceptibility to movements on slopes adjacent to road infrastructures (rockfalls). An inventory of slopes movements was mapped. From the development of the inventory of constant cases of mobilization that is used as a dependent variable, two statistical models can be obtained and compared for the same study area. One of them is based on the concept of frequency, whilst the other one is based on the application of a logistic regression. The results reveal the preponderant importance of lithology as a predictive variable, followed, at a considerable distance, by the slope gradient. Likewise, the importance of an unnatural and characteristic variable area of study, such as the presence of artificial cuts, is indicated as a causative factor. The results show a high degree of coincidence between the tendency of susceptibility predicted by the model, and the effective presence of empirical mobilization signs on the slopes, with Area Under Curve (AUC) values for Receiver Operating Characteristics (ROC) around 0.8.

This study introduces an integrated method for managing process risks in a Business Process Reengineering (BPR) project, using Robust Data Envelopment Analysis (RDEA) and machine learning (ML). The goal is to prioritize risks based on three standard factors of PFMEA: Severity, Occurrence, and Detection (S-O-D), and incorporating two additional factors (Breakdown Cost and Breakdown Duration) seen as undesirable outputs. The model also accounts for the effect of uncertainty on expert-estimated values by applying disturbance percentages in the linear PFMEA-RDEA model. A machine learning model is proposed to predict new values if partial or total modifications have been made to the processes. The approach was implemented in an au-tomotive sector company, and the results showed the impact of uncertainty on values by com-paring different approaches such as RPN, PFMEA-DEA, and PFMEA-RDEA. A new reduced risk categorization was achieved, who allowed for decision-makers to focus on necessary actions for reengineering.

: Border management serves as a crucial control checkpoint for governments to regulate the quality and safety of imported food. In 2020, the ensemble learning prediction model EL V.1 was introduced to Taiwan's border food management. This model primarily assesses the risk of imported food by combining five algorithms to determine whether quality sampling should be performed on imported food at the border. In this study, a second-generation ensemble learning prediction model, EL V.2, was developed based on seven algorithms to enhance the "detection rate of unqualified cases" and improve the robustness of the model. The chi-square test was employed to compare the efficacy of "pre-launch (2019) random sampling inspection" and "post-launch (2020–2022) model prediction sampling inspection". For cases recommended for inspection by the ensemble learning model and subsequently inspected, the unqualified rates were 5.10%, 6.36%, and 4.39% in 2020, 2021, and 2022, respectively, which were significantly higher (p=0.000***) compared with the random sampling rate of 2.09% in 2019. The prediction indices established by the confusion matrix were used to further evaluate the prediction effects of EL V.1 and EL V.2, and the EL V.2 model exhibited superior predictive performance compared with EL V.1, and both models outperformed random sampling.

When discussing the concepts of risk, safety, and security, people have an intuitive understanding of what these concepts mean, and, to a certain level, this understanding is universal. However, when delving into the real meaning of these concepts, one is likely to fall into semantic debates and ontological discussions. In industrial parks, it is important that (risk) managers from dierent companies, belonging to one and the same park, have the same understanding of the concepts of risk, safety, and security. It is even important that all companies in all industrial parks share a common understanding regarding these issues. As such, this paper explores the similarities and dierences behind the perceptions of these concepts, to come to a fundamental understanding of risk, safety, and security, proposing a semantic and ontological ground for safety and security science, based on an etymological and etiological study of the concepts of risk and safety. The foundation has been induced by the semantics used in the ISO 31000 risk management guidance standard. Hence, this article proposes a coherent, standardized set of concepts and definitions with a focus on the notion “objectives” that can be used as an ontological foundation for safety and security science, linking “objectives” with the concepts of safety, security, risk, performance and also failure and success, theoretically allowing for an increasingly more precise understanding and measurement of (un)safety across the whole range of individuals, sectors and organizations, or even society as a whole.

Patients with pT1 high-grade (HG) bladder cancer (BC) and a very high risk of progression might benefit from immediate radical cystectomy (RC), but this option remains controversial. Validation of a standardized method to evaluate the extent of lamina propria (LP) invasion (with recognized prognostic value) in transurethral resections (TURBT) specimens is still needed. The Rete Oncologica Lombarda (ROL) system showed a high predictive value for progression after TURBT in recent retrospective studies. Our aim was to validate ROL system on a large mono-institutional prospective series of primary urothelial carcinomas. From 2016 to 2020, we adopted ROL for all patients with pT1 HG BC on TURBT. We employed a 1.0-mm threshold to stratify tumors in ROL1 and ROL2. A total of 222 pT1HGBC were analyzed. Median age was 74 years, with male predominance (73.8%). ROL was feasible in all cases: 91 cases were ROL1 (41%) and 131 ROL2 (59%). At a median follow up of 26.9 months (IQR 13.8-40.6), we registered 80 recurrences and 40 progressions. ROL was a significant predictor of tumor progression at both univariable (HR 3.53; CI 95% 1.56 – 7.99; p<0.01) and multivariable (HR 2.90; CI 95% 1.25 – 6.75; p=0.01) Cox regression analyses. At Kaplan-Meier estimates, ROL showed correlation with both PFS (p=0.0012) and RFS (p=0.0167). Our results confirmed the strong predictive value of ROL for progression on a large prospective series. We encourage the application of ROL for reporting the extent of LP invasion, substaging T1 HG BC, and improving risk tables for urological decision making.

Coastal zones experience increasing climatic and human pressures, which lead to growing risks and tipping points (TPs) under future scenarios and natural resource scarcity. To avoid crossing TPs with irreversible coastal losses, this paper proposes the development of adaptation pathways based on advanced coastal oceanography and engineering knowledge that enables an objective assessment of evolving coastal risks. These pathways feature sequential interventions, combining conventional engineering works with nature-based solutions (NbS), steered by simulations and observations as a function of available coastal resources (space and sediment) and risks for infrastructure and socioeconomic assets. Such an adaptation has been developed for urban and peri-urban Mediterranean beaches, considering conventional coastal engineering together with NbS. Both types of interventions are assessed in terms of key physical variables, which serve to evaluate performance and estimate TPs. This analysis supports the new coastal protection and management plan promoted by the local government and the coastal adaptation plan of the central government. The approach and results illustrate the potential of adaptation pathways for beach sustainability, enhancing the compatibility between short/long-term coastal protection objectives under present/future climate and management scenarios. The adaptation pathways development underpins an increasing stakeholder cooperation to achieve shared decisions for coastal sustainability.

Coronavirus disease 2019 (COVID-19) is associated with high risk of malnutrition, primarily in elderly people; assessing nutritional risk using appropriate screening tools is critical. This systematic review identified applicable tools and assessed their measurement properties. Literature was searched in the MEDLINE, Embase, and LILACS databases. Four studies conducted in China met the eligibility criteria. Sample sizes ranged from six to 182, and participants’ ages from 65 to 87 years. Seven nutritional screening and assessment tools were used: the Nutritional Risk Screening 2002 (NRS-2002), Mini Nutritional Assessment (MNA), MNA-short form (MNA-sf), Malnutrition Universal Screening Tool (MUST), Nutritional Risk Index (NRI), Geriatric NRI (GNRI), and modified Nutrition Risk in the Critically ill (mNUTRIC) score. Nutritional risk was identified in 27.5% to 100% of participants. The NRS-2002, MNA, MNA-sf, NRI, and MUST demonstrated high sensitivity; the MUST had better specificity. The MNA and MUST demonstrated better criterion validity. The MNA-sf demonstrated better predictive validity for poor appetite and weight loss; the NRS-2002 demonstrated better predictive validity for prolonged hospitalization. mNUTRIC score demonstrated good predictive validity for hospital mortality. Most instruments demonstrate high sensitivity for identifying nutritional risk, but none are acknowledged as the best for nutritional screening in elderly COVID-19 patients.

Background: Patients with chronic obstructive pulmonary disease (COPD) often suffer from acute exacerbations. Our objective was to describe recurrent exacerbations in a GP based Swiss COPD cohort, and develop a statistical model for predicting exacerbation. Methods: In a questionnaire-based COPD cohort, demographic and medical data were recorded for 24 months. Data set was split into training (75%) and validation (25%) datasets. A negative binomial regression model was developed using the training dataset to predict the exacerbation rate within 1 year. An exacerbation prediction model was developed, and the overall performance was validated. A nomogram was created to facilitate the clinical use of the model. Results: Of the 229 COPD patients analyzed, 77% of patients had no exacerbation during the follow-up. The best subset in the training dataset found that lower forced expiratory volume, high scores on the MRC dyspnoea scale, exacerbation history, being on combination therapy of LABA+ICS or LAMA+LABA at baseline were associated with a higher rate of exacerbation. When validated, the area-under-curve (AUC) was 0.75 for one or more exacerbations. Calibration was accurate (predicted 0.34 exacerbations vs observed 0.28 exacerbations). Conclusion: Nomograms built from these models can assist clinicians in the decision-making process of their COPD care.

Radon (²²²Rn) is the second most common type of lung cancer after smoking. As radon poses a significant risk to human health, radon-affected areas should be to ensure people’s awareness of risk and remediation. The primary goal of this research was to investigate the local natural radioactivity (in soils, water and indoors) because of the presence of tuff outcrops (from middle lower Pleistocene volcanic activity) that naturally produce radioactive gas radon at Cerveteri (Rome, Central Italy). The study area is characterized by the presence of several funerary sites pertaining to the Etruscan Necropolis of Cerveteri, which extends over a volcanic rock plateau. The results of the radon survey highlighted moderate (>16000 Bq/m³) but localized anomalies in soils and medium low (< 200 Bq/m³) values of indoor radon excepting some cases exceeding the threshold (> 300 Bq/m³) recommended by 2013/59 Euratom Directive. Although for thoron (²²⁰Rn) effects on human health, there exist no clinical data, the study of ²²⁰Rn average activity concentration in the soil gas survey has revealed new insights for the interpretation of radon sources that can affect dwellings, even taking into account the considerable difference in the half-lives of the ²²²Rn and ²²⁰Rn.

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.

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.

