Background: Diabetes mellitus (DM) and osteoporosis are two of the most widespread metabolic disease in the world. The aim of this study is to investigate the prevalence of DM among patients affected by osteoporosis and fragility fractures, and to search differences in clinical features. Methods: 713 patients belonging to CTO Bone Unit because of osteoporosis and fragility fractures were divided into two groups, according to the diagnosis of DM. The clinical and bone characteristics of patients were compared. Results: Prevalence of DM was 10.8%. When compared to patients without DM, the median age at the time of first fracture was similar (72 years ± 14 IQR vs 71 years ± 12 IQR); prevalence of combination of vertebral and hip fractures was higher (p=0.039), as well as prevalence of males, although not significantly (p=0.051). Bone mineral density (BMD) at all sites was higher in DM group; Trabecular Bone Score (TBS), instead, was significantly lower (p<0.001). Conclusions: Patients with fragility fractures and DM more frequently show combination of major fractures with higher BMD levels. In these patients, TBS could be a better indicator of bone health than BMD and therefore should be used as a diagnostic tool in clinical practice.

Osteoporotic spinal fractures represent an increasingly widespread health problem in our aging society. We aimed to investigate the treatment options for low-energy spinal fractures in the el-derly and their impact on mortality, focusing on surgical stabilization using minimally invasive and open techniques. We evaluated 1356 patients over 50 years of age with compression frac-tures sustained due to low energy trauma treated at a single trauma center. We compared the mortality of patients following stable and operated/non-operated unstable compression frac-tures and the eligibility to surgery using the open and minimally invasive approach. The pa-tients received surgical or conservative care according to severity and eligibility to surgery. The mortality hazard ratio of patients who underwent screw fixation was 1.02 (P > .91), of patients who refused surgery was 1.68 (P < .001) and that of patients with anesthesiological contraindica-tion was 1.57 (P = .08), compared to conservatively treated patients with stable fractures. The dif-ference in mortality between open and minimally invasive surgeries was not significant, but the number of patients eligible for surgery with the minimally invasive procedure was significantly higher (OR: 0.25; P < .001). Spinal stability after fractures may be an important predictor of sur-vival in patients with low-impact fractures.

Background: Essential hypertension is a major public health associated with increase pressure on the vascular walls and red blood cells (RBCs). In the present work, osmotic fragility (OF) of RBCs was reexamined in the means of its correlation with two risk factor; iron status and lipid profile. Experimental: OF, iron status parameters, and lipid profile components were measured in 60 patients and compared with the results of 30 controls. Results: The results showed a significant increase in all iron indices of hypertensive patients in comparing with healthy control group except TIBC, UIBC, and transferrin concentrations, which decrease in these patients in comparing with control group. Serum TGs, total cholesterol, VLDLc, and LDLc were increased while there is no significant in serum HDLc in patients to comparing with control group. There is no significant change in OF between patients and controls where p=0.173. The iron status parameters and lipid profile components were dependent on sex and smoking state. Hemoglobin and PCV were correlated significantly with total cholesterol and LDLc. Transferrin saturation showed a positive correlation with cholesterol, LDLc, and TGs, but negatively correlated with HDL_c. No significant correlation between all the measured parameters and OF in HT patients. There is a significant correlation between serum ferritin and systolic BP and between Hb and systolic BP. Conclusion: No significant effect on the OF in HT patients. HT patients have elevated level of iron parameters in comparing with controls. OD has no correlation with iron status parameters or with lipid profile components.

