Foot lesions are among the most frequent causes of morbidity and disability in the diabetic population. Thus, exploration of means of preventive control are vital for detecting early signs and symptoms of this disease, Infrared thermography has been proven effective in the control of diabetic foot is among the complementary diagnostic tools available for this disease. The last review on this topic was published in 2015 and so, here we conducted a bibliographic review of the main databases (PubMed, the Web of Science, Cochrane library, and Scopus) during the third quarter of 2023. We aimed to identify the effectiveness of infrared thermography as a diagnostic element in pre-ulcerous states in diabetic patients and to detect diabetic foot ulcer complications. We obtained a total of 200 articles, 22 of which were included in this present review; 17 articles had been published after 2017. After analysing the use of infrared Thermography in diabetic patients both with and without ulcers, as well as in healthy individuals, we concluded that is an effective tool for detecting early-stage ulcers in diabetic foot patients.

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

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

Data relating to the rate at which pesticide active substances dissipate on or within various plant matrices are important for a range of different risk assessments; however, despite the importance of this data, dissipation rates are not included in the most common online data resources. Databases have been collated in the past, but these tend not to be maintained or regularly updated. The purpose of the exercise described herein was to collate a new database in a format compatible with the main online pesticide database resource (the Pesticide Properties Database, PPDB), to validate this database in line with the Pesticide Properties Database protocols and thus ensure that the data is maintained and updated in future. Data was collated using a systematic review approach using several scientific databases. Collated literature was subjected to a quality assessment, and then data was extracted into an MS Excel spreadsheet. The outcome of the study is a database based on data collated from 1390 published articles covering over 400 pesticides and over 200 crops across a wide variety of different matrices (leaves, fruits, seeds etc.) for pesticide residues on the crop surface, as well as residues absorbed within the plant material. This data is now fully incorporated into the PPDB.

The epidemiological patterns of Bovine Viral Diarrhea (BVD) in North Africa and Mediterranean Basin (MB) are endemic with highly socio-economic impacts. The objective of the study was conducted to investigate the level of sero-prevalence of BVDV in Libya and the associated risk factor. A total of 1599 serum samples were collected from herds of cattle which belonging to seven Libyan regions. All sera were assayed by using screening ELISA assay for detection of antibodies against BVDV. An overall seroprevalence of BVDV was estimated to be 48.6% (95% CI, 46.08%-50.98%). Considering the age group, a seroprevalence of 36.8% was detected in cattle <1 year, 41.0% in cattle between 1 and 2 years of age and 48.6% in cattle aged more than 2 years. Statistically significant differences (p<0.001) between age groups were reported. Seroprevalence of BVDV was significantly associated with geographical region (P=0.033). This is the first study on BVD in Libya and the results of this study would suggest that BVD is endemic in Libya.

This work reviews three frameworks for responding to economic disruption: risk mitigation, systemic recovery, and economic resilience. Specifically, by reviewing extant literature in economics, communication, and other disciplines, we argue that current approaches to understanding resilience in economics largely fail to address ongoing and emergent disruptions to the economic and social world. In response to these issues, we work to synthesize economic frameworks and the communication theory of resilience to forward a new way of examining the overlapping questions of economic resilience related to metatheoretical commitments, analytic contexts, and implications for theory, method, and practice.

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.

Human perception of nature and God have always been inextricably linked. In order to understand nature and its inherent processes, including various natural hazards, the reasons for their origin were often attributed to God's will, suffering for sin and the similar. Fear of material and human losses prompted a man to pray and offer sacrifices/gifts and other rituals to appease the "wrath of the gods". The progress of civilization and technology has not alleviated the destruction and trauma that natural disasters inflict on all aspects of social life. A major obstacle to this is the exponential population growth in vulnerable areas. The frequency of natural disasters and the fatalistic attitudes that limit the effective fight against them have motivated religious communities and individuals to cooperate with international and international organizations and institutions to reduce the risk of local disasters. Believers thus receive the necessary psychological and financial assistance and support from religious communities during all phases of disaster management. Therefore, the subject of this paper is a comprehensive examination relationship between the degree of religiosity of the population and how this connection impacts the policy of reducing disaster risk. The aim of the research is to scientifically describe the nature of the relationship between the degree of religiosity of citizens and different segments of disaster risk reduction.

The primary objective of this systematic review was to analyze the main physical agents representing risk factors for commercial aircrew, together with their consequences. The secondary objective was to identify the countries in which studies on the topic were conducted, as well as the quality of the publications available. Thirty-five articles, published between 1996 and 2020, were selected for the review, having met all inclusion criteria. The majority of studies were conducted in the United States, Germany and Finland and had moderate or low methodological quality of evidence. The main risk factors for aircrew identified in publications were exposure to abnormal air pressure, cosmic radiation, noise, and vibrations. Hypobaric pressure was explored in response to demands for studies on this agent, a factor which may lead to otic and ear barotraumas, as well as acceleration of atherosclerosis of the carotid artery. However, there is a dearth of research exploring this phenomenon.

The aim of this study was a large-scale ecological analysis of nutritional and other environmental factors potentially associated with the incidence of cardiovascular diseases (CVDs) in the global context. Indicators of CVDs from 158 countries were compared with the statistics of mean intake (supply) of 60 food items between 1993 and 2011, obesity rates, health expenditure and life expectancy. This comparison shows that the relationship between CVD indicators (raised blood pressure, CVD mortality, raised blood glucose) and independent variables in the global context is influenced by various factors such as short life expectancy, religiously conditioned dietary customs, the imprecision of some statistics and undernutrition. However, regardless of the statistical method used, the results always show very similar trends and identify high carbohydrate consumption (mainly in the form of cereals and wheat in particular) as a dietary factor most consistently associated with the risk of CVDs. These findings are in line with the changing view of the causes of CVDs. Because only the statistics of raised blood glucose include people using medications and reflect true prevalence that is independent of healthcare, more objective data on the prevalence of CVDs are needed to confirm these observed trends.

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.

Throughout its history Western science has tended to treat complexity as a problem to be avoided or solved. A philosophy of simplification achieved significant improvements in human life and prevails as a model for achieving societal good. However, misplaced efforts to control complexity worsen our sustainability challenges. Effective responses to modern day dilemmas such as floods and climate change require ways of thinking that are more congruent with the complexity of the world. Further, governmental programs to reduce flood risk depend on the support of an informed and engaged public. It has proven difficult to communicate risk in ways that align scientific and technical expertise based on an objective worldview, with communal and individual under-standings of risk based on subjective experiences and perspectives. I introduce Paul Cilliers’ philosophy of critical complexity as the basis of a new conceptual framework that values and balances complexity and simplicity. This paper shows how objective strategies that rely on analytic and probabilistic thinking can be integrated with subjective approaches that draw on the experiential and possibilistic. An example depicts how the problematic framing of the “100-year flood” can be replaced by a model of the data that covers a range of possibilities within an experiential time frame. Cilliers’ work opens an ethical dimension in which we make more intentional choices and acknowledge our limitations. Complexability – understanding how to live with complexity rather than aiming to simplify it – is a vital component of sustainability communication and education.

Japanese encephalitis virus is a mosquito-borne member of the Flaviviridae family. JEV is the leading cause of viral encephalitis in Asia and is characterized by encephalitis, high lethality and neurological sequelae in survivors. The virus also causes severe disease in swine, which are an amplifying host in the transmission cycle, and in horses. US agricultural authorities have recently recognized the threat to the swine industry and initiated preparedness activities. Other mosquito-borne viruses exotic to the Western Hemisphere have been introduced and established in in recent years, including West Nile, Zika, and chikungunya viruses, and JEV has recently invaded continental Australia for the first time. These events amply illustrate the potential threat of JEV to US health security. Susceptible indigenous mosquito vectors, birds, feral and domestic pigs, and possibly bats, constitute the receptive ecological ingredients for spread of JEV in the US. Fortunately, unlike the other virus invaders mentioned above, an inactivated whole virus JE vaccine (IXIARO®) has been approved by the US Food & Drug Administration for human use in advance of a public health emergency, but there is no veterinary vaccine. This paper describes the risks and potential consequences of introduction of JEV in the US, the need to integrate planning for such an event in public health policy and the requirement for additional countermeasures, including antiviral drugs and an improved single dose vaccine that elicits durable immunity in both humans and livestock.

A study of the water quality of the Adolfo López Mateos Reservoir (ALMD) was developed through different indicators from a spatial and seasonal perspective. Variables related to the general characteristics of water quality, trophic level and ecological risk were assessed through the water Quality Index (WQI_NSF-BROWN), Trophic State Index (TSI_CARLSON) and the Ecological Risk Index (RI_HAKANSON). Using data from physical, chemical and biological parameters obtained from four sampling points in the ALMD, the water quality was assessed in each model used. The results indicated that the reservoir presents a water quality classified as “medium” (WQI_NSF-BROWN = 70), where significant variations in the concentrations of some parameters are observed. The reservoir showed a general trophic state classified as “Mesotrophic” (TSI_{GENERAL-AVERAGE} = 43.04). The ecological risk analysis achieved the best classification of the methodology, discarding contamination by heavy metals in surface waters. Through this type of applied methodologies will help as decision making tools in the dam, as well as for application in other dams in the region.

Sulfotransferases (SULTs) family plays a significant role in the biotransformation of a variety of xenobiotics and endogenous compounds by which carcinogenesis and mutagenicity of different malignancies are increasingly affected. Recent data identified various genetically polymorphic SULTs enzymes with significant variations in the enzyme activity. This study aimed to investigate the impact of SULT1A1 gene polymorphism and and its potential risk on females with breast cancer in Jordan using a PCR-RFLP and Sanger Sequencing methods. The analysis showed that 24.7% of the patients and 25.3% of the controls were homozygous for the SULT1A1*1 allele (SULT1A1*1/SULT1A1*1) compared to 8.8% and 5.7% homozygous for the SULT1A1*2 allele (SULT1A1*2/SULT1A1*2) for patients and controls respectively. Most of the patients and controls were heterozygous for SULT1A1*1 allele (SULT1A1*1/SULT1A1*2) with rates of 66.5% and 69.0% in patients and controls respectively. In addition, the frequencies of the mutant SULT1A1*2 allele were 0.42 and 0.4 in the patient and control groups respectively. No significant difference in genotype and allele distribution was noted between the breast cancer and control groups. The risk of breast cancer in individuals carrying the SULT1A1*2 allele was determined by combining the SULT1A1*1/SULT1A1*2 and ULT1A1*2/SULT1A1*2 genotypes. No association was observed between SULT1A1 polymorphism and breast cancer incidence (P = 0.63; OR, 0.93; 95% CI, 0.68–1.26). However, SULT1A1*2 allele was found to increase the risk of breast cancer by 1.26-fold.

