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 <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<0.01; Mann-Whitney test) were observed for the electrical conductivity, total carbon, total organic and total inorganic carbon. None difference (P> 0.05; Mann-Whitney test) was found for pH and oxidation-reduction potential parameters.

: Chemical accidents can occur anywhere. The need for chemical management in Korea was realized following the 2012 Gumi hydrofluoric acid accident in 2012. The Chemicals Control Act was enacted in 2015. This system evaluates the risks (high, medium, low) and consequent safety management at all plants that handle hazardous chemical substances. However, the system was criticized as excessive when most plants were designated high-risk without considering their size. Thus, laboratories and hospitals handling very small quantities were subject to regulation. Accordingly, in 2021 Korea revised the system to include off-site consequence analyses and a Korean-style risk analysis. Plants handling very small quantities, such as laboratories and hospitals, were exempt from regulation. In this study, plating and paint manufacturing companies, which were classified as high-risk in the previous system, even though they were medium-size business plants, were re-evaluated as low-risk plants. In the Korean-style risk analysis, it is possible to see at a glance what is lacking in the plants, such as cooperation between local residents and local governments and the construction of safety facilities according to the type of accident scenario. The revised system is a reasonable regulation for medium business plants.

Background: During the COVID-19 pandemic, hygiene behaviors such as keeping distance, avoid-ing masses, wearing face masks and adhering to hand hygiene recommendations became impera-tive. The current study aims to determine factors interrelating with hygiene behaviors. Methods: 4,049 individuals (1,305 male, 2,709 female, aged 18-80 years) were recruited from rehabilitation clinics or freely on the internet and surveyed via online questionnaire between May 2020 and August 2021. Socio-demographics, hygiene behaviors, emotions (fear), life-satisfaction, risk factors and disability as well as communication were assessed. Results: Prevalence for hygiene behaviors was: keeping the distance 84.9%, avoiding mass gatherings 84.6%, wearing face masks 96.5% and hand hygiene 80.7%. Hygiene behaviors were significantly related to fear with linear and quad-ratic associations. Conclusion: Individuals with disabilities, risk factors and psychological symp-toms are more compliant. Especially hand hygiene should be targeted to achieve higher compli-ance rates. A medium level of fear is more functional than too elevated fear. Behavioral interven-tions and targeted communication aiming at improving different behaviors in orchestration can help individuals to remain healthy and maintain a high life-satisfaction. Thereby, communication in the healthcare setting is imperative and all involved individuals should become more aware of this to ensure high hygiene standards and patient safety.

Reassessment of the fatigue life for wind turbines structural components is typically performed using deterministic methods with the same partial safety factors as used for the original design. However, in relation to life extension, the conditions are generally different from the assumptions used for calibration of partial safety factors; and using a deterministic assessment method with these partial safety factors might not lead to optimal decisions. In this paper, the deterministic assessment method is compared to probabilistic and risk-based approaches, and the economic feasibility is assessed for a case wind farm. Using the models also used for calibration of partial safety factors in IEC61400-1 ed. 4 it is found that the probabilistic assessment generally leads to longer additional fatigue life than the deterministic assessment method. The longer duration of the extended life can make life extension feasible in more situations. The risk-based model is applied to include the risk of failure directly in the economic feasibility assessment and it is found that the reliability can be much lower than the target for new turbines, without compromising the economic feasibility.

(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.

COVID-19 (2019-nCoV) is a pandemic disease with an estimated mortality rate of 3.4% (estimated by the WHO as of March 3, 2020). Until now there is no antiviral drug and vaccine for COVID-19. The current overwhelming situation by COVID-19 patients in hospitals is likely to increase in the next few months. About 15 percent of patients with serious disease in COVID-19 require immediate health services. Rather than waiting for new anti-viral drugs or vaccines that take a few months to years to develop and test, several researchers and public health agencies are attempting to repurpose medicines that are already approved for another similar disease and have proved to be fairly effective. This study aims to identify FDA approved drugs that can be used for drug repurposing and identify biomarkers among high- risk and asymptomatic groups. In this study gene-disease association related to COVID-19 reported mild, severe symptoms and clinical outcomes were determined. The high-risk group was studied related to SARS-CoV-2 viral entry and life cycle by using Disgenet and compared with curated COVID-19 gene data sets from the CTD database. The overlapped gene sets were enriched and the selected genes were constructed for protein-protein interaction networks. Through interactome, key genes were identified for COVID-19 and also for high risk and asymptomatic groups. The key hub genes involved in COVID-19 were VEGFA, TNF, IL-6, CXCL8, IL10, CCL2, IL1B, TLR4, ICAM1, MMP9. The identified key genes were used for drug-gene interaction for drug repurposing. The chloroquine, lenalidomide, pentoxifylline, thalidome, sorafenib, pacitaxel, rapamycin, cortisol, statins were proposed to be probable drug repurposing candidates for the treatment of COVID-19. However, these predicted drug candidates need to be validated through randomized clinical trials. Also, a key gene involved in high risk and the asymptomatic group were identified, which can be used as probable biomarkers for early identification.

Risk-based redispatch optimization is proposed as a methodology to support the Transmission System Operator (TSO) with preventive remedial actions obtained by extending the security constrained unit commitment/economic dispatch with constraints resulting from the risk assessed for the power system. Although being heuristic, the methodology is based on comprehensive dynamic security assessment as time-domain simulations are used, allowing to express the degree of all types of instabilities, e.g., caused by contingencies, in monetary terms. Therefore, the risk is assessed as the expected value of the cost incurred by the TSO. Such approach forms a new pathway to including risk in planning procedures already used by TSOs. Results obtained for the IEEE39 dynamic power system, with costs assigned to load shedding and generator tripping due to single transmission lines short-circuits, are shown as a reference case.

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.

Warming of the climate system is unequivocal, and many of the observed changes are unprecedented over five decades to millennia. Globally the atmosphere and ocean is increasingly getting warmer, the amount of ice on the earth is decreasing over the oceans, and the sea level has risen. According to Intergovernmental Panel on Climate Change, the total increasing temperature globally averaged combined land and surface between the average of the 1850-1900 period and the 2003 to 2012 period is 0.78 °C (0.72 to 0.85). But should we prepare for such the relatively small change? The importance is not the mean of the warming but the considerable likelihood of climate change that could trigger extreme natural hazards. The impact and the risk of climate change associated with railway infrastructure have not been fully addressed in the literature due to the difference in local environmental parameters. On the other hand, the current railway network in Malaysia, over the last decade, has been significantly affected by severe weather conditions such as rainfall, lightning, wind and very high temperatures. Our research findings point out the extremes that can lead to asset system failure, degraded operation and ultimately, delays to train services. During the period of flood, the embankment of the track can be swept away and bridge can be demolished, while during drought, the embankment of the track can suffer from soil desiccation and embankment deterioration, high temperature increases the risk of track buckling and high winds can result in vegetation or foreign object incursion on to the infrastructure as well as additional quasi-static burden exerted. This review is of significant importance for planning and design of the newly proposed high speed rail link between Malaysia and Singapore.

This review focuses on the emerging evidence for the association between estimated cardiorespiratory fitness (eCRF) and metabolic risk factors. Given the challenges associated with directly measuring cardiorespiratory fitness (CRF) in large populations, eCRF presents a practical alternative for predicting metabolic health risks. A literature search identified six relevant cohort studies from 2021 to 2024 that investigated the association of eCRF with hypertension, hyperglycemia, dyslipidemia, and obesity. The review findings highlight a consistent inverse relationship between higher eCRF and lower incidence of metabolic risks in line with CRF cohort studies. This review highlights the importance of low eCRF as a primordial indicator for metabolic risks and underscores the need for broader application. Future research directions should include exploring eCRF's predictive accuracy across diverse populations and health outcomes and testing its real-world applicability in healthcare and public health settings.