Pressure ulcers carry a significant risk in clinical practice and require effective preventive measures. This paper proposes a practical and interpretable approach to estimate the risk levels of pressure ulcers using decision tree models. In order to address the common problem of imbalanced learning in nursing classification datasets, various oversampling configurations are analyzed to improve data quality prior to modeling. The decision trees built are based on three easily identifiable and clinically relevant pressure ulcer risk indicators: mobility, activity and skin moisture. Their analysis allows nursing professionals to predict the risk levels of pressure ulcer and make informed decisions about patient care. Additionally, this research introduces a novel tabular visualization method to enhance the usability of the decision trees in clinical practice. The approach proposed aims to support nursing professionals in making timely decisions regarding the appropriate preventive interventions according to the risk levels of pressure ulcers, thus improving patient outcomes and healthcare costs. The usefulness and effectiveness of the models presented make them a valuable resource for nursing care in the prevention of pressure ulcers.

The current global financial sector is dedicated to providing customers with more advanced and strategic services. With channels like internet banking, mobile phone banking, and telephone banking, the industry delivers multi-channel banking services to satisfy its clients. The COVID-19 pandemic has directly impacted the global economy, as well as the financial sector, with the banking sector facing lockdown initiatives to curb the virus's spread. As a result, mobile payment methods have been favored by people over physical money for transactions. This study analyzes the factors that influenced mobile banking usage during the pandemic in Sri Lanka.. Convenience sampling was used, comprising of 200 online questionnaires conducted among customers in Sri Lanka. The collected data was analyzed using descriptive analysis, exploratory factor analysis, and multiple linear regression through IBM SPSS 25. Research findings revealed that trust and risk were significant factors affecting mobile banking usage in Sri Lanka. Trust had a positive effect while Risk negatively effects to the mobile banking usage. Ease of use and Usefulness were irrelevant factors during the COVID-19 pandemic in Sri Lanka.

As the demand for aromatic and medicinal herbs increases, so does the pressure to intensify production, increasing the risk of overexploitation of these natural resources. Sustainability corresponds to the preservation of something that exists in the present and must be maintained in the future, implying accountability and obligation. However, in order to maintain the conditions and essential goods for the survival of future generations, consumers and businesses must commit to sustainable practices. The circular economy is considered one of the solutions to promote a sustainable system and can be defined as a transition from a linear model, where resources are transformed, used and discarded, to a circular (regenerative) model, where materials are reused whenever possible. An ecologically correct approach to waste reuse avoids the negative impacts associated with improper disposal of agro-industrial wastes, such as mass proliferation of microorganisms, production of greenhouse gases, loss of energy potential, and other negative impacts on the environment or human health. The objective of this study is to provide a compilation of good agricultural practices that promote sustainability in the production of medicinal and aromatic herbs, particularly in the areas of cultivation, harvesting, drying, extraction, and packaging, and to highlight the potential for evaluating processing residues in medicinal and aromatic herbs.

Direct-to-consumer genetic testing companies aim to predict the risks of complex diseases using proprietary algorithms. Companies keep algorithms as trade secrets for competitive advantage, but a market that thrives on the premise that customers can make their own decisions about genetic testing should respect customer autonomy and informed decision making and maximize opportunities for transparency. The algorithm itself is only one piece of the information that is deemed essential for understanding how prediction algorithms are developed and evaluated. Companies should be encouraged to disclose everything else, including the expected risk distribution of the algorithm when applied in the population, using a benchmark DNA dataset. A standardized presentation of information and risk distributions allows customers to compare test offers and scientists to verify whether the undisclosed algorithms could be valid. A new model of oversight in which stakeholders collaboratively keep a check on the commercial market is needed.

Climate change is a major development challenge to Ethiopia. Unless adaptation measures are widely implemented, climate change can set back development efforts and achievements by years. Recognizing this, the Government of Ethiopia (GoE) and civil society organizations have since recently been making considerable efforts to tackle the climate change problem. This paper documents the experience of CARE International in Ethiopia in facilitating bottom-up approaches to promote community-led disaster risk management and climate change adaptation planning through a participator scenario planning (PSP) methodology. PSP is a coordinated approach which leverages a variety of stakeholders' skills and mandates to explore potential climate change risks and their impacts, and then develop locally relevant and shared adaptation action plans that support livelihoods, social capital and ecosystem resilience. The approach has facilitated timely access to and communication of seasonal climate advisories which in turn is empowering communities to take advantage of opportunities that climate presents, which is a key part of adapting to climate change. The institutionalization of the approach by district and regional disaster prevention and food security coordination offices in the southern pastoral regions of Ethiopia encouraged integration of PSP into community livelihood adaptation and local government development planning, hence continuity of the process. Sustainability is expected to be fully achieved when local government planning processes recognize the importance of and provides resources for the participation of meteorological services and community forecasting experts to help refine plans on a seasonal basis, and for systems for dissemination of advisories. Key words: Climate Change, Disaster Risk Reduction, Adaptation, Pastoralism, Ethiopia,

Salmonellosis is a bacterial zoonosis with array of health conditions. Non-typhoidal salmonellosis (NTS) have a discrete adaptation to certain animals; in poultry, pullorum and fowl typhoid are its primary disease manifestations. The diseases are prevalent in the Nigerian poultry and have been well studied in Nigeria, but less so in the north central Nigeria (NCN). Using field sampling, laboratory methods and semi structured questionnaire in 1000 poultry farms from NCN, we explore the incidence and risk factors for the persistence of NTS infection in poultry. Approximately 41.6% of the farms have experienced NTS but only 6.3% have current infection with NTS. Farm experience of NTS moderately predicted awareness of salmonellosis. Increasing stock in smallholder farms, self-mixing of concentrate on the farm, usage of stream water, pen odour, non-adherence and partial adherence of farms to recommended poultry vaccination against pullorum and fowl typhoid, and lack of and non-adherence to biosecurity were identified risk factors that increased the odds of NTS infection in poultry. Antibiotic use practice may have reduced the isolation rate of NTS, yet NTS continues to challenge poultry farms in Nigeria. Identified risk practices must be mitigated intentionally and biosecurity and hygiene must improve to reduce the burden of NTS.

The COVID-19 pandemics has had an unprecedented global impact, and the COVID-19 mass vaccination campaign has been commonly regarded as crucial to overcome the pandemics. Since all-cause mortality is the best way to measure the consequences of a health intervention, the present study was devised to analyze the all-cause mortality data of the United Kingdom (UK), which are made publicly available broken down by vaccination status. Data from January to May 2022 were retrospectively collected and analyzed according to age groups and vaccination status and the relative risk (RR) for all-cause mortality was calculated in comparison to the corresponding unvaccinated groups. All-cause mortality RR was also calculated from January to May 2021 for vaccinated people. Results show that the all-cause mortality RR was higher in people who received one or two doses of COVID-19 vaccines throughout the whole period and in any of the age groups considered. People vaccinated with three doses more than 21 days earlier had RRs lower than unvaccinated people, which however linearly increased over time. RR in vaccinated people of all ages in comparison to unvaccinated people were lower in January-May 2021, however they steadily grew over time. The finding that all-cause mortality RR in vaccinated in comparison to unvaccinated people increases over time requires careful examination to understand the underlying factors. Meanwhile, all the other major countries should undertake a systematic collection of all-causes mortality broken down by vaccination status, and mass vaccination campaigns should be suspended.

(1) Background: This paper investigates the epidemiological risk related to temperature before and during COVID-19 in Italy; (2) Methods: Deaths in 2015-2019 and temperatures were correlated. Excess and COVID-19 deaths were examined to estimate the relationships with temperatures; (3) Results: Annual deaths were higher during the cold months (+45,000, SD = 4,700, S = 21). The scenario worsened during COVID-19. Mortality was higher during minimum temperature periods, although the curve moderately rose in the warmest months (r = -0.75, 95% CI = [-0.87; -0.56], S = 23). COVID-19 deaths showed a decreasing seasonality. Monthly excess deaths during COVID-19 were high (+4,200, IQR = [2,800; 8,000], S = 28) with a doubt of seasonality. COVID-19 mortality was correlated with regional latitude (r = 0.86, 95% CI = [0.68; 0.94], S = 20). Discrepancies between COVID-19 and excess deaths were found. The exposed population was subject to aging; (4) Conclusions: The epidemiological risk in Italy is seasonal and geographically dependent. Low and very high temperatures can lead to mortality peaks. Therefore, COVID-19 and any other epidemiological risk must be evaluated in light of this evidence. Health systems need to be strengthened during cold and extremely hot periods. Future research should investigate these phenomena at the causal level.

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.

This research focuses on the use of the HEC-RAS model to estimate flash flood risk. It combines advanced hydraulic modeling techniques and precise data entry. The aim is to contribute knowledge to assess flash flood risk and reduce impacts on communities and infrastructure. The selection of study areas with a history of severe flooding, such as the Lam Saphung Basin, Phrom River Basin, and Lam Chern River Basin Part 1 in Thailand, highlights the importance of thorough flash flood risk assessment. By leveraging the HEC-RAS model, the results of this research inform proactive risk management strategies, improve emergency preparedness and help develop sustainable mitigation measures. The results are important in developing emergency response strategies and overall recovery ability in areas at risk of flash floods. The research combines advanced hydrologic modeling and real-world flash flood data. In addition to the flood condition assessment, the extent of the flood area and associated hazards were assessed using a two-case simulation strategy. The study covers future scenarios related to land use changes and retrospective analysis of past flood events. The results have practical implications for improving emergency response strategies, land use planning, and overall resilience in flash flood-prone areas. The integrated approach emphasizes the research output to providing insights and actionable solutions for communities facing ongoing challenges posed by flash floods.

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.

In the last decades farm animals kept in confined and mechanically ventilated livestock buildings are increasingly confronted with heat stress (HS) due to global warming. These adverse conditions cause a depression of animal health and welfare and a reduction of the performance up to an increase of the mortality. To facilitate sound management decisions, livestock farmers need relevant arguments, which quantify the expected economic risk and the corresponding uncertainty. The economic risk was determined for the pig fattening sector based on the probability of HS and the calculated decrease in the gross margin. The model calculation for confined livestock buildings showed, that HS indices calculated by easily available meteorological parameters can be used for assessment quantification of indoor HS, which is so far difficult to determine. These weather-related HS indices can be applied not only for an economic risk assessment but also for a weather-index based insurance for livestock farms. Based on the temporal trend between 1981 and 2017, a simple model was derived to assess the likelihood of HS for 2020 and 2030. Due to global warming, the return period for a 90-percentile HS index is reduced from 10 years in 2020 to 3-4 years in 2030. The economic impact of HS on livestock farms was calculated by the relationship between an HS index based on the temperature-humidity index (THI) and the reduction of the gross margin. From the likelihood of the HS and this economic impact function, the probability of the economic risk could be determined. The reduction of the gross margin for a 10 year return period was determined for 1980 with 0.27 € per year and animal place and increased by the 20-fold to 5.13 € per year and animal place in 2030.

