Our objective was to evaluate whether pregnancy is prolonged by use of a proteomics-based maternal serum screening test followed by treatment interventions. This is a secondary analysis of the PREVENT-PTB randomized trial comparing screening with the PreTRM test versus no screening. The primary trial analysis found no significant between-group difference in preterm birth rate. Rather than considering a dichotomous outcome (preterm vs term), we treated gestational age at birth as a continuous variable using survival analysis. We also evaluated between-group difference in NICU length of stay and duration of respiratory support. Results indicated that pregnancy was significantly prolonged in subjects screened with PreTRM test compared to controls (adjusted hazard ratio 0.53, 95% confidence interval 0.36-0.78, P <0.01). Newborns of screened subjects had significantly shorter NICU stay but no significant decrease in duration of respiratory support. In the PreTRM screen-positive group, interventions that were associated with pregnancy prolongation included care management and low-dose aspirin but not 17-hydroxyprogesterone caproate. We concluded that screening with the PreTRM test followed by interventions for screen-positive pregnancies can prolong pregnancy and reduce NICU-LOS.

Background: Multi-drug resistance organisms (MDRO) often cause increased morbidity, mortality, and length of stays (LOS). However, there is uncertainty whether the infection of MDRO increase the morbidity, mortality, and ICU-LOS. Objective: This study performed to determine the prevalence of MDRO in ICU, site of infection and the association of MDRO or site of infection with mortality. Secondary outcome was determined by ascertaining the association of MDRO or site of infection with (ICU-LOS). Methods: A retrospective cohort study was performed with adult sepsis patients in ICU. Univariate and multivariate (MVA) logistic regression with cox regression modeling were performed to compute the association of MDRO on ICU-mortality. MVA modelling was performed for ICU-LOS predictors. Results: Out of 228 patients, the isolated MDRO was 97 (42.5%) of which 78% were gram-negative bacteria. The mortality rate among those with MDRO was 85 (37.3%). The hospital acquired infection (HAI) was significantly predictor for ICU-LOS in univariate linear regression (R² = 0.034, P=0.005). In MVA linear regression, both Enterococcus faecalis infection and acinetobacter baumannii (AC) -MDRO were predictors for ICU-LOS with (R² = 0.478, P<0.05). In the univariate cox regression, only the infection with AC- MDRO was a risk factor for ICU-mortality with [ HR =1.802 (95% CI: 1.2 – 2.706; P = 0.005)]. Conclusions: Identifying risk factors for MDRO highlight the appropriate administration of empirical antibiotics and effectively control of source of infection which would reduce mortality and ICU-LOS. The usage of broad- spectrum antibiotics should be limited for those having substantial risk factors to acquire MDRO.

Lower respiratory infections (LRI), upper respiratory infections (URI), and nutritional deficiency (ND) in under-5 children from low-middle-income countries has been at a high level for decades, despite efforts that have been realized in some countries. The study used data extracted from the global burden of diseases (GBD) to analyze the trends behavior between 1990 and 2019, and evaluate their association with maternal factors. Between 1990 and 2019, the incidence of LRI decreased between 1.2 percent and 1.3 percent (1.2-1.3%) in different female age groups, and by nearly 1 to 1.3% in those of the male gender. The incidence of URI did not decrease (0.0%) in any of their age groups. ND incidence declined around 0.7 to 4.9% in the under-5 children. LRI declined mostly in the female age groups (1.2 to 1.3%), while ND decreased more in the male gender (0.9 to 4.9%). Maternal risk factors were strongly associated to the incidence of the three conditions with over 90 percent. Maternal prevalence of HIV/AIDS and tuberculosis positively impacted the incidence of LRI, URI, and ND in Chadian under-5 children. Although the incidence of LRI and ND declined, URI incidence remained steady between 1990 and 2019 in Chadian under-5 children. To improve the health and provide a healthy growth of under-5 children, the maternal prevalence of HIV/AIDS and tuberculosis infection should be strongly addressed for a prompt accomplishment of the sustainable development goals.

Lean practice is recognised for having a great potential in promoting safety risk management in offsite construction (OSC). This paper presents results of a study conducted to assess the impact of lean practice in safety risk management in OSC in a developing country. A quantitative approach using survey-based questionnaire was adopted. Lean management practices (LMPs) identified from literature review were empirically tested using a sample survey of 103 OSC contractors. The survey responses were subjected to descriptive and inferential statistics. The top ranked LMPs for safety risk management in OSC included two mistake proofing practices, i.e., use of personal protective equipment (PPE) and use of hazard warning equipment; two last planner system (LPS) practices, i.e., involvement of workers in safety planning and providing necessary working equipment and one first run studies (FRS) practice, i.e., critical analysis of work methods. These LMPs are useful in controlling high consequence safety risks in OSC. Based on evidence found in this study, the paper argues that lean practice can bring great value in the safety risk management in OSC in countries where OSC is transitioning.

From the existing millions of fungal species only a few cause disease. In this study, we investigated invasive fungal infections in the head and neck over a 19-year period (2005 to 2024) at a large academic healthcare system. Among 413 cases, 336 were noninvasive, and 77 were invasive. The highest incidence of invasive infections occurred in the sinonasal cavities, with a 15-fold difference compared to other sites. Most infections affected adults over 40 years old. The most common organisms were Mucorales (51%), hyaline molds (29%), and Candida (11%). Risk factors included malignancy, transplant, diabetes, and illicit drug use. Mortality was high in patients with malignancy and/or transplant. Infections affecting the mandible were usually a complication of osteoradionecrosis and were associated with coinfection of Candida and Actinomyces. At other sites, infections were rare and were usually the result of penetrating injuries or immunosuppression. Treatment typically involved a combination of antifungals and surgical procedures.

Emergence of COVID-19 had profound impact on global stock markets, including Indian mar-ket. Key indices like NIFTY50 and Sensex dropped by approximately 40% within two months in 2020, which also affected major mutual funds, leading to significant depreciation of their Net Asset Value. Securities and Exchange Board of India (SEBI) allows mutual funds to use deriva-tives for hedging purposes, capped at 100% of the scheme's net assets covering debt, equity, and derivatives. However, circular amendment by SEBI in January-2019 permitted covered call strat-egies on constituent stocks of Sensex and NIFTY50 for mutual fund schemes, excluding ETFs and Index Funds. This study investigated whether mutual funds increased their derivative us-age as risk mitigation strategy during COVID-19 pandemic, analyzing derivative holdings from 2019-2023. Surprisingly, findings indicated a decline in derivative holdings in 2020 compared to pre-pandemic levels. Statistical tests and performance evaluation metrics such as T-test, F-test, Treynor Ratio, Sharpe Ratio, and Jensen's calculations were employed to assess mutual fund performance. Although derivative-holding mutual funds didn't outperform benchmarks in aver-age returns, it showcased significantly reduced volatility, offering investors favorable risk-return trade-offs. research sheds light on derivative utilization in Mutual Fund industry, potentially in-forming regulators, fund managers, and investors in their decision-making

The aim of the study was to compare the standard baseline imaging, with extended radiological staging. To assess our hypothesis, we performed a prospective, single-centre study which included 132 participants recruited between October 2015 and March 2020. Descriptive statistics, the Friedman and chi-squared tests were performed and p &lt; 0.05 was considered significant. Patients were grouped into two cohorts, CT scan cohort (n=87) and PET-CT cohort (n=43). In the first group the originally determined disease stage changed in 36.8 % of cases, in second group in 51.2 %. The consistency between assessment of axillary lymph nodes by imaging (cN) and the postoperative pathology report (pN) was evaluated. In most cases, clinical and pathological evaluation of involved nodes was consistent, for CT scan the result was χ2(1) = 18.98; p &lt; 0.001, for PET-CT the result was χ2(1) = 6.41; p = 0.03. Highly customized radiation therapy defined as dose boost within the involved lymph nodes, not covered by surgeon, was applied in nine patients.

The hepatitis E virus (HEV) is a zoonotic pathogen with a variety of hosts, including pigs, which act as reservoirs. In industrialized countries, sporadic cases caused by genotype 3, contracted by ingestion of contaminated uncooked or undercooked meat, have been reported. However, in developing countries, HEV infection is mainly dominated by genotype 2 and often associated with poor hygiene conditions and drinking water supplies. In West Africa, HEV infection and its circulation in domestic fauna are very poorly documented. The aim of this study was to assess the presence of HEV in pork sold in Saint-Louis. Meat products were collected between 20 and 25 August 2022 in three location of Saint-Louis region. After purchasing 250 g of sample, we minced 2 g of sample for extraction of total nucleic acids using the Purelink™ Viral DNA/RNA kit and then RT-PCR using the One-Taq™ One-Step RT-PCR kit targeting the HEV ORF2 genomic region. The products obtained were visualized on a 1% agarose gel. Of a total of 74 samples, divided into pork meat (n=65) and pork liver (n=9), 5.4% (n=4) were tested positive for HEV. In both cases, 2 samples were positive, representing a rate of 3.1% and 22.2% for meat and pork liver respectively. All new viral sequences obtained form a monophyletic group within HEV genotype 3. These preliminary results reveal a potential circulation of HEV in the pig population. The high proportion of contamination in the pork liver samples highlights a major risk associated with their consumption.

The broad and rapid application of new genomic techniques (NGTs) such as CRISPR-Cas has led to a fast increase in the number of genetically modified crops. With the recently published EU Commission’s (EC) regulatory proposal on plants generated with NGTs (July 5, 2023) the process of admission of such genetically modified plants is aimed to get accelerated and simplified. NGT plant applications shall be categorized based on their molecular characteristics into category 1 NGT (NGT1) and category 2 NGT (NGT2), which is in divergence from the current legislation centered around Directive 2001/18/EC. In the regulatory proposal NGT2 plants are envisioned to undergo a reduced risk assessment while for NGT1 plants no risk assessment is foreseen at all. To demonstrate were the path of the proposal leads to in practice, we applied the proposed criteria for categorization to a list of NGT plant applications that are currently in the commercialization pipeline. A key finding is that out of those plant applications affected by the EC proposal, 94% would be classified as NGT1 and thus would receive a market approval without risk assessment, monitoring and sufficient labeling provisions. The remaining 6% of applications would be classified as NGT2 plants for which, in deviation from the current regulation, an adapted risk assessment is proposed. A screening of intended traits in the pipeline highlights that certain NGT1 plants can pose similar environmental risks (e.g. invasiveness) compared to other genetically modified organisms (GMOs), as defined in Directive 2001/18/EC. For example, NGT1 applications based on RNAi technology can exhibit insecticidal effects with potential side effects on non-target organisms (i.e. other insects). Our quantitative and case-specific elaboration on how the current EC regulatory proposal would affect the environment, health or consumer protection will be informative for decision makers and politicians.

Rice cultivation is the main agricultural activity in Asia, and it results in an enormous amount of agricultural waste, that are usually disposed-off by burning, causing serious environmental health and climate problems. Pakistan is the tenth largest producer in the world and the fourth exporter of rice in the world. To date, there are no studies targeting Pakistan’s profile monitoring its contribution in open burning emissions from rice straw waste. This study presents the characterization of PCDD/Fs, PCBs and PAHs emissions from three samples of rice straw collected from the main rice cultivation regions of Pakistan (Punjab, Sindh and Azad Jammu and Kashmir) in relation to the role of metal-based agricultural additives. PCDD/Fs, PCBs and PAHs emissions were quantified using a fixed grid system biomass plant and measuring the macro-pollutants online and sampling the organic micro-pollutants and metals in isokinetic mode, followed by ISO and CEN standards methods. In addition, role of agrochemicals was monitored in terms of metal catalysis resulted in POPs emissions. This study provides the characterization of most relevant group of pollutants (metals, PCDD/Fs, PCBs and PAHs) as a result of agricultural waste combustion. The rice straw samples from AJK showed high values of organochlorine micro-pollutants compared to the values followed by samples from Punjab and Sindh, i.e., respectively, ∑PCDD/F (2594>1493>856 pg/Nm³) and ∑PCB (41>38>30 pg/Nm³). Whereas the organic micro-pollutants ∑PAH, indicators of incomplete combustion (PICs), were recorded high in the samples from Sindh followed by Punjab and AJK. This study supports the idea that the phenomena that lead to the formation of PCDD/F and PCB are influenced not only by poor combustion but also by the presence of metal catalysts or precursors in the burned fuel.

Dual antiplatelet therapy (DAPT), comprising aspirin and a P2Y12 receptor inhibitor, is the cornerstone of post-percutaneous coronary intervention treatment to prevent stent thrombosis and reduce the risk of adverse cardiovascular events. The selection of an optimal DAPT regimen, considering the interplay of various antiplatelet agents, patient profiles, and procedural characteristics, remains an evolving challenge. Traditionally, a standard duration of 12 months has been recommended for DAPT in most patients. While contemporary guidelines provide general frameworks, DAPT modulation with longer or shorter treatment courses followed by aspirin or P2Y12 inhibitor monotherapy are evolving towards an individualized strategy to optimize the balance between efficacy and safety. This review comprehensively examines the current landscape of DAPT strategies after coronary stenting, with a focus on emerging evidence for treatment individualization.

