The Internet of Things (IoT), as a technology, transforms every day, consumer devices into devices capable of collecting and transmitting data. This momentous progress highlights the need for reliable risk management frameworks that address the potential risks associated with IoT devices across all aspects of life. Traditionally, the feasibility of IoT was limited by the high costs of sensors and their connectivity. Although, recent advancements have greatly reduced costs, enabling widespread connectivity of devices to the Internet. Consequently, numerous IoT devices and networks are left vulnerable without a comprehensive framework for managing these risks effectively. This paper introduces a more systematic framework designed to counter security risks and safeguard IoT devices. This framework takes a step-by-step approach for focusing on mitigating risks arising from inadequate security designs for IoT devices. It involves procedures for risk identification, evaluation, and prioritization which is followed by comprehensive risk analysis and control measures, and because risk evaluation is tedious, we suggest using machine learning (ML) to accelerate the risk evaluation process, boost the precision and consistency of risk assessments, and provide valuable insight, which ultimately enables risk analysts to make better informed and timely decisions. Through multiple case studies, we demonstrate the practicality and efficacy of the framework for evaluating IoT device risks and guiding the implementation of appropriate controls to safeguard devices and networks. We also develop security dashboards that provide visual summaries comparing device values, threat assessments, and risk mitigation costs, aiding in clear communication and prioritization of security measures.

(1) Polycyclic aromatic hydrocarbons (PAHs) are hazardous organic compounds with known carcinogenic and toxic properties. Exposure to PAHs occurs through various sources, including diet, inhalation, and skin contact, and they can transfer into breast milk following maternal exposure, potentially endangering breastfeeding infants. (2) This study aimed to determine the PAH content in breast milk samples from 50 Hungarian mothers using high-performance liquid chromatography with fluorescence detection (HPLC/FLD). The carcinogenic risk to infants was estimated using the Incremental Life Risk Calculation (IRCL) model. (3) Total PAH concentrations ranged from 0 to 78 ng/mL, with fluorene (5.3 ng/mL), phenanthrene (3.2 ng/mL), and pyrene (2.5 ng/mL) being the most abundant. PAHs were detected in 48 of the 50 samples, with phenanthrene present in 92% of samples. Dibenzo (a,h)anthracene was not detected. (4) Based on IRCL calculations, 10% of the samples were classified as safe, while 88% presented an acceptable carcinogenic risk for infants. Statistical analysis of questionnaires completed by the mothers indicated that factors such as diet, residence, and education may influence PAH levels in breast milk.

As the whisky industry applies circular economy principles to maximize resource utilization and minimize environmental impact, companies become exposed to several risks, which require complex assessments to ensure reliable outcomes. This study provides an organized framework to identify, prioritize and rank various risk factors commonly observed in whisky industry through the development of an Analytical Hierarchy Process (AHP) multi-criteria analysis model. Experts from 18 small European distilleries identified five main risk criteria and nineteen sub-criteria from brainstorming workplace observations, and categorized them as: environmental (5), operational (4), technological innovation (3), food safety (3) and economical (4) risks. The Analytical Hierarchy Process (AHP) approach was used to determine the weights and ranks of the main criteria and sub-criteria based on the survey responses received from experts from each distillery. The final judgements are consistent, as indicated by consistency values (CR) of less than 0.1 for all risk criteria. Unlike traditional risk assessment methods, the AHP model effectively integrates qualitative and quantitative data, aiding strategic decision-making in the whisky industry by breaking down complex problems into manageable sub-problems. Future research directions may expand the criteria and explore additional sustainable practices.

This paper explores the effectiveness of the Non-dominated Sorting Genetic Algorithm III (NSGA-III) and traditional Mean-Variance optimization in financial portfolio management. Using a dataset comprising global financial assets, we applied both methodologies to optimize portfolios based on multiple objectives, including risk, return, skewness, and kurtosis. The findings reveal that NSGA-III outperforms the Mean-Variance method in achieving a more diverse set of Pareto-optimal portfolios. NSGA-III portfolios exhibited superior performance in balancing risk and return, demonstrated by higher Sharpe ratios, more favorable skewness, and lower kurtosis. Additionally, NSGA-III's ability to simultaneously optimize across multiple conflicting objectives highlights its robustness in navigating complex financial landscapes, offering enhanced portfolio resilience. In contrast, the Mean-Variance approach, while effective in achieving balanced risk and return, was limited in addressing higher-order moments of the return distribution. These results underscore NSGA-III's potential as a powerful tool for portfolio optimization, providing a comprehensive alternative to traditional methods in modern financial markets where multiple objectives must be considered.

Soil potentially toxic elements (PTEs) pollution in black soil is of significant concern in China. However, research is scarce regarding the current status, ecological risk, and human health risk of PTEs in the black soil area of northeast China. In our study, 304 soil samples (0-20 cm) were collected in Gonghe Town, Hailun City. The pollution degree and spatial distribution patterns of soil PTEs were analyzed by using the single-factor pollution index (PI) and the Nemerow pollution index (NPI). The source apportionment of PTEs was carried out by combining correlation analysis, principal component analysis (PCA), and positive matrix factorization (PMF) methods. Meanwhile, the potential ecological risk (RI) and the human health risk (HI) associated with soil contamination from various sources were evaluated through the RI and the HI. The results demonstrated that the average content (mean ± standard deviation) of As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn were 11.16 ± 1.32 mg/kg, 0.11 ± 0.04 mg/kg, 65.29 ± 3.46 mg/kg, 22.56 ± 1.32 mg/kg, 0.03 ± 0.01 mg/kg, 27.07 ± 1.46 mg/kg, 26.09 ± 2.84 mg/kg, and 66.01 ± 4.52 mg/kg, respectively. The overall PTEs in the study area exhibited slight pollution levels. The PCA and PMF model source apportionment was validated against each other to yield four sources, which were natural source (33.2%), irrigation source (29.5%), traffic source (23.4%), and fertilizer source (13.2%). The overall RI in the study area was determined to be at the level of slight ecological risk. The non-carcinogenic risk of PTEs to children and adults was ignored, and the carcinogenic risk was at an acceptable level. The comprehensive analysis of PTEs, pollutant sources, RI, and HI concluded that the fertilizer source should be the primary control source, with Cd identified as the first control PTE. The irrigation source and the traffic source were identified as the secondary control sources, with As, Pb, and Hg identified as the secondary control PTEs. This study revealed the status, risks, and sources of PTEs in black soils and provided a scientific basis of PTEs control for policymakers.

Background: Many risk-modifying factors affect cancer incidence and mortality rates. Solar UVB reduces cancer risk by producing vitamin D, which has many mechanisms to reduce risk of cancer incidence, progression, and metastasis. Obesity increases cancer risk through several mechanisms, including increased inflammation. Method and Materials. We present an ecological study (a type of observational study) of incidence and/or mortality rates for cancers during 2007–2016 of 17 anatomical sites with respect to solar ultraviolet-B (UVB) doses and obesity prevalence. Data were averaged for 12 geographical regions. Results: Solar UVB doses were significantly inversely correlated with incidence rates for three types of cancer for males. They were inversely correlated with mortality rates for five cancers for males and four for females. Obesity prevalence was directly correlated with mortality rates for three cancers for males and seven for females. Discussion: The ecological approach has certain limitations, such as its sensitivity only to regional variations in relation to specific risk-modifying factors. In this study, these limitations include numerous factors influencing cancer risk and the fact that the data are averaged across entire regional populations, which may not reflect individual risks. Despite this, the study reveals important correlations. Specifically, it found that solar UVB exposure is linked to a lower risk of certain cancers, while obesity is associated with an increased risk of some cancers in France. These findings are consistent with results from a similar study in the United States on cancer rates between 2016 and 2020. The association between obesity and cancer risk aligns with other observational studies. However, it is uncertain to what extent higher solar UVB exposure or elevated serum 25-hydroxyvitamin D levels might mitigate the impact of obesity on cancer risk. Reducing cancer mortality in France may be achievable through vitamin D supplementation and efforts to lower obesity prevalence.

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.

In the last decade, the role of Computed Tomography Pulmonary Angiography (CTPA) in diagnosing and managing pulmonary embolism (PE) has significantly evolved. Once a purely diagnostic tool, CTPA now plays a crucial role in initial emergency department assessments and treatment planning tailored to the patient’s condition. Advances in CTPA technology, including image quality enhancements and artificial intelligence (AI) applications, necessitate a reassessment of its current utility. This narrative review updates on new CTPA tools and techniques and focuses on data extraction challenges in emergency settings. CTPA studies, often conducted with multidetector scanners, provide essential information for risk stratification and treatment planning. The quantification of thrombotic burden using CTPA is vital for predicting mortality and determining appropriate treatments. Classical scoring systems, such as those developed by Qanadli, Mastora, and Ghanima, convert CTPA findings into quantifiable data to assist clinical decision-making. Despite CTPA not being a standard mortality predictor, significant research suggests including CTPA data, especially RV dysfunction indicators, for prognostic purposes. Recent studies highlight automated techniques for quantifying pulmonary perfusion and thrombus composition, enhancing the accuracy of PE severity assessment. The integration of AI in CTPA, particularly through deep learning algorithms, shows promise in automating thrombus load assessment and improving risk stratification. The continuous development of imaging techniques positions CTPA as a potential tool for comprehensive PE management, aiding in diagnosis, prognosis, and treatment decisions.

Lymphadenopathy is a common manifestation of both reactive and malignant diseases, and fine needle aspiration (FNA) is an effective and inexpensive screening method. It can prevent unnecessary invasive surgery and excisional biopsy, especially in benign cases. Unfortunately, the lack of universally accepted terminology for reporting results has hindered its widespread support. The Sydney system proposal for lymph node cytopathology categorization and reporting introduced five diagnostic categories to address the lack of universally accepted terminology for reporting results in lymphadenopathy. Our study analyzed 188 lymph node FNC samples from King Abdulaziz University Hospital, Saudi Arabia, examining clinical follow-up data, pathology records, patient information, and final diagnosis from January 2019 to December 2022. Most specimens were from axillary LNs, with 99.5% tissue correlation. The Sydney System Category classification identified 56.9% of cases as malignant, while 26.1% were benign. The final surgical specimen diagnosis revealed a higher percentage of malignant diagnoses, with the highest ROM in malignant/Category V. In conclusion, our study demonstrates that LN-FNAC offers high diagnostic accuracy for LN aspirates, with the Sydney approach potentially aiding risk stratification and achieving consistency in cytologic diagnosis, but further multi-centric research is needed.

