Among the array of structurally and toxicologically diverse mycotoxins, aflatoxins have attracted the most interest of scientific research due to their high toxicity and incidence in foods and feeds. Despite the undeniable progress made in various aspects related to aflatoxins, the ultimate goal consisting of reducing the associated public health risks worldwide is far from being reached due to multiplicity of social, political, economic, geographic, climatic, and development factors. However, a reasonable degree of health protection is attained in industrialized countries owing to their scientific, administrative, and financial capacities allowing them to use high-tech agricultural management systems. Less fortunate situation exists in equatorial and sub-equatorial developing countries mainly practicing traditional agriculture managed by smallholders for subsistence, and where the climate is suitable for mould growth and aflatoxin production. A situation that worsens by the climatic change being increasingly suitable for aflatoxigenic mold growth and toxin production. Accordingly, it is difficult to harmonize the regulatory standards of aflatoxins worldwide, which prevents agri-foods of developing countries from access to the market of industrialized countries. To tackle the multi-facetted aflatoxin problems, actions should be taken collectively by the international community involving scientific research, technological and social development, environment protection, awareness promotion, etc. International cooperation should foster technology transfer and exchange of pertinent technical information. This review presents the main historical discoveries leading to our present knowledge on aflatoxins and the challenges that should be addressed presently and in the future at various levels to ensure higher health protection for everybody. In short, it aims to elucidate where we come from and where we should go in terms of aflatoxin research/development.

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

Bonfire night is a worldwide phenomenon given to numerous annual celebrations characterised by bonfires and fireworks. Since Thailand has no national ambient air quality standards for metal particulates, it is important to investigate the impacts of particulate injections on elevations of air pollutants and ecological health impacts resulting from firework displays. In this investigation, Pb and Ba were considered potential firework tracers because their concentrations were significantly higher during the episode and lower than/comparable with minimum detection limits during other periods, indicating that their elevated concentrations were principally due to pyrotechnic displays. Pb/Ca, Pb/Al, Pb/Mg, and Pb/Cu can be used to pin-point emissions from firework displays. Air mass backward trajectories (72 h) from the Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) model indicated that areas east and north-east of the study site were the main sources for the air transportation. Although the combined risk associated with levels of Pb, Cr, Co, Ni, Zn, As, Cd, V, and Mn was far below the standards mentioned in international guidelines, the lifetime cancer risks associated with As and Cr levels exceeded US-EPA guidelines, and may expose inhabitants of surrounding areas of Bangkok to elevated cancer risk.

Complexity is a crucial metric for evaluating urban intersection scenarios. However, existing complexity evaluations are often derived indirectly from the driving risk of autonomous vehicles, leading to subjective and incomplete evaluations. Therefore, this study undertakes a comprehensive evaluation of intersection scenarios from a systems perspective by quantifying the number of vehicles and the characteristics of vehicle interactions within the intersection.Specifically, we propose an objective framework for assessing complexity. In this framework, the number of vehicles serves as the foundation for assessment, while three interaction characteristics—interaction density, interaction disorder, and interaction risk—are modeled as scaling factors of complexity. In particular, by combining logistic and hyperbolic tangent functions, we accurately capture the nonlinear effects of vehicle numbers and interaction characteristics on complexity.The experimental results demonstrate that the evaluation outcomes of the proposed method are highly correlated with the risk and efficiency performance of autonomous vehicles at intersections, thereby validating the method. Additionally, this method is utilized to guide the generation of highly complex urban intersection scenarios, achieving double the generation efficiency compared to the random sampling method.

It is critical to keep abreast of emerging dangers in the constantly changing field of cyber security. As 2024 approaches, numerous technological developments and trends are changing how businesses handle cyber security. This article explores the cutting edge of cyber security developments that are expected to rule in 2024. The field of cyber security is undergoing a revolution, from the adoption of Zero Trust Architecture (ZTA) as the new paradigm to the integration of AI and ML for real-time threat detection. Solutions for Extended Detection and Response (XDR) are becoming the mainstay for thorough threat detection and response in a variety of contexts, including networks, endpoints, and cloud environments. The use of biometric authentication techniques is growing in popularity because they provide better access control and identity verification. Concurrently, Deception Technologies are altering defensive tactics by using fictitious assets to trick and identify attackers at an early stage. Quantum-resistant cryptography, which aims to protect sensitive data from future quantum attacks, is on the horizon given the threat posed by quantum computing. Furthermore, the growing number of linked devices emphasizes how critical it is to strengthen IoT security protocols. Moreover, as long as companies are using cloud computing, they must make sure that strong cloud security protocols are in place. Simultaneously, the emergence of containerization technologies demands a targeted strategy for containerized environment security. Organizations must adopt these practices and strengthen their defenses against new threats as the cyber security landscape changes. Businesses may confidently and resiliently traverse the complex cybersecurity landscape of 2024 by remaining aware and implementing proactive security measures.

Background/Objectives: Vitamin D’s effect on risk health outcomes is often evaluated using prospective cohort studies. Risk ratios (RRs; e.g., hazard ratios or odds ratios) are determined for incidence for participants with baseline serum 25-hydroxyvitamin D [25(OH)D] concentrations below or above specified values. Serum 25(OH)D concentrations vary over time, thereby diluting the effect of 25(OH)D for long follow-up periods. Inverse relationships between RR and follow-up period have been reported for all-cause mortality rate and cancer incidence rates. Here I evaluate the effect for neurological outcomes. Methods: I analyzed how follow-up period affected results from 10 cohort studies of all-cause dementia, 6 studies of Alzheimer’s disease, and 9 for cognitive impairment with respect to vitamin D deficiency. Results: For all-cause dementia, Alzheimer’s disease, and cognitive impairment, respectively, the linear regression fits are RR = 2.9 – 0.14 × years, r = 0.73, p = 0.02; RR = 2.9 – 0.14 × years, r = 0.69, p = 0.13; and RR = 1.8 – 0.066 × years, r = 0.72, p = 0.03. The regression fit to RR for the shortest follow-up period for each outcome is considered the best estimate of vitamin D deficiency’s effect on risk. Those values are approximately twice that found by averaging all RRs without considering the effect of follow-up period. Conclusions: Vitamin D’s effect on risk of neurological conditions should be determined with relatively short follow-up periods after repeated 25(OH)D measurements as warranted during follow-up.