Background and Objectives: Overuse and inappropriate use of testing and hospital admission are common in syncope evaluation and management. Though guidelines are available to optimize syncope care, study suggested that the current clinical guidelines have not significantly impacted resource utilization surrounding emergency department (ED) evaluation of syncope. Matching implementation strategies to barriers and facilitators and tailoring strategies to local context hold significant promise for a successful implementation of clinical practice guideline (CPG). Our team applied implementation science principles to develop a stakeholder-based implementation strategy. Methods and Materials: We partnered with patients, family caregivers, frontline clinicians and staff, and health system administrators at four health systems to conduct quantitative surveys and qualitative interviews for context assessment. The identification of implementation strategies was done by applying the CFIR-ERIC Implementation Strategy Matching Tool and soliciting stakeholders’ inputs. We then co-designed with patients and frontline teams, developed and tested specific strategies. Results: 114 clinicians completed surveys and 32 clinicians and stake-holders participated in interviews. Results from the surveys and interview indicated low awareness of syncope guidelines, and communication challenges with patients, lack of CPG protocol integration into ED workflows, and organizational process to change were recognized as major barriers. Thirty-one patients and their family caregivers participated in interviews and ex-pressed their expectations: clarity regarding their diagnosis, context surrounding care plan and diagnostic testing, and a desire to feel cared about. After identifying change methods to address those barriers, the multilevel, multicomponent implementation strategy, MISSION, included pa-tient educational materials, mentored implementation, academic detailing, Syncope Optimal Care Pathway and corresponding Mobile App, and Lean quality improvement methods. The pilot of MISSION demonstrated feasibility, acceptability and initial success on appropriate testing. Con-clusions: Effect multifaceted implementation strategies that target individuals, teams, and healthcare systems can be employed to plan successful implementation and promote adherence to syncope CPGs.

The study focused on investigating the natural incidence of deoxynivalenol (DON) in corn and products from corn producing districts of Punjab, Pakistan. The analysis was carried out using HPLC with UV detector and immunoaffinity cleanup columns. The detection limit (LOD) and limit of quantification were 25 and 50 µg/kg, respectively. Total 1220 samples of corn and products were analyzed to detect the DON, and 539 (44.2%) samples were observed to be contaminated with DON (n ≥ LOD). Furthermore, 92 (7.5%) samples of corn & products have DON levels, elevated than the proposed limits of the EU. The data is significantly different from a normal distribution for DON in corn and products samples and from different locations (p < 0.05) for Shapiro-Wilk and Kolmogorov-Smirnov values. However, a significant difference in DON levels was found between corn and corn derived-products types (p ≤ 0.05). The lowest and highest exposure & hazard quotient (HQ) of 0.92 and 9.68 µg/kg bw/d were documented in cornflour samples.

Pluvial flooding (PF), triggered by intense short-duration rainfall events, poses a growing challenge in urban areas due to climate change and rapid urbanization. To mitigate the risk, it is imperative to identify flood-prone areas and implement mitigation strategies collaboratively with the public. This study aims to create a GIS-MCDA model of PF susceptibility zones based on topographical, environmental, and hydrological criteria and investigate the public perception of risk in Gospić. The survey included 5% of the city population (N=64), and data were obtained via face-to-face interviews. Five factors were examined: (F1) risk awareness, (F2) anthropogenic and (F3) natural causes of PF, (F4) potential consequences, and (F5) preparedness. All factors have moderate mean values, i.e., awareness, causes of PF, expectations of consequences, and preparedness is moderate. The reliability of questionnaire is very high (&gt; 0.71). The PF susceptibility zones were derived with an accuracy of 76%. The most susceptible zone covers 10% of the city, including agricultural land, forests, meadows, and residential properties. Of all respondents, 36% live in the most flood-prone area. In conclusion, mitigation measures for decision-makers were proposed. Results from this research can be a starting point for further research in Croatia and guidelines for decision-makers in implementing a risk mitigation strategy.

The purpose of this paper is to explore the impact on corporate social responsibility when Jordanian banks disclose risks. The main objective of the study is to investigate the relationship between risk disclosure and corporate social responsibility in the banking sector in Jordan. To achieve this goal, data was collected from 23 Jordanian banks listed on the Amman Stock Exchange (ASE) over a period of 10 years, from 2010 to 2019. The data was analyzed using a regression model with four independent variables that represent the risk disclosure; corporate social responsibility was used as the dependent variable. The study also built in controls for the age of each bank, its size, leverage, and ROE, to ensure that the results were not affected by these factors. The results of the study show that all independent variables are positively correlated with corporate social responsibility. This suggests that disclosing risks is an effective way to improve corporate social responsibility in the banking industry. The findings of this study have important practical implications for bank managers, future researchers, and policymakers. The study also highlights the importance of future research in this field in order to understand the relationship between risk disclosure and corporate social responsibility in other countries and within other sectors of industry.

Greek consumers perceive an increased risk of pesticide residues in food. This study examined Greek consumers' perceptions on the safety of Greek plant-based food compared to those originating from other EU countries. Half of Greek consumers believe that Greek food is as safe as other European foods, while the other half disagree. According to a principal components analysis and a bivariate logistic regression, several factors, such as perceived safety of plant foods, education, age, gender, traceability, perceived benefits and risks of pesticides, actual pesticide use, and authoritative information sources, influence this attitude. Authoritative knowledge in this field can reduce risk perception and improve Greek consumers’ attitudes towards food safety. Latent class analysis identified two categories of consumers. The first class receives limited information about pesticides, leading to a lower perceived pesticide benefits, higher mistrust of traceability and concerns about pesticide residues. In contrast, the second class actively searches for information from credible sources, endorses the Greek plant foods safety, acknowledges the pesticides benefits, and trust traceability. Official information is associated to reduced risk perception. Regulators should consider the impact of socio-demographic and other intrinsic characteristics on individuals' risk perceptions and prioritise transparency in risk communication strategies.

This study investigates how the determinants including risk preference affect farmers’ decision to adopt SLM practices in upland areas of Vietnam. Empirical data collected through in-depth interviews with 200 farmers in Na Ri district, Bac Kan province were used. The factors affecting SLM adoption of farmers in Na Ri district were examined by the 2SLS or IV-Probit model. The estimated 2SLS regression indicated that there is a set of factors affecting SLM adoption, namely, relative risk aversion, farming experience, farm size, knowledge of SLM, membership in farmers’ organization, number of labors, and slope of farm land. Specifically, relative risk aversion had a negative effect on SLM practices adoption. The farmers who are less risk averse are more likely to adopt more SLM practices. This implies that reducing farmer’ risk exposure could promote SLM practices. This result is also helpful for policymakers to understand farmers’ behaviors and promote the diffusion of SLM practices across regions on a large scale.

In the past two decades, several floods have affected people and their properties in Burkina Faso, with the unprecedented flooding occurring in Ouagadougou in September 2009. So far, most studies have focused on Ouagadougou and surrounding localities and have paid little attention to other flood-prone regions in Burkina Faso. Specifically, there is a data and knowledge gap about the flood risk in the Haut-Bassins region, which in turn hampers the development of mitigation strategies and risk reduction measures in communities. This study demonstrates how data collected at the household level can be used to understand flood risk and its components at the village level in this data-scarce region. Using an indicator-based method, we analyze both flood risk and flood risk perception at the village level. Moreover, we determine the factors influencing flood risk perception at the household level using an ordered logit model. We find that 12 out of the 14 villages considered, experience high levels of flood risk. The management of runoff from the nearest urban areas and poorly designed civil engineering infrastructures, such as roads, were highlighted by the households as significant factors that increase their vulnerability. Hence, dependencies in space and between urban and rural areas may play a substantial role in modifying risk. The perceived flood risk consistently exceeds the estimated flood risk, with an insignificant positive correlation between both risk indices. Regression results indicate that flood risk perception is mainly influenced by informational and behavioral factors of the households. The findings of this study can provide valuable information to municipal and regional authorities involved in disaster risk management in the study area. Moreover, the method is transferable to other data-scarce regions

This study explores individual and contextual risk factors for the onset of work interfering with private life (WIL) and private life interfering with work (LIW) among self-employed men and women across European countries. It also studies the relationship between interference (LIW and WIL) and wellbeing among self-employed men and women and the effect of macro level risk factors. Data from the fifth round of European Working Conditions Survey was utilized and a sample of self-employed men and women with active businesses was extracted. Applying multilevel regressions, results show that though business characteristics are important for level of WIL, time demand is the most evident risk factor for WIL and LIW. There is a relationship between wellbeing and WIL and LIW respectively, and time demands is the most important factor in this relationship. Gender equality on the labor market did not relate to level of interference, nor did it mediate the relationship between interference and wellbeing. However, the main and most important risk factor for experiencing WIL and LIW and for how interference relate to wellbeing is gender relation processes in work and life, both on individual and contextual level.

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 VUCA world is the epitome of the challenges linked with some of the undercurrents currently shaping businesses in the projectified society. The terms volatility, uncertainty, complexity and ambiguity (VUCA) are used as descriptive for the continuous flux project managers and project planners are forced to keep at bay. In this article, the authors present an idea to connect the VUCA concept as a risk identification platform to access, identify and isolate low-probability but high-impact events often called black swans or fat tail events. It is argued that the assumptions of conventional risk assessment in the domain of project management can lead to skewed general outcomes due to limitations of the intellect to assess probability. The outline of the VUCA meter is drafted and argued that the meter can augment the conventional risk assessment

Floods are the most frequent and devastating disasters in Bangladesh. The riverine islands, known as char-lands, are particularly vulnerable to flooding. As flooding poses a significant threat to the lives and livelihoods of residents, especially farmers, it is crucial to understand how they perceive flood risk and assess their adaptation strategies in this geographically susceptible context. However, the existing literature has not adequately addressed these issues. Therefore, this study aims to analyze the factors influencing farmers' perceived flood risk and their assessments of flood adaptation. In a survey of 359 farmers in Bangladesh's char-land region, located in the Chowhali sub-district of Sirajganj district, we used the protection motivation theory (PMT) to measure farmers' perceived flood risk and adaptation assessments. Multiple regression analysis was employed to identify factors influencing them. Farmers prioritized the risk to livelihoods (production and income) over psychological aspects (health and diseases). Larger farms, more flood experience, and greater risk awareness are associated with higher overall flood risk perception; and better flood adaptation, indicating higher self-efficacy, response efficacy, and response cost among farmers. Farmers perceived lower flood risk in exchange for greater house distance from the river and more trust in government actions. Hence, strengthening campaigns and programs is crucial to understanding flood risk in char-lands for improved adaptation to floods. The study highlights the application of PMT to assess farmers' perceptions of flood risk and their attitudes towards adaptation, suggesting further research opportunities.