Background: In recent years, whole blood parameters and derivatives have been used as prognostic criteria in the course of the disease in various diseases. The prognostic nutritional index (PNI), the systemic immune-inflammation index (SII), the neutrophil-lymphocyte ratio (NLR) have been adapted as an indicator of inflammation and have been widely studied to define the severity of inflammation in some diseases. The aim of this study was to evaluate the relationship between parameters such as NLR, SII, PNI, controlling nutritional status (CONUT) score, nutritional risk index (NRI) and with immunonutrition status and disease activity in patients with ischemic stroke of small vessel, large vessel and other etiologies. Methods: We retrospectively evaluated the records of 1454 consecutive ischemic stroke patients hospitalized in the emergency department of Gaziosmanpasa Education and Research Hospital from 2019 to 2023. Results: Of the 1350 SVO patients included in the study, 58.8% had small vessel, 29.3% had large vessel and 11.9% had other etiologies. There was a significant difference between the 3 etiology groups for PNI and CONUT. The median PNI was 47.03 (41.33-52.85) in the other etiology group, 35.29 (33.69-37.25) in the small vessel group, and 34.11 (30.23-36.87) in the large vessel group. The CONUT median was 5(5-6) in the small vessel group, 5(4-6) in the large vessel group and 4(4-4) in the other etiology group. In addition, CONUT and PNI were also found to be independent risk factors for death. A negative significant correlation was observed between PNI and NLR (r:-0.692), SII (r:-0.591), CONUT (r:-0.685). Significant correlations were observed between CONUT and NLR (r:0.402), SII (r:0.312). Conclusion: PNI and SII were significantly associated with disease activity. PNI, CONUT and NRI as a more accurate prognostic indicator of nutritional status in patients with ischemic stroke of small vessel, large vessel and other etiologies. NLR and SII may be important predictive markers in the course and prognosis of stroke.

Capturing atmospheric CO2 and storing it in natural rock systems (i.e., alkaline earth silicate and hydroxide minerals) through carbonation reactions is a promising greenhouse gas mitigation research, and largely depends on the use of hydrated ultramafic rocks (serpentinites), which are widespread in orogenic belts around the globe. The Jurassic ophiolites in the Southern Apennines represent a natural analogue and a great opportunity for the mineralogical sequestration of CO2. Serpentinites of the Pollino ophiolite Massif have been widely studied for their mineralogical, petrographic, and chemical characteristics, providing major findings on their impact on environmental and human health issues. Serpentinites here have been divided into cataclastic and massive types based on their structures and are characterized by pseudomorphic and vein textures. The mineralogy of the studied serpentinites consists of lizardite, antigorite, clino-crysotile, Cr-chlorite, magnetite, tremolite, actinolite, pyroxene and calcite, and the most commonly occurring serpentine minerals are polymorphs of serpentine including lizardite, clino-crysotile and antigorite. Systematic petrographic and mineralogical studies of serpentinites in ophiolites, such as those outcropping in the Southern Apennines can represent a starting point for the study of natural materials, which can be used for CO2 storage and sequestration. A particular attention must be given to those carbonate phases, produced by carbonation processes to check whether the serpentinites of the Pollino Massif can be used for the induced mineral Carbon Capture Storage (CCS). If successful, this technique and the Pollino Massif serpentinites can become highly significant in safeguarding the health of our planet's climate.

At 12:28 UTC (8:28 PM, local time) on 15 January 2023, a shallow, moderate earthquake with a magnitude (Mw) of 4.7 and a depth of one (1) kilometer shook the northern part of Leyte Island in the central part of the Philippines. The ground shaking was felt at PHIVOLCS Earthquake Intensity Scale (PEIS) VI, (very strong) equivalent to Modified Mercalli Intensity (MMI) VI in areas along the strike of the Leyte segment of the Philippine Fault. Even though this earthquake is classified as moderate in size, significant geologic, structural, and socio-economic impacts were documented. Most of the earthquake impacts that include surface rupture, liquefaction, and mass movements are limited near the epicentral area. The earthquake produced an 8-km-long surface rupture, the first documented rupture generated by a magnitude <6 along the Philippine Fault, and is unusual in other surface rupturing earthquakes worldwide. It injured 18 persons and damaged 434 residential buildings and 26 public infrastructures which amounts to about 500 thousand US dollars. Structural damages were caused by surface rupture and/or poor engineering construction practices. Analysis of the seismic waveform and recorded peak ground acceleration (PGA) suggests that the subsurface geology influenced the ground motion amplification in an area near the epicenter. Based on the hypocenter, focal mechanism solution, aftershock distribution, and actual field observation, the causative fault for this event is the northern end of the Philippine Fault – Leyte segment. Moderate in size, this earthquake emphasizes the need and importance of documenting moderate-sized earthquakes as a tool and guide for medium and long-term earthquake risk assessment and resiliency.

Obesity is a worldwide epidemic; hence it is crucial to understand how it can be effectively prevented/treated. Thus, obesity should be tackled considering that it is a multifactorial condition. This work examines a wide range of factors and attempts to understand which contribute most to variability in overweight/obesity. Eighty-four subjects with overweight/obesity were recruited. Dietary baseline information was obtained by analyzing three 24-hour recalls. Resting metabolic rate was measured using indirect calorimetry, physical activity through accelerometry, cardiometabolic parameters were determined in blood samples and body composition by anthropometry and bioimpedance. Factor analysis of principal components (PCA) was carried out (SPSS v22.0). Large interindividual variability was observed in dietetic, biochemical, and physical activity measurements (coefficient of variation ≥30%), but body composition was homogeneous. Volunteers had an unbalanced diet and low physical activity. PCA reduced the 26 analyzed variables into 7 factors, accounting for 81,5% of total data variability. The main factor was the ‘‘caloric and lipid factor’’ related to diet, responsible for 25.9% of total variability, followed by ‘‘adiposity factor’’ (16,9%) and ‘‘cardiometabolic risk factor’’ (13,2%). Diet seems to be the factor that contributes the most to data variability in people with overweight/obesity, especially the intake of lipids, energy and proteins.

To address the problems of wind abandonment in the regional integrated energy system (RIES), which occurs when cogeneration unit operates in a heat-determined electricity operation mode, and the low efficiency of the energy storage system in a low-temperature environment, we propose an optimal scheduling method for RIES based on fine energy storage and wind power dissipation. First, a fine energy storage model is established on the source side and the conditional value at risk(CvaR) theory is used to quantify the uncertainty of wind power; then a combined heat and power demand response mechanism is introduced on the load side to reduce the peak-to-valley difference between heat and power loads, and to promote the consumption of wind power. Finally, with the objective of minimizing the total cost of RIES optimal dispatch, the example is solved on the MATLAB platform. The simulation results show that compared with the traditional model, the proposed model is not only more adaptable to the low-temperature environment, but also can effectively improve the system economy and wind power consumption.

Successful implementation of antibiotic stewardship programs (ASP) requires a well-structured approach involving all stakeholders. Despite embracing key responsibilities, nurses’ role remains poorly defined, preventing consistent engagement. We conducted a scoping survey to assess knowledge, attitude and perception of nurses towards nurse-led initial sepsis risk evaluation using the sepsis risk calculator (SRC) of newborns admitted to the mother-baby unit. Single-center, cross-sectional study. Study link was sent to all full-time nurses in mother-baby unit. Survey centered around knowledge of unit’s ASP and attitude and perception towards nurse-led initial sepsis risk evaluation. 89% response rate. 100% agreed that SRC reduced antibiotic use and 66% felt nurse-led sepsis risk evaluation will enhance nurse involvement, but this was offset by extra burden of work (66%) and low confidence in differentiating stable from clinically unstable infants (46%). Other facilitating factors included greater nurse/patient ratio (100%), targeted education (89%) and incorporation of the SRC into EMR (78%). Only 11% were willing to serve as champions for it. There was no significant correlation to age or experience however, greater number of fresh grads were interested in championing this effort. Our study identifies a need for strong foundation of knowledge and greater nurse/patient ratio as two main factors for improving nurse-led use of the SRC. Multi-site studies scoping barriers to nursing involvement for successful implementation of ASPs are necessary.