The rapid evolution of financial technology (fintech) has significantly transformed the financial services landscape, creating opportunities for innovation and introducing new risks. Traditional financial institutions and fintech companies operate under different paradigms, resulting in disparate risk management practices. This paper proposes a comprehensive framework for integrating operations and risk management practices between traditional financial institutions and fintech companies. By leveraging advanced technologies such as artificial intelligence (AI) and machine learning (ML), the framework aims to ensure consistent and effective risk assessment across the financial sector. The financial services industry is characterized by rapid innovation, primarily driven by fintech companies offering various services that enhance efficiency, accessibility, and customer satisfaction. However, the growth of fintech brings substantial risks, including cyber threats, data privacy concerns, regulatory compliance challenges, and operational vulnerabilities. Traditional financial institutions prioritize stability, security, and compliance within established risk management frameworks. The divergence in operational models and risk management approaches creates a fragmented risk landscape, posing significant challenges to the financial system's stability and security. This paper identifies the critical need for a unified framework integrating the risk management practices of traditional financial institutions and fintech companies. The proposed framework leverages AI and ML to enhance the accuracy and comprehensiveness of risk assessments, utilizing a centralized data repository for real-time risk assessment. Unified risk management policies covering cybersecurity, operational risk, regulatory compliance, financial crime, and real-time monitoring and reporting tools ensure robust risk management protocols and prompt response to potential risks. Aligning with regulatory requirements and incorporating best practices from both sectors, the integrated risk management approach enhances the financial ecosystem's stability, security, and public confidence.

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.

Polycystic ovary syndrome (PCOS) is a common condition in reproductive-age women. Women with PCOS are at higher risk of pregnancy complications including gestational diabetes (GDM). The prevalence of PCOS and GDM varies according to the diagnostic criteria used. The mechanism for the occurrence of GDM in women with PCOS is still unclear. Materials & Methods- A systematic search of the electronic database was done using keywords like PCOS, and GDM to include studies between April 2008 and March 2023 where uniform diagnostic criteria were used. Studies were excluded with high-risk of bias after the assessment of bias, and meta-analysis was done with relative risks and confidence intervals. Results & Discussion-Out of 1896 search results, 95 were selected for full-text. The quality of the studies was scrutinized and a total of 28 studies were included as they fulfilled the inclusion criteria. The incidence of GDM in women with PCOS was found to be 10.55 % (2.9- 54.9%) from pooled data involving 1,280,245. The prevalence of PCOS in women diagnosed with GDM was found from pooled data of 36,351 women in retrospective studies to be 2.47% (1.5- 50.1%). Selection predominantly included cohort studies, most commonly from China. The meta-analysis reported the risk of GDM is higher in women with PCOS than in those without PCOS (HR: 1.59, 95% CI: 1.27–1.91, p < 0.001). Family history of diabetes, ethnicity, pre-pregnancy BMI, insulin resistance, gestational weight gain, use of assisted reproductive techniques, and multifetal gestation were the risk factors for GDM in women with PCOS. Conclusion- The prevalence of GDM in patients with PCOS is high, but the causality is complex. The newer predictive models are promising in clarifying the causative relationships, yet use various parameters at different cut-offs. There is a need for the development of universally acceptable parameters for the early prediction of GDM in women with PCOS.

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.

We estimate general public’s willingness to pay (WTP) for agricultural soil quality protection and improvement in Spain (n=1000) and the UK (n=984) using data from a cross-sectional survey via Qualtrics panels in March-April 2021. We use a double bound dichotomous choice contingent valuation approach to elicit the individuals’ WTP. We investigate the effect of uncertainty on the success of policies aiming at achieving soil protection. In addition, to understand the heterogeneity in individuals’ WTP for agricultural soil quality protection and improvement we model individuals’ WTP through individual’s awareness and attitudes toward agricultural soil quality protection and the environment, trust in institutions; risk and time preferences; pro-social behavior and socio-demographics in Spain and the UK. We found that there is significant public support for agricultural soil quality protection and improvement in Spain and the UK. We also found that the support does not vary significantly under uncertainty of success of policies aiming at achieving soil protection. However the individual’s reasons for supporting agricultural soil quality protection and improvement are found to depend on the level of uncertainty and country. Hence, promoting public support for soil protection needs to be tailored according to the level of general public’s perceived uncertainty and geographic location.

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.

In response to increasing urbanization and the need for infrastructure resilient to natural hazards, this study introduces an AI-driven predictive model designed to assess the risk of soil liquefaction. Utilizing advanced ensemble machine learning techniques, the model integrates geotechnical and geographical data to accurately predict the potential for soil liquefaction in urban areas, with a specific focus on Yokohama, Japan. This methodology leverages comprehensive datasets from geological surveys and seismic activity to enhance urban planning and infrastructure development in smart cities. The primary outputs include detailed soil liquefaction risk maps that are essential for effective urban risk management. These maps support urban planners and engineers in making informed decisions, prioritizing safety, and promoting sustainability. The model employs a robust combination of neural networks and gradient boosting decision trees to analyze and predict data points, assessing soil susceptibility to liquefaction during seismic events. Notably, the model achieves high accuracy in predicting soil classifications and N-values, which are critical for evaluating soil liquefaction risk. Validation against an extensive dataset from geotechnical surveys confirms the model’s practical effectiveness. Moreover, the results highlight the transformative potential of AI in enhancing geotechnical risk assessments and improving the resilience of urban areas against natural hazards.

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.

Functional copy number alterations (fCNAs) are DNA copy number changes with concordant differential gene expression. These are less likely to be bystander genetic lesions and could serve as robust and reproducible tumor biomarkers. To identify candidate fCNAs in neuroendocrine tumors (NETs), we integrated chromosomal microarray (CMA) and RNA-seq differential gene expression data from 31 pancreatic (pNET) and 33 small bowel neuroendocrine tumors (sbNET). Tumors were resected from 47 early disease progression (24 months) patients. Candidate fCNAs that accurately differentiated these groups in this discovery cohort were then replicated using fluorescence in situ hybridization (FISH) on formalin-fixed, paraffin-embedded (FFPE) tissues in a larger validation cohort of 60 pNETs and 82 sbNETs (52 early and 65 late disease progression samples). Logistic regression analysis determined the predictive ability of these biomarkers as well as the assay performance metrics of sensitivity, specificity, and area under the curve. Our results indicate that copy number changes at chromosomal loci 4p16.3, 7q31.2, 9p21.3, 17q12, 18q21.2, and 19q12 may be used as diagnostic and prognostic NET biomarkers. This involves a rapid, cost-effective approach to determine primary tumor site for patients with metastatic liver NETs and to guide risk stratified therapeutic decisions.

Current trends in systemic risk literature provide new insights into multi-hazard risks that interact and compound with built environments, creating more significant impacts on socio-economic and human systems. Recurrent natural hazards and extreme weather events are more likely to compound and cascade into more impactful events, especially in vulnerable societies. In small-island communities (SICS), including large archipelagos and Small Island Developing States (SIDS), the long-term impact of multi-, compounding-, and cascading-hazards (MCC hazards) can result in persistent vulnerability and residual risks. This is due to delayed responses, limited resources, poverty, fewer evacuation options, and inadequate markets and infrastructure. Using Ternate, a densely populated small volcanic island in North Maluku, Indonesia, as a case study, this paper assesses the impacts of seven types of natural hazards: flash floods, landslides, extreme weather, extreme waves and abrasion, earthquakes, tsunamis, and volcanic eruptions. The research focuses on the multi-hazard impact on population, land use, and infrastructure exposures in 60 villages in Ternate. The findings highlight population density, land use, and infrastructure exposure to multi-hazard risks, providing valuable information on potential losses in future hazard events.

By using a two-stage physiologically based extraction test (PBET) and (W-PBET), the authors of this paper have estimated the bioaccessibility of metals (Pb and Fe) and their compounds in the GI tract of waterfowl and mammals. It has been shown that the metals (Pb and Fe) have low bioaccessibility; combined with the short time of shot exposition at the GI tract, this eliminates the risk of toxic effects in the case of shot ingestion by waterfowl. It has also been discovered that there is a significant difference in the bioaccessibility of metals and their compounds. A model was proposed and tested to predict the toxic effects of lead on biological objects depending on the threshold mass of consumption. This model takes into account data on the bioavailability of lead and regulatory values indicating dangerous concentrations of lead.

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 formation of hydrogen sulfide (H₂S) in petroleum reservoirs by anaerobic microbial activity is called biogenic souring of reservoirs and is a risk in the oil and gas industry as the compound is extremely toxic, flammable and corrosive. In this paper, we present a workflow and the tools to assess biogenic souring from a pragmatic engineering perspective. The retention of H₂S in the reservoir due to the reactions with iron-bearing rock minerals (e.g. siderite) is shown in a theoretical approach here and supported with literature data. Cases are given for two fields under secondary (waterflooding) and tertiary flooding with microbial enhanced oil recovery (MEOR). The use of the Monte Carlo method as a numerical modelling tool to incorporate uncertainties in the measured physical/chemical/ biochemical data is demonstrated as well. A list of studies conducted with different chemicals alone or in combination with various biocides to mitigate biogenic souring provides an overview of potential inhibitors as well as possible applications. Furthermore, the results of static and dynamic inhibition tests using molybdate are presented in more detail due to its promising mitigation ability. Finally, a three-step workflow for the risk assessment of biogenic souring and its possible mitigation is presented and discussed.

Cervical cancer is one of the ailments that endangers the health of women all over the world and causes infertility. Fortunately, this disease can be avoided. Both the results and participation rates of the current preventative strategy remain poor. Hence, preventative or early detection methods remain challenging and open. In gynecology and computer science fields, few studies on identifying cervical cancer are based on behavior risk factor and machine learning. Moreover, various social and behavioral aspects might often make it more difficult to detect cervical cancer especially in low‑ and middle‑income countries (LMICs). Accordingly, focus on predicting the presence of cervical cancer through behavioral risk factors is the basic structure of this research. We proposed an approach to classify cervical cancer from a social-behavioral perspective using logistic regression to predict cervical cancer. We got significantly improved outcomes than the existing methods. Moreover, we used feature engineering to formulate less dimensionality as a pre-processing step and optimized parameters to be prepared for classification phase. The results proved that using the logistic regression with regularization type L1 had a promising performance. The accuracy of Logistic Regression (LR) L1 was 97.2%. Such results support the proposed work as a reliable classification predictive tool.