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

Limited understanding exists concerning leptospirosis in Zanzibar. The objective of this study is to evaluate the degree of knowledge and awareness of leptospirosis within the urban and peri-urban populations of Unguja. A cross-sectional study was conducted utilizing semi-structured questionnaires from January to April 2022. Two hundred respondents were randomly selected (130 males and 70 females) aged between 18 and 89 years. Descriptive analysis was employed to assess the main trends in knowledge and awareness, and χ2 analysis was utilized to determine associations between demographic characteristics with respondents’ knowledge and awareness. The majority of respondents (64%) lacked awareness of leptospirosis' etiology, but a significant proportion of respondents had a favorable attitude (68.6%) towards leptospirosis compared to their average knowledge and awareness (35%) and practices (29.3%). Nonetheless, the livestock keeper, farmers, fishermen, and healthcare providers had low levels of knowledge and awareness. The findings also demonstrated that males had a strong association with occupational physical activities, while educational level was associated with preventive practices. Living in urban or peri-urban areas was significantly linked with the respondents' practices. The study's outcomes demonstrated low levels of community knowledge and awareness regarding leptospirosis' etiology, mode of transmission, and symptoms among livestock keepers, farmers, fishermen, and healthcare providers. Although most respondents had a favorable attitude, their low level of knowledge and poor practices indicate that supplementing a positive attitude with enhanced knowledge and awareness is necessary to promote individual engagement in preventive measures.

To safeguard against meat supply shortages during pandemics or other catastrophes, this study analyzed the potential to provide the average household’s entire protein consumption using either soybean production or distributed meat production at the household level in the U.S. with: 1) pasture-fed rabbits, 2) pellet and hay-fed rabbits, or 3) pellet-fed chickens. Only using the average backyard resources, soybean cultivation can provide 80%-160% of household protein and 0%-50% of a household’s protein needs can be provided by pasture-fed rabbits using only the yard grass as feed. If external supplementation of feed is available, raising 52 chickens while also harvesting the concomitant eggs or alternately 107 grain-fed rabbits can meet 100% of an average household’s protein requirements. These results show that resilience to future pandemics and challenges associated with growing meat demands can be incrementally addressed through backyard distributed protein production. Backyard production of chicken meat, eggs, and rabbit meat reduces environmental costs of protein due to savings in production, transportation, and refrigeration of meat products and even more so with soybeans. Generally, distributed production of protein was found to be economically competitive with centralized production of meat if distributed labor costs were ignored.

Thoracic aortic calcium (TAC) appears to be a subclinical marker of cardiovascular disease (CVD) and to predict CV mortality. However, studies on TAC use tomographic scans obtained for coronary artery calcium (CAC) score, which does not include the aortic arch. This study evaluates TAC prevalence in aortic arch (AAC), ascending (ATAC) and descending thoracic aorta (DTAC) and verify whether they are associated with the same CV risk factors. Cross-sectional analysis, including 2,427 participants (mean age 55.6 ± 8.7; 54,1% women) of the ELSA-Brasil cohort. Nonenhanced ECG-gated tomographies were performed in 2015-2016. Multivariable logistic regression estimated the CV risk factors associated with calcium in each segment. Overall prevalence of ATAC, AAC and DTAC was, 23,1%, 62.1%, and 31.2%, respectively. About 90.4% of the individuals with TAC had AAC and only 19.5% had calcium in all segments. In the multivariable analysis, increasing age, lower levels of schooling, current smoking, higher body mass index, and hypertension remained associated with calcium in all segments. No sex or race/ethnicity differences were found in any aortic segment. Diabetes and Dyslipidemia were associated with ATAC and DTAC, but not with AAC, suggesting that AAC may reflect an overlap of mechanisms that impact vascular health, including atherosclerosis.

Background and aim: To explore the discriminant accuracy of Cytokeratin 18 (CK18, including M65 and M30 forms) for an elevated fatty liver index (FLI) as a validated proxy of Non-Alcoholic Fatty Liver Disease (NAFLD), and cardiovascular disease (CVD) risk in the general population. Methods: Both serum CK18 forms were measured using a commercial immunoassay in randomly selected samples from 312 participants of the PREVEND general population cohort. FLI ≥60 was used to indicate NAFLD. Framingham Risk Score (FRS) and the SCORE2 were used to estimate the 10-year risk of CVD. Receiver Operating Characteristic (ROC) curve, linear/logistic regression models and Spearman's correlations were used. Results: Intricate associations were found between CK18, FLI and CVD risk scores. While M30 was the only independent predictor of FLI≥60, M65 discriminated best NAFLD individuals at very-high 10-years CVD risk according to SCORE2 (AUC:0.71; p=0.001). Values above the predefined manufacturer cut-off (400 U/l), were associated with an independent 5-fold increased risk (adjusted odds ratio: 5.44, p=0.01), with negative predictive value of 93%. Conclusions: Confirming that NAFLD is associated with an increased CVD risk, our results point to CK18 M65 as a candidate biomarker to identify NAFLD individuals at low CVD risk in European general population.

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

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.

Wildfires can be destructive to highway infrastructure. Despite the substantial number of wildfires experienced every year, research on the physical impacts of wildfire on highways has been understudied. This research examines historical and potential future highway physical damage from wildfires. To accomplish our research objectives, we examined three major areas related to physical harm to highways and the consequences of that damage – physical characteristics, roadway impacts, and traffic impacts. These categories were subsequently broken into additional metrics, the first being physical characteristics, which includes length of highway affected and reduced average daily traffic (RADT) impacts during the event. Roadway impacts were broken into the number of trees requiring removal (those that present a danger either standing or fallen), pavement damage (burning asphalt concrete), slope/rock scaling (loose hazard rocks/vegetation), and structural damage (guardrail, signs, and delineators). Traffic impacts included the need for traffic control, road closures required, and reduced annual average daily traffic (RAADT) impacts for the year. The physical characteristics on the three highways researched during the 2020 Oregon Labor Day wildfires (Beachie Creek, Archie Creek, and Holiday Farm) indicated less than 61% of the highways were affected. The highway impacts, which included damage from hazard trees, damage to various structures – guardrail, signs, and delineators as well as bridges, slope/rock scaling damage and pavement destruction – averaged 34% for the three highways, while the three of eight arterial highway routes studied in the Oregon Cascades saw a 21% reduction in AADT. Results from this study can be used not only to assess physical damage to highways from wildfires, but as a baseline for measuring and assessing potential future wildfire highway impacts.

The current discussion about a “risk culture” in financial services was triggered by the recent series of crisis (from the US subprime mortgage crisis to the lock-in trap of central banks in the aftermath of the sovereign debt crisis). The last decade saw a long list of hybris, misconduct and criminal activities by human beings on a single or even a collective basis in banks, in the industry or in the whole economy. As a counter-reaction, financial authorities called for a guidance by a “new” risk culture in financial institutions based on a set of abstract, formal and normative governance processes. In the humanities, culture is a paraphrase for the behaviour in collectives and dynamics of organization found in human societies. Therefore, a “risk culture” should be a link between those normative guidelines and the positive “real-world” decision-making in financial services. This paper will focus on “risk culture” from the perspective of human beings interacting in dynamical and intertemporal commercial relations. In this context, “risk” is perceived by economic agents ex-ante as the consequence of the time-lag between the present and the uncertain future development (compared to a probability distribution calculated by observers ex-post). For all those individual decisions – to be made under uncertainty – future “risk” includes the so-called “normal accidents”, i.e. failures that will happen at some uncertain point in time but inevitable, and it is only the questions, when failure will happen and how to maintain function in the first line of defence. Finally, the sum of all decisions with individual responsibility for things to come is the positive economical context of a “risk culture” in the sense of the (rational) behaviour of an honourable merchant in long-term and repeated commercial relations in a merchant community, as this is a heritage of European business culture.

The benefit of adjuvant radiotherapy (RT) after radical hysterectomy in patients with cervical cancer remains controversial. The aim of this study was to determine the impact on survival of adjuvant RT according to the Sedlis criteria. Patients with early-stage cervical cancer who underwent radical hysterectomy between 2005 and 2022 at a single tertiary institution were included. A multivariate analysis was performed to determinate if RT was an independent prognostic factor for recurrence or death. We also analyzed whether there was a statistically significant difference in overall survival (OS) between patients who met only one or two Sedlis criteria, depending on whether they received adjuvant RT or not. In this retrospective study 121 patients were included of whom 48(39.7%) received adjuvant RT due to the presence of unfavorable pathological findings. In multivariate analysis, RT was not found to be a statistically significant prognostic factor for OS (p=0.584) or disease-free survival (DFS) (p=0.559). When comparing patients who met one or two Sedlis criteria, there were no statistically significant differences in OS between RT and no adjuvant treatment in either group. Since the selection of patients with cervical cancer eligible for surgery is becoming more accurate, adjuvant RT might not be necessary for patients with intermediate-risk factors.

Traditional edible barbecue products use with lemon juice not only make the barbecue more delicious but also reduce the risk of PAHs in the barbecue products. One of the major economics crops in Taiwan, the waste from citrus fruits was very tremendous mass. However, the peelings of citrus fruits are rich in essential oil, especially, the limonene is the major. Whether the anti-carcinogenesis activities of terpene, such as limonene, in citrus fruits essential oil extraction. This study to demonstrate the PAHs content in fish skin increased markedly after being roasted at 210℃ for 20 minutes and greater mutagenicity risk of roasted fish skin was observed by Ame's test. The reduction of mutagenicity risk of roasted fish skin, which the antimutagenic abilities of substances in descending order were limonene > cold pressure oil > lemon >grapefruit. The antimutagenicity rate and ability of the three extracts were limonene: 18–23%; cold-pressed lemon oil: 18–22%; and steam distilled lemon essential oil: 8–16%. The obvious anti- mutagenicity effects against the PAHs mutagenicity of roasted fish skins can be found in citrus fruits essential oil extraction.

The management of existing water distribution system (WDS) is challenged by ageing of infrastructure, population growth, increasing of urbanization, climate change impacts and environmental pollution. Therefore, there is a need for integrated solutions that support decision makers to plan today, while taking into account the effect of these factors in the mid and long term. The paper is part of a more comprehensive project, where advanced hydraulic analysis for WDS is coupled with a dynamic resources input-output analysis model. The proposed modeling solution can be used to optimize the performance of a water supply system while considering also the energy consumption and consequently the environmental impacts. Therefore, as a support tool in the management of a water supply system also in the intervention planning. Here a possible application is presented for rehabilitation/replacement planning while maximizing the network mechanical reliability and minimizing risk of unsupplied demand and pressure deficit, under given economic constraints.

The quadruple burden of diseases, early discharge from hospital and hospital at home have resulted in home-based care services becoming a requirement in South Africa. The home-based care services generate a significant amount of health care risk waste that is mismanaged. However, more attention is given to the health care risk waste generated in hospitals and clinics than to health care risk waste generated by home-based caregivers. Therefore, this study investigates the health care risk waste management practices by home-based caregivers. The study adopted a mixed research approach, qualitative and quantitative methods, using a literature review, interviews, and questionnaires as means of data collection. Results show that there are different types of health care risk waste generated as a result of different activities performed by home-based caregivers, but that the waste was found to be managed in an unsafe manner. The majority of households receiving home-based care did not have basic sanitation facilities such as toilets, running water and waste removal services, aggravating the issue of health care risk waste mismanagement. The study recommends a new policy framework that will lead to safe management practices of generated health care risk waste to be adopted by home-based caregivers.