Patient safety is a top priority for all healthcare systems globally. Promoting the adoption of policies for reporting and learning from errors is an important strategy for improving care safety. Therefore, the aim of our study was to detect how much patient safety culture influences the reporting of adverse events and the use of the incident reporting tool. The study protocol was developed according to PRISMA guidelines. Articles were searched electronically in PubMed/MEDLINE, the COCHRANE library, and Google Scholar by two independent reviewers, and those that met the eligibility criteria were included. Synthesis of qualitative data from included studies was performed by graphical descriptive statistical analysis. The results of the systematic review showed that health care organizations' increasing focus on staff development of a safety culture has led to a significant increase in incident reporting rates over the years. Moreover, in situations where safety culture is placed at the top of the nations, there is a higher frequency of incident reporting. An efficient incident reporting system should be an essential foundation for healthcare organizations, as it allows them to collect experiences and data and provide feedback to healthcare providers and staff involved in care.

Background: There is an exponential increase in caesarean sections with epidemic proportions worldwide, which is considered as a serious public health issue that influences negatively both maternal and childhood health. Aims: This study aimed to evaluate the associations between pre-dominant maternal risk factors and the prevalence of caesarean section in a representative sample of women from Greece. Methods: This is a cross-sectional study conducted on 5182 healthy, re-productive-aged women from 11 geographically diverse Greek areas after applying specific inclu-sion and exclusion criteria. Statistical analysis was applied to evaluate the impact of maternal so-ciodemographic, anthropometric, lifestyle and perinatal factors in the risk of caesarean section de-liveries. Results: A high prevalence of 56.4% of caesarean section deliveries was recorded in the study population. The incidence of caesarean sections reached to 51.5% in private hospitals in which an increasing rate of 47.5% for planned caesarean sections were noticed. Older maternal age, pre-pregnancy overweight and obesity, excess gestational weight gain, high rates of preterm birth, better economic status, smoking habits, and private type of birth hospital were significantly related with enhanced risk of caesarean section, independently of multiple confounding factors. Conclu-sions: Our study revealed that caesarean section rates are continuously increase, while several maternal risk factors, including especially pre-pregnancy overweight/obesity and excess gestational weight gain, cumulatively raise its prevalence which further increase the risk for postnatal adverse outcomes for both the mothers and their children. Emergent public health policies and strategies should be promoted to confront the predominant maternal risk factors-related with caesarean sec-tion and inform future mothers how to be prevented from them by applying healthier nutritional and lifestyle habits and to select caesarean section only due to emergency medical reasons. Alarmingly enough, targeted nutritional intervention strategies are strongly recommended to ef-fectively reduce the prevalence of maternal pre-pregnancy overweight/obesity and the excess gestational weight gain, which in turn may minimize the risk of childhood overweight/obesity.

From 2020 to 2023 many people around the world were forced to wear masks for large proportions of the day based on mandates and laws. We aimed to study the potential of face masks for the content and release of inanimate toxins. A scoping review of 1003 studies was performed (database search in PubMed/MEDLINE, qualitative and quantitative evaluation). Twenty-four studies were included (experimental time 17 min to 15 days) evaluating content and/or release in 631 masks (273 surgical, 228 textile and 130 N95 masks). Most studies (63%) showed alarming results with high micro- and nanoplastics (MPs and NPs) release and exceedances could also be evidenced for volatile organic compounds (VOCs), xylene, acrolein, per-/polyfluoroalkyl substances (PFAS), phthalates (including di(2-ethylhexyl)-phthalate, DEHP) and for Pb, Cd, Co, Cu, Sb and TiO₂. Of course, masks filter bacteria, dirt and plastic particles and fibers from the air we breathe and have specific indications, but according to our data they also carry risks. Depending on the application, a risk-benefit analysis is necessary. However, mask mandates during the SARS-CoV-2 pandemic have been generating an additional source of potentially harmful exposition to toxins at population level with almost zero distance to the airways.

The global transport sector of the world economy contributes about 15% of the Greenhouse Gas (GHGs) emissions in the world today. The University of Saskatchewan has pursued the green energy transition over the years. They have spearheaded diverse sustainability projects and agendas, due to the importance of curbing climate change and advancing sustainability. The transport system in the university campus is one area of focus where the Sustainability Office plans to introduce some innovations, as a way of curbing GHG emissions while also advancing sustainability practice in the university campus. The study carried out an economic benefit analysis on the campus fleet (consisting of 91 ICE vehicles) to determine if it is economically or financially feasible to transition from Internal Combustion Engine (ICE) or PVs (Petrol Vehicles) to Electric Vehicles (EVs). The analysis used RETScreen Expert software for analyzing renewable energy technology projects. The variables of Payback Period (PBP), cash flow projections, savings made from transitioning (fuel cost savings and energy cost savings), Benefit-Cost-ratio, GHG emission reduction potential, etc. were analyzed. The findings revealed that the GHG emission from the campus fleet will be reduced by 100% (this will result in the removal of about 298.1 tCO₂ from the environment). Also, the fleet manager will save approximately $129,049 (88.9%) in fuel costs. Apart from these, the return on investment will be achieved in year 5 (all things being equal), but can be reduced to year 2 if the vehicles are put into constant and active use (eliminating most idle times. Also, the Sustainability Office will be making a GHG reduction revenue of $14,906.

The aim of this study was to evaluate the acceptability and feasibility of a theory-derived sedentary workplace intervention (single arm, pre-post design) for police office staff. Twenty-four staff participated in an 8-week intervention incorporating an education session, team competition with quick response (QR) codes, team trophy, and weekly leaderboard newsletters, a self-monitoring phone app, and electronic prompt tools. The intervention supported participants to reduce and break up their sitting time with three minutes of incidental movement every 30 minutes at work. Feasibility and acceptability were assessed using mixed methods via the RE-AIM QuEST and PRECIS-2 frameworks. The intervention was highly pragmatic in terms of eligibility, organisation, adherence, outcome, and analysis. It was slightly less pragmatic on recruitment and setting. Delivery and follow-up were more explanatory. Reach and adoption indicators demonstrated feasibility among police staff, across a range of departments, who were demographically similar to participants in previous office-based multi-component interventions. The intervention was delivered mostly as planned with minor deviations from protocol (Implementation fidelity). Participants perceived the intervention components as highly acceptable. Preliminary results showed improvements in workplace sitting and standing, as well as small improvements in weight and positive affect. Evaluation of the intervention in a fully powered randomised controlled trial to assess behaviour and health outcomes is recommended.

Economic risks for livestock production are caused by volatile commodities and market conditions, but also by environmental drivers like increasing uncertainties due to weather anomalies and global warming. These risks impact the gross margin of farmers and can stimulated investment decisions. For confined pig and poultry production, farmers can reduce the environmental impact by implementing specific adaptation measures to reduce heat stress. A simulation model driven by meteorological data was used to calculate heat stress impact as a projection for 2030. For a business-as-usual livestock building, the indoor climate for several adaptation measures was calculated. The weather-related value-at risk quantified the economic risks caused by global warming and the stochastic component of the weather. The results show that only energy-saving adaptation measures to reduce the inlet air temperature are appropriate to reduce the economic risk to the level of the year 1980. The efficiency of other adaptation measures to reduce heat stress is distinctly lower. The results in this study can support the decision making of farmers concerning adaptation management and investments. It can inform agricultural policy design as well as technological development.

Electricity distribution network operators face several operational constraints in the provision of safe and reliable power given that investments for network area reinforcement must be commensurate with improvements in network reliability. This paper provides an integrated approach for assessing the impact of different operational constraints on distribution network reliability by incorporating component lifetime models, time-varying component failure rates as well as the monetary cost of customer interruptions in an all-inclusive probabilistic methodology that applies a time-sequential Monte Carlo simulation. A test distribution network based on the Roy Billinton test system is modelled to investigate the system performance when overloading limits are exceeded as well as when preventive maintenance is performed. Standard reliability indices measuring the frequency and duration of interruptions, and the energy not supplied are complemented with a novel monetary reliability index. The comprehensive assessment includes not only average indices but also their probability distributions to adequately describe the risk of customer interruptions. Results demonstrate the effectiveness of this holistic approach as the impacts of operational decisions are assessed from both reliability and monetary perspectives. This informs network planning decisions through optimum investments and consideration of customer outage costs.