The purpose of this review is to elucidate the actual threat of the most prevalent mycotoxins in agricultural commodities and human/animal food/feed for appearance of foodborne ailments and diseases. The underestimated hazard of joint mycotoxin uptake of animals or humans is critically discussed with regards to synergistic or additive interaction between some target mycotoxins. The real toxicity of target mycotoxin combinations as it happens in practice is evaluated and possible lower limit values or control measures are suggested in such cases. Some critical points in adequate risk assessment, hygiene control and regulation of mycotoxns are discussed. The efficiency of current mycotoxin regulations and control measures is evaluated in regards to human/animal health hazard. The risk assessment in the case of multiple mycotoxin exposure of humans/animals via the food/feed or agricultural commodities is evaluated and some suggestions are proposed in such cases. Appropriate control measures and food safety issues throughout the food supply chain are proposed in order to prevent target foodborne diseases. Some preventive measures and possible veterinary hygiene control or risk assessment are proposed in some practical cases of foodborne diseases for preventing mycotoxin contamination of animal products designed for human consumption and to avoid possible public health issues.

In recent years, the implementation of artificial intelligence (AI) in accounting has grown in many domains, including auditing. AI permits auditors to evaluate large data sets and rapidly identify discrepancies and sequences in audit. This means auditors can review all of a client's transactions via a low time and effort. This entails auditing firms investing heavily in technological infrastructure as well as training their human resources to use cutting-edge AI technologies. Thus, this research sought to investigate the impact of the use of AI techniques by Jordanian external auditors in fraud risk assessment, the moderating effect of auditor size. The descriptive analytical method was used by distributing 280 questionnaires electronically to auditors employed in auditing firms operating in Jordan, The result reveals that AI techniques are extremely beneficial in fraud risk assessment at all levels, and the relationship between the use of AI techniques and the assessment of fraud risk has improved as auditor size has increased.

Infections with multi-drug-resistant (MDR) pathogens in food-animals threaten public health and food security. However, the epidemiology and factors associated with MDR Escherichia coli on Ugandan farms are not well known. This study investigated the prevalence, resistance patterns and factors associated with MDR E. coli carriage on chicken farms. A total of 158 E. coli strains were isolated from 158 chicken farms. The disc diffusion method for susceptibility testing was performed. Clinical breakpoints were interpreted according to Clinical and Laboratory Standards Institute guidelines. MDR was defined as resistance to three or more classes of antimicrobials. MDR E. coli prevalence on chicken farms was 62.7% (95% CI: 55.0 – 70.3). High resistance was observed against ampicillin 79.8% (95% CI: 72.7–85.4), tetracycline 72.8% (95% CI: 65.2–79.2), cotrimoxazole 55.7% (95% CI: 47.8–63.3), and ciprofloxacin 38% (95% CI: 30.7–45.9). Farmers who were males (APR = 0.72, CI: 0.55, 0.93), and attained at least secondary education (APR=0.64, CI: 0.46, 0.88) and administration of recommended antibiotic doses (APR = 0.76, CI: 0.59–0.96) posed a lower risk of MDR E. coli carriage. Farms without footbaths posed a heighten risk (APR=1.48, CI: 1.16–1.88). MDR E. coli were highly prevalent on chicken farms. This study underscores the need for antimicrobial stewardship and improved infection prevention strategies on chicken farms.

Human papillomavirus (HPV) infections, primarily transmitted through sexual contact, have been linked to various cancers, including cervical, penile, anal, oropharynx, breast, and prostate cancers. This study presents a unique case of concurrent high-risk HPV35, HPV45, and HPV59 infections in both prostate and bladder cancer tissues from a single patient, representing the first documented instance worldwide with identical HPV types detected in two adjacent organs of the same individual. Employing a multiplex-PCR approach, gel electrophoresis, and Sanger sequencing, we confirmed the presence of these high-risk HPV types. Additionally, Western blot analysis using an HPV E7 antibody demonstrated the active expression of HPV oncoproteins in both cancer types. This discovery underscores the potential for HPV intra-organ transmission and necessitates further exploration of alternative transmission routes. The implications of our results offer new insights into the complex dynamics of HPV transmission in cancer pathogenesis.

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 purpose of this study is to analyze the causes of cost variation in natural disaster prevention projects (NDPP) in Gyeongsangbuk-do and to develop effective cost and risk management strategies. The study collected data by conducting an online survey of 244 stakeholders. Binary logistic regression was used to analyze the impact of various variables on cost deviation, in-cluding project management risk (PMR), project costing and execution risk (PCER), project exe-cution strategy risk (PESR), construction project risk (CPR), project cost and schedule risk (PCSR), project management challenges (PMC), and construction project subcontractor and safety man-agement (CPSSM). The results showed that PMR (OR=3.744, 95% C.I. [1.657, 8.457]), PCER (OR=5.068, 95% C.I. [2.236, 11.484]), PESR (OR=3.447, 95% C.I. [1. 853, 6.413]), CPR (OR=2.292, 95% C.I. [1.020, 5.151]), PCSR (OR=4.817, 95% C.I. [2.250, 10.317]), PMC (OR=2.954, 95% C.I. [1.452, 6. 013]), and CPSSM (OR=2.419, 95% C.I. [1.297, 4.515]) had statistically significant effects on cost deviation. In particular, PMR, PCER, and PESR were identified as the main causes, and the effects of additional factors such as CPSSM were also important. The developed predictive model plays an important role in helping stakeholders of NDPP to manage risks in advance and take appro-priate preventive measures to ensure the success of the project. This study empirically supports the theoretical hypotheses of previous studies and provides a clear understanding of the causes of cost deviation in NDPP, which provides important insights for strategic decision-making and provides a new perspective on risk management.

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).

Uncontrolled chronic inflammation results in cardiovascular disease and early death. In this review, we studied the impact of rheumatoid arthritis on the cardiovascular system, including the early and accelerated development of atherosclerosis, and its clinical manifestations, focusing on the inflammatory mechanisms leading to arterial wall damage, rapid atherosclerotic plaque formation, and thrombosis. Furthermore, the influence of medications used to treat rheumatoid arthritis on the cardiovascular system. The influence of chronic inflammation and medicaments on traditional cardiovascular risk factors is not the main subject of this review. We found that uncontrolled chronic inflammation and some medications directly impact all stages of atherosclerosis. In conclusion, reducing inflammation and maintaining long-term remission in rheumatoid arthritis may pre-vent early atherosclerosis. We believe that this review will encourage a better interdisciplinary approach for these patients and further research in this field.

Sudden water pollution accident is a tough environmental challenge to solve due to its uncertainty, unpredictability and destructiveness. Therein, the dangerous goods transportation accidents on the cross-tributary bridges are increasing worldwide with the acceleration of industrialization and urbanization, posing threats to the water ecological environment and human health. To prevent and control the risk, this study evaluated the risk of sudden water pollution accidents associated with dangerous goods transportation on the cross-tributary bridges by using the expert judgment fuzzy language method and Bayesian network model. Baiyangdian lake as the largest freshwater shallow lake in North China was chosen as a study case. Different accident scenarios were simulated to put forward risk prevention and control measures. The results showed that the primary risk factors were divided into five categories: personnel factors, vehicle factors, tank factors, weather factors, and road environment factors. The probability of dangerous goods transportation accidents was a possible event (P=0.115), with a high risk level. Furthermore, the Baiyangdian lake would suffer from serious environmental pollution and water quality degradation without prevention and control measures by simulating the oil leakage accident. Therefore, emergency prevention and control measures are expected to be formulated and implemented before and after the occurrence of the sudden water pollution accidents. This study provides useful insights into risk prevention and control strategies for sudden water pollution accidents, and the framework can be made applicable to other rivers facing similar risk challenges worldwide.

To date, only a few studies focused on carbon monoxide (CO) production during waste composting; all targeted on CO inside piles. Here, the CO net emissions from compost piles and the assessment of worker’s occupational risk of exposure to CO at large-scale composting plants are shown for the first time. CO net emissions were measured at two plants processing green waste, sewage sludge, or undersize fraction of municipal solid waste. Effects of the location of piles (hermetised hall vs. open yard) and turning (before vs. after) were studied. Higher CO net emission rates were observed from piles located in a closed hall. The average CO flux before turning was 23.25 and 0.60 mg‧m-2‧h-1 for hermetised and open piles, respectively, while after – 69.38 and 5.11 mg‧m-2‧h-1. The maximum CO net emissions occurred after the compost was turned (1.7x to 13.7x higher than before turning). The top sections of hermetised piles had greater CO emissions compared to sides. Additionally, 5% of measurement points of hermetised piles switched to ‘CO sinks’. The 1-h concentration in hermetised composting hall can reach max. ~50 mg CO∙m-3 before turning, and &gt;115 mg CO∙m-3 after, exceeding the WHO thresholds for a 1-h and 15-min exposures, respectively.

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.

Abstract: Sand-cement bound screed floor layers are at risk for work-related low back pain, lumbosacral radicular syndrome and knee osteoarthritis given their working technique of level-ling screed with their trunk bended and mainly supported by their hands and knees. To reduce the exposure of the physical demands of bending of the trunk and kneeling, a manually moved screed levelling machine was developed for floor layers in the Netherlands. The aim of this pa-per is to estimate the potential health gain of the manually moved screed levelling machine on the risk of low back pain (LBP), lumbosacral radicular syndrome (LRS) and knee osteoarthritis (KOA) compared to the traditional working technique. The potential health gain was assessed using the epidemiological population estimates of the Population Attributable Fraction (PAF) and the Potential Impact Fraction (PIF) combined with work-related risk estimates for these three disorders from systematic reviews. The percentage of workers exceeding these risk esti-mates was based on worksite observations among in total 28 floor layers. For LBP, 16/18 work-ers were at risk using the traditional working technique with PAF=38%, and for the manually moved screed levelling machine this was 6/10 with PIF=13%. For LRS, these data were 16/18 with PAF=55% and 14/18 with PIF=18% and for KOA, 8/10 with PAF=35% and 2/10 with PIF=26%. A manually moved screed levelling machine might have a significant impact on the prevention of LBP, LRS and KOA among floor layers in the Netherlands and a health impact assessment is a feasible approach to assess health gains in an efficient way.