Aims: Chronic coronary syndrome is associated with several risk factors, such as dyslipidemia and hypertension. AIP has been demonstrated to be a biochemical risk factor for coronary artery disease (CAD). This study aimed to determine whether AIP is an effective parameter for estimating obstructive CAD. Methods and Results: A total of 345 patients (mean age 62,2±10,3; 63% male) who underwent coronary angiography were included in this study. Obstructive CAD is defined as having one or more vessels with a stenosis of≥50%. Depending on the presence of obstructive CAD, all patients were divided into two groups. The AIP was significantly higher in the obstructive coronary artery group (AIP; 0,49±0,26 vs. 0,58±0,27, p=0,002). In univariate analysis, AIP was significantly associated with obstructive coronary artery disease [OD:3,74 (CI95% 1,62-8,64), P=0,020]. The AIP was further adjusted for confounding risk factors in three multivariate analysis models. Therefore, all three models showed a significant association. According to ROC analysis, 0.49 is the cut-off value for AIP, and a value above 0.49 indicates 50% coronary artery stenosis Conclusions: AIP may be used in the assessment of cardiovascular risk in patients with stable angina pectoris, and it may also be used to estimate obstructive CAD.

Background: The diagnosis of metabolic syndrome (MetS) is a challenge in people with spinal cord injury (SCI). We aimed at identifying clinical risk factors or early markers of MetS in SCI that would facilitate a timely diagnosis and implementation of preventive/therapeutic strategies. Methods: 168 patients with chronic (>1 year) SCI underwent clinical and biochemical evaluations. MetS was diagnosed according to modified criteria of the International Diabetes Federation validated in people with SCI. Results: MetS was diagnosed in 56 of 132 men (42.4%) and 17 of 36 women (47.2%). At univariate regression analyses, putative predictors of MetS were an older age, a higher number of comorbidities, a lower insulin-sensitivity, the presence and intensity of pain, a shorter injury duration, a poorer leisure time physical activity (LTPA) and an incomplete motor injury. At the multiple regression analysis, a significant independent association with MetS only persisted for a poorer LTPA in minutes/week (OR: 0.998, 95%CI: 0.996, 0.999) and more severe pain symptoms as assessed by numeral rating scale (OR: 1.353, 95%CI: 1.085, 1.793). Conclusions: In patients with SCI, intense pain symptoms and poor LTPA may suggest a high likelihood of MetS, regardless of age, SCI duration, motor disability degree, insu-lin-sensitivity and comorbidities.

Different toll collection types of vehicles and different distribution of tollbooths lead to the toll plaza diverging area becoming a typical vehicle weaving area with frequent crossing behaviors and conflicts on highways. This study aims to identify contributing factors to conflict risks of four vehicle-following patterns in a toll plaza diverging area by developing random parameters ordered logit models with heterogeneity in means and variances. The model can flexibly capture the unobserved heterogeneity of the contributing factors in different vehicle-following patterns. Real-world vehicle trajectory data obtained from the toll plaza diverging area in Nanjing, China, are used for model estimation. The results show that vehicle-following patterns with the same toll collection types have higher percentage of severe conflict risks. The average acceleration of the following vehicles, lane marking indicator, the initial lanes and lane-changes of vehicles are significantly associated with the collision risk levels. The standard deviation of surrogate safety measures of all vehicles in sub-segments are found differ significantly between vehicle-following patterns. Furthermore, a series of likelihood ratio tests are adopted to test the spatial dependence in sub-segments of the diverging area. The findings of this study could provide valuable information for safety improvement in toll plazas.

The functions of annexin A1 (ANXA1) that is expressed on membranes and in cytoplasmic granules have been fully described. Nonetheless, the role of this protein in protecting against DNA damage in the nucleus is still emerging and requires further investigation. Here, we investigated the involvement of ANXA1 in DNA damage response in placental cells. Placenta was collected from ANXA1 knockout mice (AnxA1-/-) and pregnant women with gestational diabetes mellitus (GDM). The placental morphology and ANXA1 expression, which are related to the modulation of cellular response markers in the presence of DNA damage, were analyzed. Total area of AnxA1-/- placenta was smaller because of reduced labyrinth zone, enhanced DNA damage, and impaired base excision repair (BER) enzymes, which resulted in the induction of apoptosis in the labyrinthine and junctional layers. The placentas from pregnant women with GDM showed reduced expression of AnxA1 in the villous compartment, increased DNA damage, apoptosis, and reduction of enzymes involved in the BER pathway. Our translational data provide valuable insights into the possible involvement of ANXA1 in the response of placental cells to oxidative DNA damage and represent advancement in investigations on the mechanisms involved in placental biology.

The effects of global warming combined with the progressive expansion of urbanization have considerably increased exposure to urban flooding and runoff widespread erosion risk, also causing shallow landslides and mud flows, respectively in urbanized areas of lowland and hill/foothill environments. Increasing urban flooding resilience has become a priority at virtually all levels of governance. The analysis of a different hazard scenarios, in which various hydro-meteorological conditions and management alternatives are examined, should act as the basis for the effective design and evaluation of interventions to improve urban flooding resilience. Turin Metropolitan Area (TMA), located in north-western Italy, represents a unique case due to its complex orography, with a mountainous sector in the west side and a flat or hilly part in the east side. During the warm season, these environmental conditions make the urban area prone to severe atmospheric convection causing frequent hailstorms and rainstorms of high intensity that may impact on urban infrastructures (i.e., drainage system and road network), thus requiring an adequate management as a key factor to reducing risk and losses. The urban areas of TMA are monitored by polarimetric Doppler weather radars and by a dense rain gauges network. Analyzing several case studies of urban flooding, this research work assesses the feasibility of a meteorological radar early warning system based on the identification of rainfall thresholds that characterize urban flooding, occurring in the lowlands, and the runoff erosion phenomena affecting the urbanized hills and foothills.

Outcomes of repeated decision--making processes may be affected by adversarial actors, without being noticed. Adversaries may try to gain knowledge about a particular decision--making process, identify its decision--makers, and guess which underlying decision support model is used. Then they can simulate the process, and craft different scenarios to affect its decision outcomes. Therefore, designers of decision support systems need to incorporate this in the decision modeling phase. The purpose of this study is to demonstrate this for the repeated decision--making in a patent application process. In this process, two sequential decision outcomes can be affected by adversarial actors: a company's decision to which type of patent office to send a patent request to, and the decision of a specialized patent officer to grant an application, or not. It is motivated that the company's decision--maker is \emph{bounded} rational. A theory for information--theoretic bounded rational decision--making under uncertainty proposed by Ortega et al.\ is adopted to model this type of decision--maker. A framework is provided to simulate a number of scenarios that adversaries may deploy to affect decision outcomes of a repeated patent application decision--making process. The framework is also utilized for statistically testing the presence of the scenarios, and to demonstrate how to discourage adversaries from deploying them.

The present study aims to develop a risk-based approach to find optimal solutions for life extension management for offshore wind farms based on Markowitz’s modern portfolio theory, adapted from finance. The developed risk-based approach assumes that the offshore wind turbines (OWT) can be considered as cash-producing tangible assets providing positive return from the initial investment (capital) with a given risk attaining the targeted (expected) return. In this regard, the present study performs a techno-economic life extension analysis within the scope of the multi-objective optimisation problem. The first objective is to maximise the return from the overall wind assets, while the latter aims to minimise the risk associated with obtaining the return. In formulating the multi-dimensional optimisation problem, the life-extension assessment considers the results of a detailed structural integrity analysis, free-cash-flow analysis, and probability of project failure, local and global economic constraints. Further, the risk is identified as the variance from the expected mean of return on investment. The risk-return diagram is utilised to classify the OWTs of different classes using an unsupervised machine learning algorithm. The optimal portfolios for the various required rate of return are recommended for different stages of life extension.

This paper shows the influence of CCP’s collateralization on the pricing of the Credit Default Swaps (CDS). A narrowly variant in the way the CDS seller decides over the resources in the settlement comes with a substantial change on the elements that determine the price of the CDS.

Caesarean scar ectopic pregnancy (CSEP) is an uncommon form of ectopic pregnancy. This review defines types of CSEP, discusses pathophysiology, clinical presentation and diagnosis and compares common treatment options and outcomes. The pathophysiology is not yet fully understood. One third of patient are asymptomatic. In symptomatic patients vaginal bleeding and pelvic pain which is usually misdiagnosed as threatened or missed abortion. The main principles of treatment for CSEP are early diagnose, quick management, and maintain reproductive function as much as possible. Up to date; no consensus or guidelines for the treatment and management of CSEP. Management of CSEP depends on the clinical presentation and gestational age. Significant controversy exists regarding management, for this reason, several factors should be considered including age of the patient, myometrial thickness, clinical symptoms, hemodynamic status, fertility preservation.

In Taiwan, colorectal cancer is ranked second and third in terms of mortality and cancer incidence, respectively. In addition, medical expenditures related to colorectal cancer are considered to be the third highest. While advances in treatment strategies have provided cancer patients with longer survival, potentially harmful second primary cancers can occur. Therefore, second primary colorectal cancer analysis is an important issue with regard to clinical management. In this study, a novel predictive scheme was developed for predicting the risk factors associated with second colorectal cancer in patients with colorectal cancer by integrating five data mining classification techniques, including support vector machine, random forest, multivariate adaptive regression splines, extreme learning machine, and extreme gradient boosting. In total, 4,287 patients in the datasets provided by three hospital tumor registries were used. Our empirical results revealed that this proposed predictive scheme provided promising classification results and the identification of important risk factors for predicting second colorectal cancer based on accuracy, sensitivity, specificity, and area under the curve metrics. Collectively, our clinical findings suggested that the most important risk factors were the combined stage, age at diagnosis, BMI, surgical margins of the primary site, tumor size, sex, regional lymph nodes positive, grade/differentiation, primary site, and drinking behavior. Accordingly, these risk factors should be monitored for the early detection of second primary tumors in order to improve treatment and intervention strategies.

Abstract: Purpose – In this article we lay out the change management practices adopted by financial firms in small states within the Eurozone. We determine whether these organisations have the ability to identify triggers for change (Red Flags) and subject them to eight thematic elements to understand whether management practices can continue to exist and support operational environments, even when unexpected circumstances affect their day to day operations and processes. In doing this we examine the extent to which the eight thematic elements from the model designed by Dalli Gonzi, (2019) (The Dali Model) can assist organisations in risk identification and business continuity planning. Design/methodology/approach – A self-administered questionnaire purposely designed for this study was administered to personnel working in internal controls within financial institutions of small Eurozone states. The participants were asked to grade statements using a 5-point Likert scale, ‘1’ being ‘totally disagree’ and ‘5’ being totally agree’ to the statement posed under the thematic elements forming the basis of the Dali Model. Findings – Factor analysis provided support for the eight hypothesised dimensions of the decision-making model: connection, capacity, governance, network, policy, training, process improvement, standards. Originality/value – The study provides a better understanding and support of “best practice” in change management through an understanding and assessment of the eight factors that are the basis of this model. It addresses practical recommendations to ensure application to a wider frame of use.

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

Covid-19 is an airborne disease, with the vast majority of infections occurring indoors. By comparison, little transmission occurs outdoors. Here, we investigate the airborne transmission pathways that differentiate the indoors from outdoors, and conclude that profound differences exist, which help to explain why SARS-CoV-2 transmission is much more prevalent indoors. Near and far-field transmission pathways are discussed along with factors that affect infection risk, with aerosol concentration, air entrainment, thermal plumes, and occupancy duration all identified as being influential. In particular, we present the fundamental equations that underpin the Wells-Riley model, and show the mathematical relationship between inhaled virus particles and quanta of infection. A simple model is also presented for assessing infection risk in spaces with incomplete air mixing. Transmission risk is assessed in terms of aerosol concentration using simple 1D equations, followed by a description of thermal plume-ceiling interactions. With respect to this, we present new experimental results using Schlieren-visualisation and Computational Fluid Dynamics (CFD) based on the Eulerian-Lagrangian approach. Pathways of airborne infection are discussed, with the key differences identified between indoors and outdoors. In particular, the contribution of thermal and exhalation plumes is evaluated, and the presence of near-field/far-field feedback loop postulated, which is absent outdoors.

This study explores the complexities of risk communication practices in orthodontics, specifically examining the perspectives of orthodontists in Greece and Slovakia. Informed by the foundational importance of effective communication in health sciences, particularly in facilitating valid consent and shared decision-making, this research addresses gaps identified in the literature concerning the consistent communication of potential treatment risks based on demographic and cultural characteristics. The study identifies 15 potential critical risks with orthodontic treatment. These risks include root necrosis; temporary undesired changes to the occlusion; sleep difficulties; not achieving an ideal result; development of black triangles between teeth; taking additional X-rays; speech difficulties; using a protective splint during sports; duration of treatment; number of visits; transmission of infectious diseases; and swallowing orthodontic appliances. The questionnaire, distributed electronically to orthodontists in Greece (n=570) and Slovakia (n=210) from Sept. 2022 to Dec. 2022, aimed to assess risk communication practices, with consideration to country, gender, and degree-related variations. 168 valid questionnaires (91 from Slovakia and 77 from Greece) were obtained indicating significant disparities in the risks emphasized and preferred forms of consent. The Greek orthodontists focused more on the risks involved such as on relapse, root resorption, temporal occlusal changes, and failure of desired movement, while the Slovak practitioners tend to be interested more about sleeping difficulties, temporal occlusal changes and not achieving an ideal result. They also tend to obtain written or digital consent from patients or their parents/guardians more frequently than the Greek team. Male orthodontists discussed specific risks more frequently, including relapse and extractions, whereas females preferred written or digital consent. PhD-trained orthodontists prioritized certain risks, indicating the need for tailored approaches. This study underscores the dynamic nature of risk assessment in orthodontic practice, emphasizing its ethical and strategic dimensions. The findings advocate for tailored risk communication strategies, that recognize individual, contextual, and cultural factors and the need of an orthodontic informed consent protocol for tailored communication approach for patients to elevate the standard of care in European orthodontics. The reliance on digital tools reflects contemporary trends in enhancing patient understanding, thereby supporting ongoing innovation in orthodontic practices.