In light of the urgency raised by the COVID-19 pandemic, global investment in wildlife virology is likely to increase, and new surveillance programs will identify hundreds of novel viruses that might someday pose a threat to humans. Our capacity to identify which viruses are capable of zoonotic emergence depends on the existence of a technology—a machine learning model or other informatic system—that leverages available data on known zoonoses to identify which animal pathogens could someday pose a threat to global health. We synthesize the findings of an interdisciplinary workshop on zoonotic risk technologies to answer the following questions: What are the prerequisites, in terms of open data, equity, and interdisciplinary collaboration, to the development and application of those tools? What effect could the technology have on global health? Who would control that technology, who would have access to it, and who would benefit from it? Would it improve pandemic prevention? Could it create new challenges?

NASA mission systems proposals are often compared using an equivalent system mass (ESM) framework wherein all elements of technology to deliver an effect- its components, operations and logistics of delivery- are converted to effective masses since this has a known cost scale in space operations. To date, ESM methods and the tools for system comparison have not considered complexities wherein systems that serve a mission span multiple transit and operations stages, such as would be required to support a crewed mission to Mars, and thus do not account for the different mass equivalency factors operational during each period and the inter-dependencies of the costs across the mission. Further, ESM does not account well for the differential reliabilities of the underlying technologies. Less reliability should incur an equivalent mass cost for technologies that might otherwise provide a mass advantage. We introduce an extensions to ESM to address these limitations and show that it provides a direct method for analyzing, optimizing and comparing different mission systems. We demonstrate our extended ESM (xESM) calculation with crop production technologies -- an aspect of the developing offworld biomanufacturing suite -- since it represents a case with strong coupling among stages of the mission and a relatively high-risk profile.

The aim of this cross-country research is to examine how the profit and loss sharing mudarabah investment deposits are classified and disclosed in the financial statement of Islamic banks. The cross-country study examined the financial statements of fifty-one fully-fledged Islamic banks. The results of the data analysis show that Islamic banks disclose the mudarabah investment account in different ways. The absence of standardized disclosure for mudarabah investment deposit confuses the stakeholders. This research suggests to the regulators to fully or partially adopt the AAOIFI standards specifically for Islamic financial institutions.

The introduction of the Internet of Things (IoT), i.e. the interconnection of embedded devices over the Internet, has changed the world we live in from the way we measure, make calls, print information and even the way we get energy in our offices or homes. The convenience of IoT products, like CCTV cameras, IP phones, and oscilloscopes, is overwhelming for end-users. In parallel, however, security issues have emerged and it is essential for infrastructure providers to assess the associated security risks. In this paper, we propose a novel method to detect IoT devices and identify the manufacturer, device model, and the firmware version currently running on the device using the page source from the web user interface. We performed automatic scans of the large-scale network at the European Organization for Nuclear Research (CERN) to evaluate our approach. Our tools identified 233 IoT devices that fell into eleven distinct device categories and included 49 device models manufactured by 26 vendors from across the world.

Accurate and reliable project cost estimates are fundamental to achieve successful municipal capital improvement (CIP) programs. Engineering cost estimates typically represent critical information for key decision makers to authorize and efficiently allocate the necessary funds for construction, budgeting, to generate a request for proposals, contract negotiations, scheduling, etc. for these reasons, cost estimators are using different estimating methods and approaches that allow for required levels of accuracy. As the project’s scope becomes more detailed and the potential risks are identified and/or the project design stage progresses these cost estimates are revised and updated. In this paper, the most common project cost estimation methods and approaches were collected and categorized into two main groups of (1) probabilistic and (2) deterministic methods. Under these groups overall ten different methods were identified and discussed addressing their requirements, advantages, and shortcomings, including the potential risk that can positively or negatively affect the project’s cost outcome. This paper will be a good resource for professionals who are in budget development and/or are seeking to a better understanding of different methods in determining an appropriate base cost margin and produce a meaningful and reliable project cost estimate.

The purpose of work is to quantify the changes of the organism functional reserves during the successive phases of the human health Space-Time Continuum (STC) on the basis of postulates of reliability complex systems theory. The study is devoted to the problem of age-related human involution, which is evaluated not from the causal, but from the kinetic point of view. The analysis of 10 most important basic life support systems of human body — cardiovascular (CVS), respiratory (RS), nervous (NS), digestive (DS), endocrine (ES), immune (IS), excretory (EXS), brain (BS), musculo-skeletal (MSS), hematopoietic (HS) was carried out. Based on this analysis two levels of ensuring the reliability of organism’s work were revealed: sequential and parallel. The system of logical equations for reduced sequential system is: Ys1 = CVS ∧ RS ∧ BS, where ∧ is the notation for the conjunctions of set elements. The system of logical equations for the reduced parallel system is: Ys2 = NS ∨ DS ∨ ES ∨ IS ∨ HS ∨ EXS ∨ MSS ,where ∨ is the disjunction of the scheme elements. Visualization of human STC changes the concept of the kinetics of age-related changes in the organism and the role of determinants of health as a stable factor accompanying a uniform, smooth transition from the most pronounced functions of the body to their gradual extinction. For human STC is formulated the following regularity kinetics of involutionary processes: after 30 years of age in the human body morphological changes regress in arithmetic progression, and the functions of organs in a geometric one. Assumption of health as a state redundancy of functions is suggested.

The extensive use of engineered nanoparticles (ENPs) such as zinc oxide nanoparticles (ZnO NPs) in various commercial fields has spurred significant concern about its possible toxicological effects of ZnO NPs on human health and eco-system. Therefore, it is substantial to understand the aggregation phenomena which could attenuate this effect. This data article provides information on aggregation of ZnO NPs under the influence of various parameters of water chemistry. Moreover, Taguchi orthogonal array L27(313) design matrix was used to evaluate the effect of multiple parameters in aqueous solution. The data were obtained from single beam UV-Vis spectrophotometer (Optizen 2120 UV, Mecasys, Korea) using Optizenview 4.2.5 PC interference software, Fourier transform infrared spectrometer (FT/IR-4700, spectroscopy, JASCO Analytical Instruments, Easton, USA) and particle electrophoresis (NanoZS, Zetasizer, Malvern Instruments Ltd, Worcestershire, UK). The dataset draws attention on dominant parameters influencing aggregation of ZnO NPs in water. The analysis of variance (ANOVA) data revealed that electrolyte concentration, type and natural organic matter (NOM) concentration were the most significant parameters. Furthermore, FT-IR data presents a possible mechanism of ZnO NPs stabilization in the presence of different NOM. This data will be helpful for the development of environmental risk assessment strategies and prediction of fate and mobility of other ENPs in the aquatic environment.

Very little is known about laboratory confirmed blood stream infections (LCBIs) in neonatal intensive care units (NICUs) in resource-limited settings. The aim of this cohort study was to determine the incidence, risk factors, and causative agents of LCBIs in a level-2 NICU in India. The diagnosis of LCBIs was established using the Centre for Disease Control, USA criteria. A predesigned questionnaire containing risk factors associated with LCBIs was filled-in. A total of 150 neonates (43% preterm) were included in the study. The overall incidence of LCBIs was 31%. The independent risk factors for LCBIs were: preterm neonates (relative risk (RR) 2.23), duration of NICU stay more than 14 days (RR 1.75), chorioamnionitis in the mother (RR 3.18), premature rupture of membrane in mothers (RR 2.32), neonate born through meconium-stained amniotic fluid (RR 2.32), malpresentation (RR 3.05), endotracheal intubation (RR 3.41), umbilical catheterization (RR 4.18), and ventilator-associated pneumonia (RR 3.17). The initiation of minimal enteral nutrition was protective from LCBIs (RR 0.22). The predominant causative organisms were gram-negative pathogens (58%). The results of the present study can be used to design antibiotic interventions to reduce LCBIs in resource-limited settings.

The scarcity and pollution of freshwater are extremely crucial issues today and the expansion of water reuse have been considered as an option to reduce its impact. This study aims to assess the efficiency of an integrated greywater treatment system and hydroponic lettuce production as a part of a green wall structure and to evaluate the health risk associated with the production and consumption of lettuce through quantitative microbial risk assessment (QMRA) and chemical health risk assessment. The study was conducted based on the unique configuration of source separation system; on-site greywater treatment system; green wall structure as a polishing step; and hydroponic lettuce production in the green wall structure. The final effluent from the system was used to grow three lettuce varieties by adding urine as a nutrient solution. Both water samples and plant biomass were collected and tested for E. coli and heavy metals contamination. The system has gained a cumulative 5.1 log10 reduction of E. coli in the final effluent and no E. coli found in the plant biomass. QMRA results indicated that the system attained the health-based targets, 10–6 DALYs per person per year. Similarly, health risk index (HRI) and targeted hazard quotient (THQ) results did not exceed the permissible level, thus the chemical health risk concern was insignificant.