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

Limited knowledge is available about the association between autistic spectrum disorder (ASD) and precocious puberty. Our study examined the association between the two medical conditions, and the effect modification by sex and neuropsychiatric comorbidities in a nationwide population. To compare the risk of precocious puberty between ASD and non-ASD cases, we conducted Cox regression analysis, using ASD as exposure and time-to-precocious puberty as outcome. We adjusted for sex, attention-deficit/hyperactivity disorder (ADHD), tics disorder, obsessive–compulsive disorder (OCD), anxiety disorder, intellectual disability, and epilepsy. We performed a moderation analysis to examine the potential moderating effects by sex or comorbidities. Patients with ASD were prone to have precocious puberty, with an adjusted hazard ratio (aHR) of 1.80 (95% CI: 1.61-2.01). For the effect modification, sex, specifically females, moderated the association between ASD and precocious puberty, with relative excess risk due to interaction (RERI) 7.35 (95% CI 4.90-9.80). No significant effect modification was found for any of the comorbidities within the scope of additive effect modification. We found that patients with ASD were prone to precocious puberty, regardless of sex or comorbid neuropsychiatric disorders. Girls with ASD are at particularly higher risk to develop precocious puberty.

.Bacground: Sepsis remains a major health challenge worldwide, characterized by a dysre-gulated host response to infection, leading to high mortality and morbidity in intensive care units (ICUs). The Fibrosis 4 (FIB-4) index, originally developed to assess liver fibrosis in hepatitis C patients, has recently been explored for its potential prognostic value in sepsis patients. Method: This study retrospectively analyzed 309 sepsis patients admitted to the Internal Me-dicine and Anaesthesia ICUs between December 12, 2021, and December 15, 2023, to inves-tigate the relationship between FIB-4 levels, Acute Physiology and Chronic Health Evaluation (APACHE), and Sequential Organ Failure Assessment (SOFA) and clinical outcomes. Results: The study found that higher FIB-4 measurements were statistically significantly asso-ciated with increased 28-day mortality, with a cut-off value of 4.9 providing a sensitivity of 54.92% and specificity of 74.25%. Logistic regression analysis indicated that elevated Conclusion:FIB-4 levels were a significant predictor of early mortality, suggesting that the FIB-4 index could serve as a valuable prognostic tool in assessing the severity and prognosis of sepsis patients.

Traditional path planning algorithms have drawbacks in unmanned vehicle path planning, such as low efficiency, unsuitability for dynamic environments, and high computational complexity. To address these issues, this paper proposes a dynamic path planning method for unmanned vehicles that combines the A* algorithm with an improved Dynamic Window Approach (DWA). Firstly, a collision risk function is incorporated into the DWA algorithm to evaluate scores based on the braking distance corresponding to the current vehicle speed and the distance to obstacles, determining whether timely braking or obstacle avoidance is feasible. The earlier the braking or obstacle avoidance, the higher the score, thereby enhancing the evaluation algorithm of the DWA. Secondly, the key points extracted by the A* algorithm are used as temporary target points for the DWA algorithm, reducing the eight search directions to five. Finally, the key points of the A* algorithm’s path are set as the temporary end points for the DWA algorithm, integrating the two algorithms to plan a smoother curved path that can avoid unknown and dynamic obstacles. Simulation data demonstrates that compared to traditional artificial potential field methods, RRT, and Dijkstra’s algorithm, the new fusion algorithm reduces time by 11.71 seconds, a decrease of 6.9%, and shortens path length by 3.093 meters, a reduction of 4.16%, while increasing average linear velocity by 2.9%. The proposed algorithm ensures smoother paths while also making paths more rational and efficient

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

Background: Although lower extremity revascularization is commonly performed in hemodialysis patients, poor prognosis remains a major problem. Protein-energy wasting is reportedly associated with chronic inflammation and advanced atherosclerosis in hemodialysis patients. We investigated the association between the geriatric nutritional risk index (GNRI) as a surrogate marker of protein-energy wasting, C-reactive protein (CRP), and their joint roles in the prediction of amputation and/or mortality. Methods: We enrolled 800 patients successfully underwent lower extremity revascularization. Patients were divided into low, middle and high tertile (T1, T2 and T3) according to GNRI and CRP levels, respectively. Results: Amputation-free survival rates for 8 years were 47.0%, 56.9%, and 69.5% in T1, T2, and T3 of the GNRI, and 65.8%, 58.7%, and 33.2% for T1, T2, and T3 of CRP, respectively (p<0.0001 for both). Declined GNRI [adjusted hazard ratio (aHR) 1.78, 95% confidence interval (CI) 1.24-2.59, p=0.0016 for T1 vs. T3] and elevated CRP (aHR 1.86, 95%CI 1.30-2.70, p=0.0007 for T3 vs. T1) were independent predictors of amputation and/or mortality. In the combined setting of both variables, the risk was 3.77-fold higher (95% CI 1.97-7.69, p<0.0001) in the T1 of GNRI with T3 of CRP than in the T3 of GNRI with T1 of CRP. Conclusions: Patients with pre-procedural decreased GNRI and elevated CRP levels frequently experienced amputation and/or mortality, and a combination of both variables could more accurately stratify the risk.