The 3D/3D+ multidimensional geriatric assessment tool provides an optimal model of emergency care for patients aged 75 and over who attend the Emergency Department (ED). The baseline, or static, component (3D) stratifies the degree of frailty prior to the acute illness, while the current, or dynamic, component (3D+) assesses the multidimensional impact caused by the acute illness and helps to guide the choice of care facility for patients upon their discharge from the ED. The objective of this study was to evaluate the prognostic value of the 3D/3D+ to predict short- and long-term adverse outcomes in ED patients aged 75 years and older. Multivariable logistic regression models were used to identify the predictors of mortality 30 days after 3D/3D+ assessment. Two hundred and seventy-eight patients (59.7% women) with a median age of 86 years (interquartile range: 83-90) were analysed. According to the baseline component (3D), 83.1% (95%CI: 78.2-87.3) presented some degree of frailty. The current component (3D+) presented alterations in 60.1% (95%CI: 54.1-65.9). The choice of care facility at ED discharge indicated by the 3D/3D+ was considered appropriate in 96.4% (95%CI: 93.0-98.0). Thirty-day all-cause mortality was 19.4%. Delirium and functional decline were the dimensions on the 3D/3D+ that were independently associated with 30-day mortality. These two dimensions had an area under receiver operating characteristic of 0.80 (95%CI: 0.73-0.86) for predicting 30-day mortality. 3D/3D+ enhances the provision of comprehensive care by ED professionals, guides them in the choice of patients’ discharge destination, and has a prognostic validity that serves to establish future therapeutic objectives.

Background: Handover is a critical process for ensuring quality and safety in healthcare. Considerable research suggests that poor handover results in significant morbidity, mortality, dissatisfaction, and excess financial costs. Despite this, little formal attention, education, and evaluation has been given to handover. There is also paucity of data on the opinions of practitioners on the safety of handover.Objectives: The aim of this study was to measure the perceived risk, degree of patient harm and the systems used to support handover, and to understand how this varied by care setting, type of clinical practice, location, or level of experience. Methods: An open, anonymous and confidential online questionnaire covering: (a) respondent characteristics; (b) peer-to-peer handover; (c) internal referrals; (d) discharges and transfers between organisations; and (e) leading and improving handover was conducted with healthcare practitioners and managers from various settings. Results: We gathered a total of 432 completed responses from 26 countries. The average reported performance of handover was rated as 3.9 out of 5.For each type of handover, 12 - 14% reported errors occurring more than weekly. Of those that knew the outcome of such errors, between 29% and 34% reported that they had witnessed moderate or severe harm. 12% and 17% of respondents believed that handover was high or very high risk (See table 4). These respondents were more likely to have witnessed moderate or severe harm, or to be more senior.A wide combination of handover systems was utilised by respondents. 28% - 32% relied exclusively on EPRs (with or without face-to-face contact). 21% used Office documents such as Word and Excel for peer-to-peer handover, and over 30% used hand-written or manual systems. Conclusions: This study suggests the need to do more — and go further — to improve communication and reduce risk during all types of handovers. Clinical leaders should find ways to train and support handover with effective systems, with less experienced staff being the primary focus. More research is needed to demonstrate the interventions that improve the safety of handover.

The famous Capital Asset Pricing Model (CAPM) takes into account only business risk. In practice, companies use debt financing and operate at non–zero levels of leverage. This means that it is necessary to take into account the financial risk associated with the use of debt financing along with business one. The purpose of this paper is to simultaneously take into account the business and financial risk. A new approach to CAPM has been developed that takes into account both business and financial risk. We combine the theory of CAPM and the Modigliani–Miller (MM) theory. The first is based on portfolio analysis and accounting for business risks in relation to the market (or industry). The second one (the Modigliani–Miller (MM) theory) describes a specific company and takes into account the financial risks associated with the use of debt financing. The combination of these two different approaches makes it possible to take into account both types of risks: business and financial ones. We combine these two approaches analytically, while Hamada did it phenomenologically. Using the Modigliani–Miller (MM) theory, it is shown that the Hamada’s model, first model, used for this purpose half a century ago, is incorrect. In addition to the renormalization of the beta–coefficient, obtained in the Hamada model, two additional terms are found: the renormalized risk–free return and the term dependent on the cost of debt kd. A critical analysis of the Hamada model was carried out. The vast majority of listing companies use debt financing and are levered, and the Hamada model is not applicable to them in contrast to a new approach applicable to leveraged companies. Implemented a new approach to specific companies. A comparison of the results of the new approach with the results of the conventional CAPM is shown. Two versions of CAPM (market or industry) are considered.

This study aims to identify the model that best approximates the credit spread that should be fixed on debt instruments issued by both public and private companies, considering the particularities of the Mexican market. Five models were analyzed: Merton's [1], those proposed by Denzler et al., the one presented in this paper, which includes the conformable derivatives, taking as a reference the change of variable made by Morales-Bañuelos et al., and the Corporate Default Risk Model (DRSK) for Publics Firms of Bloomberg [4]. The required financial information was obtained from the Bloomberg platform, from which the probabilities of default, credit spreads, and credit ratings for each company in the sample under the model (DRSK) were extracted directly. Likewise, the program developed by Moody's K.M.V. was used to obtain the EDF (Expected Default Frequencies). It was concluded that the Modified Merton model approximates to a greater extent the credit spreads that fix on a prime rate on the loans granted to the Mexican non-financial companies.

In this work, the Pumped Storage Unit (PSU) is proposed to be integrated with wind-thermal generation system owned by a company whose aim is to maximize its profit through optimal self-scheduling of its units by finding the best bidding strategy in day-ahead energy market. The mathematical formulation of the scenario based unit-commitment and coordinated trading problem is formulated as a stochastic mixed integer linear program. The formulation takes into account several uncertain parameters; such as the wind power generation, energy market prices, and imbalances up/down prices. The expected total profit obtained from energy trading with and without coordinating pumped storage system (PSS) with thermal-wind generation system were compared, and a significant improvement in profit resulted from coordination was observed. Furthermore, coordination between PSS and wind-thermal generation improve the conditional value at risk (CVaR) which monitors the biding risk level.

Previous studies have acknowledged the impact of weather changes on retail uncertainty. They primarily focus on understanding how weather conditions affect offline consumer behavior and aiming to develop effective marketing strategies. However, there is little research on the complex impact of weather on online shopping behavior. To bridge this gap, we conduct a study with a sample of 261 consumers from China with shopping experience in Community Retail Shops (CRSs). We utilize the S-O-R model and theories including meteorological emotional effect theory, emotional coherence and meteorological psychology to propose and validate models elucidating the relationship between weather and consumers' online shopping behavior in CRS. Our findings reveal that weather conditions affect consumers' spending patterns and purchase diversity, mediating by consumers' emotion and risk aversion, when they comfortably shop online at home. Furthermore, employing the fsQCA model, we identify the critical path through which weather conditions and consumer types influence risk aversion awareness. The results provide management implications for retailers to develop online marketing strategies for different consumer types.

This qualitative research explores Supplier Relationship Management (SRM) practices within the e-commerce fashion industry, aiming to uncover key strategies and their impacts. Through semi-structured interviews with supply chain managers, procurement officers, and supplier representatives, critical themes emerged: communication, trust, risk management, sustainability, and digital technologies. Effective communication, characterized by transparency and regular updates, emerged as pivotal for aligning expectations and resolving issues promptly. Trust-building practices, including fair dealings and formal agreements, were essential in fostering long-term partnerships, reducing transaction costs, and enhancing collaboration. Robust risk management strategies, such as supplier diversification and contingency planning, were identified as crucial for mitigating disruptions and ensuring supply chain resilience. Sustainability was highlighted as a strategic imperative, driven by ethical sourcing and environmental standards, supported by technologies like blockchain for transparency. The transformative role of digital technologies—supply chain management software, blockchain, IoT, and data analytics—was evident in enhancing visibility and decision-making across global supply chains. Viewing suppliers as strategic partners, rather than mere vendors, promoted collaborative innovation and mutual growth. Despite challenges like cultural differences and regulatory complexities, opportunities exist to enhance SRM through integrated best practices. By prioritizing effective communication, trust-building, risk management, sustainability, and digital innovation, companies can strengthen supplier relationships, optimize supply chain performance, and achieve competitive advantage in the e-commerce fashion sector.

This qualitative study explores the pivotal role of Supplier Relationship Management (SRM) in enhancing resilience within e-commerce supply chains. In an era marked by rapid digital transformation and global interconnectedness, the resilience of supply chains has become a strategic imperative for organizations striving to maintain operational efficiency and meet customer expectations. Through semi-structured interviews with supply chain managers, procurement officers, and strategic sourcing specialists across diverse industries, this research investigates the strategies, challenges, and outcomes associated with SRM practices. Findings reveal that effective communication and collaboration are fundamental to successful SRM, fostering trust, transparency, and responsiveness in supplier relationships. Strategic risk management through proactive identification and mitigation strategies enables organizations to navigate uncertainties such as economic fluctuations and geopolitical tensions. SRM implementation yields significant organizational benefits, including improved supply chain efficiencies, enhanced product quality, and increased customer satisfaction. However, challenges such as technological complexities, cultural differences among global suppliers, and regulatory compliance issues underscore the need for adaptive strategies and digital investments. The integration of digital technologies such as AI and blockchain enhances SRM effectiveness by enabling real-time data exchange, predictive insights, and decision-making capabilities. Ultimately, SRM emerges as a cornerstone of sustainable growth and competitive advantage in e-commerce, empowering organizations to optimize supply chain performance and resilience amidst dynamic market conditions.

This qualitative study explores the transformative role of Supplier Relationship Management (SRM) in the context of e-commerce, focusing on the integration of digital technologies and evolving supplier interactions. As digital advancements such as artificial intelligence, blockchain, data analytics, cloud computing, and the Internet of Things (IoT) reshape traditional SRM practices, e-commerce companies are experiencing significant improvements in efficiency, transparency, and collaboration. This research employs semi-structured interviews, document analysis, and case studies to examine the impact of these technologies on SRM, identify key collaborative practices, and assess risk management strategies. Findings indicate that digital integration enhances decision-making, streamlines operations, and fosters deeper, trust-based supplier relationships. AI facilitates predictive analytics and automates processes, while blockchain provides transparency and reduces fraud. Data analytics supports informed sourcing decisions and risk mitigation, and cloud platforms improve real-time collaboration. IoT enhances supply chain visibility, allowing for better inventory management. Despite these benefits, challenges such as high implementation costs, integration difficulties, data privacy concerns, and security risks remain significant barriers. Collaboration practices, including joint development, shared resources, and coordinated marketing, contribute to innovation and mutual growth, emphasizing the need for effective communication and trust. Risk management strategies, such as scenario planning and supplier diversification, are crucial for maintaining supply chain resilience. Strategic alignment between e-commerce companies and suppliers, including goal congruence and capability matching, is essential for seamless coordination and competitive advantage. The study underscores the importance of a holistic approach to SRM, integrating technology, collaboration, risk management, and strategic alignment to navigate the complexities of supplier relationships in the digital age. These insights provide a framework for e-commerce companies to optimize their SRM practices and achieve sustainable growth in a dynamic marketplace.

Smoking is a pervasive global health concern associated with a myriad of diseases, but its impact on cellular aging, particularly in relation to telomeres, is increasingly recognized. Telomeres, protective caps at the ends of chromosomes, play a crucial role in maintaining genomic integrity. This review critically examines the existing evidence on the association between smoking and telomere atrophy, exploring the molecular mechanisms involved and the implications for accelerated aging and heightened disease risk. The comprehensive analysis encompasses both cross-sectional and longitudinal studies, elucidating potential gender and age disparities. Insights into the molecular pathways linking smoking to telomere shortening are discussed, along with the broader implications for public health. The review concludes by outlining potential interventions and suggesting future research directions in this critical area.

Over the last decade, highly pathogenic avian influenza (HPAI) has severely affected poultry production systems across the globe. In particular, massive pre-emptive depopulation of all poultry within the certain distance has raised concerns regarding animal welfare and food security. Thus, alternative approaches to reducing unnecessary depopulation, such as risk-based depopulation, are highly demanded. This paper proposes a data-driven method to generate a rule table and risk score for each farm to identify preventive measures against HPAI. To evaluate the proposed method, 105 cases of HPAI occurring in a total of 381 farms in Jeollanam-do from 2014 to 2023 were evaluated. The accuracy of preventive measure identification was assessed for each case using both the conventional culling method and the proposed data-driven method. The evaluation showed that the proposed method achieved an accuracy of 84.19%, significantly surpassing the previous 10.37%. The result was attributed to the proposed method reducing the false-positive rate by 83.61% compared with the conventional method, thereby enhancing the reliability of identification. The proposed method is expected to be utilized in selecting farms for monitoring and management of HPAI.

The increasing prevalence of periprosthetic femoral fractures, specifically in the vicinity of the hip, has emerged as a significant issue in recent times. Consequently, there is a need for a thorough examination to enhance the effectiveness of management and treatment approaches. The findings emphasized a significant disparity in the occurrence and characteristics of these fractures, as multiple studies have highlighted the efficacy of various treatment strategies, such as open reduction and internal fixation, as well as the utilization of cortical strut allografts. Furthermore, the research has identified potential risk factors that have an impact on the characteristics of fractures, providing valuable insights that could be crucial in the development of preventive strategies. This research provides a thorough examination of periprosthetic femoral fractures, highlighting the importance of a cohesive treatment algorithm to improve the handling of such fractures. Moreover, it promotes the need for a collaborative endeavor in conducting research in this field, cultivating a more profound comprehension that has the potential to drive progress in therapeutic approaches, ultimately enhancing patient results over an extended period of time. It is crucial that forthcoming research endeavors persist in expanding upon these discoveries, striving towards a unified methodology in tackling this substantial clinical obstacle.