Risk management for technological hazards mainly focuses on the consequences on human lives. Although technological risk analysis evaluates environmental vulnerability, it does not reflect the consequences on environmentally exposed elements, such as rivers, water springs, flora, and fauna. This paper's objective was to propose a conceptual framework and create a multidisciplinary evaluation model for environmental risk analysis in the oil and gas industry. Initially, the problem was approached from a global perspective to justify the necessity of a holistic environmental risk analysis methodology in the oil industry, using environmental risk factors as well as underlying factors, such as environmental fragility and lack of resilience. The holistic assessment was carried out based on probabilistic risk analysis methodologies to obtain a holistic environmental risk index, HERI. This methodology was applied to an oil and gas industry company in Colombia. This allowed greater disaggregation of the results to establish priorities for risk reduction actions and identify the company's weaknesses.

Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death worldwide and the risk of a major cardiovascular event is highest among those with established disease. Ongoing management of these patients relies on the accurate assessment of their response to any prescribed therapy, and their residual risk, in order to optimize treatment. Recent international guidelines and position statements concur that the plasma concentration of apolipoprotein B (apoB) is the most accurate measure of lipoprotein associated ASCVD risk. This is especially true for the growing number of individuals with diabetes, obesity or the metabolic syndrome, and those on statin therapy. Most guidelines, however, continue to promote LDL-C as the primary risk marker due to uncertainty as to whether the greater accuracy of apoB is sufficient to warrant a paradigm shift. Recommendations regarding apoB measurement vary, and the information provided on how to interpret apoB results is sometimes insufficient, particularly for the non-lipid specialist. Misinformation regarding the reliability of the assays is also frequently repeated despite its equivalent or better standardization than many other diagnostic assays. Thus, demand for apoB testing is relatively low, which means there is little incentive to increase its availability or reduce its cost. In this review, we examine the results of recent clinical outcomes studies and meta-analyses on the relative values of apoB, LDL-C and non-HDL-C as markers of ASCVD risk. Although there is seemingly minimal difference among these markers when only population-based metrics are considered, it is evident from our analysis that, from a personalized or precision medicine standpoint, a great many individuals would benefit, at a negligible total cost, if apoB measurement were better integrated into the diagnosis and treatment of ASCVD.

This research investigates the relationship among human knowledge, behavior, and risk as they relate to urban chicken husbandry in the U.S. Concern over zoonotic diseases has been on the rise, especially with increasing contact. In particular, avian influenza, or bird flu, Salmonella enterica (salmonella), and Escherichia coli (E. coli), can all cross species lines between people and poultry. This study analyzed knowledge and practices in urban chicken husbandry to assess how they relate to risk of disease acquisition, hypothesizing that certain practices associated with a lessened knowledge base may heighten the risk. This study used social surveys to examine the self-reported knowledge base of individuals involved in chicken husbandry as they relate to beliefs and behaviors associated with the care of these animals. These results identify key factors that may heighten the risk of disease transmission, and demonstrate that an increased knowledge base could act to lessen this risk.

Several recent epidemiological studies attempted to identify risk factors for Alzheimer's disease. Age, family history, genetic factors (APOE genotype, Down syndrome), physical activity, and a low level of schooling are significant risk factors. In this review, we summarize the known psychosocial risk factors for the development of Alzheimer's disease in Down syndrome patients and their association with neuroanatomical changes in the brains of people with Down syndrome. We completed a comprehensive review of the literature on PubMed, Google Scholar, and Web of Science about psychosocial risk factors for Alzheimer's disease, for Alzheimer's disease in Down syndrome, and Alzheimer's disease in Down syndrome and their association with neuroanatomical changes in the brains of people with Down syndrome. Alzheimer's disease causes early pathological changes in Down syndrome patients, especially in the hippocampus and corpus callosum. The field needs more data about the neuroanatomical changes during childhood, how they change with increasing age, and the presence or absence of psychosocial risk factors. Further neuroimaging and psychosocial assessment-focused research is needed to understand the mechanisms leading to Alzheimer's disease at an early age and create more sensitive and relevant clinical, memory, and reasoning assessments for people with Down syndrome.

While Twitter has been touted to provide up-to-date information about hazard events, the reliability of tweets is still a concern. Our previous publication extracted relevant tweets containing information about the 2013 Colorado flood event and its impacts. Using the relevant tweets, this research further examined the reliability (accuracy and trueness) of the tweets by examining the text and image content and comparing them to other publicly available data sources. Both manual identification of text information and automated (Google Cloud Vision API) extraction of images were implemented to balance accurate information verification and efficient processing time. The results showed that both the text and images contained useful information about damaged/flooded roads/street networks. This information will help emergency response coordination efforts and informed allocation of resources when enough tweets contain geocoordinates or locations/venue names. This research will help identify reliable crowdsourced risk information to enable near-real time emergency response through better use of crowdsourced risk communication platforms.

Cash crops are agricultural crops intended to be sold for profit as opposed to subsistence crops, meant to support the producer, or to support livestock. Since cash crops are intended for future sale, they translate into large financial value when considered on a wide geographical scale, so their production directly involves financial risk. At a national level, extreme weather events including destructive rain or hail, as well as drought, can have a significant impact on the overall economic balance. It is thus important to map such crops in order to set up insurance and mitigation strategies. Using locally generated data -such as municipality-level records of crop seeding- for mapping purposes implies facing a series of issues like data availability, quality, homogeneity etc. We thus opted for a different approach relying on global datasets. Global datasets ensure homogeneity and availability of data, although sometimes at the expense of precision and accuracy. A typical global approach makes use of spaceborne remote sensing, for which different land cover classification strategies are available in literature at different levels of cost and accuracy. We selected the optimal strategy in the perspective of a global processing chain. Thanks to a specifically developed strategy for fusing unsupervised classification results with environmental constraints and other geospatial inputs including ground-based data, we managed to obtain good classification results despite the constraints placed. The overall production process was composed using ``good-enough" algorithms at each step, ensuring that the precision, accuracy, and data-hunger of each algorithm was commensurate to the precision, accuracy, and amount of data available. This paper describes the tailored strategy developed on the occasion as a cooperation among different groups with diverse backgrounds, a strategy which is believed to be profitably reusable in other, similar contexts. The paper presents the problem, the constraints and the adopted solutions; it then summarizes the main findings including that efforts and costs can be saved on the side of Earth Observation data processing when additional ground-based data are available to support the mapping task.

There is a need for developmental screening that is easily administered in resource-poor settings. 1) We hypothesized that known risk factors would predict failed developmental screening on an adapted screening tool in East African children living in poverty. 2) The sample included 100 healthy Ugandan children aged 6-59 months. We adapted a parent-reported developmental screener based on the Child Development Review chart. The primary outcome was failure to meet age-appropriate milestones for any developmental domain. Venous blood was analyzed for lead, and caregivers completed a demographics questionnaire. We used multivariate logistic regression models to determine if elevated blood lead and stunting predicted failure on the screener, controlling for maternal education level, age in months past the lower bound of the child’s developmental age group, and absence of home electricity. 3) In the sample, 14% (n=14) of children failed one or more milestones on the screener. Lead levels or stunting did not predict failing the screener after controlling for covariates. 4) Though this tool was feasibly administered, it did not demonstrate preliminary construct validity and is not yet recommended for screening in high-risk populations. Future research should include a larger sample size and cognitive interviews to ensure it is contextually relevant.

Background: Ceramides are a new kind of lipid biomarkers and have already been demonstrated to be valuable risk predictors in coronary patients. Patients with peripheral artery disease (PAD) are a population with worse prognosis and higher mortality risk compared to coronary artery disease (CAD) patients. However, the value of ceramides for risk prediction in PAD patients is still vague and has been addressed in the present study. Methods: This observational study included 379 PAD patients. The primary endpoint was all-cause mortality at 10 years of follow-up. A set of ceramides was measured by LC-MS/MS and combined according to the coronary event risk test (CERT) score which categorizes patients into one of four risk groups (low risk, moderate risk, high risk, very high risk). Results: Kaplan Meier survival curves revealed that the overall survival of patients has decreased with the increasing risk predicted by the four CERT categories, advancing from low risk to very high risk. Cox regression analysis demonstrated that every 1-step increase in category resulted in a 35% rise in overall mortality risk (HR=1.35 [1.16-1.58]). Multivariable adjustment, including amongst others age, T2DM, and statin treatment before baseline, did not abrogate this significant association (HR=1.22 [1.04-1.43]). Moreover, we found that the beneficial effect of statin is significantly stronger in patients with a higher risk according to CERT. Conclusion: We conclude that the ceramide-based risk score CERT is a strong predictor of the 10-year mortality risk in patients with PAD.

Cryptocurrencies like Bitcoin rely on a proof-of-work system to validate transactions and prevent attacks or double-spending. A new proof-of-work is introduced which seems to be the first number theoretic proof-of-work unrelated to primes: it is based on a new metric associated to the Collatz algorithm whose natural generalization is algorithmically undecidable: the inflation propensity is defined as the cardinality of new maxima in a developing Collatz orbit. It is numerically verified that the distribution of inflation propensity slowly converges to a geometric distribution of parameter $0.714 \approx \frac{(\pi - 1)}{3}$ as the sample size increases. This pseudo-randomness opens the door to a new class of proofs-of-work based on congruential graphs.