Objectives: To evaluate the relationship between the type of conization, the volume and dimensions of the cone, with the persistence/recurrence of CIN 2-3, presence of affected margins and post-cone HR-HPV positivity. Methods: 227 women treated with LLETZ and histologically confirmed CIN2-3 were evaluated between 1996 and 2006 and followed up until June 2016. Age, type of resection according to IFCPC 2011, volume, cone dimensions, margins were studied. of resection, post-cone high-risk human papillomavirus (HR-HPV) status and viral load. Determinants of HR-HPV positivity were estimated using unconditional logistic regression and time to recurrence was assessed using Kaplan-Meier curves. Results: Persistent/recurrent CIN2-3 was found in 12 cases (5.2%), type 1 conization was performed in 81 patients, with 5 recurrences (6.1%), type 2 in 101 patients, with 6 recurrences (5 .9%) and type 3 resection in 45 women, with 1 recurrence (2.2%). Volume and dimensions were not associated with recurrence. The Log-Rank Test did not show a significant difference between the 3 treatments (p= 0.18). The free margins in type 1 were 37%, in type 2 resection 61% and in type 3 71% (p=0.001). Resection type 1 had 15% HR-HPV post positive cone, type 2 reached 16% and type 3 had 9%, this difference being non-significant (p=0.58). The incidence of recurrence at 36 months in type 1 resection was 0.08%, in type 2 treatment it was 0.04% and in type 3 resection it was 0.0%. Conclusions : Type 3 resection had a higher proportion of free margins and lower post-cone HR-HPV positivity, with a lower incidence of persistence/recurrence.

Introduction: Desmoid tumor (DT) is a rare benign neoplasm rising from muscle aponeurosis, having been associated mostly with trauma or pregnancy. DT has an infiltrative and locally aggressive growth pattern and usually does not metastasize. However, it has a high recurrence and complication rate. When they occur in pregnancy, are all pregnancies and deliveries taken as individual case for optimal management by the physicians and midwifes, who need to be cautious in finding the optimal delivery mode for patients, which depends on tumor size, location, behavior and past history. Study Objectives: We present a case report of a large desmoid tumor of the anterior abdominal wall in a 29-year-old woman in pregnancy, presenting a delivery problem, which resolved in surgical management. Moreover, we are bringing a systematic review of the literature to provide an overview on pathomechanism, symptoms, diagnostics and treatment management of the pregnant women affected by DT. Results: The authors report a case of pregnant women who underwent systemic oncological treatment for abdominal wall desmoid tumor and have been pregnant afterwards. The observational conservative management was chosen with an elective cesarean section at the 38+4 pregnancy week with uncomplicated postpartum follow-up. Conclusion: Pregnancy-associated desmoid tumors are very rare and optimal management of this tumor is not well established, despite some guidelines for non-pregnant patients. The authors reviewed the literature focusing on the actual modern management of desmoid tumors at all, including patients during the pregnancy, as well.

Background: This study aimed to estimate the prevalence of sexualized drug use (SDU) in gay, bisexual, and other men who have sex with men living with HIV (HIV+GBMSM) in Madrid during 2019/2020 and compare it with data from 2016/2017. Methods: We analysed the frequency of SDU in a sample of HIV+GBMSM attending HIV clinics, who participated in an anonymous online survey regarding sexual behaviour and recreational drug use. The association between SDU, sexual risk behaviours, and STIs was evaluated. The methodology employed in the present study(U-SEX-2) in 2019/2020 was consistent with that of a previous study(U-SEX-1) in 2016/2017. Results: The study included 424 HIV+GBMSM, with a mean age of 40(10.43) years. Overall, 94% (396) reported being sexually active. Additionally, 33% (140) had been diagnosed with an STI within the previous year. Moreover, 54% (229) had used drugs in the last year, 25% (107) engaged in SDU, and 15% (17) reported engagement in slamsex. After adjusting for confounding factors, SDU was associated with STIs, fisting, unprotected anal intercourse, and having &gt; 24 sexual partners in the last year. According to the DUDIT test scores, 76% (81) probably had problematic drug use (≥6 points), and 5% (8) probable drug dependence (≥25 points). When comparing the U-SEX-1(2016/2017) data with the U-SEX-2(2019/2020) data, no significant differences were found in the proportion of participants practicing SDU or slamsex. Conclusion: The prevalence of SDU among HIV+GBMSM has remained high in recent years and without significant changes. We observed a clear association between SDU, high-risk sexual behaviors, STIs, and the risk of drug related problems.

Since the 20th century, Japan has experienced a period of very rapid urbanization. Cities have experienced substantial densification and expansion, resulting in gradually elevated flood risk. Urban flooding has also occurred in most large cities in Japan, particularly in Tokyo. In response to this growing problem, much effort and resources have been spent on research and development aimed at understanding, simulating, and managing urban flood risk in Japan. The objective of this review is to summarize, discuss and share key outputs from some of the main research directions in this field, significant parts of which have been uniquely developed in Japan and only published in Japanese. After a general introduction to urban runoff modelling, in the next section, key historical works in Japan are summarized, followed by a description of the situation in Japan with respect to observations of precipitation and water level. Then, the storage function model approach is reviewed, including an extension to urban basins, as well as recent experiments with AI-based emulation in Japanese basins. Subsequently, we review the prospects of detailed hydrodynamic modelling involving high-resolution, vector-based Geographical Information System (GIS) data for the optimal description of the urban environment with applications in Tokyo. We conclude the paper with some future prospects related to urban flood risk modelling and assessment in Japan.

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

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

Disordered eating is a serious health concern globally. The etiology is complex and multidimensional and differs somewhat for each specific eating disorder. Several risk factors have been identified which include psychological, genetic, biochemical, environmental, and sociocultural factors. Poor body image, low self-esteem, teasing, family dynamics, and exposure to media images have also been identified as risk factors. While it is enticing to consider a single behavioral risk factor, doing so fails to consider the documented environmental, social, psychological, biological, and cultural factors that contribute to the development of an eating disorder in a multidimensional and complex integration that is undoubtedly unique to everyone. Focusing only on any one factor without taking the complex etiology into account is remiss. For example, it has been suggested that the use of dietary supplements may lead to eating disorders, despite a lack of evidence to support this conjecture. Therefore, the purpose of this review is to examine the evidence-based risk factors for eating disorders and discuss why connecting dietary supplements to eating disorder etiology is not supported by the scientific literature and may interfere with treatment. Established, effective prevention and treatment approaches for eating disorders should be the focus of public health initiatives in this domain.