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.

Chronic obstructive pulmonary disease (COPD) is increasingly being recognized as a systemic disease rather than a mere disorder of the lungs. Central (respiratory) and peripheral (limb) muscle weakness are among the main pronounced systemic effects of COPD. While the disease primarily affects the lower limb muscles and contributes to gait impairment, COPD is also associated with an increasing risk of falls in patients (COPDp). Previous studies have reported higher rates of falls among COPDp (1.17 to 1.20 falls/person-year), amounting to four times higher than an age-matched healthy group. Potential fall risk factors include muscle weakness, impaired daily activities, cognitive dysfunction, and gait and balance impairment. Although COPDp often manifest many of these risk factors, there remains a gap in literature regarding falls during walking in this population. This study aimed to 1. analyze the literature to identify the risk factors of falling in COPDp, and 2. investigate the underlying mechanisms by which these risk factors can lead to increased prevalence of falling. The results suggest that in addition to the known risk factors of falling, low back pain and mental fatigue should also be considered as relevant risk factors in the treatment process of these patients. Moreover, respiratory problems, which are common in this population, have demonstrated pronounced effects on energy expenditure, gait, and other types of activities of daily living (ADLs), leading to reduced intensity, disrupted coordination of the trunk-pelvic structure with the lower limbs during gait, and altered motor control performance due to activation of muscles in an inefficient synergic manner. These problems potentially lead to the increased vulnerability of these patients to external disturbances and higher incidence risk of falls and injuries. Cognitive problems, which are typically due to reduced oxygen received by the brain, as well as general inflammation caused by COPD, also play a significant role in gait disruption and balance. Future research is warranted to determine the prevalence of falls in COPDp by examining the response of these patients to Medio-Lateral (ML) and Anterior-Posterior (AP) disturbances during gait in association with traditional and recommended fall risk factors.

Proximal Junctional Kyphosis (PJK) as one of the most discussed problems after corrective surgery in adolescent idiopathic scoliosis (AIS), is still not fully clarified and seems to be multifactorial. Biome-chanical and few clinical studies have shown the influence of destruction of posterior ligaments by re-section of spinous processes and some parameters concerning rod contouring as risk factors for PJK. To verify these results 192 patients with AIS and corrective surgery via posterior approach between 2009 and 2017 were included. Radiographic parameters were analyzed preoperatively (preOP), postoperatively (postOP), and with a mean follow up (FU) of 27 months. The participants were divided into two groups (PJK group and non-PJK group). The incidence of PJK was 15.6%. Contrary to the results of biomechanical studies, we could not find any significant influence of the spinous process resection. However, the PJK group had significantly larger preOP T4-T12 kyphosis (31.1°±13.93° vs. 23.3°±14.93°, p=.016). Furthermore, the PJK group showed a significantly larger rod contour angle (RCA) (8.0°±4.44° vs. 5.9°±3.28°, p=.003) and mismatch of postOP proximal junctional angle (PJA) and RCA (3.5°±5.72° vs. 0.9°±4.86°, p=.010) compared to the non-PJK group. An increase of the mismatch of postOP PJA and RCA (OR=1.14, p=.008) and a high RCA are risk factors for PJK and need to be focused on by surgeons.

This transdisciplinary review of research about international cooperation on social and environmental change builds the case for replacing Sustainable Development as the dominant framework for an era of increasing crises and disasters. The review is the output of an intentional exploration of recent studies in multiple subject areas, based on the authors’ decades of work in related fields since the Rio Earth Summit 30 years ago (rather than a keyword search of databases). It summarizes the research which documents failure to progress towards the Sustainable Development Goals (SDGs). Consequently, the extensive scholarship critiquing the conceptual framework behind those ‘Global Goals’, and the economic ideology they arose from and support, is used to explain that failure. Although the pandemic set back the SDGs, it further revealed the inappropriate strategy behind those goals. This suggests the Global Goals constitute an ‘own-goal’ scored against people and nature. From this conclusion, alternative frameworks for organizing action on social and environmental issues become more important and are therefore briefly reviewed. It is argued that such a future framework must relate a new eco-social contract between citizen and state, and engage existing organizations and capabilities that are relevant to an increasingly disrupted world. Therefore, the case is made for considering an upgraded form of Disaster Risk Management (DRM) as an overarching framework. The proposed upgrades include detaching from economic ideologies, and recognizing that a wider metadisaster from climate chaos may reduce the future availability of external support. Therefore, self-reliant resilience and locally-led adaptation are identified as important to the future of DRM. Some options for professionals continuing to use the term sustainability, such as this journal, are discussed.

A recent survey that determined heavy metal concentrations in an abandoned Hg mine in Palawan, Philippines, found the occurrence of Hg with As, Ba, Cd, Co, Cr, Cu, Fe, Hg, Mn, Ni, Pb, Sb, Tl, V, and Zn. While the Hg originated from the mine waste calcines as supported by previous studies, the critical knowledge about the origin of the other heavy metals remains to be unknown. Our study investigated the sources of heavy metal pollution surrounding the abandoned Hg mine; and assessed the soil and sediment quality, ecological risks, and health risks associated with these toxic metals. Multivariate analyses, such as hierarchical cluster analysis (HCA), principal component analysis (PCA), and Pearson correlation analysis, were used to identify the heavy metal sources from the results of a previous paper. Our results showed that Fe, Ni, Cr, Co, and Mn are associated with the ultramafic geology of the study, whereas As, Ba, Cd, Cu, Pb, Sb, Tl, V, and Zn are likely due to historical mining and processing of cinnabar from 1953-1976. The mine waste calcines were used as construction material for the wharf and as land filler for the adjacent communities. The modified contamination factor (mCdeg) showed that the coast of Honda Bay is highly contaminated, while the inland areas, including the rivers, are very- to ultra-highly contaminated. There is a considerable ecological risk associated with the heavy metals, wherein Ni, Hg, Cr, and Mn contribute an average of 46.3 %, 26.3 %, 11.2 %, and 9.3 % to the potential ecological risk index (RI), respectively. The overall mean hazard index (HI) for both adults (1.4) and children (12.1) exceeded 1, implying the probability of non-carcinogenic adverse effects. The mean total cancer risk over a lifetime (LCR) for both adults (1.19×10-3) and children (2.89×10-3) exceeded the tolerable threshold of 10-4, suggesting a potentially high risk for developing cancer mainly by Ni, Co, and Cr exposure.

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.

Background: This article evaluates the perception of drug use control and strategies in Valencia City (Spain) in a general and clinical population, in two independent studies. Material and Methods: 1071 people participated. In the Study 1 (n= 924) the entire sample came from general population (GP), and in the Study 2 (n=147), 68 were drug users being treated in an Addictive Behaviors Unit (ABU), and 79 people of the GP. The drug use control perception and strategies in both subgroups were compared. The participants filled in the Drug Use Strategies Scale and a Drug Use Survey. Results: A high level of perception of drug control in GP was obtained (72,7% in the Study 1 and 67,5% in the Study 2), and 32.5% in ABU subgroup. People in the PG and drug users in treatment differ in some control strategies. A predictive profile of the perception of control was obtained for the Study 2. Conclusion: The high degree of perception of controlling drug use in the GP, and partially in drug users being treated, and the specific control strategies reported suggests that moderate use and drug control strategies are a great value alternative to bear in mind compared to abstinence.

Multiple governmental agencies and private organisations have made commitments for the colonisation of Mars. Such colonisation requires complex systems and infrastructure that could be very costly to repair or replace in cases of cyber-attacks. This paper surveys deep learning algorithms, IoT cyber security and risk models, and established mathematical formulas to identify the best approach for developing a dynamic and self-adapting system for predictive cyber risk analytics supported with Artificial Intelligence and Machine Learning and real-time intelligence in edge computing. The paper presents a new mathematical approach for integrating concepts for cognition engine design, edge computing and Artificial Intelligence and Machine Learning to automate anomaly detection. This engine instigates a step change by applying Artificial Intelligence and Machine Learning embedded at the edge of IoT networks, to deliver safe and functional real- time intelligence for predictive cyber risk analytics. This will enhance capacities for risk analytics and assists in the creation of a comprehensive and systematic understanding of the opportunities and threats that arise when edge computing nodes are deployed, and when Artificial Intelligence and Machine Learning technologies are migrated to the periphery of the internet and into local IoT networks.

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.

Estimating the economic risks of climate shocks and climate stressors on spatially heterogeneous cities over time remain highly challenging. The purpose of this paper is to present a practical methodology to assess the economic risks of climate change in developing cities to inform spatially sensitive municipal climate response strategies. Building on a capital-based framework (CBF), spatially disaggregated baseline and future scenario scores for economic wealth and its exposure to climate change are developed for six different classes of capital and across 77 major suburbs in Cape Town, South Africa. Capital-at-risk was calculated by combining relative exposure and capital scores across different scenarios and with population impacted plotted against the major suburbs and the city’s 8 main planning districts. The economic risk assessment presented here provides a generic approach to assist investment planning and the implementation of adaptation options through an enhanced understanding of relative levels of capital endowment vis-à-vis relative levels of exposure to climate-related hazards over time. An informed climate response strategy in spatially heterogeneous cities need to include spatially sensitive estimates on capital-at-risk and populations disproportionally impacted by climate exposure over time. The economic risk assessment approach presented here helps in advancing to such a goal.

The aim of this study was to develop and validate a predictive early tooth loss multivariable model for periodontitis patients before periodontal treatment. A total of 544 patients seeking periodontal care at a university dental hospital were enrolled in the study. Teeth extracted after periodontal diagnosis and due to periodontal reasons were recorded. Clinical and sociodemographic variables were analyzed, considering the risk of short-term tooth loss. This study followed the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) guidelines for development and validation, with two cohorts considered as follows: 455 patients in the development phase and 99 in the validation phase. As a result, it was possible to compute a predictive model based on tooth type and clinical attachment loss. The model explained 25.3% of the total variability and correctly ranked 98.9% of the cases. The final reduced model area under the curve (AUC) was 0.809 (95% Confidence Interval (95% CI): 0.629 - 0.989) for the validation sample and 0.920 (95% CI: 0.891 - 0.950) for the development cohort. The established model presented adequate prediction potential of early tooth loss due to periodontitis. This model may have clinical and epidemiologic relevance towards the prediction of tooth loss burden.