AbstractWe investigated the effect of cigarette smoking on pathological staging in clinically low-risk patients. Data of 59 patients who were diagnosed with bladder tumor for the first time and had a single lesion radiologically and endoscopically smaller than 3 cm were investigated retrospectively. 33 patients who smoked were classified as Group I, and 26 patients who did not smoke were classified as Group II. Pathological diagnoses of the patients in both groups were compared. The mean age of the patients were 64.8 (20–86) years. In Group II, 5 (19.2%) were female and 21 (80.8%) were male (p < 0.05). Nine patients (27.3%) in Group I and 18 patients (69.2%) in Group II had Ta disease (p < 0.05). Nineteen patients (57.6%) in Group I and 5 patients (19.2%) in Group II had T₁ disease (p < 0.05). The number of patients with low grade (LG) tumor were 8 (24.2%) and 19 (73.1%) in Group I and in Group II, respectively (p < 0.05). The number of patients with high grade(HG) tumor were 25 (75.8%) and 7 (26.9%) in Group I and in Group II, respectively (p < 0.05). TaHG was detected in 9 (27.3%) patients in Group I. In contrast, no patients in Group II had TaHG disease (p < 0.05). The number of patients with T₁HG was 17(51.5%) patients in Group I and 2 (7.69%) patients in Group II (p < 0.05). Smoking is associated with pathologically HG and stage in patients with first time bladder tumor which is single and smaller than 3 cm.

Oil has become the object of global exploits and fierce competition among the major world powers as it is a key strategic non-renewable resource. Transnational petroleum investment is therefore an important mechanism available to countries and international corporations to control oil resources even though there are numerous inherent uncertainties and risks. A new risk assessment index system is proposed in this paper based on use of the Delphi expert scoring system and fuzzy comprehensive evaluation that aims to minimize the potential risks inherent to multinational petroleum investment. This approach encapsulates political, legal, socioeconomic, and infrastructural factors to develop a technical method that can be used for transnational petroleum investment risk assessment. An evaluation of oil investment risk within a case study area is also presented; results provide reference data that can be applied by national and international oil companies to mitigate risks of transnational oil investment.

The association between obesity and the risk of gliomas remains unclear. We sought to evaluate the potential association between general and abdominal obesity and the risk of gliomas based on a nationwide population-based cohort study of Koreans. Using data from the Korean National Health Insurance System cohort, 6,833,744 people older than 20 years who underwent regular national health examination in both 2009 and 2011 were followed until the end of 2017. We documented 4,771 glioma cases based on an ICD-10 code of C71 during the median follow-up period of 7.30 years. Individuals with a body mass index (BMI) ≥ 25.0 kg/m2 were at significantly higher risk of gliomas than those with a BMI < 25.0 kg/m2 (HR 1.08 CI 1.02-1.15). Individuals with a waist circumference (WC) ≥ 90 cm (males)/85 cm (females) also had a significantly higher risk of gliomas than those with a WC < 90 cm (males)/85 cm (females) (HR 1.16 CI 1.09-1.24). In the group with a BMI ≥ 25.0 kg/m2, individuals with abdominal obesity were at significantly higher risk of gliomas (HR 1.18 CI 1.09-1.27) than those without abdominal obesity. The role of abdominal obesity in this association was stronger in women than in men. To our knowledge, this is the first demonstration that obese people may be at higher risk of gliomas, especially centrally obese people from an Asian population with a BMI ≥ 25.0 kg/m2. Loss of visceral fat in people with abdominal obesity may reduce their risk of gliomas.

The apple leaf-curling midge, Dasineura mali Kieffer (Diptera: Cecidomyiidae), is an invasive pest of apple. To provide crucial information for its pest risk analysis, forecast and management, we investigated the effects of temperatures (5, 10, 15, 20 and 25°C) and daylengths (10, 11, 12, 13, 14 and 15 hrs) on its development and survival. The midge could not complete its development at 10°C or lower. After transferred from 20°C to 10°C, mature larvae could survive for about two months and develop to adults. Pupation and emergence rates were significantly higher at 20°C than at 10°C and 25°C. Daylength had no effect on these parameters. The low temperature threshold and thermal requirement to complete development from eggs to adults were 3.7°C and 627 degree-days, respectively. The midge had significantly lower thermal requirement for completion of its lifecycle at 20°C (614.5 degree-days) than at 15°C (650.1 degree-days) and 25°C (634.8 degree-days). The thermal model developed in this study provided accurate predictions of the number of D. mali generations and adult emergence time in each generation in different regions of New Zealand. We suggest that the model could be used to predict population dynamics of this pest in other parts of the world.

In recent years, rainfall-induced waterlogging has become a common hazard in the highly urbanized coastal city of Chattogram, Bangladesh resulting in high magnitude of property damage and economic loss. Therefore, the primary objective of this research is to prepare a waterlogging inventory map and understand the spatial variation of the risk by means of hazard intensity, exposure, and vulnerability of waterlogging. In this research, the inventory map and factors influencing waterlogging hazard were determined from a participatory survey and other spatial data including land elevation, population, and structural data were collected from secondary sources. Analytical Hierarchy Process was applied to measure the hazard intensity and the exposure and vulnerability were estimated by overlaying the spatial data onto the hazard intensity map. A total of 58 locations in 22 wards have been identified as waterlogging affected, which covers ~8.42% of the city area. Obtained waterlogging vulnerability index map suggests that ward no. 5, 6, 16, 17, and 33 are greatly vulnerable to waterlogging in terms of their social, infrastructure, critical facilities, economic and environmental vulnerability. We show that ~2.71% of the study area is at very high risk, while the risk score is considerably higher for ward no. 5, 8, 17, 19, and 33.

The study of the distribution and health risk assessment is meaningful to provide basic data for environmental management．To investigate the pollution of potential toxic organics and their health risk to human beings, water samples were collected at 7 sites of main surface water of Beijing during wet and dry seasons respectively. The targeted 92 organics were detected, including phthalates (PAEs), volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs) and phenols. The results showed that: there were 56 organics detected out, and the number ratios of detected compounds to the total compounds of the same kind increased as the following: VOCs, phthalates, phenols, PAHs. 8 VOCs were detected in wet season, and 3 in dry season. The concentration of 2,2-Dichloropropane was highest as 10.62ug/L, while the concentrations of other VOCs were below 5ug/L; There were 11 phthalates detected during dry season. The content of Bis(2-methoxyethyl) phthalate was highest as 188.47ng/L; 17 phenols were found in samples during wet season, and the highest concentration was 1244.73ng/L for 4-nitrophenol; PAHs could be detected in all samples, and the detected compounds and the corresponding average concentrations were higher in wet seasons than those in dry seasons, which indicated that non-point pollution was possibly the main pollution source. The health risk assessment of the detected 56 pollutants by using a model from US EPA showed that, the risk caused by the four kinds of toxic organics in this study was in the acceptable ranges.

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.

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.

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 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.

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.

While studies that examined risk perceptions in various environments have been previously conducted, the relationship between risk perceptions measured in such environments had not been examined. Such a relationship, if found, may indicate that when one learns to identify risks in one environment, they may identify risks more easily and quickly in another.This study examined the relationship between measures of risk perception in several separate environments. The findings suggest that when learning to identify and assess risks in a particular environment, one may better identify and assess risks in a similar environment – for example, learning to identify and assess risks while driving makes it easier to identify and assess risks when crossing a road. Conversely, the findings also indicate that learning to identify and assess risks in one environment does not make it possible to better identify and assess risks in a disparate environment – for example, learning to identify and assess risks while driving does not make it easier to identify and assess risks in a workplace environment. This may also suggest that while disparate environments such as the road environment and the workplace environment are perceived as two separate environments, the road environment is experienced as one single environment by both drivers and pedestrians.

Background: Necrotizing enterocolitis (NEC) is one of the leading causes of death in newborns, however, little is understood of which patients can be treated medically or require surgery. The purpose of our study is to analyze the associated factors of surgically treated patients compared to patients requiring only medical treatment. Methods: Patients diagnosed with necrotizing enterocolitis over a period of 14 years in a single children’s hospital were retrospectively enrolled. Demographics and clinical data patients were collected and analyzed. Results: A total of 189 patients with NEC were included. Surgically treated patients had a lower gestational age (P = .018), body weight at birth (P = .034), and percentage of exclusive breast milk feeding (P= .001). They had increased comorbidity with respiratory distress syndrome (RDS) (P = .005), number of days of antibiotic use (P = .014), and length of hospital stay (P = .000). In multivariate logistic analysis, a lower percentage of exclusive breast milk feeding (OR = 0.366, 95% CI: 0.164-0.817) and a longer hospital stay (OR = 1.010, 95% CI: 1.001- 1.019) was associated with surgical NEC. Conclusion: Comparing medical and surgical NEC, a significantly lower percentage of surgical NEC patients were exclusively fed breast milk and their hospital stays were longer.

This study integrated coastal-watershed models and combined a risk assessment method to develop a methodology to investigate the impact resulting from coastal disasters under climate change. The mid-western coast of Taiwan suffering from land subsidence was selected as the demonstrative area for the vulnerability analysis based on prediction of sea level rise (SLR), wave run-up, overtopping, and coastal flooding under the scenarios of 2020 to 2039. Database from tidal gauges and satellite images were used to analyze sea level rise using EEMD (Ensemble Empirical Mode Decomposition). Extreme wave condition and storm surge were estimated by numerical simulation using WWM (Wind Wave Model) and POM (Princeton Ocean Model). Coastal inundation was then simulated via WASH123D watershed model. The risk map of study areas based on the analyses of vulnerability and disaster were established using the AHP (Analytic Hierarchy Process) technique. Predictions of sea level rise, the maximum wave condition and storm surge under the scenarios of 2020 to 2039 are presented. The results indicate that the sea level at the mid-western coast of Taiwan will rise in an average of 5.8 cm, equivalent to a rising velocity of 2.8 mm/year. The analysis indicates that Wuqi, Lukang, Mailiao, and Taixi townships are susceptive, low resistant and low resilient, and reaches the high risk level. The assessment provides that important information for making adaption policy in the mid-western coast of Taiwan.

The Internet-of-Things (IoT) triggers new types of cyber risks. Therefore, the integration of new IoT devices and services requires a self-assessment of IoT cyber security posture. By security posture this article refers to the cybersecurity strength of an organisation to predict, prevent and respond to cyberthreats. At present, there is a gap in the state-of-the-art, because there are no self-assessment methods for quantifying IoT cyber risk posture. To address this gap, an empirical analysis is performed of 12 cyber risk assessment approaches. The results and the main findings from the analysis is presented as the current and a target risk state for IoT systems, followed by conclusions and recommendations on a transformation roadmap, describing how IoT systems can achieve the target state with a new goal-oriented dependency model. By target state, we refer to the cyber security target that matches the generic security requirements of an organisation. The research paper studies and adapts four alternatives for IoT risk assessment and identifies the goal-oriented dependency modelling as a dominant approach among the risk assessment models studied. The new goal-oriented dependency model in this article enables the assessment of uncontrollable risk states in complex IoT systems and can be used for a quantitative self-assessment of IoT cyber risk posture.