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

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

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

The frequent incidents of oil spills and other forms of pollution arising from crude oil exploration and exploitation (OEE) in the Niger Delta have caused several investigations on Polycyclic Aromatic Hydrocarbons (PAHs) pollution. This study aimed at developing a comprehensive report on PAH pollution and its human health risks recorded in the Niger Delta. Studies were extracted from Google Scholar, PubMed, and ResearchGate using a defined selection criterion. The quality of each study was assessed using the Newcastle – Ottawa Scale. Thirty-eight studies were selected with the majority reporting on PAH pollution in aquatic environments. Across all the selected studies, the total number of PAHs recorded ranged from 7 to 28 PAH congeners. Also, PAH potential sources reported in the studies were of pyrogenic and petrogenic sources. PAH concentrations recorded in water, sediment, aquatic organisms (fish and shrimp), soil, dust, and crop samples ranged from below detection limit (BDL) to 450 ± 117.9 mg/L, BDL to 1821.5 mg/kg, 0.005 to 1.098 mg/kg, ND to 4154 ± 3461 mg/kg, 165.1 to 1012 mg/kg, and 0.020 to 3.37 mg/kg, respectively. Majority of the selected studies reported PAH levels which were higher than the permissible limits. Incremental Lifetime Cancer Risk (ILCR) assessment of PAHs in samples ranged from low to high via ingestion and dermal routes of exposure to humans. It is recommended that the Federal Government of Nigeria promotes environmentally friendly operations of OEE. Future studies should focus on PAH pollution in farmlands, ambient air and the associated human and ecological health risks.

Cold brew coffee is a new trend in coffee industry. This paper presents pilot studies into several aspect of this beverage. Using an online survey, the current practices of cold brew coffee preparation were investigated identifying a rather large variability with a preference for extraction of medium roasted Arabica coffee using 50-100 g/l at 8°C for about 1 day. Sensory testing using ranking and triangle tests showed that cold brew may be preferred over iced coffee (cooled down hot extracted coffee). Extraction experiments at different conditions combined with nuclear magnetic resonance (NMR) analysis showed that the usual extraction time may be longer than necessary as most compounds are extracted within only a few hours, while increasing turbulence (e.g. using ultrasonication) and temperature may additional increase the speed of extraction. NMR analysis also revealed a possible chemical differentiation between cold brew and hot brew using multivariate data analysis. Decreased extraction time and reduced storage times could be beneficial for cold brew product quality as microbiological analysis of commercial samples detected samples with spoilage organisms and contamination with Bacillus cereus.

Radiological risk affect the quality of the environment in buildings since population and workers can be potentially exposed to high level of dose. Radon gas emanated from both subsoil and building materials represents the most important source of radiation exposure for people. This study investigates the sustainability concept of a small rural village of Ischia Island, named Ciglio, in relation to the radiological risk. Radon activity concentration was measured in typical green tuff dwellings and in water samples collected from a local spring using E-Perm devices. Moreover, for green-tuff as building material, the radon emanation coefficient was calculated by gamma spectroscopy. The results highlight the importance to perform environmental radon monitoring and to investigate the radon content of building materials, especially in geographical areas characterized by traditional use of typical stones for constructions. In conclusion, the sustainability development of rural buildings is possible if the radiological risk for inhabitants and workers was assessed.

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

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

Diet influences, and is influenced by, a wide range of socioeconomic, cultural, geographic, and genetic variables. Here we survey a matrix of such interactions as well as their connection to a variety of health outcomes, in a cohort of 689 diverse adults employed at Emory University and enrolled in the Center for Health Discovery and Well-Being (CHDWB) study. Principal component analysis (PCA) of the Block Food Frequency Questionnaire revealed seven PC cumulatively explaining 25.8% and each individually at least 2% of the proportional consumption of 110 food items. PC1 is strongly correlated with the Healthy Eating Index-2015 measure, and accordingly healthier scores associate with multiple measures of physical and mental health. It, as well as PC2 (likely a measure of food expense) and PC3 (carbohydrate versus protein consumption) show significant geographic structure across the Atlanta metropolitan area, correlating with race and ethnicity, income level, age and sex. Notably, a polygenic score for body mass index (BMI) consisting of 281 SNPs explains 2.8% of the variance in PC5, which is as strong as its association with BMI itself. PC5 appears to differentiate participants with respect to conscious eating behavior related to the choice of diet or comfort foods. Our analysis adds to the growing literature on factor analysis of socio-demographic influences on nutrition and health.

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

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

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

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

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

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

Traditional flood hazard analyses often rely on univariate probability distributions; however, in many coastal catchments, flooding is the result of complex hydrodynamic interactions between multiple drivers. For example, synoptic meteorological conditions can produce considerable rainfall-runoff, while also generating wind-driven elevated sea levels. When these drivers interact in space and time, they can exacerbate flood impacts; this phenomenon is known as compound flooding. In this paper, we build a Bayesian Network based on Gaussian copulas to generate the equivalent of 500 years of daily stochastic boundary conditions for a coastal watershed in Southeast Texas. In doing so, we overcome many of the limitations of conventional univariate approaches and are able to probabilistically represent compound floods caused by riverine and coastal interactions. We calculate the resulting water levels using a 1D steady-state hydraulic model and find that flood stages in the catchment are strongly affected by backwater effects from tributary inflows and downstream water levels. By comparing with a bathtub modeling approach, we show that simplifying the multivariate dependence between flood drivers can lead to an underestimation of flood impacts, highlighting that accounting for multivariate dependence is critical for the accurate representation of flood risk in coastal catchments prone to compound events.

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

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

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

A copula is a useful tool for constructing bivariate and/or multivariate distributions. In this article, we consider a new modified class of (Farlie-Gumbel-Morgenstern) FGM bivariate copula for constructing several dierent bivariate Kumaraswamy type copulas and discuss their structural properties, including dependence structures. It is established that construction of bivariate distributions by this method allows for greater flexibility in the values of Spearman's correlation coefficient rho,  and Kendall's tau . For illustrative purposes, one representative data set is utilized to exhibit the applicability of these proposed bivariate copula models.