There are two purposes for this article. The first purpose is to perform a reiew of previous research on global supply chain management (GSCM) principles that can adapt and survive adversity, such as the COVID-19 pandemic. The second purpose is to put forth a conceptual framework for the GSCM that is sustainable in the event of future turbulence similar to that experienced during the COVID-19 pandemic. With regard to the issues raised, the article posits the following questions. Is there, perhaps, a sustainable post-COVID-19 pandemic GSCM? Can the COVID-19 pandemic-related international logistics system (GSC) turbulences be predicted with certainty using these sustainable post-COVID-19 pandemic GSCM concepts? Putting it all together, the paper concludes that, while debatable, sustainable GSCM is feasible and can be accomplished utilizing JIT, supply chain mitigation, and supply chain visibility, as demonstrated by the manufacturing firms referenced in the article.

The implications related to the fight against alien organisms often affect different sectors, from the economic to the landscape one or from the public health to the ecological one. This paper is an upgrade of our previous study focused on the evolution of the red palm weevil in a coastal urban area (central Italy); we investigate the evolution of this parasite in the following period (2013-2020), considering both the effectiveness of the chemicals used and their potential effects. With a multidisciplinary approach, on the one hand we carried out a spatio-temporal analysis to analyze the extent and mode of pest spread over time using historical aerial photos, freely available remote sensing images and field surveys, integrated in a GIS environment, and on the other hand we performed an assessment of the chemical risk associated with the substances used to protect the palms from the red weevil. The fight against weevil is now concentrated in specific areas (parks, relevant roads, villas, hotels, farmhouses, nurseries); the applied preventive chemical treatments are very effective in preserving the palms, but they show a toxic potential for all organisms. We discuss current local management of this pest focusing on the several aspects involve into the fight against this beetle in an urban area.

Coastal flooding exacerbated by climate change is recognised as a major global threat which is expected to impact more than a quarter of people currently residing in Pacific Islands countries. While most research in the last decade has focused on understanding the dynamics and impacts of future coastal flooding from extreme sea levels, relative sea level rise (RSLR) effects on tsunami hazards are not well understood. Far-field or distant-sourced tsunamis tend to have relatively lower impacts in Pacific Island states compared with locally sourced events, but there is limited understanding on how the impact of far-field tsunamis changes over time due to RSLR. Using the hydrodynamics software BG-Flood, we modelled the Tōhoku tsunami from propagation to inundation in Samoa under incremental SLR to examine the effects that RSLR has on changing the exposure of the built environment (e.g., buildings) to a far-field tsunami. Outputs of maximum tsunami inundation and flow depth intensities which incorporate incremental SLR were then combined with digital representations of buildings and depth-damage functions in the RiskScape multi-hazard risk modelling software to assess the changes in building exposure over time. Results indicate that present day buildings exposure in Samoa to a Tōhoku-oki type far-field tsunami will increase by approx. 600% with 1 m RSLR by 2080–2130, and approx. 2,350% with 2 m RSLR by 2130–2140. These findings provide a useful baseline for tsunami hazard risk assessment under changing sea level conditions in analogous island environments.

In this paper we focus on an implicit assumption in the BSM framework that limits the scope of market network connections to seeking gains in the currency basis, i.e., on trading strategies between the numeraire and the stock and between the numeraire and the option, separately. We relax this assumption and derive the equivalent of the standard BSM approach under a more general market network framework in order to assess its implications. In doing so, we find that it is not possible to hedge the implicit option that allows one to directly trade the option and stock. This represents a potential challenge to the BSM framework, since the missing market network connection provides a potentially useful mechanism for risk-bearing portfolio managers to alter their portfolios.

We investigate the effect of geopolitical risk on the returns of the Information Technology, Communication Services, and Consumer Staples sector firms within the S&P 500 index. We use the event study methodology and perform more than 17,000 regressions to provide empirical evidence at the sector level that geopolitical risk leads to different responses across these 3 sectors. The response of the Information Technology sector is negative for all event windows under study, except the one spanning 10 days prior to the geopolitical event and 10 days after. The Communication Services sector has positive returns as a result of geopolitical events for all event windows, except the one from the geopolitical event date and 5 days after. The Consumer Staples sector shows a negative impact on geopolitical risk for all event windows except the one from the geopolitical event date and 5 days after, demonstrating a negative correlation to the Communication Services sector.

The Capital Asset Pricing Model is a widely applied model to describe risky markets and to deduce their systematic risk. Its estimation, therefore, remains an important task in Econo-financial studies. Empirically, it focuses on the impact of return interval on the betas. Existing studies somehow turn around the same idea of measuring the value of the beta according to the uniform intervals of time during a fixed period. However, it is noticed easily, and especially in the last decade that many factors such as socio-political, and Econo-environmental ones have led to a perturbation in the timeline of the worldwide development, and especially in countries and regions having political changes. This led us to introduce a new idea of risk estimation taking into account the non-uniform changes in markets by introducing a non-uniform wavelet analysis. We aim to explain the Econo-political situation of Arab spring countries and the effect of the revolutions on the market beta. The main novelty is firstly the construction of a dynamic backward-forward model for missing data, and next the application of random non-uniform wavelets. The proposed procedure will be acted empirically on a sample corresponding to TUNINDEX stock as a representative index of the Tunisian market actively traded over the period January 14, 2016, to January 13, 2021. The chosen 5-years period is important as it constitutes the first 5-years-after the revolution and depends strongly on the Socio-Econo-political stability in the revolutionary countries.

In recent years, there is a growing concern about the alarming spread of antimicrobial resistance (AMR) in different environments. Increasingly, many species of bacteria, fungi and viruses are becoming immune to the most commonly used pharmaceuticals. One of the causes of the development of the resistance is the persistence of these drugs, excreted by humans, in municipal and hospital wastewater (WW). Consequently, wastewater treatment plants (WWTPs) are a primary source of antimicrobial resistance genes as novel pollutants. This systematic review sought to examine the relevant literature on pharmaceutical residues (PRs) responsible for AMR in municipal and hospital WW in order to propose a classification of the PRs of greatest concern and provide an updated source for AMR management in WWTPs. Among 546 studies collected from four databases, 18 were included in the present review. The internal and external validity of each study was assessed, and the risk of bias was evaluated on a 20-parameter basis. Results were combined in a narrative synthesis discussing influents and effluents PR concentrations at 88 WWTPs, seasonal variations, differences between hospital and municipal WW, environmental risk assessment values of antimicrobial substances and treatment facilities removal efficiencies. Among the 45 PRs responsible for AMR evaluated in this study, the antibiotics ciprofloxacin, clarithromycin, erythromycin, metronidazole, ofloxacin, sulfamethoxazole and trimethoprim constitute a considerable risk in terms of ubiquitous distribution, worrying concentrations, risk quotients values, and resistance to removal treatments. Gaps in knowledge, data and information reported in this review provide a valuable source for managing AMR in WWTPs.

Bovine tuberculosis (bTB) outbreaks, caused by Mycobacterium bovis infection, are a costly animal health challenge. Understanding factors associated with the duration of outbreaks, known as breakdowns, could lead to better disease management policy development. We undertook a retrospective observational study (2012-2018) and employed Finite Mixture Models (FMM) to model the outcome parameter, and to investigate how factors were associated with duration for differing subpopulations identified. In addition to traditional risk factors (e.g. herd size, bTB history), we also explored farm geographic area, parcels/farm fragmentation, metrics of intensity via nitrogen loading, and whether herds were designated controlled beef finishing units (CBFU) as potential risk factors for increased duration. The final model fitted log-normal distributions, with two latent classes (k) which partitioned the population into a subpopulation around the central tendency of the distribution, and a second around the tails of the distribution. The latter subpopulation included longer breakdowns of policy interest. Increasing duration was positively associated with recent (<3 yrs) TB history and the number of reactors disclosed, (log) herd size, beef herd-type relative to other herd types, number of land parcels, area, and being designated a controlled finishing unit (“feedlot”), and having high annual inward cattle movements within the “tails” subpopulation. Breakdown length was negatively associated with year of commencement of breakdown (i.e. a decreasing trend) and non-significantly with the organic nitrogen produced on the farm (N kg/hectare), a measure of stocking density. The latter finding may be due to confounding effects with herd size and area. Most variables contributed only moderately to explaining variation in breakdown duration, that is, they had moderate size effects on duration. Herd-size and CBFU had greater effect sizes on the outcome. The findings contribute to evidence-based policy formation in Ireland.

Consistent data is seldom available for whole-catchment flood modelling in many developing regions, thus this study demonstrates how the complementary strengths of open and readily available geospatial datasets and tools can be leverage to map flood risk within acceptable levels of uncertainty for flood risk management. Available fragmented remotely-sensed and in situ datasets (including hydrological data, altimetry, digital elevation model, bathymetry, aerial photos, optical and radar imageries) are systematically integrated using 2-dimensional CAESAR-LISFLOOD model to quantify and recreate the extent and impact of the historic 2012 flood in Nigeria. Experimental modelling, calibration and validation is undertaken for the whole Niger-South hydrological catchment area of Nigeria, then segmented into sub-domains for re-validation to understand how data variability and uncertainties impact on the accuracy of model outcomes. Furthermore, aerial photos are applied for the first time in the study area for flood model validation and to understand how different physio-environmental properties influence synthetic aperture radar flood delineation capacity in the Niger Delta region of Nigeria.

COVID-19 has affected 210 countries around the world, killed more than 240,000 and infected more than 3.4 million. Bangladesh, a South Asian low-middle-income economy, has experienced a demographic and epidemiological transition with rapid urbanization and a gradual increase in life expectancy. It is the seventh most populous country in the world and population of the country is expected to be nearly double by 2050. The increasing burden of noncommunicable diseases in Bangladesh can be attributable to rapid urbanization and nearly 50% of all slum dwellers of the country live in Dhaka division. In 2017, National Rapid Response Team of IEDCR investigated 26 incidents of disease outbreak. The joint survey of the Power and Participation Research Centre and BRAC Institute of Governance and Development reveals that per capita daily income of urban slum and rural poor drops by 80% due to present countrywide shutdown enforced by the government to halt the spread of Covid-19. 40%-50% of these population took loans to meet the daily expenses.

Introduction: Due to the spread of SARS CoV-2 virus responsible for COVID-19 disease, there is an urgent need to analyse COVID-19 epidemic perception in Poland. This study aims to investigate social perception of coronavirus in the Internet media during the epidemic. It is a signal report highlighting the main issues in public perception and medical commutation in real time. Methods: We study the perception of COVID-19 epidemic in Polish society using quantitative analysis of its digital footprints on the Internet on platforms: Google, Twitter, YouTube, Wikipedia and electronic media represented by Event Registry, from January 2020 to 29.04.2020 (before and after official introduction to Poland on 04.03.20). We present trend analysis with a support of natural language processing techniques. Results: We identified seven temporal major clusters of interest on the topic COVID-19: 1) Chinese, 2) Italian, 3) Waiting, 4) Mitigations, 5) Social distancing and Lockdown, 6) Anti-crisis shield, 7) Restrictions releasing. There was an exponential increase of interest when the Polish government “declared war against disease” around 11/12.03.20 with a massive mitigation program. Later on, there was a decay in interest with additional phases related to social distancing and an anti-crisis legislation act with local peaks. We have found that declarations of mitigation strategies by the Polish prime minister or the minister of health gathered the highest attention of Internet users. So enacted or in force events do not affect interest to such extent. Traditional news agencies were ahead of social media (mainly Twitter) in dissemination of information. We have observed very weak or even negative correlations between a colloquial searching term 'antiviral mask' in Google, encyclopaedic definition in Wikipedia “SARS-CoV-2” as well official incidence series, implying different mechanisms governing the search for knowledge, panic related behaviour and actual risk of acquiring infection. Conclusions: Traditional and social media do not only reflect reality, but also create it. Risk perception in Poland is unrelated to actual physical risk of acquiring COVID-19. As traditional media are ahead of social media in time, we advise to choose traditional news media for a quick dissemination of information, however for a greater impact, social media should be used. Otherwise public information campaigns might have less impact on society than expected.

Trees in residential landscapes provide many benefits, but can injure persons and damage property when they fail. In hurricane-prone regions like Florida, USA, the regular occurrence of hurricanes has provided an opportunity to assess factors that influence the likelihood of wind-induced tree failure and develop species failure profiles. We assessed open-grown trees in Naples, Florida, following the passage of Hurricane Irma in September 2017 to determine the effect of relevant factors on the degree of damage sustained by individual trees. Of 4,034 assessed individuals (n = 15 species), 74% sustained no damage, 4% sustained only minor damage (i.e., minimal corrective pruning needed), 6% sustained significant damage (i.e., major corrective pruning needed), and 15% were whole tree failures (i.e., overturned trees or trees requiring removal). The proportion of individuals in each damage category varied among species, stem diameter at 1.4 m above ground, and the presence of utility lines, which was a proxy for maintenance. We compared our results with the findings of seven previous hurricanes in the region to explore species’ resilience in hurricanes.