Renal cell carcinoma (RCC) accounts for approximately 90-95% of all kidney cancers in adults, with the clear cell RCC (ccRCC) the most frequently identified subtype. RCC is known for its responsiveness to immunotherapy, making it an area of significant research interest. Immune checkpoint (IC) molecules, which regulate immune surveillance, are established therapeutic targets in RCC. The aim of this study was to analyze the influence of polymorphisms in genes HVEM and CD160 on susceptibility to ccRCC and patient overall survival (OS) with over a ten-year period of observation. We genotyped three HVEM single nucleotide polymorphisms (SNPs): rs1886730, rs2234167, and rs8725, and two CD160 SNPs: rs744877 and rs2231375, in 238 ccRCC patients and 521 controls. Our findings indicated that heterozygosity within rs2231375 and/or rs2234167 increases ccRCC risk. Furthermore, in women, heterozygosity within additional HVEM SNPs, rs8725 and rs1886730, is associated with an increased ccRCC risk. The presence of a minor allele for rs1886730, rs2234167, rs8725, and rs2231375 was also correlated with certain clinical features of the disease. Moreover, the rs1886730 SNP was found to be associated with patients' OS. In conclusion, our study highlights an association between HVEM and CD160 polymorphisms and the risk of developing ccRCC as well as patient’s OS.

Biochar (BC) is a carbonaceous material obtained by pyrolysis at 200−1000 °C in the limited presence of O2 of different vegetable and animal biomass feedstocks. BC has demonstrated great potential, mainly in environmental applications, due to its high sorption ability and persistent free radicals (PFRs) content. These characteristics enable BCs to carry out the direct and PFRs-mediated removal/degradation of environmental organic and inorganic contaminants. The types of PFRs possibly present in BC depend mainly on the pyrolysis temperature and the kind of pristine biomass. Since they also can cause ecological and human damage, a systematic evaluation of the environmental behavior, risks, or management techniques of BC-derived PFRs is urgent. PFRs generally could consist of a mixture of carbon- and oxygen-centered radicals, and of oxygenated carbon-centered radicals, depending on the pyrolytic conditions. Here, to promote a more productive and beneficial use of BC and related PFRs and stimulate further studies to make them environmentally safer and less hazardous to humans, we have first reviewed the most common methods used to produce BC, its main environmental applications, the primary mechanisms by which BC remove xenobiotics, as well as the reported mechanisms for PFRs formation in BCs. Secondly, we have discussed the PFRs environmental migration and transformation; we have reported the main PFRs-mediated applications of BCs to degrade inorganic and organic pollutants, the correlated environmental potential risks, and the possible strategies to limit them.

Grasping the spatial and temporal patterns of forest fires, along with the key factors that drive them and the ability to forecast such events accurately, is essential for the successful management of forests. In China's southern region, forest fires significantly endanger the ecological system, public safety, and economic well-being. Through the application of Geographic Information Systems (GIS) and LightGBM (Light Gradient Boosting Machine) model, this study investigates the determinants of fire incidents and formulates a predictive model for forest fire occurrences, alongside a zoning strategy, within the Central-South area. The results indicate: (i) Spatially, fire points exhibit significant clustering and autocorrelation characteristics; (ii) The Central-South Forest Fire Prediction Model shows exceptional accuracy, reliability, and predictive power, with high performance metrics across training and validation sets, including over 85% accuracy, precision, recall, and F1 scores, along with AUC values above 89%, underscoring its efficacy in forecasting forest fires and distinguishing between fire events; (iii) Throughout the year, forest fire risks in the Central-South region of China vary by region and season, with risk spikes from March to May in Guangdong, Guangxi, Hunan, Hubei, and Hainan. From June to August, localized risks are observed in Heyuan and Huangshi, while from September to November, an increase in risk is noted in Guangdong (Meizhou, Heyuan, Shaoguan), Guangxi (Nanning, Hezhou, Yulin), and Hunan (Binzhou, Yongzhou, Hengyang) due to cooler, drier conditions and leaf litter accumulation. From December to February, the risk continues in specific areas across Guangdong, Guangxi, Hunan, and Hubei.

Cervical cancer, primarily caused by high-risk human papillomavirus (HR-HPV) types 16 and 18, is a major global health concern. Persistent HR-HPV infection can progress from reversible pre-cancerous lesions to invasive cervical cancer, which is driven by the oncogenic activity of human papillomavirus (HPV) genes, particularly E6 and E7. Traditional screening methods, including cytology and HPV testing, have limited sensitivity and specificity. This review explores the ap-plication of p16/Ki-67 dual-staining cytology for cervical cancer screening. This advanced im-munocytochemical method allows for simultaneously detecting p16 and Ki-67 proteins within cervical epithelial cells, offering a more specific approach for triaging HPV-positive women. Dual staining and traditional methods are compared, demonstrating their high sensitivity and negative predictive value but low specificity. The increased sensitivity of dual staining results in higher detection rates of CIN2+ lesions, which is crucial for preventing cervical cancer progression. However, its low specificity may lead to increased false-positive results and unnecessary biopsies. The implications of integrating dual staining into contemporary screening strategies, particularly considering the evolving landscape of HPV vaccination and changes in HPV genotype prevalence are also discussed. New guidelines and further research are necessary to elucidate the long-term effects of integrating dual staining into screening protocols.

Breast cancer is the most common cause of mortality due to cancer for woman both in Lithuania and worldwide. Chances of survival after diagnosis differ significantly depending on the stage of disease at the time of diagnosis and other factors. One way to estimate survival is to construct a Kaplan-Meier estimate for each factor value separately. However, in cases when it is impossible to observe a large number of patients (for example, in case of countries with lower numbers of inhabitants) dividing data into subsets, say, by stage at diagnosis may lead to results where some subsets contain too little data so that results of Kaplan Meier (or any other) method will become statistically incredible. The problem may become even more acute if the researcher would like to use more risk factors, such as stage at diagnosis, sex, place of living, treatment method, etc. Alternatively, Cox models are used to analyse survival data with covariates, and they don’t require dividing the data into subsets according to chosen risks factors (hazards).

Conflicts are frequent within the complex professional environment of the construction industry. If claims cannot be overcome amicably, they result in disputes that lead to litigation. Identification of the causes of these claims and their impact on the duration, cost, and quality of the final project is expected to facilitate the prevention of unsuccessful performance of construction contracts. The novelty of this study is that after codifying the most common causes of construction contract claims derived from the extant literature, they are further investigated in terms of their probability of occurrence and the perceived impact they have on the project completion time, its total cost, and quality. Based on calculated relative importance indices from expert opinion, this paper proposes probability and severity of impact values for 39 common causes of claims in the construction industry. These can be applied to calculate their risk values for stakeholders in public construction contracts to plan mitigation measures of contractual claims. The findings show that the top five riskiest causes of contractual claims in the Greek construction industry are changes in quantities, work, or scope, design quality deficiencies or errors, payment delays, delays in work progress, and the financial failure of the contractor.

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

The Canadian Prairies are associated with high natural hydroclimatic variability including the frequent periodic occurrence of droughts and pluvials. These extremes carry various risks in-cluding significant damage to the economy, environment and society. The well-documented level of damage necessitates further risk assessment and planned reductions to vulnerability, particu-larly in light of a warming climate. A logical starting point involves awareness and information about the changing characteristics of such climate extremes. We focus on the compound occurrence of droughts and pluvials as the risks from this type of event are magnified compared to the hy-droclimatic extremes in isolation. Also, research on compound droughts and pluvials is limited. Therefore, the purpose of this paper is to synthesize recent literature concerning the risks of com-pound droughts and pluvials, including examples of past occurrences, with a focus on the Cana-dian Prairies. Since literature from the Prairies is limited, global work is also reviewed. Rela-tionships between drought and pluvials are characterized using the SPEI Global Monitor for the Prairies, emphasizing the recent past, and through synthesis from the Prairie literature. That re-search mostly considers drought and pluvials as separate events, but is integrated here to charac-terize the relationships of these extremes. Examples of periods of compound droughts and exces-sive rainfall provide insights into the regional hydroclimatic variability. Furthermore, most lit-erature on future projections strongly suggests that this variability is likely to increase, mainly driven by anthropogenic climate change. These findings suggest means of decreasing vulnerabil-ity and associated damages. Although the study area is the Canadian Prairies, the work is rele-vant to other regions that are becoming more vulnerable to increasing risks of and vulnerabilities to such compound extremes.