Objective: The primary objective of this study was to develop a logistic regression model to predict post-operative in-hospital mortality rates for patients undergoing emergency cardiac surgeries, with the aim of improving predictive accuracy over traditional risk assessment tools and enhancing patient outcomes and clinical decision-making. Methods: Data were collected from 4,855 patients who underwent emergency cardiac surgeries at a tertiary hospital between 2008 and 2017. The analysis incorporated demographic, anthropomet- ric, and clinical factors, including the ASA classification, emergency status, and various preoperative laboratory values. A logistic regression model was developed, and the Elixhauser Comorbidity Index was calculated using standard ICD-10 codes for its comprehensive assessment of comorbidities. Model performance was evaluated using metrics such as AUROC, AUPRC, accuracy, precision, recall, and F1 score. Results: The logistic regression model demonstrated strong predictive performance, with an AUROC of 0.939 and an AUPRC of 0.350. Key pre-operative factors identified included emergency operation status, ASA classification, and preoperative prothrombin time. The model significantly outperformed the traditional ASA classification system, which showed an AUROC of 0.524 and an AUPRC of 0.010. These findings suggest a substantial improvement in predicting post-operative mortality. Conclusion: The logistic regression model significantly improves the prediction of post-operative mortality in emergency cardiac surgeries compared to the ASA classification system. These findings highlight the potential of incorporating comprehensive pre-operative factors into predictive models to enhance clinical decision-making and patient outcomes. Implementing such models in routine clinical practice could lead to more accurate risk assessments, better resource allocation, and improved patient care.

(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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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

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.

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 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.

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.

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.

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.

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.

Food authorities aim to safeguard our food. This requires sensitive analyses to guarantee detection of both banned and regulated substances at low concentrations. At the same time, broad screening methods are needed to identify new emerging risks. For this purpose effect-based bioassays combined with mass spectrometric analyses offer an advantage. During the regular monitoring of dioxins in agricultural products, a discrepancy was observed between the results of the DR CALUX (Dioxin-Responsive Chemical Activated Luciferase gene Expression) bioassay and the confirmatory gas chromatographic high resolution mass spectrometric (GC-HRMS) analysis in egg and broiler fat samples. The response in the bioassay was high, suggesting a clear exceedance of the maximum limits of dioxins in these samples, yet regulated dioxins or dl-PCBs were not detected by GC/HRMS analysis . Ultimately, a broad screening analysis using GC-HRMS resulted in the identification of 2,3,7,8-tetrabromo-dibenzofuran (2,3,7,8-TBDF) in both egg and broiler fat. To investigate the potential; source of this brominated furan contaminant, different samples were analysed: bedding material, poultry feed, feed additives (choline chloride and L-lysine) and seaweed. The poultry feed and feed additives all contained 2,3,7,8-TBDF. Using a feed to food converter, it became clear that the poultry feed was probably the source of 2,3,7,8-TBDF in broilers and eggs through a feed additive like L-lysine or choline chloride. This study underlines the importance of using a combination of effect based screening assays with sensitive analytical methods to detect potential new and emerging risks.

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.

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.

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.

(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.

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.

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.

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.

To assess the presence of organochlorine pollutants (OCP) in Alaskan sub-Arctic latitudes, we analyzed ice core and meltwater samples from Jarvis Glacier, a polythermal glacier in Interior Alaska. Jarvis Glacier is receding as atmospheric warming continues throughout the region, increasing opportunity for OCP transport both englacially and into the proglacial watershed. Across all meltwater and ice core samples we identify the pesticides DDT, DDE and DDD, α- HCH and ϒ-HCH. OCP concentrations in ice core samples were highest at the 7-14 m depth (0.51 ng/L of DDT) and decreased gradually approaching the bedrock at 79m. Meltwater concentrations from the proglacial creek slightly exceeded concentrations found in the ice core, potentially indicating aggregate OCP glacial loss, with peak OCP concentration (1.12 ng/L of DDD) taken in July and potentially associated to peak melt. Ongoing use of DDT to fight Malaria in Asia, and the extended atmospheric range of HCH may account for concentrations in near-surface ice, correlating with use and atmospheric transport. The opportunity for biota bioaccumulation of OCPs, or human uptake of OCPs from glacial meltwater, may increase as glacial melt continues.

This paper examines cognitive biases which affect the ability of decision makers to make rational decisions in an organizational context. The motivation for this analysis begins with the observation of catastrophic accidents caused by human error but in an organizational context. This paper expands on the concept of cognitive bias to define organizational biases which are the factors that affect decisions in an organizational context. The paper distinguishes between organizational biases, which are the focus of this paper, and individual biases, which are biases experienced by individuals but may have organizational consequences. The purpose of this paper is to identify methods to mitigate the risks of organizational accidents, accidents which involve many people operating at different levels of an organization. The methodology is to identify those decisions that would address the specific organizational biases. The focus of this paper is the decisions for mitigating the risks associated with decisions in an organizational context. Results are shown for seven organizational biases, six specific case studies, and four decision options. This paper concludes that organizational biases are intrinsically different from individual biases and that these differences lead to different decision options from those that mitigate individual biases; however, they may exist concurrently.

The development of small scale hydroelectric power plants in Norway is determined by natural conditions, policies, attitudes and property rights. The owner of the river is the central decision maker. It is he who decides whether he will develop the power plant himself, Whether he wants to enter into a contract with an external investor and let him develop the power plant, whether he will sell his property rights or postpone the decisions. All available choices will involve risk. In order for him to make the best choice he must find the certainty equivalent to each of the choices and choose the one with the highest certainty equivalent. This is the first time the utility theory of John von Neumann and Oskar Morgenstern has been applied to decision makers in the hydro power industry in Norway.