Background: Appendicular skeletal muscle (or lean) mass (ALM) estimated using dual-energy X-ray absorptiometry (DXA) is considered to be a preferred method for sarcopenia studies. However, DXA is expensive, has limited portability, and requires radiation exposure. Bioelectrical impedance analysis (BIA) is inexpensive, easy to use, and portable; thus BIA might be useful in sarcopenia investigations. However, a large variety of models have been commercially supplied by different companies, and for most consumer products, the equations estimating ALM are not disclosed. It is therefore difficult to use these equations for research purposes. In particular, the BIA equation is often age-dependent, which leads to fundamental difficulty in examining age-related ALM loss. The aims of the current study were as follows: (1) to develop and validate an equation to estimate ALM using multi-frequency BIA (MF-BIA) based on theoretical models, and (2) to establish sarcopenia cutoff values using the equation for the Japanese population. Methods: We measured height (Ht), weight, and ALM obtained using DXA and a standing-posture 8-electrode MF-BIA (5, 50, 250 kHz) in 756 Japanese individuals aged 18 to 86-years-old (222 men and 301 women as developing equation group and 97 men and 136 women as a cross validation group). The traditional impedance index (Ht²/Z₅₀) and impedance ratio of high and low frequency (Z₂₅₀/Z₅) of hand to foot values were calculated. Multiple regression analyses were conducted with ALM as dependent variable in men and women separately. Results: We created the following equations: ALM = (0.6947 × (Ht²/Z₅₀)) + (−55.24 × (Z₂₅₀/Z₅)) + (−10,940 × (1/Z₅₀)) + 51.33 for men, and ALM = (0.6144 × (Ht²/Z₅₀)) + (−36.61 × (Z₂₅₀/Z₅)) + (−9332 × (1/Z₅₀)) + 37.91 for women. Additionally, we conducted measurements in 1624 men and 1368 women aged 18 to 40 years to establish sarcopenia cutoff values in the Japanese population. The mean values minus 2 standard deviations of the skeletal muscle mass index (ALM/Ht²) in these participants were 6.8 and 5.7 kg/m² in men and women, respectively. Conclusion: The current study established and validated a theoretical and age-independent equation using MF-BIA to estimate ALM and provided reasonable sarcopenia cutoff values.

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.

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.

Hepatitis E virus (HEV) is a zoonotic foodborne virus with an annual infection prevalence of 20 million human cases, which seriously affects public health and economic development in both developed and developing countries. To better understand the epidemiology of HEV in the Centre of Portugal, a cross-sectional study was conducted from 2016 to 2023 with sera samples from wild ungulates. The seroprevalence and risk factors for HEV seropositivity were evaluated in the present study. Specifically, antibodies against HEV were determined by a commercial enzyme-linked immune-sorbent assay (ELISA). Our results show that in the 650 sera collected from 298 wild red deer and 352 wild boars from Portugal, 9.1% red deer (95% confidence interval [CI]: 6.312.9%) and 1.7% wild boar (95% CI: 0.63.3%) were positive for antibodies to HEV. Regarding age, the seropositivity in juvenile wild ungulates was 1.3% (95% CI: 0.273.72%) and 7.2% in adults (95% CI: 4.910.11%). Logistic regression models investigated risk factors for seropositivity. The odds of being seropositive was 3.6 higher in adults than in juveniles (95% CI: 1.7218.11%) and the risk was 4.2 higher in red deer than in wild boar (95% CI: 1.64–10.69%). Both wild ungulate species were exposed to HEV. The higher seroprevalence in red deer suggests that this species may have a major contribution to the ecology of HEV in the Centre of Portugal. Further research is important to understand how wildlife affects the epidemiology of HEV infection in Portugal.

The province of Jaén (Andalusia, Spain), despite being declared the European territory with the largest number of defensive constructions (castles and fortifications), has few conservation plans, with many remains included on the Red List of Spanish Heritage lying abandoned. This presents a problem for the conservation of the landscape and the optimal use of the province’s tourism potential. Through the study case of Magaña hamlet two actions are proposed to alleviate this situation: The creation of an archaeological and environmental risk chart with which to answer such questions as “How have climate change, anthropic alterations and environmental charac-teristics affected the state of conservation of certain heritage sites?” and to put forward proposals for improving their protection using as a basis digital and technological tools, such as remote sensing (SAR), taking advantage of data from the Sentinel 2A and 2B satellites, HBIM, RPAS and GIS. To foster the promotion of smart tourism by digitalising and virtualising tourist routes and archaeological remains by building a Smart Tourism App for mobile devices. Finally, public administrations will be apprised of the need to implement a conservation policy for cultural as-sets and their surroundings in a simple, quick and cost-effective manner.

We aimed to compare prognostic factors for overall survival (OS) following percutaneous radiofrequency ablation (PRFA) with or without chemolipiodolization (CL) for early-stage hepatocellular carcinoma (HCC) using propensity score-matched analysis. We enrolled 221 patients with early-stage HCC who received PRFA with (n = 76) or without (n = 145) CL in Saga Central Hospital between April 2004 and December 2020. No significant difference was observed in OS between PRFA with and without CL cohorts (median survival time [MST]: 5.4 vs. 4.5 years; p = 0.0806). To reduce confounding effects, 108 patients were selected using propensity score-matched analysis (n = 54 for each treatment). No significant difference was observed in OS between the cohorts (MST: 3.6 vs. 4.0 years; p = 0.5474). After stratification according to tumor size, no significant difference was observed in OS for patients with tumor size ≥20 mm between PRFA with and without CL cohorts (MST: 3.4 vs. 3.5 years; p = 0.8236). PRFA with CL was not a significant prognostic factor in both univariate and multivariate analyses (p = 0.5477 and 0.9600, respectively). Our findings suggest that PRFA with CL does not demonstrate longer prognostic effects than PRFA without CL in early-stage HCC, regardless of tumor size.

In the context of seismic risk, studying the characteristics of urban soils and of the built environment means adopting a holistic vision of the city taking a step forward compared to the current microzonation approach. Based on this principle, CLARA WebGIS aims to collect, organise, and disseminate the available information on soils and buildings in the urban area of Matera. The geodatabase is populated with i) 488 downloadable geological, geotechnical, geophysical, surveys; ii) geological, geomorphological, and seismic homogeneous microzones maps and iii) a new Digital Surface Model. The CLARA WebGIS (https://smartcities-matera-clara.imaa.cnr.it/) is the first publicly available database reporting for the whole urban area the spatial distribution of the fundamental frequencies for soils and the overlying 4043 buildings, along with probability levels of soil-building resonance. The WebGIS is addressed to a broad target of end users (local government, engineers, and geologists, etc.) as a support to the implementation of seismic risk mitigation strategies in terms of urban planning, seismic retrofitting, and management of post-earthquake crises. We recommend that the database be managed by local administrators, who would also have the task of deciding on future developments and continuous updating as new data becomes available.

This systematic review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement to synthesizes the existing literature with a goal to review current conceptual frameworks of mental health of forced migrants for further practice research priorities in social work. The search was done between January 2015 to January 2021. As a result, 29 studies met inclusion criteria. Medicalizing mental health issues by relying solely on the effectiveness of medicine was a controversial risk factor that negatively affected the daily life activities of refugees and reduced their willingness for seeking professional mental health services. Empowering vulnerable minorities by giving them back their power and agency to be able to speak for themselves and raise voices of trauma and recovery was the missing protective factor for sustainable mental health practice. The benefits of group-based interventions are highlighted in which communities and individuals address mental health issues as well as isolation through building collective identities and support networks. Information and communication technologies (ICTs) can add more strength to any kind of mental health intervention. Finally, the benefits of applying ecological perspective for the mental health of refugees, and its implications for a sustainable intercultural practice are discussed. Social workers in this model are the representatives of at-risk groups, thus need more agency and creativity in reflecting client’s concrete needs.

This paper explores decision analysis on product integration of family security services and residential fire insurance in the London and Taiwan markets by using the proposed mathematical models for counting sustainable value. This paper shows the five main different results between London and Taiwan markets with ten different parameters of the family security market, to find out the optimal number of family security integrated services for each security company in London. The improvement of the risk aversion effect based on risk and financial management will enhance the market share of the private security industries in the London and Taiwan markets. The results of this research can serve as a reference for the decision-making of private security industries on product integration under sustainable value consideration. The research findings highlight the potential benefits for both the private security industry and the insurance industry in their design and negotiation for product integration to improve both of business operation and achieve corporate social responsibility goals to match the sustainability in the future.

Extreme climates such as droughts and hot extremes, may result in marked damage to crop yields and threaten regional and global food security. Maize is a major grain crop in Liaoning Province, severely affected by drought and hot events. The objective of this study is to advance an approach to estimate the risk of crop yield reduction under the compound dry-hot events (CDHE) in Liaoning Province. Results show that the ratio of stations experiencing compound dry-hot events during the twelfth leaf and maturity stage tended to increase on the time scale. On a spatial scale, the frequency of compound dry-hot events in central Liaoning Province was relatively low during the whole and various reproductive periods of maize. In addition to the twelfth leaf, western Liaoning Province is prone to compound dry-hot events. The high-risk area for the occurrence of the compound dry-hot events in maize is Chaoyang City, located in the western part of Liaoning Province, and the cities in the low-risk area account for about 64.3% of the total number of cities in Liaoning Province, mainly in the central and northern parts of Liaoning Province. Generally, this study emphasizes focusing on the impacts of compound dry-hot events on agricultural production and provides an index to assess the risk of compound dry-hot events on maize production.

Eating Disorders (ED) constitute a serious public health issue affecting predominantly women and appearing typically in adolescence or early adulthood. EDs are extremely difficult to treat as these disorders are ego-syntonic and many patients do not seek treatment. It is vital to focus on the development of successful early-intervention programs for individuals presenting at-risk and are on a trajectory towards developing EDs. This study is a randomized controlled trial evalu-ating an innovative digital gamified Acceptance and Commitment early-intervention program (AcceptME) for young females showing signs and symptoms of an ED and at high-risk for an ED. Participants (N=92; Mage=15.30 years, SD=2.15) received either AcceptME (N=62) or a waitlist control (N=30). Analyses indicated that the AcceptME program effectively reduced weight and shape concerns, with large effects when compared to waitlist controls. Most participants scored below the at-risk cut-off (WCS score<52) in the AcceptME at end-of-intervention (57.1%) com-pared to controls (7.1%) with odds of falling into the at-risk group being 14.5 times higher for participants in the control group. At follow-up, 72% of completers reported scores below the at-risk cut-off in the AcceptME group. The intervention also resulted in a decrease in ED symp-tomatology and increased body image flexibility. Overall, results suggest that the AcceptME program holds promise for early-intervention of young women at-risk for developing an ED.