The failure to acknowledge and account for environmental externalities or spillovers in climate change adaptation policy, advocacy and programming spaces exercabates the risk of ecological degradation, more so, degradation of land. In particular use of unsuitable water sources for irrigation may increase salinisation risks. However, little if any policy assessments and research effort has been directed at investigating how farmer perceptions mediate spillovers from the ubiquitous irrigation adaptation strategy. In this study cognitive failure and/or bias construct is examined and proposed as an analytical lens in research, policy and learning and the convergence of disaster risk reduction and climate change adaptation discourses. The findings from small-scale farmers, Machakos and Kakamega counties, Kenya, suggest multifaceted biases and failures about the existence and importance of externalities in adaptation planning discourses. Among other dimensions, cognitive failure which encompasses fragmented approaches among institutions for use and management of resources, inadequate policy and information support, as well as, poor integration of actors in adaptation planning accounts for adaptation failure. The failures in such Human-Environment system interactions have the potential to exercabate existing vulnerability of farmer production systems in the long run. The findings further suggest that in absence of risk message information dissemination, education level, farming experience and information accumulation, as integral elements to human capital, do not seem to have significant effect on behaviour about mitigation of environmental spillovers. Implicitly, reversing the inherent adaptation failures calls for system approaches that enhance coordinated adaptation planning, prioritises proactive mitigation of slow onset disaster risks and broadens decision support systems, such as, risk information dissemination integration into the existing adaptation policy discourses and practice.

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

LoRa and its upper layers definition LoRaWAN is one of the most promising LPWAN technologies for implementing the Internet of Things (IoT). Although being a popular technology, several works in the literature have revealed various weaknesses regarding the security of LoRaWAN v1.0 (the official 1st draft). By using all these recommendations from the academia and industry, the LoRa-Alliance has worked on the v1.0 to develop an enhanced version and provide more secure and trustable architecture. The result of these efforts ended-up with LoRaWAN v1.1, which was released on Oct 11, 2017. This manuscript aims at demystifying the security aspects and provide a comprehensive Security Risk Analysis related to latest version of LoRaWAN. Besides, it provides several remedies to the recognized vulnerabilities. To the best of authors’ knowledge, this work is one of its first kind by providing a detailed security analysis related to latest version of LoRaWAN. According to our analysis, end-device physical capture, rogue gateway and replay attacks are found to be threating for safety operation of the network. Eventually, v1.1 of LoRaWAN is found to be less vulnerable to attacks compared to v1.0, yet possesses several security implications that need to be addressed and fixed for the upcoming releases.

Disaster Risk Reduction (DRR) is a high priority on the agenda of main stakeholders involved in sustainable development and Earth Observation (EO) can provide useful, timely and economical information in this context. This short communication outlines the European Space Agency’s (ESA) specific initiative to promote the use and uptake of satellite data in the global development community: ‘Earth Observation for Sustainable Development (EO4SD)’. One activity area under EO4SD is devoted to Disaster Risk Reduction: EO4SD DRR. Within this project, a team of European companies and institutions are tasked to develop EO services for supporting the implementation of DRR in International Financial Institutions’ (IFI) projects. Integration of satellite-borne data and ancillary data to generate insight and actionable information is thereby considered a key factor for improved decision making. To understand and fully account for the essential user requirements (IFI & Client States), engagement with technical leaders is crucial. Fit-for-purpose use of data and comprehensive capacity building eventually ensure scalability and long-term transferability. Future perspectives of EO4SD and DRR regarding mainstreaming are also highlighted.

Background: Absolute uterine factor infertility (AUFI) is a kind of infertility that is completely attributable to uterine absence (surgical or congenital for women with Mayer-Rokitansky-Küster-Hauser syndrome: MRKH) or anatomic or functional abnormality that prevents embryo implantation or completion of pregnancy to term. Until recently, the only viable option to parenthood for couples with AUFI were adoption or surrogacy. Since a first attempt of uterus transplant (UTx) in 2000, nine babies were born from women with a transplanted uterus from 2014, eight of which in Sweden, and one in the United States. These promising results are raising immense hopes for the women with AUFI and there is optimism about the possibility for UTx to become part of clinical care even though, besides encouraging results, the procedure has also resulted in increased risks and harms for both the donors and recipients and increased risks of premature birth for the fetus. At present UTx is still considered as experimental and requiring more research and safety assessment before becoming a therapeutic option for AUFI. The transition from experimental procedure to therapeutic care would result in less strict ethical scrutiny for UTx and in the possibility for patients to get reimbursement for the procedure by the relevant healthcare insurance or public healthcare providers. In turn, an increase in the number of UTx performed yearly by specialized surgical teams would result in a general improvement of the “field strength”. However, at present it is difficult to establish the amount of evidence that we need in order to consider UTx as no longer experimental but routine clinical practice. The literature on UTx provides recommendations on the different outcomes that should be monitored in this experimental phase but no study is anticipating the number of subjects that should be followed and for how long. Conclusion: As for other transplants that have become routine practice, like renal transplant and heart transplant, it is likely that the decision on “routine practice readiness” will result from available cumulated evidences, from expert capacity to find a consensus on best practices and on political considerations as well, including pressures form patients and patient groups.

There have been several cases of large-scale wind generators (WGs) tripping off caused by untimely fault removing in recent years. Currently, the discoordination between the box-type transformer fuse protection (BTFP) and two-section collecting line current protection (CLCP) brings a security risk to wind farm. In order to ensure the selectivity, the first section (Sec-I) CLCP should be set a enough interval that is longer than the fuse melting time, and another interval is set for the Sec-II CLCP, which weakens the speed of the CLCP. When a fault occurs on the collecting line, there is no doubt that WGs cannot work too long in abnormal operation, which may cause WGs to be placed off the grid. For a power system with high penetration of wind power, large-scale WGs tripping off will cause a great power shortage, and affect the stability of the power system. The selectivity and sensitivity of the CLCP is analyzed in detail to make the CLCP speed better. Considering the fault ride-through ability of WGs, the fault clear time is an important factor to lead to large-scale WGs tripping off. Two main works are done in this paper. The first is to accelerate the speed of the Sec-I CLCP though reducing the protection zone. Another one is introduce the risk assessment module into the CLCP, which not only improve the speed of the CLCP but also ensure the safety of the wind farm during faults. According to the deference in trip-off causes of WGs, the matching functions are created to assess the trip-off risk of WGs on the spot. In the case of fault, the trip-off risk indicators of WGs are timely updated to data sharing center and open to the CLCPs. The set of risk indicators is divided into several subsets according to the risk range. The dynamic changes of the subsets during fault help to improved CLCP scheme. This scheme can accelerate protection speed based on the increasing risk of large-scale WGs tripping off in wind farms. Compared with traditional CLCP, this approach can make the CLCP combines selectivity and speed better based on the analysis of the ride- through ability of WGs.

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

We introduce and analyse a simple formal thought experiment designed to reflect a qualitative decision dilemma humanity might currently face in view of climate change. In it, each generation can choose between just two options, either setting humanity on a pathway to certain high wellbeing after one generation of suffering, or leaving the next generation in the same state as this one with the same options, but facing a continuous risk of permanent collapse. We analyse this abstract setup regarding the question of what the right choice would be both in a rationality-based framework including optimal control, welfare economics and game theory, and by means of other approaches based on the notions of responsibility, safe operating spaces, and sustainability paradigms. Despite the simplicity of the setup, we find a large diversity and disagreement of assessments both between and within these different approaches.

Flash flood is one of the most significant natural disasters in China, particularly in mountainous area, causing heavy economic damage and casualties of life. Accurate risk assessment is critical to an efficient flash flood management. There are more than 530,000 small watersheds in 2058 counties in China where flash flood should be prevented. In practice, with limited fund and different risk levels, the priorities of each small watershed for flash flood prevention and control are also needed for an efficient flash flood management. This paper, take Licheng county in China as an example, aims to give out these priorities for management. First, sensitive indexes are identified among index system, which includes 9 indexes based on underlying surface characteristics of small watershed in hilly region. Second, the range of each index and the rank division of each index for evaluation are determined. Based on the rank divisions for evaluation, the flash flood risk grade eigenvalue (H) is calculated by Variable Fuzzy Method (VFM ) using 1000 samplings generated by Latin hypercube sampling method. Third, the key sensitivity factors that affect flash flood risk grade eigenvalue (H) are assessed by two different global sensitivity analysis methods -- stepwise regression analysis and mutual entropy. Both results indicate that watershed slope (S) is the most sensitive factor; the second is antecedent precipitation index (CN); while other factors are slightly different sensitive in sequence. This study shows that stepwise regression analysis and mutual information analysis are appropriate for the sensitivity analysis of mountain flash flood risk. Finally, based on watershed slope (S), the priorities of flash flood prevention and control of 119 small watersheds in Licheng county are given out.

C-reactive protein (CRP) and leukocytes are blood biomarkers involved in "Inflamm-Aging", which is a risk factor for the onset and progression of age-related diseases. Studies show that higher serum concentrations of these biomarkers are associated with functional disability, increased risk of low muscle strength, decreased muscle mass and mortality in the elderly. The objective was to estimate the predictive power and discriminating criteria of C-reactive protein and leukocyte concentrations for the risk of adverse health factors in the elderly within 30 days after hospital discharge (HD). Prospective cohort study using exploratory methods and blood biomarkers with 135 older adults admitted to medical and surgical clinics at a government hospital. The elderly were monitored at home after 30 days of HD for adverse health factors (rehospitalization, falls, amount of medication consumed, disability in basic and instrumental activities of daily living and mortality). CRP> 2.4; ≥ 0.7 and> 24.7 mg / dL and leukocytes ≥ 6.410; ≥ 8.690 and> 8.310 mm³ were discriminant for rehospitalization, falls and mortality within 30 days after HD, respectively. The cut-off points described may be used as a reference in the screening of hospitalized elderly vulnerable to adverse health events after hospital discharge.

Confusion, fear and mixed sentiments prevail in the minds of people towards what is arguably one of the most important of dynamics of modern human society: Artificial Intelligence (AI). This study aims to explore the contributions of news media towards this phenomenon - we analyze nearly seventy thousand recent news headlines on AI, using natural language processing (NLP) informatics methods, machine learning (ML) and large language models (LLMs) to draw insights and discover dominant themes. Our theoretical framework was derived from extant literature which posits the power of fear producing articles and news headlines which produce significant impacts on public behavior even when available in small quantities. We applied extensive textual informatics methods using word and phrase frequency analytics, sentiment analysis and human experts based thematic analysis to discover insights on AI phobia inducing news headlines. Our rigorous analysis of nearly seventy thousand headlines using multiple validation methods in NLP (exploratory informatics including BERT, Llama 2 and Mistral based topic identification), ML (supervised informatics) and LLMs (neural nets for sentiment classification, with BERT, Llama 2 and Mistral) demonstrates the presence of an unreasonable level of emotional negativity and fear inducing verbiage in AI news headlines. The framing of AI as being dangerous or as being an existential threat to humanity can have a profound impact on public perception, and the resulting AI phobia and confusion in public perceptions are inherently detrimental to the science of AI. Furthermore, this can also impact AI policy and regulations, and harm society. We conclude with a discussion deducing implications for society and make recommendations for education and policies that could support human identity and dignity.

This study examines the DCMA concerning the future risk of the water security status. We considered three risk factors: population growth, economic growth, and natural water supply demand differences. In the risk analysis part, we consulted with experts from several sectors including academia, Non-Governmental Organization (NGOs), and industry, to predict that the probability of future water stresses in high, medium, and low scenarios are 0.73, 0.24, and 0.03, respectively. In the decision analysis part, we adopted two Multiple Criteria Decision Analysis (MCDA) approaches that include Multiple Attribute Value Theory (MAVT) and Analytic Hierarchy Process (AHP) methods to evaluate the best alternative decision to alleviate future water stresses in the DCMA. The sensitivity analysis demonstrates the best option closely connects to the weighting scheme of the criteria considered in the framework. This study provides a valuable risk and decision analysis framework to analyze the water security status associated with the future water supply and demand gap decrease caused by three risk factors: population growth, climate change, and natural water supply.

This study investigated the effects of whole-body circuit training using a weighted vest on plasma resistin, cardiovascular disease risk factors, and cardiorespiratory fitness for normal-weight obese women. In this study, thirty- six normal-weight obese women were divided into three groups: Weighted Vest Circuit Training (WVCT) (n = 12), Body Weight Circuit Training (BWCT) (n = 12), and Control (CON) (n = 12). Whole-body circuit training was conducted three times a week for eight weeks to compare and analyze plasma resistin, cardiovascular disease risk factors, and cardiorespiratory fitness before and after training. Although there was no significant baseline difference between the groups regarding skeletal muscle mass, it significantly increased for the WVCT group after eight weeks. percent body fat significantly decreased for the WVCT and BWCT groups, and there was a significant difference when the percent body fat of these two groups were compared to that of the control group. Moreover, the WVCT and BWCT groups displayed a significant decrease in plasma resistin, showing a significant difference from the CON group. The WVCT and BWCT group showed a significant decrease in plasma IL-6, whereas the CON group showed a significant increase. VO2max significantly increased post-training compared to before in the BWCT group and the WVCT group, and the WVCT group showed differences between groups compared to the BWCT group and the CON group. None of the three groups displayed significant changes in plasma hs-CRP, yet there was a significant difference between the hs-CRPs of the WVCT and BWCT group and that of the CON group. In conclusion, whole-body circuit training using a weighted vest efficiently improves body composition, plasma resistin, and cardiopulmonary fitness, reducing cardiovascular disease risk factors in normal-weight obese women.