Vaccination against HPV significantly reduced the incidence of HPV-related le-sions worldwide. Considering the increasingly younger age of patients in the gynaecological office and the resulting earlier sexual initiation and potentially contact with the HPV virus, doctors need to have tools to verify the diagnosis. Nowadays, women plan motherhood later, so it is necessary to consider whether sexual treatment in the form of, among others, LEEP-conization may increase the risk of premature birth or difficulty dilating the cervix during labour.For this reason, to avoid overtreatment of LSIL changes, methylation testing may be considered. In patients with histopathologically confirmed HSIL during biopsy and ultimately a lower diagnosis - i.e., LSIL or no signs of atypia - methylation turned out to be a useful tool. We performed Pap-smear, HPV genotyping, punch biopsy, LEEP-conization (if needed) and methylation test in 108 women admitted to the District Public Hospital in Poland. Women with a negative methylation test result were significantly more likely to be ultimately diagnosed with LSIL (p=0.013). This means that in 85.7% of patients with HSIL, major cervical surgery could have been avoided if methylation was negative. Methylation testing, as well as dual-staining and diagnostics detecting mRNA transcripts of highly oncogenic types of HPV, might be used in future in the diagnosis of pre-cancerous conditions, mainly of the cervix, and in HPV-dependent cervical cancer screening. The methylation test may also be used in the diagnosis and identification of lesions within the cervical canal, including those located deep within the frontal crypts, not visible even during a professional colposcopic evaluation of the cervix, as well as within the crypts of the palatine tonsils - in diagnostics of head and neck diseases.

Background. National surveys reported on variable prevalence of chronic kidney disease (CKD) due to differences in characteristics of population, design, equations used to estimate glomerular filtration rate (eGFR) and definitions. The EH-UH 2 survey is the first study evaluating CKD prevalence, characteristics and awareness in Croatia. Methods. This was a cross-sectional nationwide observational study designed to assess the prevalence and cardio-kidney-metabolic risk factors in Croatia which included 1765 randomly selected subjects. We estimated the prevalence of CKD by means of albumin-to-creatinine ratio (ACR) and eGFR (CKD EPI equation). Comorbidities, anthropometric and social factors related to the prevalence of CKD were analyzed, and CV risk profile was evaluated. Results. The weighted prevalence of CKD (any stage), CKD stage ≥ G3A A2, and CKD defined only as eGFR < 60 ml/min/1.73 m2 were estimated at 17.1%, 9.8% and 7.9%, respectively. The prevalence was higher in men than in women (11.8% vs. 7.9%; p 30 mg/g was 15.1%. Older age, male gender, diabetes, ePWV, and uric acid were independently associated with CKD prevalence. The awareness of CKD of 9.5%. Unaware were older with lower income, less educated, having more frequently diabetes, hypertension (less frequently controlled) and milder renal impairment. Conclusion. In Croatia, the estimated prevalence of CKD is high, being more frequently presented in men than in women. CKD patients have unfavorable CV risk profile. The awareness of CKD is very low reflecting poor health literacy in general population but also in health care workers.

Violence against healthcare workers (HCWs) is a widespread, underreported and inadequately prevented problem. Only a few companies have efficient systems for assessing the extent of the phenomenon. In 2005, the health surveillance service of a public health company introduced a system that monitored violence experienced by HCWs by means of three items from the Violent Incident Form (VIF), integrated with departmental in-depth analyses using the participatory ergonomics group technique. In 2005, the annual rate of physical assaults was 8.2%, that of threats 12.0%, while the harassment rate was 19.6%. Over the past twenty years of observation (2005-2024), the percentage of workers who reported experiencing a physical attack in the previous year at their periodic medical examination, has fluctuated between 5.8% and 11.1%, except for the years 2020 and 2021 when, during the COVID-19 pandemic, the rate was 3.9% and 3.2%, respectively. During the same pandemic period, the annual threat rate that ranged from 9.4% to 20.1%, dropped to 7.7%, while the prevalence of harassment, that was between 13.5 and 19.6, fell to 7.2%. HCWs believe that (i) limiting visitor access (ii) a better balance of the demand for services and (iii) a better attitude towards HCWs were the causes of the reduced rate of violence during the pandemic. Recording the violence experienced during health surveillance is an economical, reliable and sustainable risk assessment method.

A contemporary technique for calculating seismic risk is earthquake nowcasting (EN), which analyzes the progression of the earthquake (EQ) cycle in fault systems. 'Natural time' is a novel idea of time that serves as the foundation for EN assessment. The earthquake potential score (EPS), which has been discovered to have useful uses regionally and worldwide, is a unique tool EN uses to predict seismic risk. For the estimation of the EPS for the occurrences with the highest magnitude among these applications, we have since 2021 concentrated on Greece territory, applying sophisticated Artificial Intelligence (AI) algorithms, both wise (semi)supervised and unsupervised models, along with a customized dynamic sliding window technique that performs as a stochastic filter able to fine-tune the geo seismic occurrences. Long short-term memory (LSTM) neural networks, random forests, and clustering (geospatial) models are three machine learning techniques that are particularly good at finding patterns in vast databases and may be used to enhance earthquake prediction performance. In this study, we attempt to forecast whether practical Machine-learning and AI/Game-theoretic-based approaches can help predict big earthquakes and the normal future seismic cycle for 6-12 months. Specifically, we focus on answering two questions for a given region: (1) Is there a chance that a significant earthquake—say, one with a magnitude of M ≥ 6.0 will happen in the upcoming year? (2) What is the largest earthquake magnitude predicted in the upcoming year, and with which exact geographic coordinates (GCS)? Our results are quite promising and project a high precision accuracy score (≥ 98%) for seismic nowcasting in terms of four predictive parameters: the approximate (a) latitude, (b) longitude, (c) focal depth, and (d) magnitude of the phenomena.

This review paper focuses on the joint toxicity and interaction of carbon-based nanomaterials (CNMs) with co-existing pollutants in aquatic environments. It explores the potential harmful effects of chemical mixtures on living organisms, emphasizing the importance of scientific mod-eling to predict mixed toxic effects. The study involved a systematic literature review to gather information on the joint toxicity and interaction between CNMs and various co-contaminants in aquatic settings. A total of 53 publications were chosen and analyzed, categorizing the studies based on the tested CNMs, types of co-contaminants, and the used species. Common test models included fish and microalgae, with zebrafish being the most studied species. The review under-scores the necessity of conducting mixture toxicity testing to assess whether the combined effects of CNMs and co-existing pollutants are additive, synergistic, or antagonistic. The development of in silico models based on the solid foundation of research data represents the best opportunity for joint toxicity prediction, eliminating the need in a great quantity of experimental studies.