Radiological imaging is essential for acute patient management in Intensive Care Units (ICUs); however, it introduces the risk of exposure to ionizing radiation. This review synthesizes research on radiation exposure in intensive care unit (ICU) settings, highlighting its rise during the COVID-19 pandemic and repetitive imaging. Our analysis extends to radiation safety thresholds, revealing that some ICU patients exceed annual occupational limits, emphasizing the need to balance diagnostic utility against potential long-term risks, such as cancer. Prospective studies have demonstrated an increase in the median Cumulative Effective Dose (CED) in patients with trauma over time, prompting calls for improved awareness and monitoring. Moreover, innovative dose-reduction strategies and optimized protocols, especially in neuro-ICU units, promise to mitigate these risks. This review highlights the essential but risky role of radiological imaging in critical care. It advocates rigorous radiation management protocols to safeguard patient health, while ensuring the continuity of high-quality medical care.

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.

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

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.

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.

The aim of the article is to present a snapshot in time, of the current state in cryptocurrencies, the values and risks associated to blockchains. With emergence of over 20,000 crypto projects, the first objective of this article is to present the stage as it is in 2023, with historical overview since Satoshi presented the first paper on decentralised blockchains, until today. Second objective of the article is to review the values and risks associated to cryptocurrencies, and to clarify the differences between cryptocurrencies from blockchain technologies. The research questions that drive this article are related determining if the blockchain technology an innovation or its already obsolete technology? Are there any significant risks from cryptocurrencies? And are the potential values to society and economy worth pursuing? Would developed or developing countries benefit more from these technologies? And which blockchain projects will survive in the long run? In other words, where is the money and is there money or just hype. The review discusses the high probability that some crypto projects will fail, and given the vast number of cryptos, the article acknowledges that many of these projects are nothing more than ponzies. These are discussed and acknowledged, then the focus is shifted to the real-world use cases of blockchain projects.

The paper is an investigation on the impact of financial markets on the volatility of green bonds credit risk component, measured by the option-adjusted spread/swap curve (OAS) of the Global Bloomberg Barclays MSCI Green Bond Index, for both the non and pandemic periods. For these purpose, after observing the dynamic joint correlations between all the variables through a DCC-GARCH, we adopt GARCH(1,1) and EGARCH(1,1) models, putting the OAS as dependent variable. Our main results show that the conditional variance parameters are significant and persistent in both times, testifying the overall impact of the other markets on the OAS. In more detail, we highlight that the gamma in the two EGARCH models is positive: so the “green” credit risk volatility is more sensitive to positive shocks than negative ones. With reference to the conditional mean, we note that if during the non pandemic time only the stock market is significant, during the pandemic also conventional bonds and gold are impacting. To the best of our knowledge this is the first study that analyzes the specific credit risk component of green bond yields: we deem our findings useful to observe the change of green bonds creditworthiness in a complex market context.

Let us assume that defence mechanisms are so strong that the average outcome of a hacking attack is unsuccessful. How to calculate the costs arising from false positives and false negatives in intruder detection? Is it better for the hacker to make fewer but more effective attacks rather than several but less effective attacks? How to calculate the difference between these alternative strategies?

In the Republic of Serbia, no comprehensive scientific multimethod research has been conducted to identify weaknesses and opportunities for improving the disaster risk management system. Regarding that, in the paper, author presents project description ,,Strengthening Integrated Disaster Risk Management System in Serbia - DISARIMES” which shall enable strengthening the disaster risk management system through research, development and innovative solutions implementation in the preparation, mitigation, response, remediation and post-disaster phases. The scientific importance of the projected research is reflected in the creation of assumptions for the advancement of theoretical and empirical knowledge in the scientific field of disaster risk management, bearing in mind that it is a relatively young scientific discipline in Serbia. The results of the project research will make it easier for decision makers in Serbia to understand the shortcomings of the system, but also provide innovative opportunities to improve their functioning in conditions of increasingly frequent and serious disasters. Establishing a scientific and professional society in the field of disaster risk management will create sustainable and necessary conditions for the transfer and improvement of knowledge and experience of importance for raising the level of operability of the system of protection and rescue of the Republic of Serbia in the event of disasters. A key contribution of the research findings will be to create a sustainable knowledge base that will be supported by the relevant amount of information regarding innovative capabilities and solutions identified as necessary to raise social resilience to a much higher level. In order to achieve the set goals, DISARIMES makes it possible, through a large number of SWOT analyses and other multimethod studies, to clearly identify and systematize the objective deficiencies and barriers encountered by the disaster risk management system in Serbia in all its stages before, during and after disasters, to identify and implement the appropriate solutions based on this. The objectives of the project are: to assess and identify strengths (advantages), weaknesses (disadvantages), opportunities (innovation potential) and threats for the disaster risk management system in Serbia; to develop and update RDI (research, development, innovation) Roadmap – knowledge databases with innovative solutions and other relevant information for improvement of the disaster risk management system; to fully deploy the DISARIMES scientific-professional network involving a broad range of the disaster risk management scientists and civil protection professions and organisations; to prepare the ground for the disaster risk management policy innovations.

In the wake of the 2008 financial crisis, the Financial Stability Board (FSB) and the Basel Committee on Banking Supervision (BCBS) created a list of Systemically Important Financial Institutions (SIFIs) with the intention of determining which financial institutions were important enough to the global market that their failure would result in systemic collapse. In this work we create a model that modifies the BCBS's five indicators of size, interconnectedness, cross-jurisdictional activities, complexity, and substitutability and applies these measures of systemic stress to governments. The original application of the model is to track the systemic interdependence of the Eurozone, with particular emphasis on the case of Greece. We anticipate this model can be used in regional fiscal situations beyond the Eurozone.

In the former mining district of La Carolina (southern Spain), waste materials were accumulated without first waterproofing the substrate. Additionally, these mining dams were abandoned without any type of restoration, conditions that present a significant risk of contaminating the surrounding soils and waters. Prior to carry out the necessary works for isolating these residues, morphological characterization of the contact with the base substrate is needed. For that purpose, in recent years, different indirect study techniques have been used, among which electrical to-mography stands out. In this work, a less common geophysical technique, magnetometry, both in its magnetic and gra-diometric modalities, is used as an alternative method to analyse the geometry and structure of a mining dam. The results obtained with this methodology are compared with the results provided by electrical techniques, as well as with direct data from mechanical surveys and aerial photo-graphs prior to waste deposition. The magnetic anomaly curves obtained with geometric models generated with the Mag2dc program were also analysed. This comparative study shows the use-fulness of magnetic prospecting in characterizing the base geometry of these mining structures and therefore the interest in its application to environmental characterization studies.

As in many parts of the world, rural-urban, forest-urban interface areas surrounding urban regions expose the natural areas they interact with to a threat of fire risk that can reach various sizes. This risk has been assessed for various regions of the world using many different methods and numerical models so far. Among these, it is seen that machine learning models have successful applications in risk assessment and risk prediction studies. For the fire risk prediction of Istanbul's yet unurbanized regions, but where the city is anticipated to potentially shift, data was collected using the opportunities provided by Geographic Information Systems and Remote Sensing technologies based on fires that occurred between 2000-2021, and the region was examined. Machine learning methods' Random Forest (RF), Extreme Gradient Boosting (XGB), and Light Gradient Boosting (LGB) models were applied for the classification of factors effective in fire. The best result was given by the RF model with 0.93 accuracy, 0.062 F1 score, and 0.753 Area Under Curve (AUC) value. In the classification of factors in the RF model, the grouping between fire-initiating factors and factors effective in spreading is evident, while this distinction is partially noticeable in the other two models.

Missense mutations in the LRRK2 gene were first identified as a pathogenic cause of Parkinson’s disease (PD) in 2004. Soon thereafter, a founder mutation in LRRK2, p.Gly2019Ser (rs34637584), was described, and it is now estimated that there are approximately 100,000 people worldwide that carry this risk variant. While the clinical presentation of LRRK2 parkinsonism has been largely indistinguishable from sporadic PD, disease penetrance and age at onset can be quite variable. In addition, its neuropathological features span a wide range from nigrostriatal loss with Lewy body pathology, lack thereof, or atypical neuropathology including a large proportion of cases with concomitant Alzheimer’s pathology, hailing LRRK2 parkinsonism as the "Rosetta stone" of parkinsonian disorders. These differences may result from interactions between LRRK2 mutant protein and other proteins or environmental factors that modify LRRK2 function, and thereby influence pathobiology. This review explores how potential genetic and biochemical modifiers of LRRK2 function may contribute to the onset and clinical presentation of LRRK2 parkinsonism. We review, which genetic modifiers of LRRK2 influence clinical symptoms, age at onset, and penetrance, what LRRK2 mutations are associated with pleomorphic LRRK2 neuropathology, and which environmental modifiers can augment LRRK2 mutant pathophysiology. Understanding how LRRK2 function is influenced and modulated by other interactors and environmental factors –either increasing toxicity or providing resilience- will inform targeted therapeutic development in the years to come. This will allow developing disease-modifying therapies for PD and LRRK2-related neurodegeneration.

A micro decision-making utility model under uncertainty is presented as a complementary foundation for macro coronavirus models. The micro model consists of two functions, a risk averse utility function depending on wellness and a wellness random output which is a function of the input variable called “treatment” consisting of such elements as social distance, washing hands, wearing a face mask, and others. The decision maker selects a level of treatment that maximizes her/his expected utility, given the probabilities of the respective outputs. The focus is on how changes in a person’s psychological attitude towards the macro determined (announced) probabilities affects the optimum results of the model. Such changes create a micro-macro dynamic interaction which is briefly outlined. A short discussion of the model’s behavioral implications for health policy is also given.

This article presents a comprehensive framework for valuing financial instruments subject to credit risk. In particular, we focus on the impact of default dependence on asset pricing, as correlated default risk is one of the most pervasive threats in financial markets. We analyze how swap rates are affected by bilateral counterparty credit risk, and how CDS spreads depend on the trilateral credit risk of the buyer, seller, and reference entity in a contract. Moreover, we study the effect of collateralization on valuation, since the majority of OTC derivatives are collateralized. The model shows that a fully collateralized swap is risk-free, whereas a fully collateralized CDS is not equivalent to a risk-free one.

The use of risk measures such as the Value at Risk (VaR) or Tail Conditional Expectation (TCE) is required by the Basel Committee on Banking Supervision in determining a bank’s risk profile. However, both measures can be shown to have shortcomings in the information that they provide to regulators and investors. In this paper we present an introduction to risk measure calculations before demonstrating the weaknesses of these measures. Through the exploration of specific cases we show how familiar yet differing risk profiles have identical values for combinations of these measures. From this evidence we recommend that a sequence of several risk measures should be used to give a more accurate representation of the risk contained on banking balance sheet.