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.

Reliability assessment in traditional power distribution systems has played a key role in power system planning, design, and operation. Recently, new information and communication technologies have been introduced in power systems automation and asset management, making the distribution network even more complex. In order to achieve efficient energy management, the distribution grid has to adopt a new configuration and operational conditions that are changing the paradigm of the actual electrical system. Therefore, the emergence of the cyber-physical systems concept to face future energetic needs requires alternative approaches for evaluating the reliability of modern distribution systems, especially in the smart grids environment. In this paper, a reliability approach that makes use of failure modes of power and cyber network main components is proposed to evaluate risk analysis in smart electrical distribution systems. We introduce the application of Failure Modes and Effects Analysis (FMEA) method in future smart grid systems in order to establish the impact of different failure modes on their performance. A smart grid test system is defined and failure modes and their effects for both power and the cyber components are presented. Preventive maintenance tasks are proposed and systematized to minimize the impact of high-risk failures and increase reliability.

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.

Total Nigeria Plc is a Marketing and Services subsidiary of Total; a multinational energy company operating in more than 130 countries and committed to providing sustainable products and services for its customers. For over 50 years, Total Nigeria Plc has remained the leader in the downstream sector of the Nigerian oil and gas industry. This study investigated the volatility of the stock price of Total Petroleum Nigeria plc using nine (9) GARCH models namely sGARCH, gjrGARCH, eGARCH, iGARCH, aPARCH, TGARCH, NGARCH, NAGARCH and AVGARCH. We also investigated the Value-at-Risk (VaR) and Backtesting of the Models. The aim actually of this study is to boost the confidence of the shareholders and investors of the Total Nigeria plc. To achieve this, daily stock price for Total petroleum Nigeria plc from secondary was collected from January 2^nd 2001 to May 8^th 2017. . The study used both normal and student t innovations, using Akaike Information Criterion (AIC) to select the best model, for normal innovations for log returns and cleansed log returns of Total plc, the eGARCH and sGARCH models performed best respectively, while NGARCH model performed best for student t innovation for both log returns and cleansed returns of Total plc. The persistence of the models are stable except in few cases where iGARCH, eGARCH where not stable. Also for student t innovation, the sGARCH and gjrGARCH fails to converge. The mean-reverting number of day for the returns of Total Nigeria plc differs from model to model. Evidence from the VaR Analysis revealed from the selected models revealed that the Risk of VaR losses is high at 99% confidence level, slightly high at 95% confidence level and better at 90% confidence level. Although The Duration-Based Tests of independence conducted revealed that the models are correctly specified since in all cases the null hypotheses were accepted. This means that the probability of an exception on any day did not depends on the outcome of the previous day. Finally, both the unconditional (Kupiec) and conditional (Christoffersen) coverage tests for the correct number of exceedances for both Total stock returns and cleansed returns. The tests revealed rejection of the models at 1% level of significance. This confirms that unconditional (Kupiec) and conditional (Christoffersen) coverage tests for the correct number of exceedances are reliable compared to the Duration-Based Tests of independence. Therefore we recommend that shareholders and investors in Total Nigeria plc are to remain and continue to investment in Total Nigeria plc because if there is any form of losses, the price of the stock has the potentials to improve in the future. Again, though the risk is high at 99% confidence level, this in line with the financial theory that states that an asset with high expected risk would pay higher return on the average.

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.

The core of risk aggregation in the Solvency II Standard Formula is the so-called square root formula. We argue that it should be seen as a means for the aggregation of different risks to an overall risk rather than being associated with variance-covariance based risk analysis. Considering the Solvency II Standard Formula from the viewpoint of linear geometry, we immediately find that it defines a norm and therefore provides a homogeneous and sub-additive tool for risk aggregation. Hence Euler's Principle for the reallocation of risk capital applies and yields explicit formulas for capital allocation in the framework given by the Solvency II Standard Formula. This gives rise to the definition of diversification functions, which we define as monotone, subadditive, and homogeneous functions on a convex cone. Diversification functions constitute a class of models for the study of the aggregation of risk, and diversification. The aggregation of risk measures using a diversification function preserves the respective properties of these risk measures. Examples of diversification functions are given by seminorms, which are monotone on the convex cone of non-negative vectors. Each L^p norm has this property, and any scalar product given by a non-negative positive semidefinite matrix does as well. In particular, the Standard Formula is a diversification function and hence a risk measure that preserves homogeneity, subadditivity, and convexity.

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 article examines the integration of artificial intelligence (AI) and robotic process automation (RPA) in financial accounting and management, underscoring their role in driving the digital transformation of corporate finance. It discusses the shortcomings of traditional financial processes and highlights the potential of AI and RPA technologies to enhance efficiency, accuracy, and cost-effectiveness. The paper also explores the limitations of RPA, such as its challenges in processing unstructured data and handling complex decision-making scenarios. Looking forward, it considers the future trends in AI and RPA, emphasizing the benefits of cloud technology in scaling automated systems and addressing associated challenges.

This paper analyzes ServiceNow’s overall strategy, business model, mission, vision, and key strategic risks. ServiceNow, a platform-as-a-service provider, has experienced significant growth and is poised for further expansion. The paper identifies strategic risks such as legislative and regulatory challenges, strategy development and execution risks, and competition in the cloud computing industry. Using Porter’s Five Forces framework, the assignment explores these risks and proposes mitigation strategies. Recommendations are made to protect intellectual property, maintain customer loyalty through subscription models, and ensure innovation in response to evolving market demands.

Numerous Epidemiologic studies have used remote sensing to quantify the contribution of greenness, air pollution, and wildfire smoke to asthma and other respiration outcomes. This is the first review paper to evaluate the influence of remote sensing exposures to specific outcome severity and risk factors in different ecologic settings. Literature searches utilizing PubMed and Google Scholar identified 61 unique studies published between 2009-2023, with 198 specific outcomes. Respiration specific outcomes were lower in greenness, and higher in air pollution, and in wildfire ecologic settings. Aerosol optical depth (AOD)-PM2.5 readings and specific outcomes were higher in economically developing than in economically developed countries. Prospective studies found prenatal and infant exposure to higher ambient AOD-PM2.5 concentration level readings contributed to higher childhood asthma incidence. Lung function was higher in greenness, and lower in the other two ecologic settings. Age, environment, gender, other, and total risk factors showed significant differences between health outcomes and ecologic settings. Published studies utilized physiologic mechanisms of immune, inflammation, and oxidative stress to describe obtained results. Individual and total physiologic mechanisms differed between ecologic settings. Study results were used to develop a descriptive physiologic asthma model and then use it to propose updated population-based asthma intervention program guidelines.

This paper provides a thorough examination of important themes critical to understanding and tackling modern cyber threats. It explores the revolutionary significance of AI and machine learning in cybersecurity, emphasizing their dynamic influence on defense systems. It also addresses how zero-trust designs have caused a paradigm change in network security, highlighting the significance of trust verification in current cybersecurity frameworks. Furthermore, the article investigates the integration of cybersecurity with corporate strategy, arguing for a collaborative approach to efficiently mitigating risks while minimizing operational impact. Furthermore, it investigates the idea of cyber resilience, highlighting an organization's ability to recover from assaults and adapt to changing threats. Furthermore, the paper discusses the issues faced by deepfakes in the synthetic media revolution and emphasizes the rising worry about data privacy in the digital era. Finally, it looks into the introduction of behavioral biometrics as a possible way to improve authentication and security methods. This paper contributes to the discussion of effective tactics for mitigating cyber threats in today's digital ecosystem by providing a thorough overview of these subjects.

INTRODUCTION: This study focusses on diagnosis of stages of AD (Alzheimer’s disease) including MCI (Mild Cognitive Impairment) from two data modalities - gene expression and clinical data of ADNI (Alzheimer’s Disease Neuroimaging Initiative ) participants using multiclassification. The gene expression dataset is highly imbalanced and of HDLSS (high-dimensional and low-sample-size) characteristics. This is the only study where multiclassification based AD stage diagnosis is done to identify multiple stages of Alzheimer. We are able to achieve the best multiclassification result in both the modalities and identify new genetic biomarkers. METHODS: Combination of XGBoost and SFBS (“Sequential Floating Backward Selection”) methods is used to select features. We are able to select the most effective 95 gene probsets out of 49,386. For clinical study data, 8 most effective biomarkers could be selected using SFBS. For both genomic and clinical data, DL (‘Deep Learning’) classifier is used to identify stages - CN (Cognitive Normal), MCI (Mild Cognitive Impairment), AD (Alzheimer’s Disease / Dementia). Because of high data imbalance in genomic data, border line oversampling is used for model training and original data for validation. RESULT & DISCUSSION: With clinical data, we achieved ‘ROC AUC’ scores 0.97, 0.95, 0.94 for CN, MCI, Dementia stage respectively . We achieve ‘ROC AUC’ scores 0.75, 0.74, 0.70 for CN, MCI, Dementia stage respectively and 0.67 for both micro average F1 scores and micro weighted F1 score. This is the best result so far for AD stage diagnosis from gene expression profile data through multiclassification with ADNI data. Results reflect that our multiclassification model can efficiently handle the imbalanced data of HDLSS nature to identify samples of minority class. MAPK14, ZNF835, MID1, HLA-DQA1, TEP1 are some of the new genes found to be associated with AD risk. DRAXIN, HSPA12B, USP47 etc. are found to be AD preventive or suppressor.

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.