This study examines the balancing between urban transportation security and supply chain efficiency amid global disruptions like the COVID-19 pandemic, attacks on maritime lanes, and geopolitical conflicts. The authors combine bibliometric network analysis and natural language processing (NLP) to review scholarly literature from 2017 to 2023. This approach identifies and visualizes evolving thematic trends. Findings reveal a shift towards integrating advanced technologies such as blockchain, AI, and IoT to enhance security without compromising efficiency. This study highlights the significance of integrating urban planning principles and sustainable practices to enhance transportation security and supply chain efficiency within urban environments. Actionable insights for policymakers and supply chain managers emphasize the adoption of integrated, technology-driven security solutions to foster resilient and sustainable supply chains. This research contributes to academic discourse by refining the understanding of evolving priorities in transportation security and supply chain management, offering both theoretical and practical implications for secure and efficient global supply chains.

The problem of energy poverty, when energy becomes unaffordable for some population group, is not only a problem for developing countries, but this phenomenon is appearing more and more often in European countries as well. In Europe, it is estimated that 50 to 125 million people are at risk of energy poverty. We hear more and more about energy poverty in connection with the current energy crisis and rising energy prices, but also as a result of insufficient use of renewable energy sources. Due to rising energy prices, we are increasingly hearing about deepening energy poverty in Slovakia as well. The aim of the contribution is to examine the development of energy poverty in Slovakia compared to other EU countries. The situation is studied from the view of the number of days of heating and cooling, the percentage of the population that cannot maintain adequate heat at home, the percentage of the population that has a lack of heat and the percentage of residents without enough heat. During the research, we used distribution analysis, trend analysis, analysis of variance and one-way analysis. The main results show that HDD index recorded decrease, CDD index recorded increase, and Energy poverty is most obvious in low-income group of inhabitants, having shortage of heat, when RES use contribute to mitigation of energy poverty. Solving the unfavorable situation with energy poverty is possible by increasing the share of Renewable energy sources in the gross final energy consumption for heating and cooling, primarily in residential buildings. The results provide information for policy makers in area of economic, social and environmental decision-making.

Debates on climate change challenges around the world are moving in favour of nature-based solutions (NBS) as potential mitigation and adaptation options. Mangroves and associated blue carbon ecosystems are nature-based solutions against sea level rise and other coastal hazards. As such, protecting the existing mangrove forests and restoration of the degraded areas is integral in this aspect. However, conventional mangrove restoration approaches in high-energy areas result in poor performance due to the removal of seedlings by waves. Here, we assessed the efficacy of using modified Riley Encasement Methods in the restoration of eroding intertidal areas of Gazi Bay, Kenya. Vegetation and soil baseline data were collected in 49 square plots of 100m2; established along belt transects perpendicular to the waterline. The following mangrove vegetation data was collected; species composition, tree height (m), and stem diameter (cm); from which the importance value index (IV), basal area and standing density (stems/ha) were derived. Sediment cores were made in the center of each square plot for carbon and grain size analysis. Mangrove (Rhizophora mucronata) planting adopted a randomized complete block design (RCBD) in which the planting area was divided into three blocks (A, B, C). Within each block, treatments (bamboo and different-sized PVC pipes) were randomly assigned locations. Results show that seedlings grown within PVC encasements had high survival and growth rates, surpassing bamboo and control groups. This implies that PVC pipes offer better protection from external factors. These findings are critical in highlighting potential enhancements for the effectiveness of PVC pipes in mangrove restoration. They also reinforce on the need to consider the incorporation of PVC encasements as an alternative mangrove restoration technique in high-energy locations.

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

Abstract: This is a retrospective study of patients admitted to Jackson Hospital, Montgomery, Alabama with a diagnosis of COVID-19 from January 1, 2021, to February 15, 2022. The independent variable used in the models were patient sex, age, race, BMI category, daily D-dimer categories, categories of anticoagulation doses (Enoxaparin 40 mg VS. Enoxaparin 80 mg VS Enoxaparin 1mg/kg or equivalent), bleeding episodes, and vaccination status. The three different categories of anticoagulation doses were considered for the purpose of the study. Results: The study reviewed a total of one hundred (100) hospitalized patients. Intermediate-dose anticoagulation was found to be the optimal dose as only fourteen percent (14%) patients died compared to a thirty-six percent (36%) and fifty percent (57%) death rate among those treated with low-dose and high-dose anticoagulation, respectively. The multivariate linear regression model predicting patient oxygen requirements revealed D-Dimer and bleeding status to be statistically significant predictors with a p value of <0.01. For the patients who had a D-dimer value ≥ 2 µg/mL, the oxygenation requirement was predicted to be 31 L higher than those with a D-dimer <2 µg/mL (99% CI; p<0.01). When mean D-dimer and corresponding oxygen requirements were calculated per hospitalization days category, the D-dimer levels and oxygen requirements were noted to follow the same trends indicating both values tended to increase and decrease simultaneously. Conclusion: The study concludes daily D-dimer trends can predict COVID-19 patient survival or daily oxygen requirements indicating D-dimer can be the miracle molecule for COVID-19 prognosis.

A critical aspect of coronary heart disease (CHD) care and secondary prevention is ensuring patients have access to evidence-based information. The purpose of this review is to summarise the guiding principles, content, context and timing of information and education that is beneficial for supporting people with CHD and potential communication strategies including digital interventions. We conducted a scoping review involving searching four databases (Web of Science, PubMed, CINAHL, Medline) for articles published from January 2000 to August 2022. Literature was identified through title and abstract screening by expert reviewers. Evidence was synthesised according to the review aims. Results demonstrated that information-sharing, decision-making, goal-setting, positivity and practicality are important aspects of secondary prevention and should be patient-centred and evidenced based with consideration of patient need and preference. Initiation and duration of education is highly variable between and within people, but hence communication and support should be regular and ongoing. In conclusion, text messaging programs, smartphone applications and wearable devices are examples of digital health strategies that facilitate education and support for patients with heart disease. There is no one size fits all approach that suits all patients at all stages and hence flexibility and a suite of resources and strategies is optimal.