The aim of this study is to present a method for developing fragility curves for soil liquefaction that are consistent with the seismic hazard using Monte Carlo simulation. This method can account for all the uncertainties and variabilities of the input parameters. The seismic parameters of earthquake magnitude (M) and the associated peak ground acceleration (PGA) are considered together for the liquefaction assessment. The liquefaction potential and damages obtained by this method are more realistic. A case study is performed using data from a sand-boil site in Yuanlin, Changhua county, where liquefaction occurred during the Chi-Chi earthquake in Taiwan in 1999. The results show that the liquefaction potential index, IL, the post-liquefaction settlement, St, and the liquefaction probability index, PW, are all suitable parameters for evaluating the liquefaction damages. The fragility curves for soil liquefaction developed by this method can support the performance-based earthquake engineering (PBEE) approach, provide guidance for liquefaction evaluation to the ‘Taiwan Earthquake Loss Estimation System’-TELES, and serve as a basis for scenario simulation and an earthquake early warning system for liquefaction damages.

Studies have found critical software malfunctions responsible for some of the worst accidents in recent times. These malfunctions are often only minor defects that snowball into large problems; a few lines of code is all it takes. Complexity, safety, quality, and resilience are among the key attributes defining a software’s operational success. There are many leading factors for complexity, such as increases in the product size, the rate of requirement changes, and the number and type of stakeholders, and failure to manage these issues efficiently always has the same consequence, i.e., massive failure and sometimes technological catastrophe. This work analyzes some of the architecture, design, and implementation guidelines used as detection and mitigation techniques. It also discusses the safety considerations, as considering how the steam industry has handled safety issues could offer some guidance for ensuring safety. Complexity in such systems also causes some of the worst side effects from the quality auditor's perspective. While failures in the software are hard to predict, one of the most significant ways of showing preparedness is practicing software resilience. New mitigation areas, such as the fragility spectrum and failure obviation, and their usage for building a safer system are analyzed. Also discussed are various architecture styles in practice and the dramatic effect human factors can have on the success of the software being developed.

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.

While the container crane is an important part of daily port operations, it has received little attention compared with other infrastructures, such as buildings and bridges. Crane collapse due to earthquake affects the operation of the port, and indirectly impacts the economy. This study proposes fragility analyses for various damage levels of the container crane that allow the port owner and partners to better understand the seismic vulnerability presented by container cranes. A large quantity of nonlinear time history analyses was applied for a three-dimensional (3D) finite element model to quantify the vulnerability of the container crane in considering the uplift and derailment behavior. The uncertainty of demand and capacity of the crane structures were also considered through random variables, i.e. elastic modulus of members, ground motion profile, and intensity. The results analyzed in the case of a Korean container crane showed that the probability of exceeding the first uplift with or without derailment is shown before the crane reaches the structure’s limit states. This means that under low seismic excitation, the crane might be derailed without any structural damage. But when the crane reaches the minor damage state, it is always coupled with a certain probability of uplift with or without derailment. This study also proposes the fragility curves developed for different structural periods to enable port stakeholders to assess the risk of their container crane.

Sustainable and Responsible Design (SRD) harnesses design’s potential to address eco-social problems and in doing so challenge the status quo of design education by reframing the social and ecological consequences, boundaries and agencies of design. This critical and transdisciplinary approach frays the edges of traditional design disciplines with embedded and reflexive modes of learning. We describe characteristics of SRD education and present theories of learning to empower students in this complex terrain. The learning associated with SRD education is ecologically engaged, participative, critical, expansive and designerly. We recount case studies of our own experiences advancing sustainable and responsible undergraduate design education in the UK. We identify path constraints such as disciplinary fragility, appropriation, and power dynamics in the design school. The push for a revision of priorities generates tensions where there is often greenwashing rhetoric of sustainability and inclusivity. We describe strategies and tactics to address these tensions. We highlight the agency we have as educators and designers and argue that design education can only meaningfully participate in response to the challenges presented by climate change, other types of ecocide, and social problems when educators make substantive commitments to supporting sustainability literacies and design approaches that serve the interests of diverse stakeholders.