This study explores the intricacies of supplier relationships and inventory optimization within high-technology industries, offering a comprehensive analysis of the strategic imperatives and operational challenges faced by firms in these sectors. By adopting a qualitative research methodology involving semi-structured interviews with supply chain professionals and documentary analysis, the study provides in-depth insights into the evolving dynamics of supply chain management. Findings reveal a marked shift towards collaborative and strategic supplier relationships, characterized by trust, transparency, and joint innovation initiatives. These partnerships are essential for enhancing operational efficiency, driving product development, and navigating market uncertainties. Additionally, the research underscores the critical role of advanced technologies, such as artificial intelligence and the Internet of Things, in optimizing inventory levels and improving supply chain visibility. The integration of these technologies facilitates precise demand forecasting and proactive inventory management, thereby reducing costs and enhancing service levels. However, the study also highlights significant challenges, including geopolitical uncertainties, supply chain disruptions, and cultural barriers, which necessitate robust risk management strategies and adaptive supply chain practices. Strategic implications for organizational leaders and policymakers include the need to invest in supplier development, embrace digital transformation, and enhance risk management frameworks to build resilient and agile supply chains. This study contributes valuable insights into the complex interplay between supplier relationships, inventory optimization, and technological integration in high-technology industries, offering actionable recommendations for practitioners and researchers seeking to drive innovation and maintain competitiveness in a dynamic global marketplace.

This qualitative research explores the influence of supply chain disruption management on brand resilience and consumer perception. Amidst increasingly complex global dynamics, effective strategies are crucial for organizations to mitigate risks, maintain operational continuity, and preserve consumer trust. The study employs semi-structured interviews with stakeholders across diverse industries, focusing on strategies employed, outcomes observed, and challenges faced in managing disruptions. Key findings underscore the significance of proactive measures such as risk assessment, contingency planning, diversification, technology integration, and collaboration in enhancing organizational resilience. These strategies not only enable businesses to navigate disruptions effectively but also contribute to sustaining competitive advantage and stakeholder confidence. Consumer perception during disruptions emerges as pivotal, shaped by brands' transparency, responsiveness, and ethical considerations in managing supply chain challenges. Transparent communication and reliable service delivery during disruptions enhance brand reputation and foster consumer loyalty. However, challenges including information gaps, resource constraints, coordination issues, and regulatory compliance complexities highlight the need for adaptive strategies and robust partnerships across the supply chain. Overall, the study provides insights into the interconnectedness of disruption management, brand resilience, and consumer perception, offering practical implications for organizations seeking to strengthen their resilience strategies and consumer relationships in dynamic market environments.

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.

This review paper aims to understand the current processing plant maintenance systems and further identify on-stream phased array corrosion mapping (PACM) to reduce turnaround maintenance (TAM) activity during plant operations. Reducing the TAM duration and extending the TAM interval are common goals of most researchers. Thus, a detailed review was performed to understand the maintenance systems and the problems faced. Furthermore, a review of the current PACM application and the possibility of applying it during on-stream inspection was also per-formed. PACM has better detectability for localized corrosion, and the results can be obtained for a range of thicknesses, which is the main advantage of this method. The challenge is to apply it to a surface with high temperatures, owing to the greater probe contact and the limitation of ultrasonic properties. This literature review provides a more precise direction for future research to evaluate PACM on piping that can be utilized in inspection during plant operation at elevated temperatures. Detecting and monitoring corrosion growth without shutdown.

The study aimed to evaluate for the first time the degree of contamination of soil and crops with major and trace elements (Cd, Co, Cr, Cu, Ni, Pb, Zn, F, Na, Mg, Si, P, Cl, Fe, Al) in agricultural lands situated in the Lower Danube Basin, Galati and Braila counties (SE Romania), impacted by the steel industry. Soil samples from two depths (0–5 cm and 5–30 cm), as well as leaves and seeds of wheat, corn, and sunflower, were collected from 11 different sites. Along with elemental and mineralogical analysis, performed by HR-CS AAS, PIGE, SEM-EDX and ATR-FTIR, the soil pH, texture, organic matter, electric conductivity and CaCO3 content were investigated. The results showed that the levels of Cr (83.270–383.100 mg kg-1), Cu (17.110–68.151 mg kg-1), Ni (30.157–55.656 mg kg-1), and F (319–544 mg kg-1) in soil exceeded the Romanian regulations for sensitive use of the land. The pollution indices (Igeo, EF, PI, PERI) indicate that the soil is moderate to highly contaminated with Cr, Ni and Cu, while CSI and mERMQ indices suggested a relatively low risk for metal contamination. The concentrations of elements in plant tissues and bioaccumulation factors (BFs) show the soil-plant relation and health risk, but also the elemental selectivity of vegetal compartments. Thus, the results showed that wheat plants tend to exclude the bioaccumulation of certain elements in their tissues, while for Zn and Cu, the bioaccumulation pattern is different. In the case of corn, most BFs were below 1, indicating limited phytoaccumulation capacity. However, exceptions were observed for Cd, Zn, and Cu. Sunflower BFs indicate higher bioconcentration of Cu, Cd, and Zn in both the leaves and seeds compared to other elements. Chromium (Cr) contributes to non-carcinogenic dermal contact and ingestion hazards, with children being more susceptible to the adverse effects of this contaminant.

Despite significant prevention efforts, the numbers of physically inactive individuals, chronic illnesses, exhaustion syndromes and sick leaves are increasing. A still unresolved problem with exercise promotion is the low participation of sedentary persons. This collective term covers heterogeneous subgroups. Their engagement with movement campaigns and resistance to change are influenced by numerous factors. Our aim was to analyse survey data on health, performance, lifestyle habits and the approachability to physical activity campaigns obtained from the Germany-wide ActIv survey. From 2,888 study participants aged 50-60 years, 668 persons were categorised into the subgroups "never-athletes", "sports-dropouts", "always-athletes" and "sports-beginners". Large and significant group differences were found for BMI, assessment of quality of life, health and fitness, risk factors and health problems. 42.5% of "never-athletes" and 32.5% of "sports-dropouts" did not state any barriers to sport. There are substantial disparities between the non-athlete groups in terms of their motivation to exercise. In contrast, there are comparatively minor differences in motivation between "sports-dropouts" and "sports-beginners", whose health and fitness are the primary motivators for sport. Our analyses suggest that (i) negative health and performance trends cannot be compensated by appeals for voluntary participation in exercise programmes and (ii) powerful incentive systems are required.

Integrated disaster risk reduction in schools represents a key component of safety strategies within the educational sector of every country. In this study, a series of 850 face-to-face interviews (650 with students and 200 with teachers) were conducted throughout 2023 in 10 out of the total 18 municipalities in the Western Morava Basin of the Republic of Serbia. The paper proposes two central hypotheses regarding school-based disaster risk reduction. Firstly, it suggests that gender, age, parent's employment, academic achievement, living situation, paternal and maternal education levels, and engagement with social media collectively influence students' perspectives on this matter. Secondly, it posits that gender, age, marital status, parenthood, and educational background significantly impact teachers' viewpoints on school-based disaster risk reduction. Multivariate linear regression was used to explore predictors of students' and teachers' insights on school-based disaster risk reduction. Various statistical tests including Chi-square, t-tests, one-way ANOVA, and Pearson's correlation were employed to investigate the influence of demographic and socioeconomic factors on these insights. The results of multivariate regression analyses indicate that age, gender and marital emerge as the primary predictors across various facets of students' and teachers' insights on school-based disaster risk reduction (awareness of disasters, disaster education activities, attitudes on disaster risk reduction education, enhancement of disaster information accessibility, etc). The results of this study provide insight into the key factors influencing students' and teachers' perceptions of disaster risk reduction in schools. As such, they can serve as a basis for improving educational programs, developing policies and strategies, normative educational frameworks, teacher training, and further research in disaster education.

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

Abstract Cholesterol has ruled the history of atherosclerotic cardiovascular diseases (CVD) for decades, and the transport of cholesterol by lipoproteins has become a cornerstone of our view of etiology of the disease. Discovery of the lipoprotein-specific transport of lipid oxidation products (LOP) has opened a new and exciting area in research of CVD by revealing strong connections between atherogenic LOP, lipoprotein transport functions and CVD. This review goes through the evidence in support of the lipoprotein-specific LOP transport and speculates of possible consequences of the proposed role of lipoprotein LOP transport as a risk factor. Association of lipoprotein LOP with known risk factors of CVD are largely parallel with those of cholesterol, and due to the common transport and cellular intake mechanisms the elucidation of independent effects of either cholesterol or LOP is difficult. Yet, unlike cholesterol, LOP can directly initiate and boost atherogenic processes. It therefore appears inevitable that increasing knowledge of the lipoprotein-specific LOP transport will affect the present view of the role of cholesterol in aetiology and as a risk factor of CVD.

Oilseed plants of the Brassicaceae plant family are cultivated for food, feed and industrial purposes on large-scale in Europe. This review gives an overview of current market-oriented applications of new genomic techniques (NGTs) in relevant Brassicaceae oilseed crops based on a literature survey. In this respect, changes in oil quality, yield, growth and resistance to biotic and abiotic stress are goals in oilseed rape (B. napus) and camelina (C. sativa). Environmental risk assessment scenarios are developed for specific NGT applications in Brassicaceae oilseed crops with either a changed oil composition or with fitness related traits. In case of a changed oil composition an increase or decrease of polyunsaturated fatty acids (PUFA) demonstrates risks for health and survival of pollinators. In case of fitness related traits other risks were identified, i. e. an increased risk of spread and persistence of NGT plants. Furthermore, there are indications for potential disturbance of interactions with the environment, involving signalling pathways and reaction to stress conditions. It is shown that for a comprehensive risk assessment the technological potential of NGTs, the plants’ biology and the scale of releases have to be considered in combination. Therefore, the release of NGT plants into the environment for agricultural purposes will require risk assessment and monitoring of single traits as well as of combinatorial and long-term cumulative effects. In addition, risk management should develop concepts and measures to control and potentially restrict the scale of releases. This is especially relevant for NGT Brassicaceae in Europe which is a centre of diversity of this plant family.

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.