Starting from the importance of risk perception for taking certain preventive measures to protect people and their property from disasters, the subject of the research is to examine the factors influencing public perception of mythically-based human behavior in disaster conditions. Using the random sampling method, 250 adult respondents were surveyed in the city of Belgrade, using a specially created and adapted survey questionnaire. The results of the research show that there is no statistically significant influence of gender, age, educational and economic factors on the public perception of human behavior in disaster conditions. The results of the research can be used to improve strategies and campaigns based on risk assessment, aimed at improving the safety of people in disasters.

Risk attitudes are relevant factors affecting the production and investment decisions at farm level. They are key factors that are related to farmers’ attitudes towards environment and climate change. Several methodological approaches are available to measure the level of stated risk of an economic agent. The Multiple Price List (MPL) method is one of the methods that is gaining relevance. In this study we apply the MPL and relate the risk outcomes with farmers’ characteristics and their perception towards environment and climate change. Data was collected using a face to face survey carried out for a group of 370 agricultural producers of the irrigation district located in northwest of Mexico. Results showed an average risk of about 0.32, locating the agricultural producers of the region in a group with risk aversion, according to the MPL scale. The heterogeneity analysis showed that the socioeconomic factors and the perceptions towards climate change are related to the farmers´ stated risk level. Farmers who are young women with propensity to use public support to invest were shown to be greater risk lovers. Farmers in the region have perceived climate change to a greater extent like floods, hail, diseases and pests, and changing vegetation.

A brief overview of the past and present trajectories made by the A(H5N1) avian influenza virus among domestic birds, avian and mammalian wildlife species and humans is presented here, thereby taking into special account the 2.3.4.4b clade of the virus recently emerged in several geographic areas of the globe.

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.

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.

Edible insects can diversify diets, improve livelihoods, contribute to food and nutrition security, and have a smaller ecological impact. European Union has categorized insects as novel food, and recently, in 2021 and 2022, two species: Tenebrio molitor and Acheta domesticus have been authorized for commercialization. Acceptance and perception of food risk derived from insect consumption vary depending on factors impacting insect consumption acceptability, including neophobic tendencies, gender differences, familiarity, and gastronomic perceptions. The aim of this work was to evaluate the perception and acceptance of edible insects by exploring those factors. The study was carried out on higher education students from Universities from Valencia (Spain). Students recognize insects for their high nutritional value, particularly protein content, and have varying knowledge levels about specific nutritional components. In terms of labeling and marketing, removing health and sustainability benefits from packaging can improve consumer responses. Most respondents prefer clear labeling of insect derivatives, quality certification seals, and complete information about insect content. Students consider marketing and knowledge as significant influencers of insect consumption. In summary, the text highlights the multifaceted nature of insect consumption acceptability. These insights offer valuable perspectives on insect consumption dynamics.

For a long time, the transition to adulthood was seen as a troubled period where good development was synonymous with the absence of problems. Positive Youth Development (PYD) emerged as a holistic and strength-based perspective that focuses on the fact that young people may have the internal and external resources for healthy and successful development through five dimensions (5C’s) that empower them: Perceived Competence, Confidence, Character, Connection, and Caring. The aim of this study was to examine the relationship between the global PYD factor (and the 5C’s) and risk behaviors, in addition to analyzing gender differences. This study showed the results of a cross-sectional study of 1044 emerging adults from 11 Spanish universities in 2021. Data collection was performed by applying an online self-report measure. The results showed that the Character was protective against substance abuse, mainly in women, while the connection was related to the participation of betting money and online betting in men. Caring was protective against money bets in the men’s sample. However, controversial results were found regarding Perceived competence, which had a positive association with substance abuse, money bets, and drunk driving. It seems that high levels of Perceived competence, rather than objective competence, were associated with engagement in various risk behaviors, especially in the absence of other C´s. These results are discussed regarding the promotion of PYD to improve successful development and may suggest the need to foster healthy lifestyles and prevent risky behaviors in youth through the 5C's promotion programs within the university context.

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.

Emerging organic contaminants (EOCs) of anthropogenic origins are ubiquitous in environmental compartments, including aquatic systems. Thus, EOCs have attracted considerable research and public attention due to their potential human and ecological health risks. However, compared to other aquatic environments such as wastewater systems, comprehensive reviews focussing on the occurrence and human health risks of EOCs in drinking water systems are still lacking. Therefore, to address this knowledge gap, the current review posits that drinking water systems harbour a cocktail of toxic EOCs, which pose public health risks via multiple exposure routes. In the present review, global evidence is examined to track EOCs along the source-pathway-receptor-impact-mitigation (SPRIM) continuum. Evidence shows that, various groups of EOCs, including pharmaceuticals and personal care products, solvents, plasticizers, endocrine disrupting compounds, gasoline additives, per- and polyfluoroalkyl substances (PFAS), food colourants, artificial sweeteners, and musks and fragrances, have been detected in drinking water systems. The anthropogenic sources of EOCs detected in drinking water systems, including wastewater systems and industrial emissions, are summarized. Further, the behaviour and fate of EOCs in the drinking water systems, including removal processes are discussed. Once in drinking water systems, human exposure to EOCs may occur via ingestion of contaminated drinking water and cooked foods, and possibly dermal contact and inhalation. The high-risk environments, and risk factors and behaviours predisposing humans to EOC exposure are discussed. Evidence on the human health risks of the various EOCs and a critique of the data are presented. Notably, besides inferential data, quantitative epidemiological evidence directly relating the occurrence of EOCs in drinking water systems to specific adverse human health outcomes is still scarce. Lastly, future research directions, including the need for quantitative public health risk assessment, and the application of emerging detection tools are discussed.

Background: Maternal mortality remains dire in Nigeria, claiming 40,000 lives yearly due to pregnancy complications. Factors like limited healthcare access, poverty, and early marriage worsen the crisis. Despite efforts to improve skilled birth attendance, Nigeria struggles to meet MDG targets, underscoring the urgent need for more effective interventions. Objectives: The objective of the study is to assess and understand the knowledge of community members regarding the risk factors influencing maternal mortality in the Ede South Local Government Area of Osun State, Nigeria. Methodology: A descriptive cross-sectional study was conducted. The study methodology involves employing the Leslie Kish formula to select 185 participants from the Ede South Local Government Area in Osun State, Nigeria. The selection process involved the use of a systematic sampling technique to ensure a representative sample based on population demographics and characteristics, ensuring a balanced and accurate selection process. Quantitative data was collected through a self-administered questionnaire and analysed using SPSS version 21. Results: The study encompassed 185 participants. 64.9% females with a mean age of 27.3 + 8.3 years. Among them, 60.5% were single, 46.6% being students, 55.7% held a BSc degree, 64.9% were Yoruba and 61.1% identified as Christian. 91.4% were aware about maternal mortality, 74.6% recognized maternal deaths in reproductive-aged women. Participants identified that maternal deaths mostly occur during labour (91.4%). Direct causes, such as bleeding (88.1%), unsafe abortion (88.6%), infection (49.2%), and hypertension (64.9%), were recognized. Results indicated substantial awareness concerning specific risk factors: lack of education (98.9%), poverty (91.6%), poor health care services in facilities (94.0%), alcohol consumption (87.6%) and poor transportation (78.4%). Conclusion: Findings revealed good awareness of maternal deaths and critical factors such as ANC impact and direct causes of maternal mortality like bleeding and unsafe abortion. However, gaps persisted in SDG awareness, suggesting the need for targeted interventions to enhance overall understanding and address identified knowledge gaps.

Exposure to air pollution have detrimental effects on the elderly, women, people with pre-existing medical conditions, people living in poverty and children. The aim of the study was to investigate the extent of community awareness and knowledge on the health risks associated with exposure to air pollution. A cross-sectional study design was used for the study, using self-administered questionnaires. A simple random sampling technique was used to select 376 respondents. Systematic sampling method was applied to select the households. SPSS version 26 was used to analyze data. Of 376 respondents, 221 were males and 154 females. 113 were aged between 23-47years and 353 were aware that if they don’t protect themselves against polluted air, they may get sick, with age and educational status associated with their awareness (p &lt; 0.05). About 361 knew what air pollution is and 188 think the air they breathe in Annadale is moderate. A total number of 278 said they feel sick/uncomfortable when the quality of air is bad. About 293 knew that people are exposed to air pollution by breathing contaminated air and 237 identified sewage smell as the main cause of air pollution. Respondents who identified internet and television as the main source of information were 199 and 177 respectively. Those who were not aware of actions implemented to reduce air pollution were 180. Based on the results of the study, respondents are aware of the dangers of exposure to polluted air, and it is necessary that air pollution risk communication strategies be implemented to empower residents.

Objectives Independent validation of risk scores after hip fracture is uncommon, particularly for evaluation of outcomes other than death. We aimed to assess the Nottingham Hip Fracture Score (NHFS) for prediction of mortality, physical function, length of stay and postoperative complications. Design Analysis of routinely collected prospective data partly collected by follow-up interviews. Setting and Participants Consecutive hip fracture patients were identified from the Northumbria hip fracture database between 2014-2018. Patients were excluded if they were not surgically managed or if scores for predictive variables were missing. Methods C-statistics were calculated to test the discriminant ability of the NHFS, Abbreviated Mental Test Score (AMTS), and ASA grade for in-hospital, 30- and 120-day mortality, functional independence at discharge, 30-days and 120-days, length of stay, and postoperative complications. Results We analysed data from 3208 individuals, mean age 82.6 (SD 8.6). 2192 (70.9%) were female. 194 (6.3%) died during the first 30-days, 1686 (54.5%) were discharged to their own home, 211 (6.8%) had no mobility at 120-days, 141 (4.6%) experienced a postoperative complication. The median length of stay was 18 days (IQR 8-28). For mortality, c-statistics for the NHFS ranged from 0.68-0.69, similar to ASA and AMTS. For postoperative mobility, the c-statistics for the NHFS ranged from 0.74-0.83, similar to AMTS (0.61-0.82) and better than the ASA grade (0.68-0.71). Length of stay was significantly correlated with each score (p<0.001 by Jonckheere-Terpstra test); NHFS and AMTS showed inverted U-shaped relationships with length of stay. For postoperative complications, c-statistics for NHFS (0.54-0.59) were similar to ASA grade (0.53-0.61) and AMTS (0.50-0.58). Conclusions and Implications The NHFS performed consistently well in predicting functional outcomes, moderately in predicting mortality, but less well in predicting length of stay and complications. There remains room for improvement by adding further predictors such as measures of physical performance in future analyses.