Polycyclic aromatic hydrocarbons (PAHs) in street dust pose a serious problem threatening both environment and human health. Street dust were collected from five different land use patterns (traffic areas TRA, urban area URA, residential areas REA, mixed residential commercial areas MCRA and suburban areas SUA) in a Saudi coastal city, Jeddah, and one in rural area (RUA) in Hada Al Sham. This study aimed to investigate the status, profile, sources of PAHs and estimate their human health risk. The results revealed an average concentration of total PAHs of 3320 ng/g in street dust of Jeddah and 223 ng/g in RUA dust. PAHs with high molecular weight represented 83.38% of total PAHs in street dust of Jeddah, while the carcinogenic PAH compounds accounted 57.84%. The highest average concentration of total PAHs in street dust of Jeddah was found in TRA (4980 ng/g) and the lowest in REA (1660 ng/g). PAHs ratios indicated that the principal source of PAHs in street dust of Jeddah is pyrogenic, mainly traffic emission. Benzo(a)anthracene/ chrysene (BaA/CHR) ratio suggests that PAHs in street dusts of Jeddah come mainly from emission of local sources, while PAHs in RUA might be transported from the surrounding urban areas. The estimated Incremental Lifetime Cancer Risk (ILCR) associated with exposure to PAHs in street dusts indicated that both dermal contact and ingestion pathways are major contributed to cancer risk for both children and adults. Based on BaP_equivalence concentrations of total PAHs, ILCR_Ingestion, ILCR_dermal and cancer risk values for children and adults exposed to PAHs in street dust of different areas in Jeddah were found between 10⁻⁶ and 10⁻⁴, indicating potential risk. The sequence of cancer risk was TRA > URA > MCRA > SUA > REA. Only exposure to BaP and DBA compounds had potential risk for both children and adults.

Transcatheter Aortic Valve Implantation (TAVI) now represents the mainstay in the treatment of severe aortic stenosis. Owing to its exceptional procedural efficacy and safety, TAVI has been extended to include patients at lower surgical risk, thus now encompassing a diverse patient population receiving this treatment. Yet, long-term outcomes also depend on optimal medical therapy for secondary vascular prevention, with antithrombotic therapy serving as a cornerstone. Leveraging data from multiple randomized controlled trials, current guidelines generally recommend single antithrombotic therapy, with either single antiplatelet therapy (SAPT) or oral anticoagulation (OAC) alone in those patients without, or with atrial fibrillation respectively. Yet, individualization of this pattern, as well as specific case uses, may be needed based on individual-patient characteristics and concurrent procedures. This review aims to discuss the evidence supporting antithrombotic treatments in patients treated with TAVI, indications for a standardized treatment, as well as specific considerations for an individualized approach to treatment.

The prevalence and incidence of obesity and the comorbidities linked to it are increasing in the world population. Current therapies for obesity and associated pathologies have proven to cause a broad number of adverse effects and often, they are overpriced or not affordable for all patients. Among the alternatives currently available, natural bioactive compounds stand out. These are frequently contained in pharmaceutical presentations, nutraceutical products, supplements, or functional foods. The clinical evidence for these molecules is increasingly solid, among which epigallocatechin-3-gallate, ellagic acid, resveratrol, berberine, anthocyanins, probiotics, carotenoids, curcumin, silymarin, hydroxy citric acid, and α-lipoic acid stand out. The molecular mechanisms and signaling pathways of these molecules have been shown to interact with the endocrine, nervous, and gastroenteric systems, as well as regulate the expression of multiple genes and, therefore, proteins involved in starvation-satiety processes, activation of brown adipose tissue, increased lipolysis, decreased lipogenesis, and inflammation, beneficial changes in metabolism and improved insulin sensitivity. This review provides a comprehensive view of nature-based therapeutic options to address the increasing prevalence of obesity. It offers a valuable perspective for future research and subsequent clinical practice, addressing everything from the molecular, genetic, and physiological bases to the clinical study of the bioactive compound.

Background: Approximately 75% of all head and neck cancer patients are treated with radiotherapy (RT). RT to the oral cavity results in acute and late adverse events which can be severe and detrimental to a patient’s quality of life and function. The purpose of this study was to explore associations between RT dose to a defined oral cavity organ at risk (OAR) avoidance structure, provider and patient reported outcomes (PROs), opioid use, and hospitalization. Methods: This was a retrospective analysis of prospectively obtained outcomes using multivariable modeling. The study included 196 patients treated with RT involving the oral cavity for a head and neck tumor. A defined oral cavity OAR avoidance structure was used in all patients for RT treatment planning. Validated PROs were collected prospectively. Opioid use and hospitalization were abstracted electronically from medical records. Results: Multivariable modeling revealed the mean dose to the oral cavity OAR was significantly associated with opioid use (p=0.0082) and hospitalization (p=0.0356) during and within 30 days of completing RT. Conclusion: The findings of this study may be valuable in RT treatment planning for patients with tumors of the head and neck region to reduce the need for opioid use and hospitalization during treatment.

Coal combustion in thermal power plants releases ash. Ash is reported to cause different adverse health hazards in humans and other organisms. Owing to the presence of radionuclides, it is also considered as a potential radiation hazard. In this study, based on the surface radiation measurements and relevant ancillary data, expected radiation risk zones were identified with regard to the human population residing near the Thermal Power Plant. With population density as the risk determining criteria, about 20% of the study area was at ‘High’ risk and another 20% of the study area was at ‘Low’ risk zone. The remaining 60% was under medium risk zone. Based on the findings remedial measures which may be adopted have been suggested.

This study analyses the short-run hydro generation scheduling for the wind power differences from the contracted schedule. The approach for construction of the joint short-run marginal cost curve for the hydro-wind coordinated generation is proposed and applied on the real example. This joint short-run marginal cost (SRMC) curve is important for its participation in the energy markets and for economic feasibility assessment of such coordination. The approach credibly describes the short-run marginal costs which this coordination bears in “real life”. The approach is based on the duality framework of a convex programming and as a novelty combines the shadow price of risk mitigation capability and the water shadow price. The proposed approach is formulated as a stochastic linear program and tested on the case of the Vinodol hydropower system and the wind farm Vrataruša in Croatia. The result of the case study is a family of 24 joint short-run marginal cost curves.

The province of Jaén (Andalusia, Spain), despite being declared the European territory with the largest number of defensive constructions (castles, fortifications, etc.), has few conservation plans, with many remains included on the Red List of Spanish Heritage ly-ing abandoned. This poses a challenge for landscape conservation and the optimal use of the province’s tourism potential. In this paper we present the early implementation of an ongoing methodological approach designed to alleviate this situation. It takes advantage of data from the Sentinel 2A and 2B satellites, HBIM, RPAS, GIS and fieldwork that will be applied across five archaeological case studies. It has been tested for the first time in the village of Magaña. Three main objectives and phases of this methodological approach have been designed: 1. Preparation of an Environmental Risk Chart with which to answer such ques-tions as “How have climate change, anthropic alterations and environmental characteris-tics affected the state of conservation of certain heritage sites?” 2. Preparation of HBIM models to foster monitorisation and conservation policies for the main archaeological remains and improving their protection based on digital and technological tools. 3. Building a Smart Tourism App for mobile devices aimed at promoting smart tourism by digitalising and virtualising tourist itineraries and archaeological remains. Finally, public administrations will be apprised of the need to implement a conservation policy for cultural assets and their surroundings in a simple, quick and cost-effective man-ner.

This purpose was to compare the ability of body shape index (ABSI) and body roundness index (BRI) with waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and body adiposity index (BAI) to predict metabolic risk. The cross-sectional study was conducted in 17,360 Chinese subjects (were aged 18-95 years old) who escaped cardiovascular disease (CVD) or diabetes. Biochemical and anthropometric variables were measured by trained staff. Receiver operating characteristic curve (ROC) and optimal cutoff values of obesity indices were recruited to compare the predictive ability for metabolic risk factors. The mean age of subjects was 53.7(13.1) years, 41.6 % were males. Within young group (<60 years), the areas under the curve (AUC) demonstrated that WC, BMI, WHR, WHtR and BRI were able to similarly predict high metabolic risk in males (0.74 vs. 0.74 vs. 0.73 vs. 0.73 vs. 0.73) and in females (0.73 vs. 0.73 vs. 0.71 vs. 0.73 vs. 0.73), while the approximate predictive ability were only acquired in males (0.73 vs. 0.73 vs. 0.70 vs. 0.73 vs. 0.73) within elder group (≥60 years). The optimal cut-off values of BRI for high metabolic risk were calculated in males (<60 y: 3.49 vs. ≥60 y: 3.46) and females (<60 y: 3.47 vs. ≥60 y: 3.60). Meanwhile, BRI displayed a strong prediction to elevated BP and elevated TG in males (AUC = 0.64; AUC = 0.70) and to elevated BP, elevated TG and elevated SUA in females (AUC = 0.67; AUC = 0.69; AUC =0.70). BRI was able to similarly predict high metabolic risk compared to WC, BMI, WHR, WHtR and BAI, while ABSI was not. Moreover, BRI revealed specific predictive ability for elevated BP, elevated TG and elevated SUA.

Deep reinforcement learning (DRL) has achieved significant results in many Machine Learning (ML) benchmarks. In this short survey we provide an overview of DRL applied to trading on financial markets, including a short meta-analysis using Google Scholar, with an emphasis on using hierarchy for dividing the problem space as well as using model-based RL to learn a world model of the trading environment which can be used for prediction. In addition, multiple risk measures are defined and discussed, which not only provide a way of quantifying the performance of various algorithms, but they can also act as (dense) reward-shaping mechanisms for the agent. We discuss in detail the various state representations used for financial markets, which we consider critical for the success and efficiency of such DRL agents. The market in focus for this survey is the cryptocurrency market.