The sensitivity of exercise ECG is marginally sufficient for detection of mild reduction of coronary blood flow in patients with early coronary atherosclerosis. Here we describe the application of new technique of ECG registration/analysis – ultrahigh resolution ECG (UHR ECG) – for early detection of myocardial ischemia (MIS). The utility of UHR ECG vs. conventional ECG (C ECG) was tested in anesthetized rats and pigs. Transmural MIS was induced in rats by the ligation of the left coronary artery (CA). In pigs, subendocardial ischemia of variable extent was produced by stepwise inflation of balloon within the right CA causing 25-100% reduction of its lumen. In rats, a reduction in power spectral density (PSD) in high-frequency (HF) channel of UHR ECG was registered at 60 s after ischemia (power 0.81±0.14 vs. 1.25±0.12 mW at baseline, p<0.01). This was not accompanied by any ST segment elevation on C ECG. In pigs, PSD in HF channel of UHR ECG was significantly decreased at 25% reduction of CA lumen, while ST segment on C ECG remained unchanged. In conclusion, UHR ECG enabled earlier detection of transmural MIS compared to C ECG. PSD in HF-channel of UHR ECG demonstrated greater sensitivity in the settings of subendocardial ischemia.

Background: Substance use continues to be on the rise in the United States and has been linked to new onset cardiovascular (CVDs) and cerebrovascular disorders (CeVDs) leading to hospitalizations. We aimed to study the association of different subtypes of substance use disorders (SUDs) among hospitalized patients, with the different subtypes of CVDs and CeVDs, using the National Inpatient Sample (NIS) Database. Additionally, we aimed to assess the odds of hospitalizations with new onset CVDs and CeVDs among patients with different types of SUDs. Methods: A retrospective study of the NIS database (2016-2017) using the ICD-10-CM codes was performed. The hospitalizations with a secondary diagnosis of SUDs were identified. Weighted univariate analysis using the chi-square test and multivariate survey logistic regression analysis was performed to evaluate for the incidence, prevalence, and odds of association between vascular events and SUDs. Results: There were a total of 58,259,589 hospitalizations, out of which 21.42% had SUDs. Out of all the hospitalized patients between the age 18-50, more patients had SUDs than not (31.83%, p< 0.0001). This difference existed for all the different subtypes of SUDs including alcohol related disorder (42.61%), amphetamine dependence (76.17% vs 31.83%), cannabis related disorder (75.17%), cocaine related disorders (57.87%), hallucinogen related disorder (82.91%), inhalant related disorders (67.25%), opioid related disorders (52.86%), and nicotine dependence (35.72%). We found a significant association of acute ischemic stroke with amphetamine dependence (OR 1.23, 95%CI 1.14-1.33), cocaine related disorders (1.17, 1.12-1.23) and nicotine dependence (1.42, 1.40-1.43). Similarly, the association of intracerebral hemorrhage was higher with amphetamine dependence (2.58, 2.26-2.93), and cocaine related disorders (1.62, 1.46-1.79). The association of subarachnoid hemorrhage was noted to be higher with amphetamine dependence (1.82, 1.48-2.24) and nicotine dependence (1.47, 1.39-1.55). In terms of association of cardiovascular disorders with SUDs,the patients with myocardial infarction had higher odds of nicotine dependence (1.85, 1.83-1.87) than not, Similarly, the patients with angina pectoris were noted to have a higher association with cocaine related disorders (2.21, 1.86-2.62), and those with atrial fibrillation had a higher association alcohol related disorders (1.14, 1.11-1.17). Conclusion: Our study demonstrates the variability of CVD and CeVD in patients hospitalized for SUD. Findings from our study may help promote increased awareness and early management of these events. Further studies are needed to evaluate specific effects of frequency and dose on the incidence and prevalence of CVD and CeVD in patients with SUD.

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

The health of the landing gear retraction and extension hydraulic system may be assessed using fuzzy comprehensive evaluation (FCE), however the traditional FCE method depends solely on human assessment by specialists, which is excessively subjective. To address the issue of excessive human subjective variables in the assessment, an improved FCE model based on enhanced risk coefficient is provided, which includes four consideration indexes: failure probability, failure severity, failure detection difficulty, and failure repair difficulty. To reduce subjective human judgment errors entirely due to expert experience, the improved FCE takes into account the likelihood of failure using a statistical method, the severity of failure using a fault simulation analysis based on the LMS Imagine.Lab AMESim simulation platform, and the difficulty of fault detection and repair using the aircraft manufacturer's professional maintenance information. As part of the evaluation model, the range of health assessment values and accompanying treatment methods are included, making it easier to implement on a daily basis in aircraft maintenance. As a final step, the simulation is evaluated and the simulated faults are calculated.

Background: Over 900,000 cases of COVID-19 and 23,000 deaths have been reported till 13 July in India. Preserving the limited healthcare workforce is part of the strategy against the pandemic. Mortality and morbidity data have a role in customising this strategy. At this time, there is no published study on COVID-related mortality among doctors or other healthcare workers in India. Methods: A multi-pronged search was made for all reported deaths linked with COVID-19 among doctors in India. Details of COVID-linked deaths reported by mainstream media and by multiple professional social media sources were collected, screened, verified and analysed. Violent deaths occurring in the setting of pandemic-related work were separately listed. Deaths from other diseases were excluded. Results: Among 108 COVID-linked deaths among doctors, there were four pandemic-related violent deaths including three road accidents and a suicide. Of the 104 non-violent deaths, 55.5% were below 60 years of age, while 29.6% and 21% were below the age of 50 and 40 respectively. The average age at death was 56.3 (range 22 - 96). Over half of the deaths occurred among general practitioners, while surgical specialties accounted for 27% of the mortality. The geographic distribution of deaths of doctors correlated with the reported number of COVID-19 patients in each state. The total number of COVID-related healthcare worker deaths was 136, out of which eight (5.8%) were violent, and occurred in young individuals with an average age of 27.8 years. Conclusions: The majority of the 104 COVID-related non-violent deaths among doctors (55.5%) occurred below the age of 60. The average at death was 56.6 years. The states with highest number of COVID-19 cases had greater number of doctor deaths. Violent deaths among young healthcare workers in the setting of the pandemic requires special attention.

The planning and decision-making for a distributed energy supply concept in complex actor structures like in districts calls for the approach to be highly structured. Here, a strategy with strong use of energetic simulations is developed, the core elements are presented and research gaps are identified. The exemplary implementation is shown using the case study of a new district on the former Oldenburg airbase in northwestern Germany. The process is divided into four consecutive phases, which are carried out with different stakeholder participation and use of different simulation tools. Based on a common objective, a superstructure of the applicable technologies is developed. Detailed planning is then carried out with the help of a multi-objective optimal sizing algorithm and Monte Carlo based risk assessment. The process ends with the operating phase, which is to guarantee a further optimal and dynamic mode of operation. The main objective of this publication is present the core elements of the planning processes and decision-making framework based on the case study and to find and identify research gaps that will have to be addressed in the future.

Wave energy converter (WEC) arrays deployed in coastal regions may create physical disturbances potentially resulting in environmental stresses. Presently, limited information is available on the nature of these physical disturbance or the resultant effects. A quantitative Spatial Environmental Assessment Tool (SEAT) for evaluating potential effects of wave energy converter (WEC) arrays on nearshore hydrodynamics and sediment transport is presented for the central Oregon coast (USA) through coupled numerical model simulations of an array of WECs. Derived climatological wave conditions were used as inputs to the model to allow for the calculation of risk metrics associated with various hydrodynamic and sediment transport variables such as maximum shear stress, bottom velocity, and change in bed elevation. The risk maps provided simple, quantitative, and spatially-resolved means of evaluating physical changes in the vicinity of a hypothetical WEC array in response to varying wave conditions. Near-field risk of sediment mobility was determined to be moderate in the lee of the densely spaced array, where the potential for increased sediment deposition could result in benthic habitat alteration. Modifications to the nearshore sediment deposition and erosion patterns were observed near headlands and topographic features, which could have implications for littoral sediment transport. The results illustrate the benefits of a risk evaluation tool for facilitating coastal resource management at early market marine renewable energy sites.