We investigated and quantified bacterial accumulation in facemasks used by the general population, using 16S rRNA (Sanger Sequencing), culture and biochemical analysis along with Rose Bengal staining. Additionally, a systematic overview of the literature on face mask contamination was undertaken. We found an average bacterial load of 4.24 × 10⁴ CFU recovered/mask, with a maximum load of 2.85 × 10⁵ CFU. This maximum is 310 times higher than the limit value for contamination of ventilation system outlet surfaces specified by the German standard VDI 6022. Biochemical and molecular identification predominantly found Staphylococcus species (80%), including Staphylococcus aureus, along with endospore-forming Bacillus spp. Literature reports also indicate contamination of masks by bacterial and fungal opportunists of the genera Acinetobacter, Aspergillus, Alternaria, Bacillus, Cadosporium, Candida, Escherichia, Enterobacter, Enterococcus, Klebsiella (including K. pneumoniae), Micrococcus, Microsporum, Mucor, Pseudomonas, Staphylococcus and Streptococcus. Bacterial counts increase linearly with wearing duration, and prolonged use may affect the skin and respiratory microbiomes, promoting consequential eye, skin, oral and airway conditions. These aspects underscore the urgent need for further research and a risk-benefit analysis in respect of mask use, particularly given their unproven efficacy in disrupting the transmission of respiratory viruses and their adverse social consequences.

Parkinson’s disease (PD) is characterized by motor deficits and a wide variety of non-motor symptoms. The age of onset, rate of disease progression and the precise profile of motor and non-motor symptoms display considerable individual variation. Neuropathologically, the loss of substantia nigra dopaminergic neurons is a key feature of PD. The vast majority of PD patients exhibit alpha-synuclein aggregates in several brain regions, but there is also great variability in the neuropathology between individuals. While the dopamine replacement therapies can reduce motor symptoms, current therapies do not modify the disease progression. Numerous clinical trials using a wide variety of approaches have failed to achieve disease modification. It has been suggested that the heterogeneity of PD is a major contributing factor to the failure of disease modification trials, and that it is unlikely that a single treatment will be effective in all patients. Precision medicine, using drugs designed to target the pathophysiology in a manner that is specific to each individual with PD, has been suggested as a way forward. PD patients can be stratified according to whether they carry one of the risk variants associated with elevated PD risk. In this review we assess current clinical trials targeting two enzymes, leucine-rich repeat kinase 2 (LRRK2) and glucocerebrosidase (GBA), which are encoded by two most common PD risk genes. Because the details of the pathogenic processes coupled to the different LRRK2and GBA risk variants are not fully understood, we ask if these precision medicine-based intervention strategies will prove “precise“ or “personalized“ enough to modify the disease process in PD patients. We also consider at what phases of the disease that such strategies might be effective, in light of the genes being primarily associated with the risk of developing disease in the first place, and less clearly linked to the rate of disease progression. Finally, we critically evaluate the notion that therapies targeting LRRK2 and GBA might be relevant to a wider segment of PD patients, beyond those that actually carry risk variants of these genes.

Background: Only few studies have studied the link between risk perception and sleep in the context of the COVID-19 pandemic. This study investigates the effect of two distinct risk appraisals—risk perception and perception of collective coordinated defense (PCCD) on Chinese adults’ sleep quality during the COVID-19 pandemic, and tested COVID-19-related fear and rumination as potential mediators of the relationships. Methods: Data were collected using a self-report online questionnaire from a sample of 224 Chinese adults during the fourth wave of the COVID-19 pandemic in Hong Kong. Results: COVID-19 risk perception and PCCD were related to poor sleep quality. Mediation analysis showed that both fear and rumination mediated the relationship between risk perception and sleep quality, whereas only fear mediated the relationship between PCCD and sleep quality. The model showed an excellent fit to the data and accounted for 44% of the variance in sleep quality in Chinese adults. Conclusions: This study demonstrates the distinct perceptual processes—risk appraisals in particular—contributed to poor sleep quality in Chinese adults during the COVID-19 public emergencies. These findings would be helpful for policy makers to address the sleep problems induced by psychological consequences of the pandemic.

The current methods for lightning risk warnings that are based on atmospheric electric field (AEF) data have a tendency to rely on single features, which results in low robustness and efficiency. Additionally, there is a lack of research on cancelling warning signals, contributing to the high false alarm rate (FAR) of these methods. To overcome these limitations, this study proposes a lightning risk warning method that incorporates enhanced empirical Wavelet transform-Adaptive Savitzky Gorey filter (EEWT-ASG) and one-dimensional morphology, using time-frequency domain features obtained through the Wavelet transform (WT). The proposed method achieved a probability of detection (POD) of 77.11%, miss alarm rate (MAR) of 22.89%, FAR of 40.19%, and critical success index (CSI) of 0.51, as evaluated on 83 lightning processes. This method can issue a warning signal up to 22 minutes in advance for lightning processes.

Background/Objectives: Bacterial infections (BI) are a major cause of mortality in patients with alcohol-associated hepatitis (AH); however, only a few studies have investigated BI in AH in the last decade. Therefore, we aimed to assess the features and outcomes of BI in patients with AH. Methods: This observational descriptive study included patients with AH admitted to a tertiary academic hospital between 2016–2021. Clinical and complete microbiological data were recorded and complications, including acute-on-chronic liver failure (ACLF), and mortality over 90-days were compared between infected and non-infected patients. Results: Overall, 115 patients with AH were recruited and 75 had severe AH; among them, 66 started corticosteroid treatment. We identified 69 cases of BI in 44 patients; the incidence of BI at hospital discharge was 32.2%, which reached 38.2% at 90 days. The predominant infection site was the chest (35%). Among the identified bacteria (52.1%), half were gram-positive and half gram-negative. A low rate of multidrug-resistant bacteria (14%) was also noted. Infected patients during hospitalization (n=37) exhibited higher rates of hepatic decompensation and ACLF p=0.001) and lower survival (81.8% vs. 95.8%, p=0.015) than did non-infected patients (n=78). In-hospital infected patients (n=22) exhibited worse survival (72.7%) than did those infected upon admission (93.3%) or non-infected patients (94.9%) (p=0.009). Corticosteroid-treated patients displayed a nonsignificant increase in the total number of BI; however, without greater mortality. Conclusions: BI were common in our cohort of patients with AH. Patients with in-hospital infections commonly experienced serious complications, including high ACLF and death rates. Infections diagnosed upon admission were treated without affecting survival.

This study examines the integration of Environmental, Social, and Governance (ESG) factors into global banking practices and their impact on financial stability, measured by the Bank to Capital Asset Ratio. Through a comprehensive literature review and data analysis, the paper highlights the dual role of banks as catalysts for ESG investment and risk managers. It discusses the challenges and opportunities in transitioning to ESG-aligned business models, emphasizing the importance of regulatory frameworks and risk management approaches. The findings suggest that ESG integration enhances bank stability and competitiveness, contributing to sustainable economic development. The paper concludes with policy implications and recommendations for further integration of ESG factors into banking governance.

This study explores the transformative impact of machine learning on predictive analytics within supply chain management. As supply chains become increasingly complex and dynamic, traditional methods of forecasting and management are proving inadequate. Machine learning offers advanced algorithms capable of analyzing vast datasets to uncover patterns and trends that enhance decision-making processes. This research investigates how machine learning improves demand forecasting accuracy, optimizes inventory management, strengthens supplier relationships, and enhances risk management. The study employs a qualitative approach, analyzing data from industry case studies and expert interviews to identify key themes and challenges associated with the adoption of machine learning. Findings reveal that machine learning significantly improves forecasting precision, reduces inventory costs, and enables proactive supplier and risk management. However, challenges such as ensuring data quality, acquiring specialized skills, integrating new technologies with existing systems, and addressing ethical considerations are critical. The study also highlights the potential of emerging technologies like blockchain, IoT, and 5G to further enhance machine learning applications in supply chain management. This research contributes to a deeper understanding of how machine learning can drive innovation and efficiency in supply chains, while also addressing the hurdles that organizations must overcome. The results underscore the need for a balanced approach that incorporates technological advancements and ethical practices to fully leverage the benefits of machine learning.

This study investigates the critical role of Supplier Relationship Management (SRM) in enhancing the e-commerce user experience. In an increasingly competitive digital marketplace, effective SRM practices are essential for optimizing supply chain operations and meeting customer expectations. The research employs a qualitative approach, combining semi-structured interviews with industry stakeholders, extensive literature review, and case studies to explore various dimensions of SRM. Key findings reveal that strategic supplier selection criteria, including quality, cost efficiency, reliability, innovation, and sustainability, are pivotal in ensuring a robust and adaptable supply chain. Effective communication practices, such as transparency, frequent updates, and digital tools, foster strong supplier relationships and enable timely issue resolution. Performance management strategies, centered on KPI monitoring and continuous improvement, support operational excellence and customer satisfaction. Risk management practices, including diversification, contingency planning, and advanced analytics, are crucial for mitigating disruptions and ensuring supply chain resilience, as highlighted by the challenges posed during the COVID-19 pandemic. Technological integration with blockchain, AI, IoT, data analytics, and automation enhances efficiency, transparency, and decision-making capabilities in SRM. Furthermore, the study underscores the evolving integration of sustainability and ethical sourcing into SRM strategies, reflecting broader corporate responsibility goals. Ultimately, this research contributes to understanding how effective SRM strategies drive competitive advantage in e-commerce by enhancing supply chain reliability, responsiveness, and customer-centricity. As e-commerce continues to evolve, adapting and innovating SRM practices will be vital for companies aiming to sustain growth and meet the dynamic demands of global markets.

Supplier Relationship Management (SRM) plays a pivotal role in enhancing delivery performance within the e-commerce sector, yet understanding its nuanced impacts remains crucial for optimizing operational efficiencies and customer satisfaction. This qualitative research explores the intricate dynamics of SRM in e-commerce, focusing on strategic alignment, technological integration, trust, collaboration, and risk management as key determinants of delivery reliability. Through in-depth interviews and thematic analysis, the study reveals that strategic alignment of supplier capabilities with firm objectives is fundamental for maintaining a responsive and synchronized supply chain. Technological integration, including AI-driven analytics and blockchain applications, emerges as critical for real-time monitoring and adaptive decision-making, thereby improving delivery accuracy and efficiency. Trust and collaboration are identified as essential pillars for building resilient supplier relationships, fostering transparent communication and joint problem-solving. Effective risk management practices, such as supplier diversification and contingency planning, mitigate disruptions and ensure consistent delivery performance. Despite these benefits, challenges such as technological adoption barriers, cultural differences, communication complexities, resource constraints, and supplier reliability issues persist, necessitating strategic interventions. Recommendations include investing in advanced SRM technologies, promoting cultural understanding, enhancing communication protocols, allocating adequate resources, and fostering collaborative initiatives with suppliers. These strategies aim to overcome challenges and optimize SRM practices, ultimately enhancing delivery performance and competitiveness in the e-commerce landscape.

This qualitative research explores the intricate relationship between cultural influences on supply chain practices and their implications for marketing strategies. Cultural dimensions such as individualism versus collectivism, uncertainty avoidance, and contextuality significantly shape decision-making processes, risk management strategies, and relationship dynamics within global supply chains. Through semi-structured interviews with supply chain managers, marketing executives, and cultural experts across diverse industries and regions, this study investigates how cultural values impact supply chain operations and consumer engagement strategies. Key findings highlight that collectivist cultures prioritize consensus-building and long-term relationships, fostering trust and collaboration among supply chain partners. In contrast, individualist cultures emphasize efficiency and accountability but may face challenges in relationship building. Risk management practices vary with cultural orientations towards uncertainty, influencing the adoption of structured versus flexible approaches to mitigate disruptions. In terms of marketing implications, the study underscores the importance of cultural sensitivity in crafting effective strategies. High-context cultures require marketing messages that resonate emotionally through implicit communication and cultural symbolism, while low-context cultures prefer clear, direct messaging focusing on product benefits. The study concludes by advocating for cultural competence as a strategic imperative for global businesses, enabling them to leverage cultural diversity for innovation and competitive advantage. It emphasizes the need for continuous adaptation to cultural nuances and market dynamics to foster inclusive collaboration and achieve sustainable growth in a globalized economy.

This qualitative research study delves into the intricate dynamics of how organizations adapt to supply chain disruptions during crises, offering profound insights into the strategies, practices, and challenges encountered in enhancing supply chain agility. Through in-depth interviews with supply chain managers across diverse industries, key themes such as proactive risk management, technological integration, collaboration with supply chain partners, and adaptive leadership have emerged as crucial determinants of agility and resilience. Additionally, the study highlights the significance of organizational culture, effective communication, and external factors such as regulatory requirements and market dynamics in shaping supply chain agility. By embracing a holistic approach that integrates these multifaceted factors, organizations can bolster their capacity to anticipate, detect, and respond to disruptions, thereby maintaining or enhancing overall performance even in the face of uncertainty and complexity. The insights gleaned from this research are poised to inform theory development, guide managerial practice, and influence policy-making in the realm of supply chain management, equipping organizations with the knowledge and tools needed to navigate future disruptions successfully.