Background and aims: Only one cohort study exists on the incidence of the risk of malnutrition (RM) in older adults, though numerous cross-sectional –and that cohort research– have reported several risk factors associated with the prevalence and incidence of this condition. However, alterations of body composition and impaired physical performance as exposition variables of RM have not been explored. This study assessed the incidence of RM and determined its association with excess fat mass, low total lean tissue, gait speed, and handgrip strength as exposition variables for RM in community-dwelling older adults. Methods: This is a secondary analysis in older adults (≥60 years old) derived from the study “Frailty, dynapenia, and sarcopenia in Mexican adults (FraDySMex)” a prospective cohort project conducted from 2014 to 2019 in Mexico City. At baseline, volunteers underwent body composition analysis and physical performance tests. Several covariates were identified through comprehensive geriatric assessment. At baseline and follow-up, RM was assessed using the long form of the mini nutritional assessment (MNA-LF) scale. Associations between the exposition variables and RM were assessed by multiple logistic regression. Results: The cohort included 241 subjects. Average age was 75.6±7.8 years; 83.4% were women. The mean follow-up period was 4.1 years, during which 28.6% of subjects developed RM. This condition was less likely to occur in subjects with excess fat mass index, even after adjusting for several covariates. RM was also more likely to occur in subjects with low total lean tissue index, according to both an unadjusted model and after adjusting for the corresponding variables. Regarding the association between RM and gait speed, RM was also more likely to occur in subjects with low gait speed according to both the unadjusted and adjusted models. Similar results were found for RM in relation to low handgrip strength; however, after adjusting for the associated covariates, models 1 and 2 no longer reached the level of significance. Conclusion: The risk of malnutrition diagnosed by MNA-LF was significantly less likely to occur among subjects with excess fat mass, but possibility was significantly higher in those with low total lean tissue and low gait speed after 4.1 years of follow-up in community-dwelling older adults. These results highlight that excess fat mass, low total lean tissue, and low gait speed are first than risk of malnutrition and not vice versa.

The assessment and prediction of drought risk under future climate change and land use land cover (LULC) scenarios is critically important for drought prevention and mitigation, as it enables a clearer understanding of potential shifts in drought patterns. The primary aim of this study is to evaluate sub-seasonal and seasonal meteorological and hydrological drought hazards across the Yellow River Basin (YRB) under projected future climate conditions and LULC patterns. The BCC-CSM1-1 climate model projections from the NASA Earth Exchange Global Daily Downscaled Projections (NEX-GDDP) dataset are utilized to represent future climate for 2025-2060 under RCP 4.5 and 8.5 scenarios. The CA-Markov model is employed to predict future LULC distributions. Meteorological and hydrological drought risks across different YRB zones are evaluated through a copula-based risk assessment approach, based on the joint probability distribution of drought duration and severity. The results indicate that sub-seasonal meteorological and hydrological droughts will likely be the primary concern moving forward. Specifically, the upper YRB (zones A, B, C) exhibits greater vulnerability to sub-seasonal meteorological drought, while the Loess Plateau (zones C, E) shows higher susceptibility to sub-seasonal hydrological drought. Moreover, zone F in the downstream region may experience increased seasonal hydrological drought risk due to projected urban expansion in the middle and lower portions of the YRB.

Postural instability (PI) in Parkinson’s disease (PD) exposes patients to increased risk of falls (RF). Although dopaminergic therapy and deep brain stimulation (DBS) improve motor performance in advanced PD patients, their effects on PI and RF are not clear. PI and RF were assessed by a stabilometric platform in 6 advanced PD patients. Patients were evaluated on and off dopaminergic medication and four DBS conditions: bilateral-DBS, DBS of the more- or less-affected side and DBS-off. Dopaminergic medication alone worsened PI and RF, DBS alone worsened RF, and no medication/DBS combination produced an improvement in postural control with respect to the OFF-medication/DBS-off condition. When ON-medication, PI and RF significantly improved after turning the DBS on, regardless of medication condition. Among DBS conditions, bilateral-DBS provided the maximal improvement of PI and RF when ON medication, and minimal worsening of PI and RF when OFF medication, whereas patients performed worse when in most-affected side DBS condition. These results can help in developing the best therapeutic strategy for postural disorders in patients with advanced PD.

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.

In the present work, we investigate the possibility that long-range airborne transport of infectious aerosols could initiate an epidemic outbreak at distances downwind beyond one hundred kilometers. For this, we have developed a simple atmospheric transport box-model which, for a hypothetical case of a COVID-19 outbreak, was compared to a more sophisticated 3-dimensional transport-dispersion model (HYSPLIT) calculation. Coupled with an extended Wells-Riley description of infection airborne spread, it shows that, the very low probability of outdoor transmission can be compensated by high numbers and densities, such as occurs in large cities, of infected and susceptible people in the source upwind and in the target downwind respectively. This may result in the creation of a few primary cases. It is worth pointing out that the probability of being infected remains very small at the individual level. Therefore, this process alone, which depends on population sizes, geography, seasonality and meteorology, can only “trigger” an epidemic which could then spread by the standard infection routes

Older adults in low-and middle-income countries experience a disproportionate burden of non-communicable diseases (NCDs). Unintentional injuries are among the major NCDs, and falls are the second leading cause of these injuries and deaths worldwide, including in Thailand. We aimed to culturally adapt the CDC’s Stopping Elderly Accidents, Deaths, and Injuries (STEADI) for Thai older adults and explore the feasibility, appropriateness, and acceptability of using STEADI in primary care via trained community health workers (CHWs) and care managers (CMs). STEADI takes a coordinated care approach that consists of three steps: screening, assessing, and intervening. In Step a, CHWs screened fall risk in 20 community-dwelling older adults using three key questions and found that all of them had fall risk, then CHWs screened with a Stay Independent questionnaire (range 0-14) and found that 100% have high fall risk (total scores 9.7± 2.4). In Step b, CMs assessed balance, vision, footwear, postural hypotension, medications, and CHWs assessed home hazards. They found that 50% had poor balance, 70% took 4+ medications,75% fell on the walkway, and 70% had no bathroom modifications. In Step c, individual participants received fall prevention interventions to mitigate their specific fall risk factors. CHWs and CMs indicated high acceptability (19.20±.1.31 of 20 total), appropriateness (18.80± 1.79 of 20 total), and feasibility (18.60±1.67 of 20 total) of the Thai-STEADI intervention. Our study showed that the community-based multifactorial Thai-STEADI delivered by CHWs and CMs is feasible and acceptable to prevent falls in older adults with limited access to health care.

In this study we propose a semi-parametric, parsimonious Value at Risk forecasting model, based on quantile regression and machine learning methods, combined with readily available market prices of option contracts from the over-the-counter foreign exchange rate interbank market. We aim at improving existing methods for VaR prediction of currency investments using machine learning. We employ two different methods - ensemble methods and neural networks. Explanatory variables are implied volatilities with plausible economic interpretation. The forward-looking nature of the model, achieved by the application of implied volatilities as risk factors, ensures that new information is rapidly reflected in Value at Risk estimates. To the best of our knowledge, this paper is the first to utilize information in the volatility surface, combined with machine learning and quantile regression, for VaR prediction of currency investments. The proposed ensemble models achieve good estimates across all quantiles. The light gra-dient-boosting machine model and the categorical boosting model both yield estimates which are better than, or equal to, those of the benchmark model. The neural network models are in general quite unstable.

(1) Background: A set of relevant Police Ergonomics Parameters (PEP) has been used for the assessment and prevention of occupational risks involved in Police Physical Interventions (PITs). Through this set of PEPs, a comparison has been made between 2 traditional PITs against 2 novel OTPs (Operational Tactical Procedures). (2) Method: The data have been collected by means of a motion capture suit fitted with 19 Inertial Measurement Units, IMUs. A specific and powerful software package specific for ergonomic analysis has been used to manage the large amount of data registered and to generate a series of 3-dimensional plots. Traditional PITs and newer OTPs have been performed for their analysis. Specifically, the PEPs corresponding to the implementation of 4 PITs have been analyzed by collecting the measurements provided by a set of IMUs installed on a motion capture suit and their occupational risk assessments have been compared against those corresponding to newer OTPs. (3) Results: For the 4 PITs, the PEPs have been analyzed with the measured values from the IMUs, throughout the duration of each technique. The two traditional intervention techniques have scored higher than the new OTPs in the REBA system, the Assymetry angle, L5-Pelvis Shear and Joint Contac Forces, and the Total Muscle Power measurements. (4) Conclusions: It has been confirmed that the new OPTs minimize the risk of injuries, since their PEPs reached lower values than those corresponding to the traditional PITs, which are still being taught at Police academies.

Breaching and liquefaction are two types of coastal flow slides proposed in the literature. While their final results are similar, liquefaction and breaching failure are two different processes, with breaching failure characterized by a different progression and sand movement mechanisms. In densely packed sand, breaching causes delayed sand grain discharge and negative excess pore pressures. Liquefaction, when a mass of soil suddenly behaves like a liquid, flow out over overly gentle slopes. Flow slides typically go unnoticed until the slope fails above ground because they start below the water. Without modern technology, diving equipment, risk assessment, and probabilistic and sensitivity assessments, flow slides inherently challenging. The authors developed a new sensitivity index to detect the susceptibility of coastal flow slides. It was established a sophisticated hybrid model that accommodates flow slides in sync with unpredictable variables employed in this new sensitivity index. Innovative hybrid model has three distinctive models. The Hybrid Hydrodynamic Model addresses wave, wind, current, climate change, and sediment transfer. The Monte Carlo Simulation analyses sensitivity, and the Bayesian Network calculates joint probability of coastal flow slide parameters of this new index that includes environmental characteristics, including climate change. With the assistance of these three models, researchers aim at a) presenting a methodology for coupling coastal flow slide projections with outcomes; b) distinguishing two flow slides; c) examining variables influencing flow slides. The use of such a hybrid model and risk index offers a robust and computationally efficient approach to evaluating the critical angle slope for breaching failure.

To remain relevant in the green transition, companies are beginning to voluntarily account for the exchange of emissions in their supply chain transactions and using the resulting greenhouse gas inventories for climate resilient decision support. Market advantages of sustainability and transparency see a shift from internal decision support tools to external communication tools which potentially expose companies to the risk of uncovering greenwashing if claims are not supported by transparent data, sound modelling, and a climate just emissions inventory, which considers external impacts connected to the production system. The different methods and standards in place for such greenhouse gas inventories, despite all referring to the ISO life cycle analysis standards and guidelines, present mixed signals and leave room for different interpretations, that may ultimately lead to cascading greenwashing, misleading results, and false successes. The new GHG Protocol Land Sector and Removals Guidance draft addresses this in part. With the GHG Protocol moving into revision periods, we identify gaps that present barriers to companies, or allow for interpretations that goes against the intentions of reporting GHG emissions related to an activity or organisation. The literature agrees that not rectifying these subtle-ties present counterproductive decision support for the green transition’s overall goal: to reduce global emissions.