Background: At altitudes beyond 2500 m the risk of developing high altitude pulmonary edema (HAPE) grows with the increases in pulmonary arterial pressure. HAPE is characterized by severe pulmonary hypertension, though the incidence and relevance of individual risk factors are not yet predictable. However, the systolic pulmonary pressure (SPAP) and peak in tricuspid regurgitation velocity (TVR) are crucial factors when diagnosing pulmonary hypertension by echocardiography. Methods: The SPAP and TVR of 27 trekkers aged 20-65 years en route in the Solu Khumbu region of Nepal was assessed. Echocardiograph measurements were performed at Lukla (2,860 m), Gorak Shep (5170 m), and the summit of Kala Patthar (5,675 m). The altitude profile and the participant’s characteristics were also compiled for correlation with the measured data. Results: The results showed a highly significant increase of SPAP and TVR after ascending Kala Patthar. The study revealed a lower increase of SPAP and TVR in the group of older participants, although the initial respective measurements in Gorak Shep were significantly higher for this group. A similar finding occurred in those using Diamox® as prophylaxis. There was an inverse relationship between TVR and SPAP, the peripheral capillary oxygen saturation and heart rate. Conclusions: The echocardiograph results indicate that older people are a risk group for developing a HAPE. The prophylactic use of acetazolamid led to higher initial SPAP values in Gorak Shep, and a lower increase of SPAP as well as TRV after ascending Kala Patthar. Arterial oxygen saturation measurements can provide an indicator for the self-assessment for the risk of developing HAPE and provide a rule of thumb for the altitude profile but does not replace a HAPE diagnosis. The collected data variables concerning backpack weight, sex, workload (actual ascent speed), and pre-existing diseases were not statistically significant factors related to SPAP and TVR (p=<0.05).

An alleged association of chronic use of thiazide diuretics with an increased risk of bone fragility fractures has been highlighted by a relatively recent prospective cohort study (Am J Med. 2016 Dec; 129(12):1299-1306). However, the concept that thiazides exert a beneficial effect on osteoporosis is still a predominant view. This effect would be mediated by the decrease in renal clearance of calcium ions, a pharmacological feature recognized for a long time now to this class of drugs , as opposed to the increase in calcium urinary excretion attributed instead to loop diuretics, i.e. furosemide and similar drugs . The purpose of this retrospective study is to attempt to clarify whether regular use of thiazide diuretics as antihypertensive therapeutics is associated with a significantly increased risk of osteoporotic fractures in female patients, aged over 70 years.

Philippines as an archipelago and tropical country, which is situated near the Pacific ocean, faces uncertain rainfall intensities. This makes environmental, agricultural and economic systems affected by precipitation difficult to manage. Time series analysis of Philippine rainfall pattern has been previously done, but there is no study investigating its probability distribution. Modeling the Philippine rainfall using probability distributions is essential, especially in managing risks and designing insurance products. Here, daily and cumulative rainfall data (January 1961 - August 2016) from 28 PAGASA weather stations are fitted to probability distributions. Moreover, the fitted distributions are examined for invariance under subsets of the rainfall data set. We observe that the Gamma distribution is a suitable fit for the daily up to the ten-day cumulative rainfall data. Our results can be used in agriculture, especially in forecasting claims in weather index-based insurance.

The campuses of Nigerian universities especially the old ones, like the University of Ibadan, comprise old trees which can pose a threat to pedestrians, structures, and roads within the school environments. However, there is no adequate information on these avenue trees thereby impeding their sustainable management. Therefore, this study provides the basic information needed by developing a geodatabase for the avenue trees along Benue, Emotan and Oduduwa roads within the University of Ibadan, Ibadan, Nigeria. The coordinates of all the avenue trees, and some within the selected roads were obtained. Tree growth data collected include; diameter at the breast height (dbh), diameter at the base, middle and at the top, crown height, crown diameter, and total height of all the avenue trees. Tree visual evaluation for diseases (TVED) was carried out for root decay, and termite attack on any part of the tree (stem, leaves and visible part of the root). Risk rate was assessed as low, medium and high, depending on the potential target (human, vehicles, structures). The risk rate depended on the incidence of leaning towards a building or road, cracked branches, root attack by termites, basal decay or branch decay. The growth data were used to compute the tree volume while the avenue trees were georeferenced. The physical health status of the avenue trees was determined using TVED data. The spatial distribution of the avenue trees was developed in GIS while all the analysed data were pulled together to develop a geodatabase for the avenue tress using design templates of BOOTSTRAP, comprising of Hypertext Markup Language, Cascade Style Sheets, JavaScripts and Hypertext Preprocessor. A total of 121 individual avenue trees belonging to 14 species were identified in the study area. The analysis of the geospatial distribution shows that Emotan Road had a lesser spatial distribution of avenue trees compared to Benue and Oduduwa roads. Furthermore, the health risk assessment of the trees in the study area indicated that 17.35% of the individual avenue trees had defects. The database created is user-friendly, suitable and has the ability for easy data storage and quick information retrieval on the avenue trees to enhance their maintenance and risk management. This can be accessed using the link http://159.203.29.155/rebs/rebs.php.

Screen viewing time is the total time spent by a child on any digital/electronic device. The objective of the present study was to determine the incidence and predictors of excessive screen viewing time in children in Ujjain, India. This cross-sectional, community-based study was conducted through house-to-house survey by using the three-stage cluster sampling method in 36 urban wards and 36 villages of Ujjain district, India. Excessive screen viewing time was defined as screen viewing for &gt; 2 h/day. The prevalence of excessive screen viewing time was 17.83%. Risk factors identified using the multivariate logistic regression model were: age (OR: 1.5, P &lt; 0.001); mobile phone use before bedtime (OR: 3.17, P = 0.008); parents’ perception about the child habituated to screen (OR: 14.03, P &lt; 0.001); television in bedroom (OR: 48.69, P &lt; 0.001); morning mobile screen viewing time (OR: 9.27, P &lt; 0.001); not reading books other than textbooks (OR: 9.71, P &lt; 0.001); and lack of outdoor play for &gt;2 h (OR: 4.20, P &lt; 0.001). Presence of eye pain was a protective factor for excessive screen viewing time (OR: 0.12, P = 0.011). The study identified multiple modifiable risk factors for excessive screen viewing time.

Multiple births or twinning in equids are dangerous, undesirable situations that compromise the life of the dam and resulting offspring. However, embryo vitrification and freezing techniques take advantage of individuals whose multiple ovulations allow flushing more fertilised embryos from the oviduct to be collected, increasing the productivity and profitability of such techniques. Embryo preservation is especially important in highly endangered populations such as certain donkey (Equus asinus) breeds; for which conventional reproductive techniques have previously failed. For instance, becoming an effective alternative to artificial insemination with frozen semen to preserve the individuals’ genetic material. The objective of this study was to examine the historical foaling records of Andalusian donkeys to estimate genetic parameters for multiple births, assessing the historical foal number born per animal, maximum foal number per birth and multiple birth number per animal. We designed an Animal Model with single records considering the fixed effects of birthyear, birth season, sex, farm, and husbandry system, and age as a linear and quadratic covariate. Restricted maximum likelihood reported heritability estimates ranging from 0.18±0.01 to 0.24±0.01. Genetic and phenotypic correlations ranged from 0.01±0.01 to 0.83±0.01 and 0.12±0.01 and 0.53±0.01, respectively. These estimates enable the potential for selection against/for these traits, offering a new perspective for donkey breeding and conservation.

Owners and managers of small and medium-sized enterprises (SMEs) have changed their perspective on risk management due to the current global negative threats in the business environment. If they want to be successful and ensure the financial performance of their business, they must accept a proactive approach to reducing strategic risks in connection with operational risks. The aim of the article is to identify and quantify the differences in operational risk management and its effect on the financial management of SMEs between four Central European countries. The statistical sample of SMEs consisted of 1,090 owners and top managers. Data collection was carried out through a questionnaire in the period December 2022-January 2023. Statistical hypotheses were evaluated with the application of correlation analysis and linear regression modelling. Empirical findings have confirmed that operational risk management has a significant positive impact on improving the profitability of the enterprise; on reducing the enterprise's indebtedness as well as in the context of reducing the enterprise's inability to pay its obligations. However, there are disparities in the perception of this influence between owners/managers with regard to the country in which they carry out their business activities. The findings are important for both national and multinational organizations and entities dealing with risk management in the business environment of small and medium-sized enterprises.

Abstract: Falls are among the top 10 causes of years lived with disability in people aged 75 and over. Preventive programs like case management (CM) are crucial. Objectives: To evaluate the effects of a multifactorial fall prevention program, based on CM, on physical performance, presence of pain and risk of falls and fractures in elderly people who have suffered falls. Methods: This is a randomized, single-blind clinical trial with parallel groups: intervention group (IG) and control group (CG) composed of 55 older people with a history of falls living in the community. All participants underwent an initial assessment via video call (containing anamnesis, Timed Up and Go test, Falls Risk Score, Short Physical Performance Battery and Clinical Frax). The IG underwent CM, the physical exercise protocol and the cognitive stimulation protocol. The CG was monitored through telephone calls and received general health and falls guidance. Results: No significant results were found in physical capacity, presence of pain, risk of falls and fractures between the intervention and control groups and between assessments. Conclusion: This program was not effective in improving functional performance, but it was important for characterizing pain and the probability of fracture in the next 10 years in this population.

In public health literature the risk of death or disease associated with a dietary, environmental of behavioral factor is most commonly denoted by odds ratio (OR), hazard ratio (HR) or risk ratio (RR). The ratio indices have several desirable statistical properties. However, the most important question is whether there are some evolved innate norms of perception of risk that people use and what they are. We conducted a simple one question survey of 98 individuals with different age, sex, educational and professional backgrounds. The respondents were asked to judge the relative perceived risk of four different hypothetical habits for which data on the percentage of people affected by the disease with and without the habit was given. They were asked to rank the risks for the four habits. Results showed that the habits that had the highest difference between probability of acquiring the disease were ranked high on risk perception. The probability ratios did not affect risk perception significantly. Further age, sex, profession or formal training in statistics did not affect the response significantly. Even individuals that were formally trained to use OR and HR as risk indicators, preferred using probability differences over ratios for judging their own risk in the perceived context. This preliminary inquiry into intuitive statistical perception suggests that designing statistical indices based on people’s innate perception may be a better strategy than trying to train people to understand the indices designed by expert statisticians.

Objective:The application of information technology (IT( is fundamental in the hospitals to stay competitive.In this regard, recognizing the main risks to the implementation of IT in hospitals can provide vastopportunities to improve its efficiency and help to make strategic decisions. This study aimed tosearch for the main risks of implementation of IT projects in the hospitals of Tehran. Methods: This was a practical and cross-sectional study which was conducted in the 18 hospitals of Tehran,Iran, 2018; in which a sample of 65 members were studied. The required data were collected using a questionnaire to examine seven main risks, including market, project management, human resources, technical, organizational, financial, strategic risks. The collected data were analyzed using SPSS 19.0. Additionally, the method used to test the risks in this study was structural equation modeling, which was ran using LISREL 9.30. Results: The results showed that among the seven main risks of to the implementation of IT in hospitals, the highest and lowest means were related to the human resource risks and the market risks, respectively. Also, according to the SEM, human resource risks and market risks had the highest and lowest effects, respectively. Conclusion: Announcing the use of IT in the hospitals, holding conferences about new IT developments with employees, suitable training, encouraging them to use IT tools, providing a motivating atmosphere to use IT tools for employees, are a few effective ways of overcoming the human resource risks.