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

This paper proposes a new method for network screening on rural low-volume roads. These roads are important as they provide critical access to agricultural land and tourist attractions. Most low-volume roads belong to the lowest functional class (local rural roads) and thus are built to lower design standards. The conventional hot spot network screening techniques may not be appropriate for low-volume roads due to the sporadic nature of crashes occurring on these roads. Contrarily sophisticated network screening approaches require extensive roadway and traffic data that are often unavailable to local agencies for lack of resources, and/or lack of technical expertise. This research attempts to address these obstacles in low-volume roads network screening which aims to identify candidate sites for safety improvements. The research used an extensive low-volume road sample from the state of Oregon and the Empirical Bayes expected number of crashes in developing the proposed models for network screening. The proposed models do not require exact measurement of roadway geometric features as all geometric variables were classified into categories that are easy to compile by local agencies. Further, the method could be used with and without traffic data, without compromising the effectiveness of the network screening process.

The movement toward prevention trials in people at-risk for Parkinson’s is rapidly becoming a reality. The authors of this article include a genetically at-risk advocate with the LRRK2 G2019S variant and two patients with rapid eye movement sleep behavior disorder (RBD), one of whom has now been diagnosed with Parkinson’s disease (PD). These authors participated as speakers, panelists, and moderators in the “Planning for Prevention of Parkinson’s: A Trial Design Forum” hosted by Massachusetts General Hospital in 2021 and 2022. Other authors include a young onset person with Parkinson’s (PwP) and retired family physician, an expert in patient engagement in Parkinson’s, and early career and veteran movement disorders clinician researchers. Several themes emerged from the at-risk participant voice concerning the importance of early intervention, the legitimacy of their input in decision-making, and the desire for transparent communication and feedback throughout the entire research study process. Challenges and opportunities in the current environment include lack of awareness among primary care physicians and general neurologists about PD risk, legal and psychological implications of risk disclosure, limited return of individual research study results, and undefined engagement and integration of individuals at-risk into the broader Parkinson’s community. Incorporating the perspectives of individuals at-risk as well as those living with PD at this early stage of prevention trial development is crucial to success.

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

The occurrence rate of occupational accidents caused by slipping and falling is 50% worldwide. Determining the slip safety risk is necessary to minimize the accidents caused by slipping in pedestrian walking areas. By on-site testing, this study aims to determine the slip risks of floor coverings used in walking areas with many pedestrians in public service buildings (PSB). For this purpose, on-site measurements were performed in two environments and six locations in PSB using portable GMG 200 and pendulum testers operating according to DIN 51131 and TS EN 14231 standards. These tests were performed on four-floor coverings with polished surface treatment in PSB. Since the floor coverings measured have a polished surface, it can be seen that the dynamic friction coefficients (DCOF) values are very low, and the slip risks are high. By statistically analyzing the slip test data using the K-means method, a new safety classification was made according to the usage areas of floor coverings. To minimize the risk of slip safety, especially for students, patients, and employees in PSB, it is recommended to use floor coverings with high DCOF values and low slip risk.

Background: Malnutrition was associated with worse survival outcomes, impaired quality of life, and deteriorated performance status across various cancer types. We aimed to identify risk factors for malnutrition in patients with epithelial ovarian(EOC) and impact on survival. Methods: In our prospective study, we included the patients with primary and recurrent EOC, tubal or peritoneal cancer conducted. We assessed serum laboratory parameters, body mass index, nutritional risk index, nutritional risk screening score(NRS-2002), and bio-electrical impedance analysis. Results: We recruited a total of 152. Patients >65 years-old, with ascites of >500 ml, or with platinum-resistant EOC showed statistically significant increased risk of malnutrition when evaluated by NRS-2002(p-values = 0.014, 0.001, and 0.007, respectively). An NRS-2002<3 was an independent predictive factor for complete tumor resectability (p=0.009). The patients with NRS-2002≥3 had a median overall survival(OS) of seven months (95% CI=0-24 months), as compared to the patients with NRS-2002<3 where median OS was 46 months(p=0,001). Phase angle(PhAα)≤ 4.5 was the strongest predictor of OS. Conclusion: Malnutrition is an independent predictor of incomplete cytoreduction in study population. It is an independent prognostic factor for poor OS. Preoperative nutritional assessment is an effective tool in identification of high-risk groups within EOC characterized by poor clinical outcome.

In these times, consumers mistakenly believe that the terms “expiration date” and “best before” found on packages only convey information about food safety. Consequently, a misunderstanding of these terms contributes to food waste. In this sense, the understanding and behavior of the con-sumer with respect to the two terms were evaluated; in addition, the consumer's perception of the health risks of consuming expired food was analyzed. The research was carried out with the population of the sector of Lurigancho-Chosica, Lima – Peru; sample size was 555 participants. An online survey was sent to consumers over 18 years of age, from different sociodemographic and socioeconomic conditions. In general terms, it was found that 45% (p <0.01) consider that both terms mean the same thing, this result is a problem for food safety. The 67% (p <0.05) and 45% (p <0.05) correctly defined the first and second terms, respectively; however, the behavior is not coherent with the understanding of the terms. In addition, irrational and dangerous behavior toward expired food was evidenced, i.e., they consume expired food - "expiration date", and discard expired food - "best before". Finally, the health risks they perceived from consuming expired foods of both terms were: upset stomach, vomiting, gas, intoxi-cation, and malnutrition; these perceptions are erroneous and unfounded. Sociodemographic and socioeconomic conditions influence the under-standing, behavior, and perception of health risks. Therefore, in general lines, the level of understanding of the terms was low (p<0.01), the be-havior was inappropriate toward expired food (p<0.01), and the percep-tion of the health risk of consuming expired food was incorrect (p<0.01).

Middle East region experiences a high prevalence of hypovitaminosis D, yet most genetic studies on Vitamin D have focused on European populations. Furthermore, there is a lack of research on the genomic risk factors affecting the elderly population, who are more susceptible to health burden. We investigated the genetic determinants of 25-hydroxyvitamin D levels in elderly Lebanese individuals (n=199) through a whole exome-based genome-wide association study. We identified new loci with suggestive evidence of an association with Vitamin D levels, including rs141064014 in the MGAM gene (P-value of 4.40 × 10−06) and rs7036592 in PHF2 (P-value of 8.43 × 10−06). A meta-analysis of the Lebanese data and the largest European genome-wide association study confirmed consistence replication of numerous variants, including rs2725405 in SLC38A10 (P-value of 3.73 x 10-08). Despite the lower performance of European-derived polygenic risk scores compared to the European estimations, it still effectively predicted Vitamin D deficiency among elderly Lebanese individuals. Our findings provide novel insights into the genetic mechanisms of Vitamin D deficiency in Middle Eastern elderly populations, facilitating the development of personalized approaches for more effective management of hypovitaminosis D. Additionally, we demonstrated that whole exome-based genome-wide association study is an effective method for identifying genetic components associated with phenotypes.

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

Methods to handle uncertainty in economic evaluation have gained much attention in the literature and the cost-effectiveness acceptability curve (CEAC) is the most widely used method to summarize and present uncertainty associated with program costs and effects in cost-effectiveness analysis. Some researchers have emphasized the limitations of the CEAC for informing decision and policy makers as the CEAC is insensitive to radial shifts of the joint distribution of incremental costs and effects in the North-East and South-West quadrants of the cost-effective plane (CEP). Furthermore, it has been pointed out that the CEAC does not incorporate risk-aversion in valuing uncertain costs and effects. In the present article we show that the cost-effectiveness affordability curve (CEAFC) captures both dimensions of the joint distribution of incremental costs and effects on the CEP and is therefore sensitive to radial shifts of the joint distribution on the CEP. Furthermore, the CEAFC also informs about the budget impact of a new intervention as it estimates the joint probability an intervention is both affordable and cost-effective. Moreover, we show that the cost-effectiveness risk-aversion curve (CERAC) allows to incorporate risk-aversion into the analysis and can therefore be used to inform decision-makers who are risk-averse. We use data from a published cost-effectiveness model of palbociclib in addition to letrozole versus letrozole alone for the treatment of oestrogen-receptor positive, HER-2 negative, advanced breast cancer to demonstrate the differences between CEAC, CEAFC and CERAC and show how these can jointly be used to inform decision and policy makers.

Working farm dogs are essential to many livestock farmers. Little is known about factors that influence dogs’ risk of being lost from work. This paper explores risk factors for farm dogs being lost through death, euthanasia and retirement. All enrolled dogs were working and minimum 18 months old. Five data collection rounds were done over four years. Data about dogs were collected from owners and dogs were given physical examinations by veterinarians. Dogs that were lost from work were counted and owner-reported reasons for loss were recorded. Multivariable logistic regression modelling was used to investigate risk factors for loss. Of 589 dogs, 81 were lost from work. Of these, 59 dogs died or were euthanized and 22 were retired. Farm dogs tended to reach high ages, with 38% being 10 years or older when last examined. Acute injury or illness was the most commonly owner-reported reason for loss. Age group (P &lt; 0.0001) and lameness (P = 0.04, OR = 1.8) significantly affected dogs’ risk being lost. These results expand our knowledge about factors that affect health, welfare and work in farm dogs. Further investigation into reasons for lameness may help improve health and welfare in working farm dogs.

Several infectious agents are ascertained causes of cancer, but the burden of cancer mortality attributable to carcinogenic infections in Italy was still unknown. To tackle this issue, we calculated the rate and regional distribution of cancer deaths due to infections sustained by seven pathogens ranked as group-1 carcinogenic agents in humans by IARC. Population attributable fractions related to these agents were applied to annual statistics of cancer deaths coded according to 10th International Classification of Diseases. The estimated burden of cancer mortality attributable to carcinogenic infections in Italy during the period 2011-2015 was on average 8.7% of all cancer deaths registered yearly. Approximately 60% of deaths occurred in men and almost the whole burden was due to four infectious agents (Helicobacter pylori, HCV, HPV, and HBV). The analysis of regional distribution showed a higher number of infection-related cancer deaths in the northern regions, where the estimates reached 30 (Liguria) and 28 (Friuli Venezia Giulia) deaths per 100,000 inhabitants in 2015. Since one-twelfth of cancer deaths were attributable to these modifiable risk factors, the implementation of appropriate prevention and treatment interventions may help to reduce the impact of these infections on cancer mortality.

The basic principles of geological risk calculation through Probability of Success (PoS) are mostly applied for numerical estimation of additional hydrocarbon existence in proven reservoirs or potential hydrocarbon discoveries in selected geological regional subsurface volume. It can be tailored and validated for a comprehensive input dataset collected in the selected petroleum province, adapted by dividing up geological events into several probability categories and classes. The most applied categories are (existence of) reservoir rocks, traps and isolators, source rocks, migration pathways and preservation conditions for hydrocarbons The methodology results in unique probability values as multiplication of independent statistical events, which can also be applied in the assessment of a potential hydrocarbon discovery of desired minimal volume and its value in any virtual currency like risk-neutral dollars. Such methodology has been extensively developed in the last decades in the Croatian subsurface, mostly in the Croatian part of the Pannonian Basin System (CPBS). Through the adaptation of geological categories, it was also applied in hybrid, i.e., stochastical, models developed in the CPBS (Drava Depression). Stochastically estimation of porosity was already applied. As the robustness of this methodology is very high, it was also modified to estimate the influence of water-flooding in increasing oil recovery in some proven Neogene sandstone reservoirs in the CPBS (Sava Depression). This new modification is being presented to be applied to geological risk calculation, intending to assess the safety of geological environment in deep wells, where depleted radioactive fuel would be disposed, a subject of great importance. The case study encompassed the magmatic and metamorphic rocks in the pre-Neogene basement of the CPBS. For disposal purpose, these are regionally lithologies considered as to be the safest ones considering petrophysical values, water saturation, recent weathering and tectonic activity.

Today project management in every field of life is prerequisite for the success of project by increasing quality reduces cost and schedule. But selecting tools and techniques to achieve our objectives and implement our plan fully is very difficult task because choice creates complexity. So, we discuss AHP to make decision simple. Ranking critical success factor, cloud computing services, risk prioritization, selection of right ETL software and many other systems AHP plays its important role. For the improvement of today’s complex systems it is very important to prioritize and select projects to remove the root cause of the problem. To attain the right selection of construction equipment for carrying out schedule tasks with high efficiency, production and financial capability is the main purpose of procurement of construction equipment process. Certain conflicts can occur due to the construction of UML models in a collaborative way. AHP is used to remove these conflicts and for establishing and evaluating modelers judgments. Nowadays it is very important and critical decision to choose the best option from multiple alternatives for a successful career after passing 12th standard and also it affects our future. “AHP and TOPSIS” methods are used for this purpose. In this paper, an “AHP and Fuzzy AHP” based hierarchical trust model has been used to rate the service providers and their various plans for infrastructure as a service.

Genome-wide association studies have revealed a locus at 8p12 that is associated with breast cancer risk. Fine-mapping of this locus identified 16 candidate causal variants (CCVs). However, as these variants are intergenic, their function is unclear. To map chromatin looping from this risk locus to a previously identified candidate target gene, DUSP4, we performed chromatin conformation capture analyses in normal and tumoral breast cell lines. We identified putative regulatory elements, containing CCVs, that loop to the DUSP4 promoter region. Using reporter gene assays, we found that the risk allele of CCV rs7461885 reduced the activity of a DUSP4 enhancer element, consistent with the function of DUSP4 as a tumor suppressor gene. Furthermore, the risk allele of CCV rs12155535, located in another DUSP4 enhancer element, was negatively correlated with looping of this element to the DUSP4 promoter region, suggesting that this allele would be associated with reduced expression. These findings provide the first evidence that CCV risk alleles downregulate DUSP4 expression, suggesting that this gene is a regulatory target of the 8p12 breast cancer risk locus.