In a context of exponential demographic growth, the imbalance between human resources and public health problems is impelling us to envision other solutions to the difficulties faced in the diagnosis, prevention and large-scale management of the most common diseases. Cardiovascular diseases represent the leading cause of morbidity and mortality worldwide. A large-scale screening program would make it possible to promptly identify patients with high cardiovascular risk in order to manage them adequately. Optical coherence tomography-angiography (OCT-A), as a window into the state of the cardiovascular system, is a rapid, reliable, and reproducible imaging examination that enables prompt identification of at-risk patients through the use of automated classification models. One challenge that limits the development of computer-aided diagnostic programs is the small number of open-source OCT-A acquisitions available. To facilitate the development of such models, we have assembled a set of images of the retinal microvascular system from 499 patients. It consists of 814 angiocubes as well as 2005 en face images. Angiocubes were captured with a swept-source OCT-A device of patients with varying overall cardiovascular risk. To the best of our knowledge, our dataset, RASTA, is the only publicly available dataset comprising such a variety of images from healthy and at-risk patients. This dataset will enable the development of generalizable models for screening of cardiovascular diseases from OCT-A retinal images.

In this paper, we address the following research question: Is feasibility to use an artificial intelligence system to predict the risk of student failure in a course based solely on their performance in prerequisite courses? Adopting a machine learning-based quantitative approach, we implement Course Prophet, the prototype of a predictive system that maps the input variables representing student performance to the target variable, i.e., the risk of course failure. We evaluate multiple machine learning methods and find that the Gaussian process with Matern kernel outperforms other methods, achieving the highest accuracy and a favorable trade-off between precision and recall. We conduct this research in the context of the students pursuing a Bachelor’s degree in Systems Engineering at the University of Córdoba, Colombia. In this context, we focus on predicting the risk of failing the Numerical Methods course. In conclusion, the main contribution of this research is the development of Course Prophet, providing an efficient and accurate tool for predicting student failure in the Numerical Methods course based on their academic history in prerequisite courses.

The COVID-19 pandemic has presented an unprecedented challenge to the healthcare system. Identifying the genomics and clinical biomarkers for effective patient stratification and management is critical to controlling the spread of the disease. Omics datasets provide a wealth of information that can aid in understanding the underlying molecular mechanisms of COVID-19 and identifying potential biomarkers for patient stratification. Artificial intelligence (AI) and machine learning (ML) algorithms have been increasingly used to analyze large-scale omics and clinical datasets for patient stratification. In this manuscript, we demonstrate the recent advances and predictive accuracies in AI and ML-based patient stratification modeling linking omics and clinical biomarker datasets, focusing on COVID-19 patients. Our ML model not only demonstrates that clinical features are enough an indicator of COVID-19 severity and survival but also infers what clinical features are more impactful, which makes our approach a useful guide for clinicians for prioritization of best-fit therapeutics for a given cohort of patients. Moreover, with weighted gene network analysis, we are able to provide insights into gene networks that have a significant association with COVID-19 severity and clinical features. Finally, we have demonstrated the importance of clinical biomarkers in identifying high-risk patients and predicting disease progression.

Floods, recognized for their erratic behavior and devastating effects, are a significant threat as a natural disaster. In Brunei Darussalam, the impact of climate change is becoming increasingly evident through higher temperatures and an expected increase in annual rainfall (5.0mm per year from 2021 to 2050), highlighting the critical need for updated flood risk management techniques. In line with the climate resilience and adaptation objectives of WAWASAN 2035, this paper introduces an innovative approach—a cutting-edge flood risk management framework that utilizes the capabilities of big data analytics, sophisticated machine learning algorithms, and smart Internet of Things (IoT) sensors. Traditional methods, which rely on numerical and physical data modeling, often do not provide precise short-term flood forecasts. Our suggested framework uses machine learning to analyze real-time flood forecasting, sensor data and enhance warning systems, addressing the shortcomings of traditional approaches. The key advantage of this approach is its potential to drastically decrease flood-related damages, protect lives, and boost infrastructure resilience. This proposal is not only in aligns with Brunei's vision for a safe and climate-adaptable future but also marks a significant step forward in adopting innovative and sustainable flood risk management solutions amidst an evolving climate.

Risk assessment of chemicals is usually conducted for individual chemicals whereas mixtures of chemical are occurring in the environment. Considering that neuroactive chemicals are a group of contaminants that dominate in the environment, it is then imperative to understand the combined effects from mixtures. The commonly used models to predict mixture effects, namely concentration addition (CA) and independent action (IA), are thought suitable for mixtures of similarly or dissimilarly acting components, respectively. For mixture toxicity prediction, one important challenge is to clarify whether to group neuroactive substances based on similar mechanisms of action, e.g. same molecular target or rather similar toxicological response, e.g. hyper- or hypoactivity (effect direction). We addressed this by using the spontaneous tail coiling (STC) of zebrafish embryos, which represents the earliest observable motor activity in the developing neural network, as a model to elucidate the link between mechanism of action and toxicological response. Two questions were asked: 1.) Can the mixture models CA or IA be used to predict combined effects for neuroactive chemical mixtures when the components share a similar mode of action (i.e. hyper- or hypoativity) but show different mechanism of action? 2.) Will a mixture of chemicals where the components show opposing effect directions result in an antagonistic combined effect? Results indicate that mixture toxicity of chemicals such as propafenone and abamectin as well as chlorpyrifos and hexaconazole that are known to show different mechanisms of action but similar effect directions were predictable using CA and IA models. This could be interpreted with the convergence of effects on the neural level leading to either a collective activation or inhibition of synapses. We also found antagonistic effects for mixtures containing substances with opposing effect direction. Finally, we discuss how the STC may be used to amend risk assessment.

Improving HIV testing efficiency saves financial and material resources for health. We conducted a retrospective secondary data analysis of routinely collected HIV risk screening program data in Uganda, from October to November 2019, to determine the performance characteristics of the adolescent and adult HIV risk screening tool in public health facility settings. A total of 19,854 clients had been screened for HIV testing eligibility and tested for HIV. The overall positivity rate (cluster weighted prevalence of HIV) among those screened was 4.5% (95% CI: 4.1%-4.8%) versus 3.71% (95% CI: 3.06-4.50) among those not screened. The sensitivity and specificity of the risk screening tool were 90.7% (95% CI: 88.4%, 92.7%) and 75.8%, (75.2-76.4) respectively. With screening, the number needed to test to identify one PLHIV was reduced from 27 to 22. Although risk screening would have led to a 24.5% (4,825/19,704) reduction in testing volume, 9.3% (68/732) of PLHIV would have been missed, being misclassified as not eligible for testing. The cost per PLHIV identified fell by 3% from $69 without screening to $66.9 with screening. We recommend the use of scientifically validated HIV risk screening tools, and a need to explore the use of HIV self-testing as a test for tirage.

The novel coronavirus (COVID-19) was first reported in the U.S. on December 29, 2019 and has spread rapidly throughout the country, affecting individuals with varying severity due to their risk status. According to the Centers for Disease Control and Prevention, it is estimated that 45.4% of US adults are at higher risk for complications from coronavirus disease because of cardiovascular disease, diabetes, respiratory disease, hypertension, or cancer. In this study, we developed a mathematical model to assess the impact of a COVID-19 vaccine among low and high risk groups. Numerical simulations shows vaccinating both low and high risk groups simultaneously, rather than prioritizing the vaccine on high risk group only, further reduces the daily mortality. The result supports the need for an aggressive vaccination program, regardless of whether individuals are within the low or high risk population.

Flood is identified as one of the major disasters in the world; it destroys both human and properties across the world, where lives are lost, properties, public infrastructure, farmlands and agricultural produce with farm crops carted away as a result of flood disaster. Studies revealed that the flood in itself is not the danger, but the level of human vulnerability to flooding disaster risk, which enhances its destructive capabilities. However, based on the challenges poses by flood disaster risk, this research identifies Ala river in Akure as a potential cause of flood, considering its location and other human activities around the river. Therefore, the research used Ala-river a case study to identify and mapped out areas susceptible to flood disaster risk. The research made use of both literature review and conducted goe-data gathering with the application GIS-computer database to retrieve georeferencing relevant data from the fieldwork in the study area of Ala-river basin to mapped out locations vulnerable to achieve the research aim. The research adopted a Geo-mapping of the vulnerable area to Ala-River basin using arc-GIS tool in combination with other software such as IKONAS and OLI (Operation Land Imager) for the production of the study area imagery, ER-ITERIM was used for the collection of rainfall data and FAO was applied for digital soil mapping. These applications produced; the land use/land cover map, digital elevation map, buffer map using 30 meters setback, annual rainfall map, soil types map, vulnerability map and soil textural table for the study area. Analysis of the produced and generated maps shows 316 buildings vulnerability to flood disaster risk; the soil texture and types, and alternative use to which the soil types can be useful. The research recommends that demolition of the identified 316 buildings prone to flood disaster and compliance of building construction to 30 meters setback by developers. Others are the conversion of the future land setback for urban agricultural purposes and preservation of water retention areas for agricultural activities during the dry season among others. The study concludes that relevant government agencies in the State and in particular in Akure South Local Government should ensure prompt compliance and implementation of the recommendations to avoid potential flood disaster risks.

Parkinson’s disease (PD) is the most common cause of movement disorder characterized by the progressive loss of dopaminergic neurons in the substantia nigra. It is increasingly recognized as a complex group of disorders presenting widely heterogenous symptoms and pathology. Except for the rare monogenic forms, the majority of the PD cases result from an interaction between multiple genetic and environmental risk factors. The search for these risk factors and the development of preclinical animal models are in progress hand in hand, providing mechanistic insights into the pathogenesis of PD. This review summarizes the studies that capitalize on modeling sporadic (i.e. non-familial) PD using Drosophila melanogaster and discuss their methodology, new findings and future perspective.