The ISO 2859 and ISO 3951 series provide acceptance sampling procedures for lot inspection, allowing both sample size and acceptance rule to be determined, starting from a specific value either for the consumer or producer risk. However, insufficient resources often make it difficult to implement “ISO sampling plans.” In cases where the sample size is determined by external constraints, the focus shifts from determining sample size to determining consumer and producer risks. Moreover, if the sample size is very low (e.g. one single item), prior information should be included in the statistical analysis. For this reason, it makes sense to work within a Bayesian theoretical framework, such as that described in JCGM 106. Accordingly, the approach from JCGM 106 is adopted and broadened so as to allow application to lot inspection. The discussion is based on a “real-life” example of lot inspection on the basis of a single item. Starting from simple assumptions, expressions for both the prior and posterior distributions are worked out, and it is shown how the concepts from JCGM 106 can be reinterpreted in the context of lot inspection. Conceptual differences regarding the definition of consumer and producer risks in JCGM 106 and in the ISO acceptance sampling standards are elucidated and a numerical example is provided.

Background: The association of echocardiographic findings and subsequent risk of left-sided native valve endocarditis (LS-NVE) is undefined. The aim of this study was to determine if transthoracic echocardiographic (TTE) measurements are associated with the subsequent development of LS-NVE in patients without cardiac predisposing conditions. Methods: Institutional databases were evaluated for adults diagnosed with LS-NVE from 2008 to 2020. Patients with prosthetic valves, cardiovascular implantable electronic devices, intracardiac devices, injection drug use, and predisposing cardiac conditions were excluded. Only patients who had a TTE performed 6 months to 3 years before the development of LS-NVE were included as cases. Controls were patients within the same Mayo location with a TTE report and were matched in a 1:3 ratio according to age, gender, Charlson Comorbidity Index, and echocardiography date. Results: There were 148 cases and 431 matched controls. As compared to controls, IE cases had a higher prevalence of diabetes mellitus (46.6% vs. 30.4%) and chronic kidney disease (46.6% vs. 28.1%) (p<0.001). Left ventricular outflow tract velocity (p=0.017), left ventricular ejection fraction (p=0.018), and E: e’ ratio (p=0.050) were associated with LS-NVE. Conclusions: Echocardiographic measurements were associated with subsequent LS-NVE development in this pilot study. A larger cohort of LS-NVE patients, however, is needed to validate these findings.

Melioidosis, or Whitmore's disease, is an infectious disease initiated by a bacteria known as Burkholderia pseudomallei. This bacteria is commonly found in contaminated soil and water. In Malaysia, the mortality from melioidosis infection was reported to be higher than in other infectious diseases. The research on melioidosis is still limited in Malaysia but slightly increasing. The article's objective was to seek all the melioidosis research related to mortality in Malaysia. The information from the selected papers was then abstracted into two sections; Section 1: Review of literature and Section 2: Findings on mortality from melioidosis in Malaysia. In Section 1, the information on transmission and clinical features of melioidosis, demographic, severity of melioidosis, a clinical signs of melioidosis, diagnosis of melioidosis, management of melioidosis, the economic burden of melioidosis, and incidence of mortality from melioidosis were discussed in this paper. Meanwhile, in Section 2, the findings on mortality of melioidosis in Malaysia were discussed according to eight published articles. It is important to manage patients with melioidosis with appropriate treatment and management to reduce severe complications, high fatality rate, and relapse. More published research on melioidosis will provide input to the clinicians on a more detailed understanding of how to improve the diagnosis of melioidosis and the prognosis factors of this disease.

Websites and applications use personalisation services to profile their users, collect their patterns and activities and eventually use this data to provide tailored suggestions. User preferences and social interactions are therefore aggregated and analysed. Every time a user publishes a new post or creates a link with another entity, either another user, or some on-line resource, new information is added to the user profile. Exposing private data does not only reveal information about single users' preferences, increasing their privacy risk, but can expose more about their network that single actors intended. This mechanism is self-evident on \emph{social networks} where users receive suggestions based on their friends' activity. We propose an information theoretic approach to measure the differential update of the anonymity risk for time-varying user profiles. This expresses how privacy is affected when new content is posted and how much third party services get to know about the users when a new activity is shared. We use real Facebook data to show how our model can be applied on a real world scenario.

Three decades ago, human arsenic (As) contamination has been recognized in Ron Phibun, a sub-district with tin mining activity in southern Thailand. Since then different government bodies have attempted to mitigate the As-contamination problem by providing safe water in households. The most recent study conducted during 2000-2002 reported only a small fraction of population still had high urinary As level. Less attention has been paid to this issue afterwards. The present study aimed to re-assess the current situation, including human As contamination, water use behavior as well as identify risk factors of elevated As concentration among residents of Ron Phibun. The survey of 560 participants living in Ron Phibun with urinary As assessment was conducted. The median urinary As concentration of study participants was higher than normal. Consumption of shallow well water, a source generally considered as As-contaminated, was higher than a previous survey. A significant association was observed between urinary As concentrations and water sources for drinking and cooking. Gender and educational level were found to be associated with urinary As concentration. Significant associations between urinary As concentration and certain diseases (respiratory diseases, dermatitis, and dyslipidemia) were observed. The findings suggested further investigation of all water sources in the area for As contamination.

Telemedicine has been increasingly considered an effective strategy to support patients with several diagnosis and therapies, avoiding the on-site visit and drastically reducing the risks to share infections. In the recent years, a number of different technologies have been developed and applied to clinical studies, with the aim to investigate new ways for increase the early diagnoses and monitor the clinical evolution of the most predictable diseases directly from the patients’ home. Telemedicine refers to all those technological interfaces used to remotely perform clinical procedures. Telemedicine applications could be useful in several medical fields, such as preventive medicine, home patient care, education for healthcare professionals and patients, research, public health, and health management. On the other hand, the synergy of these different technologies has a significant impact on the clinical risks analysis, particularly useful in frail patients. Although Telemedicine shows to have important advantages, undoubtedly important issues still remain. The present work aims to shed light on the main advantages and disadvantages related to of each application’s features, which may serve as a useful tool for researchers.

The global trend towards increased demand for organic food, greener environments, and the integration of biological control agents into pest management strategies has greatly enhanced the need for biological pesticides (biopesticides). Biopesticides are generally environmentally friendly and are made from micro-organisms or other natural substances. Despite their great potential, relatively few have been registered and commercialised in Nigeria compared to other African countries such as South Africa and Kenya. Biological active agents are so diverse such that ap-plying the same safety standards or environmental conditions to all of them is almost impossible. A review of risk assessment processes and comparative assessments of Nigeria's biopesticide regulations with other developing African countries and developed regions was conducted. Prolonged field testing, lack of bridged risk assessments and technical checklists have been identified as key factors hampering the timely development and commercialisation of biopesti-cides in Nigeria. Recommendations on necessary changes to the existing Nigeria biopesticide regulations have been made. Risk assessment matrices for microbial and biochemical biopesti-cides and a scientific/technical checklist have also been developed. Harmonisation and data ex-change among other countries in the region will also enhance the advancement of scientific and technical knowledge for sustainable regulation and cross-border trade.

Aims. In a male Italian cohort (initially aged 40-59, n=1712) followed-up during 61 years and reaching practical extinction, the natural history of major CVD mortality categories including coronary heart disease (CHD), stroke and other Heart Diseases of Uncertain Etiology (HDUE, including congestive heart failure) were studied along with their risk factor relationships. Methods and Results. Cox models were run with 12 covariates measured at entry as possible predictors. About 93% of all CVD deaths were covered by the 3 major groups selected here (N=751): 37.4% of them were diagnosed as CHD, 30.6% as stroke and 28.5 % as HDUE. CHD declined in the last 20 years of follow-up, while a sharp increase of HDUE mortality was seen. Baseline mean levels of serum cholesterol were 209.6, 204.2 and 198.0 mg/dl respectively for CHD, stroke and HDUE deaths: the multivariable coefficients of serum cholesterol were positive and significant for CHD (p<0.0001) and stroke (p=0.0203) and not significant for HDUE (p=0.3467). In Fine-Gray models, the algebraic signs of cholesterol coefficients were opposite for CHD versus the other mortality categories (t=3.13). The predictive performances of remaining risk factors were varied whereas that of Cox models was not very good, probably due to the attrition phenomenon and possible competing risks. Conclusion. Large differences in natural history and risk factors were found comparing the 3 CVD conditions, potentially indicating different etiologies and pointing to the need of not mixing them up in a grouped CVD category.

In recent years, with the increasing prominence of environmental and social issues, investors have been paying more attention to the ESG performance of enterprises, highlighting the importance of ESG factors in the financial field. This study is based on the theories of banking business models, stakeholder theory, risk management theory, and ESG investment theory. It uses the financial data and ESG scores of Chinese listed banks to deeply analyze the ESG factors and explore their impact on the liquidity risk of commercial banks. The research found that (1) good ESG performance can reduce the liquidity risk commercial banks face by improving bank value and financial performance. (2) ESG factors can also enhance the liquidity management level of commercial banks through standardization and sustainable business principles, thereby reducing the occurrence and impact of liquidity risk. Therefore, it is necessary to reduce the liquidity risk of banks and promote the sustainable development of commercial banks from four aspects: ESG performance and management, bank value, financial performance, and policy regulation.

(1) The main purpose of this article is to analyse the relationship between risk factors and the benefits of Information Technology Outsourcing (ITO). For this purpose, a structural model was created to determine the dependency of the benefits on the importance of the risk factors associated with this service. (2) The research methodology included: a literature review, descriptive analysis, and empirical and formal methods. A survey questionnaire was used to collect data, and structural equation methodology was used to build and verify hypotheses. The structural model was tested on data from business practice - 200 large organizations, mostly enterprises, operating in Poland and using IT outsourcing. (3) The purpose was accomplished by determining the relationship between the IT outsourcing benefits and the risk factors' importance. The strongest relationship exists between supplier-related risk factors and technological benefits, while a slightly weaker relationship exists between economic risk and economic benefits and customer-related risk and organizational benefits. The weakest relationship exists between security risks and strategic benefits. (4) The article’s originality and value consist in establishing the existence of a relationship between risk factors and the benefits of IT outsourcing, and in identifying which groups of risks have the strongest impact on the benefits of ITO, which can be exploited by the service suppliers.

Chikungunya virus (CHIKV) and Zika virus (ZIKV) have recently emerged as global infections with consequential disability adjusted life years (DALYs) and economic burden. This study aimed to explore the spatiotemporal heterogeneity in the occurrence of CHIKV and ZIKV outbreaks throughout Barranquilla, Colombia during 2014 and 2016 and explored the potential for clustering. Incidence data were fitted using multiple Bayesian Poisson models based on a suite of explanatory variables as potential risk factors and multiple options for random effects. A best fit model was used to analyse the case incidence risk for both epidemics to identify any risk factors during their epidemics. Neighbourhoods in the northern region of Barranquilla were hotspots for the outbreaks of both CHIKV and ZIKV. Additional hotspots occurred in the south-western and central regions of the CHIKV and ZIKV outbreaks, respectively. Multivariate conditional autoregressive models strongly identified higher socioeconomic strata (SES) and residing in detached houses as risk factors for ZIKV case incidences. These novel findings challenge the belief that these infections are driven by social vulnerability and merits further study both in Barranquilla and throughout the tropical and subtropical regions of the world.