Flood events and their associated damages have escalated significantly in the last few decades. To add to the gruesome situation, many reports and studies warn that flood risk would aggravate significantly in future periods due to significant alterations in the climate patterns and socio-economic dynamics. Floodplain mapping is looked upon as a viable option to tackle this global issue as it provides both quantitative and qualitative information on flood dynamics. Moreover, with the increasing availability of global data and enhancement in computational simulations, it has become easier to simlate flooding patterns at large scales. This study deter-mines the usability of publicly available datasets in capturing flood hazards over Canada. Run-off data set from the North American Regional Reanalysis (NARR), along with a few other rele-vant inputs are fed to CaMa-Flood, a robust global hydrodynamic model to generate flooding patterns for 1 in 100 and 1 in 200-yr return period events over Canada . The simulated maps are compared and validated with the existing maps of a few flood-prone regions in Canada, thereby establishing their performance over both regional and country-scale. Later, the simulated flood-plain maps are used in conjunction with property related information at 34 cities (within the top 100 populous cities in Canada) to determine the degree of exposure due to flooding in 1991, 2001, and 2011. The results indicate that around 80 percent of inundated spots belong to high and very-high hazard classes in a 200-yr event, which is roughly 4 percent more than simulated for 100-yr event. NARR derived floodplain maps perform very well while compared over the six flood-prone regions. While analyzing the exposure of properties to flooding, we notice an in-crease in the number during the last three decades, with the maximum rise observed in Toronto, followed by Montreal, and Edmonton. To disseminate the extensive flood-related information, a web-based public tool, Flood Map Viewer (http://www.floodmapviewer.com/) is developed. The development of the tool was motivated by the commitment of the Canadian government to provide $63 M over the next three years for the completion of flood maps for higher-risk areas. The study reaches out to demonstrate how publicly available datasets can be utilized with a lesser degree of uncertainty in representing flooding patterns over large regions. The flood re-lated information derived from the study can be used along with vulnerability for quantifying flood risk, which will help in developing appropriate pathways for resilience building for long-term sustainable benefits.

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

A total of 281 guano samples were collected from caves (N = 181) in 8 European countries (Bulgaria, Czech Republic, France, Hungary, Italy, Romania, Slovakia and Slovenia) and attics in the Czech R. (N = 100). The correlation of detection of mycobacteria between Ziehl-Neelsen (ZN) microscopy and culture examination and qPCR was strong. ZN microscopy was positive in guano from caves (58.6%) more than double than positivity in guano from attics (21.0%; P &lt;0.01). From 89 mycobacterial isolates (73 isolates from cave guano and 16 isolates from attics’ guano) 68 (76.4%) isolates of 19 sp., ssp. and complex were identified as members of 3 Groups (M. fortuitum, M. chelonae, and M. mucogenicum), and 4 Complexes (M. avium, M. terrae, M. vaccae, and M. smegmatis). A total of 20 isolates (22,5%) belonged to risk group 1 (environmental saprophytes), 48 isolates (53.9%) belonged to risk group 2 (potential pathogens), and none of isolates belonged to risk group 3 (obligatory pathogens). When comparing bat guano collected from caves and attics, differences (P&lt;0.01; Mann-Whitney test) were observed for the electrical conductivity, total carbon, total organic and total inorganic carbon. None difference (P&gt; 0.05; Mann-Whitney test) was found for pH and oxidation-reduction potential parameters.

(1) Aims: To analyse the relationship between demographic and clinical characteristics and particular kinds of suicidal behaviour and its relationship with a nurse-led suicide prevention program. (2) Methods: A 5-year cross-sectional study design. Study performed in the region of Osona (Catalonia) during 2013-2017. Suicidal behaviour was classified as suicidal ideation, interrupted self-directed violence, suicide attempt and completed suicide. (3) Results: The sample included 753 patients ─ of whom 53 died by suicide─ and encompassed 931 suicidal behaviour episodes. Men represented 38.4% of the sample but 81.1% of deaths by suicide. Mental disorders were associated with suicidal behaviour in 75.4% of the sample. 66.4% of the individuals were engaged in the nurse-led Suicidal Behaviour Case Management Program, of which 0.8% (n=4) died by suicide. (4) Conclusion: The main risk factors were female sex for suicidal behaviour, and male sex and older age for suicide. Mental disorders, widowhood and retirement were also associated with suicide. A high proportion of patients was engaged to the nurse-led suicide prevention program with a low proportion of suicides.

The rising incidence of complex illnesses and their costs have revolutionized basic research, patient management, and societal needs. Between 70 to 90% of the risk of developing a disease is due to the air we breathe, the water we drink, and the surroundings in which we work and live. Visibly polluted, infectious or not, the fact remains that we are more than ever exposed to environmental risks. Air pollution is the fourth most prevalent deadly risk factor worldwide and by far the leading risk factor for hundreds of diseases, including respiratory infections, inflammatory illness, and cancer. Thus, an unhealthy environment can be considered as a pandemic, affecting 280 million people and claiming 12 million deaths every year. Although critical for identifying of the people at risk, the causal environment components (pollutants and/or the microbiome), and the affected physiological mechanisms are not well understood. Herein, we consider the dysregulation of macroautophagy (hereafter referred to as ‘autophagy’), as the mechanism at the heart of an immediate response to environmental stress. We discuss the missing link between the autophagy gene variations, and the exposome in the susceptibility, prognosis, and management of complex diseases when embracing personalized medicine.

In this paper, we study a generalised CIR process with externally-exciting and self-exciting jumps, and focus on the distributional properties and applications of this process and its aggregated process. The first and second moments of this jump-diffusion process are used to calculate the insurance premium based on mean-variance principle. The Laplace transform of the aggregated process is derived, and this leads to an application for pricing default-free bonds which could capture the impacts of both exogenous and endogenous shocks. Illustrative numerical examples and comparisons with other models are also provided.