In the rapidly evolving FinTech sector, risk management is paramount for dealers and brokers. This paper underscores the significance and progression of risk management within this realm. Initially, it reviews the traditional risk management technologies and their inherent limitations. The discourse then shifts to contemporary solutions, specifically emphasizing the role of artificial intelligence, machine learning algorithms, and big data analytics in forecasting and mitigating potential risks. The paper also presents case studies of companies effectively utilizing these advanced techniques, highlighting their benefits in real-world scenarios. Additionally, it addresses forthcoming challenges, including regulatory compliance, data privacy issues, and the imperative for strengthened cybersecurity measures. The conclusion acknowledges that the adoption of these innovative technologies not only boosts operational efficiency but also markedly diminishes financial risks, thereby contributing to a more stable and reliable financial market

Lifestyle physical activity (PA) and nutrition are known to be effective interventions in preventing and managing obesity related comorbidities is adult populations, but less so in children and adolescents. We examined the effectiveness of lifestyle interventions in children from minority ethnic populations in western high-income countries. Our systematic review included 53 studies involving 26045 children from minority ethnic populations within western countries, who followed lifestyle intervention programs lasting between 8 weeks and 5 years with an aim to prevent and/or manage childhood obesity and associated comorbidities, including adiposity and cardiometabolic risks. Studies were heterogenous in terms of lifestyle intervention components (nutrition, PA, behavioural counselling) and settings (community vs. schools and after schools). Our meta-analysis included 31 eligible studies and showed no significant effects of lifestyle interventions when they focused on body weight and body mass index (BMI) outcomes [pooled BMI mean change = -0.09 (95% CI -0.19, 0.01), p=0.09]. This was irrespective of the intervention program duration (< 6 months vs. ≥ 6 months), type (PA vs nutrition/combined intervention) and weight status (overweight or obese vs no normal weight), all showed no significant effects in the sensitivity analysis. Nonetheless, 19 of the 53 studies reported reduction in BMI, BMI z scores and body fat percentage. However, majority of lifestyle interventions adopting a quasi-design with a combined primary and secondary obesity measures (11 out of 15 studies), were effective in reducing obesity comorbidities of cardiometabolic risks including metabolic syndrome, insulin sensitivity, and blood pressure in children with overweight and obesity. Preventing childhood obesity and associated comorbidities in children from high-risk ethnic minority groups is best achieved using a combined PA and nutrition intervention approach, which jointly target preventing obesity and cardiometabolic disease primary and secondary outcomes, especially measures of diabetes, hypertension, and cardiovascular disease.

Reading proficiency is requisite in our read-to-learn educational system, yet two-thirds of American students are not proficient readers. Assuring educational equity means supporting all learners with multiple component reading interventions that individually scaffold students while remediating weak literacy skills and providing intensive and sustainable intervention early. This study (N = 855) measured the efficacy of two different multiple component reading programs for students in grades three, four, and five. Grade levels of students were assigned to either the treatment intervention or the typical practice condition; and all students were pre-and post-tested using EasyCBM Reading Benchmarks. Students scoring at/below the 30^th percentile on either benchmark were also assessed with the WRMT-3 Passage Reading Comprehension and Oral Reading Fluency measures. Students in the treatment condition received Readable English and students in typical practice condition continued to receive Amplify CKLA during their regular ELA times for 45—60 hours. Students receiving Readable English significantly outperformed students in the typical practice condition on measures of oral reading fluency, reading rate, accuracy, and passage comprehension. Raw scores, growth scale values, and grade equivalents are reported, and implications for practice are discussed. In a school year fraught with pandemic instructional interruptions and learning loss, elementary students in the intervention condition averaged a year’s worth of growth in reading fluency and nine months of growth in reading comprehension compared to three- and five-months fluency and comprehension growth in the typical practice condition. Students in the Readable English condition experienced meaningful gains in reading rate and accuracy that will give exponential word reading volume dividends to students able to read text faster and more accurately going forward. This study adds to accumulating evidence that multiple component reading programs designed to reinforce fluency skills also support reading comprehension gains for all students.

Comorbidities can have a cumulative effect on hospital outcomes of care, such as the length of stay (LOS), and hospital mortality. This study examines patients hospitalized with Congestive Heart Failure (CHF), a life-threatening condition, which, when it coexists with a burdened disease profile, the risk for negative hospital outcomes increases. Since coexisting conditions co-interact, with a variable effect on outcomes, clinicians should be able to recognize these joint effects. In order to study CHF comorbidities, we used medical claims data from CMS. After extracting the most frequent cluster of CHF comorbidities, we: (i) Calculated, step-by-step, the conditional probabilities for each disease combination inside this cluster (ii) Estimated the cumulative effect of each comorbidity combination on the LOS and hospital mortality (iii) Constructed (a) Bayesian, scenario-based graphs and (b) Bayes-networks to visualize results. Results show that, for CHF patients, different comorbidity constructs have variable effect on the LOS and hospital mortality. Therefore, dynamic comorbidity risk assessment methods should be implemented for informed clinical decision making in any ongoing effort for quality of care improvements.

the intermittency and variability of these permeated Distributed Generators (DGs) could critically cause many security and economy risks to distribution systems. This paper applied a certain mathematical distribution to imitate the output variability and uncertainty of DGs. And then, four risk indices EENS, PLC, EFLC and SI were established to reflect the system risk level of distribution system. For the certain mathematical distribution of the DGs' output power, a developed PEM (point estimate method)-based method was proposed to calculate these four system risk indices. In this developed PEM-based method, enumeration method was used to list the states of distribution systems, an improved PEM was presented to deal with the uncertainties of DGs and the value of load curtailment in distribution systems was calculated by an optimal power flow algorithm. Finally, the effectiveness and advantages of this proposed PEM-based method for distribution system assessment were verified by the tests of a modified IEEE 30-bus system. Simulation results have shown that this proposed PEM-based method has a high computational accuracy and highly reduced computational costs compared with other risk assessment methods and is very effective for risk assessments.

The prognostic abilities of artificial intelligence and neuroscience in forensics and the criminal justice system stand as a reformatory paradigm for understanding any criminal conduct. While the use of artificial intelligence has been labeled transformational data analytical capabilities, neural predictive approaches also enable an intricate understanding of culpability and criminal propensities. The literature on the complex nature of neuroprediction and artificial intelligence, its ethical deliberations and its usability in curving recidivism are analyzed. This theoretical review elucidates the complex interplay, nuptial relationships and convergence of these relationships in the quest for justice. The consequences of not protecting individual rights in the criminal justice system are surveyed using grounded theory. The degree of acceptability and dependability of AI-generated evidence in legal proceedings are also reviewed. All these topics are yet to be contemplated under one roof to offer an argumentative view. The author expects to prompt readers and new commers to embrace more sociolegal and technological research before incorporating such research in the Indian Judiciary. The review focuses on the question of whether to blame such technology inclusion wholly or rather to prioritize the acquisition of bias-free pretrained datasets and processing models.

Retinoids are vitamin A derivatives and include trans-retinoic acid, isotretinoin, tamibarotene, and bexarotene, all of which are currently available for clinical use. The clinical development of retinoid therapy for neuroblastoma has a history spanning more than four decades. The most promising agent is isotretinoin, which can contribute to improving event-free survival in patients with high-risk neuroblastoma by approximately 10 % when administered over six months as maintenance therapy. Although isotretinoin is regarded as an essential component in the standard clinical management of high-risk neuroblastoma, its use for this purpose in the US and EU is off-label. To promote isotretinoin use in Japan as a treatment for neuroblastoma, our clinical research team is planning to launch an investigator-initiated, registration-directed clinical trial. The present review article discusses the basic science behind retinoid therapy, pre-clinical / clinical evidence on neuroblastoma, the concept of the proposed clinical trial, and prospects for this therapy.

Alzheimer's disease (AD) is a progressive and evolving neurodegenerative disease with an insidious onset that can lead to memory loss and cognitive impairment. There is no effective treatment for this disease. However, early diagnosis plays an important role in treatment planning to slow down its progression, as treatment has the greatest impact in the early stages of the disease. Neurological images obtained through different imaging techniques provide powerful information and help diagnose the disease. With the wide application of deep learning techniques in disease diagnosis, especially the prominence of Convolutional Neural Networks (CNNs) in computer vision and image processing, more and more studies are proposing the use of this algorithm for the diagnosis of AD. In this paper, we first systematically introduce the impact of AD on people, detailing the biomarkers, early clinical symptoms, and risk factors of this disease. Secondly, it goes on to detail the development of CNNs, their form, and methods to help diagnose AD. It is proposed that CNNs can help diagnose AD by analyzing medical imaging data, particularly structural brain scans such as magnetic resonance imaging (MRI) and functional scans such as positron emission tomography (PET). Finally, it is concluded that CNNs are of great importance for the diagnosis of AD and that they are likely to play an increasingly important role in the early detection of the disease, the understanding of disease mechanisms, and ultimately, in the development of effective AD therapies and interventions. CNNs are playing an increasingly important role in the Their potential impact on healthcare emphasizes the importance of continued research and innovation in neural networks and medical imaging.

Indices such as Body Mass Index (BMI), Waist Circumference (WC) and Waist to Height Ratio (WHtR) have emerged as tools to assess cardiovascular risks associated with abdominal obesity. The Timed Up and Go Test (TTUG) assesses mobility and the risk of falls, especially in the elderly and individuals with physical limitations. Objective: To correlate anthropometric indicators of cardiovascular risk (BMI, WC, WHtR) and performance in the TTUG in elderly people who practice physical activity. Methods: Cross-sectional study, CAAE: 27116319.1.0000.8044, elderly people, both sexes, average age 68 years. Anthropometric data was collected: BMI, WC, WHtR and TUG test results. Results: Average values: weight (67.8 ± 12.7 kg), height (157.2 ± 8.4 cm), TTUG (10.3 ± 2.5 26 seconds), WC (93.3 ± 10.9 cm), waist-to-height ratio (0.59) and BMI (27.4 ± 4.4): Correlations between 27 TTUG and age (r = -0.086, p = 0.683), TTUG and BMI (r = 0.29, p = 0.892) WC and WHtR (r = 0.927, p 28 < 0.001). Conclusion: This study revealed correlations between anthropometric indicators of cardio vascular risk (BMI, waist circumference, waist-to-height ratio) and performance in the TUG test in the elderly.

Background: Pulmonary embolism (PE) is a common multifactorial disease, but high-risk PE s a life-threatening condition associated with high mortality and morbidity and a heavy prognostic burden. Systemic thrombolysis is the first-line treatment approach for severe high-risk PE, but only few agents are indicated for use by international guidelines. Tenecteplase, a thrombolytic agent, is proven to reduce mortality and right ventricle dysfunction in high-risk PE, but is not approved yet by major recommendations. Aim: We present a series of cases of high-risk PE treated with Tenecteplase, with satisfying hemodynamic and clinical outcomes. Our goal is to encourage the usage of Tenecteplase with secure safety and efficacy in situations of unavailability of guidelines-approved fibrinolytic agents. Cases : Patients were included from January 2022 to January 2024. We report 3 cases of patients with high-risk PE treated with Tenecteplase where rtPA and other second-generations agents were not available. Clinical, biological and imaging data were detailed for each case. Conclusion: Tenecteplase was effective in our patients, without bleeding complications, and should be suggested in settings of unavailability of first-line recommended agents.