Structural integrity of buried pipelines is threatened by the effects of Permanent Ground Deformation (PGD), resulting from seismic-induced landslides and lateral spreading due to liquefaction parallel to the pipeline axis, requiring accurate analysis of the system performance. Analytical fragility functions allow to estimate the likelihood of seismic damage along the pipeline, supporting design engineers and network operators in prioritizing resource allocation for mitigative or remedial measures in spatially distributed lifeline systems. To efficiently and accurately evaluate the seismic fragility of buried operating steel pipeline under longitudinal PGD, this study develops an analytical model considering the asymmetric pipeline material behavior in tension and compression under varying operational loads. The validated model is further implemented within a fragility function calculation framework based on Monte Carlo Simulation (MCS), allowing to assess the probability of exceedance of the pipeline performance limit states conditioned to the intensity of PGD. The evaluated fragility surfaces showed that the pipeline probability of exceeding the performance criteria increases for larger soil displacement and lengths, as well as cover depths, because of the greater mobilized soil reaction counteracting pipeline deformation. Additionally, the performed Global Sensitivity Analysis (GSA) highlighted the influence of the PGD and soil-pipeline interaction parameters, as well as the effect of the service loads on structural performance, requiring proper consideration in pipeline system modeling and design. Finally, the proposed analytical fragility function calculation framework provides a useful methodology for effectively assessing the performance of operating pipelines under longitudinal PGD, quantifying the effect of the uncertain parameters impacting structural response.

The increasing frequency of male cancer coupled with the reduction in male fertility seen worldwide motivated us to seek a potential evolutionary link between these two phenomena, concerning the reproductive transcriptional modules observed in cancer and the expression of cancer-testis-antigens (CTA). The phylostratigraphy analysis of the human genome allowed us to link the early evolutionary origin of cancer by reproductive life cycles of the unicellulars and early multicellulars, potentially driving soma-germ transition, female meiosis and parthenogenesis of polyploid giant cancer cells (PGCCs), with the expansion of the CTA multi-families, very late during evolution. CTA adaptation was aided by retrovirus domestication in the unstable genomes of mammals, for protecting male fertility in stress conditions, particularly that of humans, as compensation for the energy consumption by a large complex brain which also exploited retrotransposition. We found that the early and late evolutionary branches of human cancer are united by the immunity-proto-placental network, which evolved in the Cambrian and shares stress regulators with the finely-tuned sex determination system. We further propose that social stress and endocrine disruption caused by environmental pollution with organic materials, which alter sex determination in male foetuses and further spermatogenesis in adults, bias the development of PGCC-parthenogenetic cancer by default.

India’s increasing reliance on equated monthly installments (EMIs) has reshaped household financial behavior in ways that pose significant risks to long-term economic stability. This paper examines the growing trend of EMI-driven debt accumulation, highlighting its detrimental effect on household savings and the rising financial vulnerability across demographic groups. Leveraging data from the Reserve Bank of India (RBI), CRISIL, and the National Statistical Office (NSO), the study delves into how debt dynamics are shifting within Indian households, particularly in the context of broader economic trends. Retail credit has expanded rapidly, growing from 12.1% of GDP in 2017 to 19.4% by 2023, with housing loans now making up nearly half of all retail loans. Concurrently, the growth of unsecured loans, such as credit card debt, has surged at an annual rate of 21.3% between 2021 and 2024, reflecting the increasing ease of borrowing for consumers. However, this boom in credit has coincided with a marked drop in household financial savings, which fell to a 47-year low of 5.3% in FY22, underscoring a troubling shift from saving to borrowing. The younger population, particularly those under 35, have been the most active in taking on debt, with loans to this group nearly doubling between 2015 and 2021 due to the rise of fintech platforms and non-banking financial companies. This shift has contributed to a steep rise in debt-service-to-income ratios, amplifying the financial risks for these households in the face of potential economic shocks. By connecting these micro-level household debt trends to broader macroeconomic risks, this paper reveals how India’s EMI culture could deepen the impact of future financial crises, leading to widespread defaults and destabilizing the economy. The study calls for proactive regulatory measures and enhanced financial literacy programs to curb the growing reliance on consumer credit and mitigate the risks of a broader financial collapse.