Changes in extreme weather patterns are expected under climate change. In this study, a risk assessment was conducted using 4 building damage history datasets and 33 weather datasets (precipitation, wind speed, snow, and temperature) from 230 regions in South Korea to quantitatively analyze and predict building damage caused by potential future natural disasters. Decision tree analysis was used to evaluate building damage risk in 230 regions. The decision tree model to determine the risk of flood, gale, and typhoon was generated, which excluded gales, with less damage. The weight (variable importance) and limit value (damage limit) of the weather variables ware derived using the decision tree model. Using these two factors, we assessed the building damage risk in 230 regions in South Korea until 2100. The number of regions at risk of flood damage increased by more than 30% in average. Conversely, regions at risk of snowfall damage decreased by more than 90%. The regions at risk of typhoons decreased by 57.5% on average, and the number of regions at high risk of typhoon damage increased by up to 62.5% in RCP 8.5. These results can be used as objective data to minimize future building damage throughout South Korea, representing the first step towards sustainable development in the region with respect to disaster response.

High fructose and sugar-sweetened soft drink (SSSD) intakes are associated with elevated blood uric acid concentrations and increased risk of gout and cardiovascular disease. Fruits are naturally high in fructose but their effect on cardiometabolic risk is unknown. We examined the effect on serum uric acid and cardiometabolic risk factors of consuming fructose from either fruit or SSSD in overweight adults. 48 healthy, overweight (BMI≥ 28 kg/m²) men (n=21) and women (n=20) were randomised to either a fruit (n = 19) or SSSSD (n = 22) intervention for 4 weeks. The fruit group received 6 items of fresh and dried fruit per day and the SSSD group received 955ml of SSSD per day with treatments matched for energy and fructose content. Serum uric acid concentrations were significantly reduced in men in the fruit group compared to the SSSD group (difference 57.2 μmol/L [95% CI: 16.4, 98.0], p= 0.008) but there was no difference amongst women (1.3 μmol/L [95%CI: -9.5, 6.9], p= 0.295). There differences in weight change or other cardiometabolic risk factors. These findings suggest no need to restrict fruit intake in individuals with elevated serum uric acid concentrations, such as those with gout.

Ménière's disease (MD) has an unclear cause. The microvascular dysregulation of the inner ear has been increasingly pointed as a potential contributor. This study investigates the prevalence of cardiovascular risk factors (CVRFs) in MD patients compared to those with posterior circulation cerebral infarction (POCI). CVRFs like hypertension, diabetes, dyslipidemia, obesity, coronary heart disease, and smoking were assessed in both MD and POCI patients. Brain MRI identified POCI etiology as "small vessel occlusion" (SVO) or "other etiology" (OE). The study included 64 MD and 84 POCI patients. Compared to MD, POCI OE showed a higher prevalence of CVRFs across various age groups, including hypertension, diabetes, dyslipidemia, and smoking. Notably, the odds of having POCI OE were significantly higher for individuals with hypertension and smoking. On the other hand, POCI SVO showed similar prevalence of CVRFs compared to MD. This study reveals no significant difference in CVRF prevalence between MD and smaller vessel POCI. However, a clear distinction emerges when comparing MD to POCI with involvement of larger blood vessels. Further research is needed to confirm these findings and explore potential shared risk factors between POCI (SVO) and MD.

In order to achieve its carbon peak and neutrality targets, a high proportion of distributed power sources are connected to the distribution network in China, which greatly increases the risk of distribution network operation. Aiming at the above problems, this paper proposes an active distribution network risk planning model based on multi-source data from carbon capture and power internet of things, and conducts exceeding testing of distribution network based on the stochastic load flow algorithm with semi-invariant and level expansion, calculates the semi-invariant of each order of node state vectors and branch current vectors, and then utilizes the Gram-Charlier level expansion to obtain the exceeding probability density function and probability distribution function of the node voltages and line powers of the distribution network. The probability density function and probability distribution function of the exceeding are obtained using the Gram-Charlier series expansion. Combined with multi-source data, the active distribution network with integrated energy system considering carbon capture is modeled. According to the risk scenario of the distribution network, the nonconvex constraints in the model are simplified by the second-order cone relaxation, and the optimal planning scheme of the distribution network is solved by combining the gurobi solver with the risk index as the first-level objective and the economic benefit as the second-level objective. The simulation results of a coupled network consisting of a 39-node distribution network and an 11-node transportation network verify the effectiveness of the proposed model.

The infections caused by various bacterial pathogens both in clinical and community settings represent a significant threat to public healthcare worldwide. The growing resistance to antimicrobial drugs acquired by bacterial species causing healthcare-associated infections has already become a life-threatening danger noticed by the World Health Organization. Several groups or lineages of bacterial isolates usually called ‘the clones of high risk’ often drive the spread of resistance within particular species. Thus, it is vitally important to reveal and track the spread of such clones and the mechanisms by which they acquire antibiotic resistance and enhance their survival skills. Currently, the analysis of whole genome sequences for bacterial isolates of interest is increasingly used for these purposes, including epidemiological surveillance and developing of spread prevention measures. However, the availability and uniformity of the data derived from the genomic sequences often represents a bottleneck for such investigations. In this dataset, we present the results of a comprehensive genomic epidemiology analysis of 17,546 genomes of a dangerous bacterial pathogen Acinetobacter baumannii. Important typing information including multilocus sequence typing (MLST)-based sequence types (STs), intrinsic blaOXA-51-like gene variants, capsular (KL) and oligosaccharide (OCL) types, CRISPR-Cas systems, and cgMLST profiles are presented, as well as the assignment of particular isolates to nine known international clones of high risk. The presence of antimicrobial resistance genes within the genomes is also reported. These data will be useful for researchers in the field of A. baumannii genomic epidemiology, resistance analysis and prevention measure development.

: Healthcare workers are affected by mental health issues, burnout and turnover, and this burden is even greater during epidemics and pandemics, such as COVID-19. The purpose of this research is to provide an overview of the measures introduced or supported in the institutions of Quebec’s health and social services network during the COVID-19 pandemic with the aim of protecting healthcare workers’ mental health. An online questionnaire survey was administered in 2021 among human resources department personnel in health and social services network institutions involved in workplace mental health in Quebec. A total of 223 key informants representing 31 of the 34 public health and social services institutions in the province of Quebec in Canada responded to the questionnaire. Measures that focus on the needs of staff, involve all levels of authority and the ones that provide flexibility, support and recognition at work were more successful, according to the advisors surveyed. Future research into whether the same measures are considered effective or ineffective outside of a pandemic context is needed.

Alzheimer's disease (AD) is a progressive and evolving neurodegenerative disease with an insidious onset that can lead to memory loss and cognitive impairment. There is no effective treatment for this disease. However, early diagnosis plays an important role in treatment planning to slow down its progression, as treatment has the greatest impact in the early stages of the disease. Neurological images obtained through different imaging techniques provide powerful information and help diagnose the disease. With the wide application of deep learning techniques in disease diagnosis, especially the prominence of Convolutional Neural Networks (CNNs) in computer vision and image processing, more and more studies are proposing the use of this algorithm for the diagnosis of AD. In this paper, we first systematically introduce the impact of AD on people, detailing the biomarkers, early clinical symptoms, and risk factors of this disease. Secondly, it goes on to detail the development of CNNs, their form, and methods to help diagnose AD. It is proposed that CNNs can help diagnose AD by analyzing medical imaging data, particularly structural brain scans such as magnetic resonance imaging (MRI) and functional scans such as positron emission tomography (PET). Finally, it is concluded that CNNs are of great importance for the diagnosis of AD and that they are likely to play an increasingly important role in the early detection of the disease, the understanding of disease mechanisms, and ultimately, in the development of effective AD therapies and interventions. CNNs are playing an increasingly important role in the Their potential impact on healthcare emphasizes the importance of continued research and innovation in neural networks and medical imaging.