A new model for risk assessment of urban rainstorm disasters, based on information diffusion method and variable fuzzy sets (IDM-VFS) was proposed. In addition, an integrated index system of urban rainstorm risk was established. In the proposed model, IDM was employed to calculate the classification standards of urban rainstorm risk levels, then the VFS was adopted to assess the dangerousness, sensitivity, vulnerability and comprehensive risk of urban rainstorm disasters. In the present study, the urban rainstorm risk of Jiangsu province was evaluated with the proposed model. The results show that Wuxi, Changzhou, Nanjing and Suzhou have higher dangerousness, due to sustained rainfall and strong rainfall intensity in short duration; Wuxi, Changzhou and Nanjing have higher sensitivity because of lower disaster resistance ability; and Wuxi and Suzhou have higher vulnerability because these cities have higher potential losses in face of urban rainstorm disasters. The comprehensive risk zoning map of urban rainstorm shows apparent regional characteristics: the northwestern cities have lower risk than the southern cities. Moreover, most cities of the Jiangsu province are of the moderate urban rainstorm risk level. The results are consistent with the actual situation of Jiangsu province, and the study can provide some decision-making references for the urban rainstorm management.

In order to summarized the polygenic background of psychiatric diseases, polygenic risk scores (PRS) have been developed. Recently, PRS have been use to predict patients with higher comorbidities in psychiatric diseases, like dual diagnosis. PRS are principally derived in analysis of Caucasian and Asian populations, we are not aware of how this PRS could be applied in populations with high admixture. In order to explored this, the present work has the aim to analyzed if previous calculated PRS for psychiatric diseases could predict dual diagnosis in Mexican population, and also, if PRS calculation could be influenced by Mexican Amerindian (MA) global ancestry. We performed PRS calculation, using PRSice, with summary genome-wide association statistics previously published for psychiatric diseases, and also, performed Nagelkerke correlation test in order to established if PRS are correlated with dual diagnosis. We found that dual diagnosis could be predicted by major depressive disorder polygenic risk score. Nevertheless, schizophrenia polygenic risk score is highly correlated with global MA ancestry, independently of the schizophrenia diagnosis. Our results reinforced the notion that PRS calculation could be deviated by the MA global ancestry, nevertheless analysis on larger sample sizes are required in order to clarified this issue.

In this article, we combine datasets from multiple research projects and remote sensing tech-nologies to evaluate the conservation conditions of La Fortaleza de Kuelap, a pre-Hispanic monument in Peru’s northeastern Andes that suffered significant damage during historically high seasonal rains in April 2022. Our analyses seek to identify the main causes of the collapse and locate places where the monument is likely at risk of further deterioration. To do so, we model surface hydrology using a digital elevation model (DEM) derived from drone LiDAR data, re-construct a history of previous collapses, and calculate the volume of the most recent by fusing terrestrial LiDAR and photogrammetric datasets. In addition, we examine subsurface water ac-cumulation through electrical resistivity data, reconstruct the stratification of the monument from seismic refraction data, and analyze vegetation loss and ground moisture accumulation using high resolution satellite imagery. Our results point to water accumulation as the most significant source of risk for La Fortaleza’s perimeter walls. Combined with adverse contemporary conser-vation interventions and natural conditions, this led to the collapse of April 2022. This integration of analytical results demonstrates how multi-scalar and multi-instrumental approaches provide comprehensive and timely assessments of conservation needs.

Objectives To develop and validate a prediction model for 28-day in-hospital mortality among adult patients critically ill with COVID-19 in the UK. Design Observational cohort study. Setting 287 adult critical care units in England, Wales and Northern Ireland, of which 260 admitted at least one eligible patient. Participants 10,933 patients with confirmed COVID-19 of whom 10,401 were eligible (excluding 532 patients with a duration of critical care less than 24 hours and 1 patient with unknown 28-day outcome): 8,666 development (March-April 2020) and 1,735 temporal validation (May-August 2020). Main outcome measures 28-day in-hospital mortality from start of critical care. Results Two models were developed using 14 patient level predictors selected from 30 candidate predictors, with and without adjustment for calendar time. In the temporal validation data, the model discrimination was maintained (c index 0.78) but calibration was poor, particularly for the model not adjusted for calendar time (ratio of observed to predicted mortality 0.74 versus 0.88 for the model adjusted for calendar time). Conclusions We developed and validated a prediction model for 28-day in-hospital mortality for patients critically ill with COVID-19. Although absolute predictions were inaccurate due to changing outcomes, the models will support risk-adjustment in analyses and monitoring changes in risk-adjusted outcome over time.

The Estimation of systemic risk in India is still in its infancy stage. There are several methods which are available but none of the methods are fully compatible to forecast the systemic risk since under different circumstances the factors responsible for the risk differs. In this paper the systemic risk estimation in India being carried out based on spread in daily stock market price(Difference between the bid and ask price of a share) of the top 100 firms in India according to market capitalization for the period of July2007 to March 2016. The results were compared with the Financial Stability Report published by Reserve Bank Of India for the period of March 2010 to June 2016.The results clearly indicates that there exits relationship between market illiquidity represented by spread and risks associated with the Financial System. In most of the cases the Z score (deviation from the mean/Standard Deviation) of the spread has become negative which provides the spread which is farther from the mean, also a good indicator of volatility in market and risk to financial system. It is also seen that the Systemic Risk Survey conducted by Reserve Bank of India which started during October 2011 has supported the results.

This paper introduces the AltumView Sentinare smart activity sensor for senior care and patient monitoring. The sensor uses an AI chip and deep learning algorithms to monitor the activity of people, collect activity statistics, and notify caregivers when emergencies such as falls are detected. To protect privacy, only skeleton (stick figure) animations are transmitted instead of videos. The sensor is highly affordable, accessible, and versatile. It was a CES 2021 Innovation Award Honoree, and has been selected by Amazon as one of only three fall detection devices integrated into its Alexa Together urgent response service, and has received very positive reviews from Amazon customers. It has also been used in different senior care settings in about ten different countries. The paper presents the main features of the system, the evidences and lessons learned from its practical applications, and future directions.

Introduction: Thyroid nodules are extremely common and require complex management to prevent unnecessary surgical intervention and ensure that no malignant disease is overlooked. Several diagnostic tools and scoring systems are available to evaluate the Risk of Malignancy (ROM). The goal is to assess variables that can aid and support the clinical recommendations suggested by the updated Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), such as the ultrasonographic features of thyroid nodules, particularly for indeterminate categories III (atypia of undetermined significance) and IV (follicular neoplasm). Methods: We retrospectively analysed the correlation of the demographic and ultrasonographic characteristics of thyroid nodules with the cytopathological and histopathological diagnoses of TBSRTC categories III (atypia of undetermined significance), IV (follicular neoplasm), V (suspicious for malignancy), and VI (malignant) in patients who underwent surgery in a single Portuguese centre over a 10-year period. Results: In total, 360 nodules were evaluated in 341 patients and 57% were histopathologically malignant or borderline. The majority were included in the TBSRTC indeterminate categories III and IV with an ROM of 44% and 43%, respectively. The ultrasonographic characteristics associated with a higher TBSRTC category and a greater ROM value were hypoechogenicity, presence of microcalcifications, irregular margins, and the presence of cervical adenopathy. When correlating with a malignant histology, only adenopathy and the presence of microcalcifications were observed to be statistically significant. Discussion: The indeterminate categories of the TBSRTC have been the most challenging ones to manage. The new TBSRTC (2023) guidelines as well as the ultrasonographic characteristics of a patient can be helpful in assessing the ROM and deciding on an appropriate course of treatment. Other resources, such as molecular tests, are also gaining a more important role in the clinical decision process and may become crucial in the future. Conclusion: The clinical management of thyroid nodules requires a careful analysis of clinical history and an evaluation of demographic details, the symptoms of the patient, comorbidities, personal and family history, ultrasonographic features, and the results of cytopathology, thyroid function, and molecular/genetic tests to provide the best care possible. Patients with thyroid nodules of an indeterminate character can obtain a definitive diagnosis through surgery. However, by employing a complete analysis of all relevant data, some patients may be suitable for active surveillance instead of a surgical intervention.

Supplier Relationship Management (SRM) tools play a crucial role in enhancing efficiency and competitiveness within e-commerce supply chains. This qualitative research explores the effectiveness of SRM tools in optimizing procurement processes, mitigating risks, and fostering collaborative partnerships with suppliers. The study employs semi-structured interviews with key stakeholders in diverse e-commerce sectors to gather insights into the implementation and outcomes of SRM tools. Findings reveal that technological advancements, including AI, blockchain, and data analytics, facilitate real-time communication, decision-making, and supply chain visibility, thereby enabling organizations to achieve cost savings and operational efficiencies. Enhanced supplier relationships through SRM tools contribute to collaborative innovation, faster product development cycles, and improved customer satisfaction. However, challenges such as technological complexity, regulatory compliance, and supplier resistance necessitate strategic management and investment in cybersecurity and compliance frameworks. The research underscores the importance of executive sponsorship, stakeholder engagement, and continuous improvement in driving successful SRM implementations.

Supply chain disruptions pose significant challenges to organizations, highlighting the critical importance of resilience in contemporary supply chains. This qualitative research explores the implications of supply chain disruptions on organizational resilience, drawing insights from interviews with supply chain managers and executives across various industries. The study identifies key factors that contribute to resilience, including agility, collaboration, risk management, strategic planning, technology integration, leadership, and organizational culture. Through thematic analysis, the research elucidates how these factors interact to enable organizations to manage and recover from disruptions effectively. Findings underscore the importance of agility in adapting to changing circumstances, collaboration with stakeholders to coordinate responses, and proactive risk management to anticipate and mitigate disruptions. Strategic planning and technology integration emerge as vital enablers of resilience, along with effective leadership and a resilient organizational culture that fosters adaptability and continuous improvement. The implications of supply chain disruptions extend beyond operational and financial impacts to include reputational and relational dimensions, emphasizing the importance of transparent communication and stakeholder engagement. The practical insights offered by this study provide guidance for organizations seeking to enhance their resilience and ensure continuity of operations in an increasingly complex and dynamic supply chain environment.

A simple bounded stochastic motion is employed for modelling equity price dynamics under shocks, where the prices are constrained to lie between two positive bounds. While the stochastic process has an inaccessible boundary, the other boundary is quasi-bounded, implying that the boundary can be breached if the probability leakage condition is met. The quasi-boundedness of the process at the boundary can thus provide an indicator of possible risk of equities under price shocks. Empirical calibration of model parameters of the proposed process for equities can be performed easily due to the availability of an analytically tractable probability density function which generates fat-tailed distributions consistent with empirical observations. The volatility and mean-reversion of the S&P500 dynamics calibrated by the process is positively and negatively co-integrated respectively with the VIX index representing the level of market distress. The process captures the high likelihood of Hertz’s default about two months earlier, using only information until that point, and before the firm filed for Chapter 11 bankruptcy in May 2020 as a result of the Covid-19 pandemic. Empirical calibration of the process for GameStop’s stock price shows that the short squeeze of the stock occurred when the condition for breaching an upper boundary was met on 14 January 2021, i.e., about two weeks before major short sellers closed out their positions with significant losses. The trading volume of the stock was positively co-integrated with the probability leakage ratio.

When attempting to quantify future harms caused by carbon emissions and to set appropriate energy policies, it has been argued that the most important metric is the number of human deaths caused by climate change. Several studies have attempted to overcome the uncertainties associated with such forecasting. In this article, approaches to estimating future human deaths tolls from climate change are compared and synthesized, and implications for energy policy are considered. Several studies are consistent with the “1000-ton rule,” according to which a future person is killed every time 1000 tons of fossil carbon are burned (order-of-magnitude estimate). If warming reaches or exceeds 2°C this century, mainly richer humans will be responsible for killing roughly 1 billion mainly poorer humans through anthropogenic global warming. Such mass manslaughter is clearly unacceptable. On this basis, relatively aggressive energy policies are summarized that would enable immediate and substantive decreases to carbon emissions. The limitations to such calculations are outlined and future work is recommended to accelerate the decarbonization of the global economy while minimizing the number of sacrificed human lives.

As an emerging network paradigm, Space-Air-Ground integrated networks (SAGIN) has attracted the attentions from academia and industry. That is because SAGIN can implement seamless global coverage and connections among electronic devices in space, air, and ground spaces. Additionally, the shortages of computing and storage resources in mobile devices greatly affect the quality of experiences for intelligent applications. Hence, we devise to integrate SAGIN as an abundant resource pool into mobile edge computing environments (MEC). To facilitate efficient processing, we need to solve the optimal task offloading decisions. Different from the existing MEC task offloading solutions, we have to face some new challenges, such as the fluctuation of processing capability for an edge computing node, the uncertainty of the transmission latency caused by the heterogeneous network protocols, the uncertain amount of uploaded tasks during a period, and so on. In this paper, we firstly describe a task offloading decision problem in new challenge environments. But, we cannot use the standard robust optimization and stochastic optimization methods to obtain the optimal result under the uncertain network environments. In this paper, we propose the condition value at risk-aware distributionally robust optimization algorithm, named as CVAR-DRO, to solve the task offloading decision problem. The proposed CVAR-DRO method combines the distributionally robust optimization and the condition value at risk model for solving the optimal result. And then, We have evaluated our approach in simulation SAGIN environments with the confidence interval, the number of mobile task-offloading and the various parameters. We compare our proposed CVAR-DRO algorithm with the state-of-the-art algorithms, such as the standard robust optimization algorithm, the stochastic optimization algorithm, the DRO algorithm, and the brute algorithm. The experimental results show that CVAR-DRO can get a sub-optimal mobile task-offloading decision. Overall, CVAR-DRO is more robust than others to the new challenges mentioned above in SAGIN.