People with severe mental illness (SMI) are often in poor physical health, resulting in higher mortality and reduced life expectancy compared to the general population. Although eating habits are one of the main predictors of physical health, few studies assess the nutritional status and eating behaviour of people with SMI. The aim of this study was to examine the nutritional status and risk of malnutrition in people with SMI and in need of intensive psychiatric treatment. The cross-sectional study included 65 inpatients and 67 outpatients with psychotic or depressive disorders from the Psychiatric Hospital of the University of Zurich. Patients’ assessments at admission included anthropometric measurements, such as weight and height, and interview data including severity of symptoms and functioning (SCL-K-9, PHQ-D, CGI, m-GAF), personal and medical data, nutrition risk screening tools (adapted NRS, MNA-SF) and laboratory values. The results showed that 32% of the inpatients (body mass index [BMI] = 25.3) and 34% of the outpatients (BMI = 27.9) were at risk of malnutrition, which was associated with higher levels of psychiatric symptoms and lower levels of functioning. These results indicate that a substantial proportion of psychiatric patients seem to be at risk of malnutrition, despite most being overweight, and hence they might benefit from nutritional support during their psychiatric treatment. Moreover, nutritional risk screening tools specifically developed for the mental healthcare setting are needed.

In the European Union (EU), cannabidiol products require pre-marketing authorisation under the novel food regulation. Currently, 19 CBD applications are under assessment at the European Food Safety Authority (EFSA). During the initial assessment of the application files, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) located several knowledge gaps in their 07 June 2022 statement on safety of cannabidiol as a novel food that need to be addressed before the evaluation of CBD can be concluded. Namely, the effect of CBD on the liver, gastrointestinal tract, endocrine system, nervous system, psychological function, and reproductive system needs to be clarified. Nevertheless, the available literature allows a benchmark dose (BMD)-response modelling of several bioassays, resulting in a BMD lower confidence limit (BMDL) of 20 mg/kg bw/day for liver toxicity in rats. Human data in healthy volunteers found increases in the liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in a study at 4.3 mg/kg bw/day, which was defined by EFSA NDA panel as a lowest observed adverse effect level (LOAEL). The EFSA NDA panel currently concluded that the safety of CBD as a novel food cannot be evaluated, leading to a so-called clock stop of the applications until the applicants provide the required data. Meanwhile, the authors suggest that CBD products still available as food supplements on the EU market despite the lack of authorisation must be considered as “unsafe”. Products exceeding a health-based guidance value of 10 mg/day must be considered as being “unfit for consumption” (Article 14(1) and (2) (b) of Regulation No 178/2002), while the ones in exceedance of the human LOAEL must be considered “injurious to health” (Article 14(1) and (2) (a) of Regulation No 178/2002).

This paper investigates whether currency risk is priced differently in the different sectors (industrial, financial, and basic materials) of equity markets in a sample of developed United States of America (USA) and developing economies (Brazil, India, Poland, and South Africa). The paper makes use of the following techniques: (i) Univariate Autoregressive Fractionally Integrated Moving Average and Exponential General Autoregressive Conditional Heteroskedastic (ARFIMA-EGARCH), (ii) the Markov-Switching method (MS), and (iii) the Canonical Vine Copulas (C-Vine) techniques. Using a sample of daily data made of the foreign exchange rate against the domestic currency and equity market sectors; our findings show that there is an asymmetry effect between equities markets and the foreign exchange rate: there is a heterogeneous, strong, and positive dependence between the two. Higher equities prices are associated with depreciation of local currencies, according to US dollar (USD) exchange rates. In addition, we find that the selected emerging economies are pricing a positive and considerable currency risk. The pricing of currency risk has a varied effect in both regimes representing the states of the economy. In fact, when currency risk pricing has a beneficial impact on certain sectors of the economy, investors predict better returns.

This research aimed to figure out the applications of HbA1c protein and HbA1 gene as the prognostic biomarkers for assessing the risks of different cancers among male T2D patients in Bangladesh considering their serological and oncoinformatic parameters. Depending on the concentrations of HbA1c (%) of the T2D patients (n=300), their individual FBS (mmol/L); THABF (mmol/L); creatinine (mg/dl); SC (mg/dl); STGs (mg/dl); HDLC (mg/dl); and LDLC (mg/dl) were estimated. The values of the patients were compared with the control (n=60) group as the serological analysis. Besides, HbA1 gene (encoding hBA1c protein) overexpression and promotor methylation responsible for BLCA, BRCA, CHOL, COAD, LUAD, LUSC, PAAD, and PRAD cancers in the male T2D patients were profiled as the oncoinformatic parameters based on the sample types; caner stages; racial footprints; gender; age; nodal metastasis; p53 methylations; pancreatitis; diabetes status; smoking behaviors; and overall/disease-free survivability. Finally, the ‘HbA1 gene strings’ responsible for genetic coexpression; endophytic vesicle regulation; antioxidant regulation; oxygen species metabolic regulation; and gene-mediated response to the reactive oxygen molecules were studied comprehensively. A strong correlation between BMI and FBS was observed in both the patients and the control (P<0.0001). Similarly, the values of FBS, THABF, and creatinine resulted in equal significance (P<0.0001) as compared to the HbA1c concentrations of all the T2D and control individuals. The SC, STGs, HDLC, and LDLC concentrations regulated ardently in both the control (P<0.0001), and patients group (P<0.0001), while HbA1c ranged from 3.8-5.8%, and 5.11-15.8% respectively. HbA1 gene is found downregulating with cancer progressed in most of the oncoinformatic parameters. According to the DA, CS, EI, CE, PC, NC, GF, H, and AT profiles; the HbA1 gene interacts with 8 other genes responsible for creating a protein cluster comprising- AHSP, HBA1, HBA2, HBB, HBD, HBE1, HBG2, RPS12, and RPS19 proteins for cancer formation. To recapitulate, HbA1c protein and HbA1 gene can be used as the prognostic serological and molecular biomarkers respectively for determining the risks of cancers among male chronic T2D patients.

Hepatitis is the eighth highest cause of mortality globally and second-highest in Pakistan. The purpose of this study was to determine frequency of Hepatitis B and C and related lifestyle and socio-demographic risk factors among adults. The data were collected though questionnaire from Hepatitis B and C patients from Mayo and Jinnah hospital Lahore. The data was analyzed using SPSS version 18. There were 5095 patients with Hepatitis B and C out of which 146 patients (67 males and 79 females) filled questionnaire. The frequency of hepatitis C was higher than hepatitis B. The significant risk factors associated with hepatitis B and C were education, marital status, family history, household income, and type of food consumed. Therefore, socio-demographic and lifestyle risk factors related interventions are needed to reduce frequency of Hepatitis B and C.

The interaction between oceanographic, meteorological, and hydrological factors can result in an extreme flooding scenario in the low-lying coastal area, called compound flooding (CF) events. For instance, rainfall and storm surge (or high river discharge) can be driven by the same meteorological, tropical or extra-tropical cyclones, resulting in a CF phenomenon. The trivariate distributional framework can significantly explain compound events' statistical behaviour reducing the associated high-impact flood risk. Resolving heterogenous dependency of the multidimensional CF events by incorporating traditional 3-D symmetric or fully nested Archimedean copula is quite complex. The main challenge is to preserve all lower-level dependencies. An approach based on decomposing the full multivariate density into simple local building blocks via conditional independence called vine or pair-copulas is a much more comprehensive way of approximating the trivariate flood dependence structure. In this study, a parametric vine copula of a drawable (D-vine) structure is introduced in the trivariate modelling of flooding events with 46 years of observations of the west Coast of Canada. This trivariate framework searches dependency by combining the joint impact of annual maximum 24-hr rainfall and the highest storm surge and river discharge observed within the time ±1 day of the highest rainfall event. The D-vine structures are constructed in three alternative ways by permutation of the conditioning variables. The most appropriate D-vine structure is selected using the fitness test statistics and estimating trivariate joint and conditional joint return periods. The investigation confirms that the D-vine copula can effectively define the compound phenomenon's dependency. The failure probability (FP) method is also adopted in assessing the trivariate hydrologic risk. It is observed that hydrologic events defined in the trivariate case produce higher FP than in the bivariate (or univariate) case. It is also concluded that hydrologic risk increases (i) with an increase in the service design life of the hydraulic facilities and (ii) with a decrease in return periods.

Socioeconomic conditions and social attitudes are known to represent epidemiological determinants. Credible knowledge on socioeconomic driving factors of the COVID-19 epidemic is still incomplete. Based on a linear random effects regression, a predictive model is derived to estimate COVID-19 incidence in German rural districts from local socioeconomic factors and popularity of political parties in terms of their share of vote. Thereby, time series provided by Germany's public health institute (Robert Koch Institute) of weekly notified 7-day incidences per 100,000 inhabitants per district from the outset of the epidemic in 2020 up to December 1, 2021, have been used to construct the dependent variable. Local socioeconomic conditions including share of votes, retrieved from the Federal Statistical Office of Germany, have been used as potential risk factors. Popularity of the right-wing party Alternative for Germany (AfD) bears a considerable risk of increasing COVID-19 incidence both in terms of predicting the maximum incidences during three epidemic periods (alternatively, cumulative incidences over the periods are used to quantify the dependent variable) and in a time-continuous sense. Thus, districts with high AfD popularity rank on top in the time-average regarding COVID-19 incidence. The impact of the popularity of the Free Democrats (FDP) is markedly intermittent in the course of time showing two pronounced peaks in incidence but also occasional drops. A moderate risk emanates from popularities of the Green Party (GRÜNE) and the Christian Democratic Union (CDU/CSU) compared to the other parties with lowest risk level. Socioeconomic parameters like \emph{per capita} income, proportions of protection seekers and social benefit claimants, and educational level have negligible impact. To the contrary, incidence significantly increases with population density. In order to effectively combat the COVID-19 epidemic, public health policymakers are well advised to account for social attitudes and behavioural patterns reflected in local popularities of political parties, which are conceived as proper surrogates for these attitudes. Whilst causal relations between social attitudes and the presence of parties remain obscure, the political landscape in terms of share of votes constitutes at least viable predictive "markers" relevant for public health policy making.

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