Chikungunya virus (CHIKV) and Zika virus (ZIKV) have recently emerged as global infections with consequential disability adjusted life years (DALYs) and economic burden. This study aimed to explore the spatiotemporal heterogeneity in the occurrence of CHIKV and ZIKV outbreaks throughout Barranquilla, Colombia during 2014 and 2016 and explored the potential for clustering. Incidence data were fitted using multiple Bayesian Poisson models based on a suite of explanatory variables as potential risk factors and multiple options for random effects. A best fit model was used to analyse the case incidence risk for both epidemics to identify any risk factors during their epidemics. Neighbourhoods in the northern region of Barranquilla were hotspots for the outbreaks of both CHIKV and ZIKV. Additional hotspots occurred in the south-western and central regions of the CHIKV and ZIKV outbreaks, respectively. Multivariate conditional autoregressive models strongly identified higher socioeconomic strata (SES) and residing in detached houses as risk factors for ZIKV case incidences. These novel findings challenge the belief that these infections are driven by social vulnerability and merits further study both in Barranquilla and throughout the tropical and subtropical regions of the world.

Background. Implementing mammogram screening means that clinicians are seeing many breast cancers that will never develop metastases. The purpose of this study was to identify subgroups of breast cancer patients who did not present events related to long-term breast cancer mortality, taking into account diagnosis at breast screening, absence of palpability and axillary involvement, and genomic analysis with PAM50. Patients and Methods. To identify them, a retrospective observational study was carried out selecting patients without palpable tumour, without axillary involvement, and a genomic analysis was performed with PAM50. Results. The probability of distant metastasis-free interval (DMFI) of 337 patients was 0.92 (95% CI, 0.90-0.93) at 20 years and 0.96 (95% CI, 0.92-1.00) in 95 patients (28%) with available PAM50 tests. In 22 (23.15%) luminal A tumours and in 9 (9.47%) luminal B tumours smaller than 1 cm and in HER2 and basal type tumours there were no metastatic events (20-year DMFI of 1.00). Conclusion. Patients with nonpalpable breast cancer found at screening with negative nodes are at very low risk. It is possible to identify subgroups without metastatic events by determining the intrinsic subtype and tumour size less than 1 cm. De-escalation of treatment should be considered.

Seismic vulnerability assessment in urban areas would in principle require the detailed modeling of each single building and the implementation of complex numerical calculations. This procedure is clearly difficult to apply at urban scale where many buildings have to be considered and therefore it is essential to have simplified, but at the same time reliable, approaches to vulnerability assessment. Among the proposed strategies, one of the most interesting concerns the application of machine learning algorithms, able to classify buildings according to their vulnerability on the basis of training procedures applied to existing datasets. In this paper machine learning algorithms will be applied to a dataset which collects and catalogs the structural characteristics of a large number of buildings and reports the damage observed in L’Aquila territory during the intense seismic activity occurred in 2009. A combination of a trained neural network and a random forest algorithm allows to identify an opportune “a-posteriori” vulnerability score, deduced from the observed damage, which is compared to an “a-priori” vulnerability one, evaluated taking into account characteristic indexes for building’s typologies. By means of this comparison an inverse approach to seismic vulnerability assessment, which can be extended to different urban centers, is proposed.

Background: The treatment plan of prosthetic restorations supported by dental implants require comprehensive scientific knowledge to deliver prostheses with good prognosis, even before the implant insertion. This review aims to analyze the main prosthetic determinants of the prognosis of implant-supported prostheses. Methods: A systematic review of the literature was conducted with a PICO question: "For partially or complete edentulous subjects treated with implant-supported prostheses, which prosthetic factors could affect clinical outcomes?". A literature search was performed electronically in PubMed (MEDLINE), Scopus and Cochrane Library with the following equation [PROGNOS* OR RISK] FACTOR IMPLANT DENTAL, and by hand search in relevant journals and throughout the selected papers. Results: This revision was carried out based on 50 papers focused on several prosthodontics-related risk factors that were grouped as follows: implant-connection, loading protocol, transmucosal abutments, prosthetic fit, provisionalization, type of retention, impression technique, fabrication technique, and occlusion. More than a half of the studies were systematic reviews (30%), meta-analysis (16%) or prospective evaluations of prosthesis with various kinds of events (18%). But also narrative reviews of literature (14%) and in vitro/animal studies (16%) were found. Conclusions: The current literature provides insufficient evidence for most of the investigated topics. However, based on the accumulated data, it seems reasonable to defend that the best treatment approach is the use of morse taper implants with transmucosal abutments, recorded by means of rigidly splinted copings through the pick-up technique, and screwed by milled prosthesis occlusally adjusted to minimize functional overloading.

This research work focused on the risks we are faced with on our day to day activities, either directly or indirectly, which can gradually accumulates and results to communal crisis, religious crisis, socio-economic agitations and tribal crises. Nasarawa Eggon Local Government Area of Nasarawa State was used as case study and a well structure close–ended questionnaire was used for data collection as it relates to Controlled Self Risk Assessment (CSRA) and linear programming technique was used to analyze. The results proved that many of this processes were neglected in these communities, making them to be prone to incessant communal crisis. The study recommend that Government should strongly, as a matter of urgency address the unemployment rate, distribution of political position, schools, primary health care and equip security personnel with the modern technology facilities, which happen to record the highest risk level.

With the growing of university chemistry experiment projects, scientific research personnel, specialized equipment, laboratory accident is increasing yearly. And accident data lacks a safety platform to store related information and cannot be guaranteed for efficient conditional sharing. To solve these problems, we designed a laboratory accident system to store, share related data and predict risk level. In this paper, we manually collected chemistry laboratory accidents by python software and class assignments, then analyses risk factor variables using Spsspro, finally established a prediction model using Stata. We intended to register laboratory related data into proposed chemistry accident system based on data ownership safety architecture. The chemistry accident system can break data barriers using confirmation and authorization key technology to trace non-tampered data source in real time when emergency accident happens. Meanwhile, our proposed system can use our designed accident risk model to predict risk level of any experiment project. It can also recommend appropriate safety education models.

Abstract – Objective: Ovarian cancer, although not possessing a high incidence, is still the most common cancer-related deaths among women diagnosed with a gynecologic malignancy. The present study aims to highlight the epidemiology, risk factors of this disease and the significance of development of improved early detection strategies. Materials and Methods: This study was conducted using current published English studies by searching PubMed and Google Scholar. The search strategy included the keywords “ovarian cancer”, “diagnosis”, “risk factors”, “screening”, “epidemiology”. Studies on incidence and mortality were also considered. Case reports were excluded.Results: The highest incidence and mortality rates are observed in Central and Eastern Europe, while rates are relatively low in Asia and Africa. These rates are highest among the white population (14.3 per 100,000) and lowest among blacks (10 per 100,000) and Asians (9.7 per 100,000). The risk factors for this disease includes a family history, hormonal factors, nutrition and diet and physical activity, with some of them playing protective roles in reducing risk of ovarian cancers. There are no reliable screening methods for ovarian cancers. The most common diagnosis methods include a transvaginal ultrasound and a blood test to detect CA125 markers.Conclusions: The mortality rate of ovarian cancer is gradually increasing; thus, preventative measures are required to reduce lifetime risk of ovarian cancers and improve mortality rate.

In mega cities such as Seoul in South Korea, it is very important to protect the city from the flooding even for the short time of period due to the enormous amount of economic damage. In impervious area of the city, stormwater pipe network is commonly applied to discharge rainfall to the outside of catchment. Therefore, the stormwater pipe network in urban catchment should be carefully designed to discharge the runoff quickly and efficiently. In this study, different types of structures in stormwater pipe network were evaluated using the relationship between the peaks rainfall and runoff in urban catchments in South Korea. More than 400 historical rainfall events were applied in five urban catchments to estimate peak runoff from different type of network structures. Linear regression analysis was implemented to estimate peak runoffs. The coefficient of determination of the regressions were higher than 0.9 which means the regression model represent very well the relationship between the two peaks. However, the variation of the prediction becomes large as the peak rainfall increases and the variation become even larger when the network structure is branched. Therefore, it depends on the structure of stormwater pipe network. When the water paths in the pipe network is unique (branched network), the increased amount of rainfall is congested around the rainwater inlets and the uncertainty of peak runoff prediction is increased. If there are many possible water paths depending on the amount of discharge (looped network), the increased rainfall is discharged more quickly through the many water paths. This can be a way to represent the reliability of the stormwater pipe network. The structures of stormwater pipe network is evaluated using drainage density which is the length of pipes over the unit catchment area and 95% confidence interval. As a result, the 95% confidence interval is increased as the drainage density is increased because the accuracy of peak runoff prediction is decreased. As mentioned earlier, because the looped networks have many alternative water flowing paths, elimination time of rainfall from the catchments become short, the 95% confidence interval become narrow, and the reliability of peak runoff prediction become high. Therefore, it is beneficial to install looped stormwater pipe network within the affordable budget. It is important factor to determine the amount of complexity in stormwater pipe network to decrease the risk of urban flooding.

Canine leptospirosis is a zoonosis of epidemiological importance. Dogs are recognized as primary reservoirs of Leptospira interrogans serogroup Canicola and a source of infection to the environment through urine. This study aimed to determine the presence of antibodies against Leptospira in canines from 49 municipalities in the Department of Antioquia, Colombia. We performed a cross-sectional study of dogs included in a neutering control program. We collected 1335 sera samples, assayed by a microagglutination test (MAT), and performed PCR detection in 21 urine samples. We also surveyed 903 dog owners. We found a seroreactivity of 11.2% (150/1335) in Antioquia with titers 1:50. Municipalities with the highest number of cases were Belmira (46.1%), Turbo (34.5%), and Concepción (31.0%). L. santarosai was identified by phylogenetic analysis in one urine sample from the municipality of Granada. The most important factor associated with a positive result was the lack of vaccination against leptospirosis (PR 3.3, p < 0.014). Environmental factors such as water presence and bare soil around the household were also associated with Leptospira seroreactivity in the Department of Antioquia. We reviewed a national epidemiological surveillance database for human cases in those municipalities. We found a correlation between the high number of cases in canines and humans, especially in the Uraba. Serological and molecular results showed the circulation of Leptospira. Future public health efforts in the municipalities with the highest numbers of seroreactivity should be directed towards vaccination to prevent animal disease and decrease the probability of transmission of Leptospira. Dogs actively participate in the Leptospira cycle in Antioquia and encourage the implementation of vaccination protocols and coverage.