Cardiovascular diseases (CVD) remain the leading cause of death across the globe, hence, establishing strategies to counteract CVD are imperative to reduce mortality and the burden on health systems. Dietary modification is an effective primary prevention strategy against CVD. Research regarding dietary supplementation has become increasingly popular. This review focuses on the current in vivo, in vitro, and epidemiological studies associated with that of omega-3 polyunsaturated fatty acids (n-3 PUFA) and polar lipids (PLs) and how they play a role against CVD. Furthermore, this review focuses on the results of several major clinical trials examining n-3 PUFA regarding both primary and secondary prevention of CVD. Notably, we place a lens on the REDUCE-IT and STRENGTH trials. Finally, supplementation of PLs has recently been suggested as a potential alternative avenue for the reduction of CVD incidence versus neutral forms of n-3 PUFA. However, the clinical evidence for this argument is currently rather limited. Therefore, we draw on the current literature to suggest future clinical trials for PL supplementation. We conclude that despite conflicting evidence, future human trials must be completed to confirm whether PL supplementation may be more effective than n-3 PUFA supplementation to reduce cardiovascular risk.

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

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

Balanced fear supports human rational decision making and useful behavioral responses. In contrast, overwhelming, persistent, and unbalanced fear can paralyze the individual and result in heightened anxiety, lack of cognitive flexibility, fear-based public compliance and serious mental health issues. Psychobiotics research has established that a healthy microbiome is required for balanced fear and mental health protection via control of fear extinction. The recent Covid-19 pandemic featured daily, persistent, fear-of-a single contagion conditioning on a global scale paired with various behavioral mandates (e.g., lockdowns of the healthy, masks, isolation from environmental microbes and each other) that degraded the human microbiome and isolated us from each other and useful environmental microbes. It also ignored the historic role of secondary bacterial pathobionts, in pandemic deaths. This narrative review examines how institutional promotion of fear-of-a single contagion, lack of balanced risk communication, and appalling disregard of our fundamental nature (as majority-microbial human superorganisms) resulted in problems rather than solutions. This review concludes that government-public health-media promotion of pervasive fear and microbiome-degrading behaviors: 1) increased public compliance, 2) reduced cognitive flexibility, and 3) increased risk of mental health conditions. It further argues that microbiome-first public health should be embraced to ensure that human freedom, rather than paralyzing fear, dominates our future.

The use of logistic regression models in data analysis and machine learning has expanded in recent years and has become the primary preference of researchers in risk assessment studies across a wide range of scientific fields. From the assessment of credit risk in financial institutions to the estimation of risk factors for traffic accidents or the identification of etiological factors for chronic diseases. All logistic models are natural extensions of the simple binary model, and their interpretation is based on it. Using the data of a cross-sectional study on the risk factors of traffic collisions, the two main extended models of logistic techniques, multinomial and ordinal logistic regression, are presented in the article in detail. Emphasis is placed on the use of ordinal regression since the outcome variable of the collision data is defined as ordinal measurement reflecting a latent continuous scale.

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

In the context of global changes, Nature-Based Solutions (NBSs) increasingly draw attention as a possible way to reduce disaster risk associated with extreme hydro-meteorological events while providing human well-being and biodiversity benefits at the same time. The PHUSICOS platform is dedicated to gather and analyse relevant NBSs used to reduce disaster risk associated with extreme hydro-meteorological events in mountainous and hilly lands. To design the platform, an in-depth review of 11 existing platforms has been performed. The platform currently references 152 literature NBS cases and is continuously enriched with demonstrator sites through the contribution of NBS community. The platform also proposes a qualitative assessment of the NBSs collected according to 15 criteria related with five ambits: disaster risk reduction, technical and economical feasibility, environment, society and local economy. This paper presents the structure of the platform and a first analysis of its content.

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

Mediterranean climate is marked by arid climate conditions in summer, therefore, crop irrigation is crucial to sustain plant growth and productivity in this season. If groundwater is utilized for irrigation, an impressive water pumping is needed to satisfy crop water requirements at catchment scale. Consequently, irrigation water quality gets worse, specifically considering groundwater salinization near the coastal areas due to seawater intrusion, also triggering soil salinization. With reference to an agricultural coastal area in the Mediterranean basin (Southern Italy), close to the Adriatic sea, an assessment of soil salinization risk due to processing tomato cultivation was carried out. A simulation model was arranged to perform, on daily basis, a water and salt balance along the soil profile. Long-term weather data and soil physical parameters representative of the considered area were utilized in applying the model, also considering three salinity levels of irrigation water. Based on the climatic analysis performed and the model outputs, the probability of soil salinity came out very high, such as to seriously threaten tomato yield. Autumn-winter rainfall resulted frequently insufficient to leach excess salts away from the soil profile and reach sustainable conditions of tomato cultivation. Therefore, alternative cropping strategies were prospected.

Nutrition support is increasingly recognized as a clinically relevant aspect of the intensive care treatment of cardiac surgery patients. However, evidence from adequate large-scale studies evaluating its clinical significance for patients’ mid- to long-term outcome remains sparse. Considering nutrition support as a key component in the perioperative treatment of these critically ill patients, led us to review and discuss our understanding of the metabolic response to the inflammatory burst induced by cardiac surgery. In addition, we discuss how to identify patients who may benefit from nutrition therapy, when to start nutritional interventions, present evidence about the use of enteral and parenteral nutrition and the potential role of pharmaconutrition in cardiac surgery patients. Although the clinical setting of cardiac surgery provides advantages due to its scheduled insult and predictable inflammatory response, researchers and clinicians face lack of evidence and several limitations in the clinical routine, which are critically considered and discussed in this paper.

This article presents a low-cost insurance system developed for small-hold farms in disaster-prone regions, primarily using free Earth Observation (EO) data and Free Open Source Software (FOSS) – collectively termed sustainable geoinformatics - with a proprietary mobile phone app that enables verification. The study examined 30 farms in Risaralda department, Colombia. A Digital Elevation Model (12.5m pixels) from the ALOS PALSAR satellite sensor was used with a Geographical Information System (GIS) to map the terrain, drainage and geohazards of each farming district. Google Earth Engine (GEE) was used to carry out Time Series Analysis of 15 EO and weather datasets for 1998 to 2020. This analysis enabled the levels of risk from hydrometeorological hazards to be determined for each farm of the study, providing key data for the setting of insurance premiums. A parametric insurance product was piloted using GPS-tagged, time-stamped mobile phone photos to verify crop health. Key features of this insurance system are its low operational cost and rapid damage verification, relative to conventional approaches to farm insurance. It is an affordable form of insurance for small-scale farmers, with the rapid verification and payment of claims. This relatively fast, low-cost and affordable approach to insurance for small-scale farming enhances sustainable development by enabling policy-holder farmers to recover more quickly from disasters.

The permanent protection of groundwater and surface sources of drinking water in the required raw water quality from contamination is the primary foundation of preserving the life of society and the entire engineering infrastructure operability not only in the Czech Republic but also in other countries of the world. One of the basic ways of contamination prevention enhancement and risk mitigation of putting a water source out of operation is the identification of the given risk as well as soil contamination monitoring. The purpose of this study is to understand specific aspects of contamination threats to drinking water sources and determine possible solutions to eliminate the risk, shown in the example case study in the Czech Republic conditions. Based on the findings, a proposal to enhance the prevention of water source contamination has been elaborated in the form of recommendations regarding the ways and means used to monitor the risk areas and to implement technical measures so as to eliminate or terminate the specified risk. A complex approach based on the integration of interdisciplinary factors and methodology is required to minimize the threats of aquatic ecosystems contamination in the Czech Republic.

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

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

Background: we aim to investigate attitudes toward vaccination, by analyzing empirical factors associated with vaccine acceptance in the Lazio region mpox vaccination (MpoxVax) campaign in Italy. Methods: all subjects who accessed to MpoxVax and signed the informed consent were prospectively enrolled in the MPOX-VAC Study and were asked to fill out an anonymous survey. Two endpoints were selected: ‘delayed acceptance’ and ‘early acceptance’, defined as access for vaccination &gt;60 and ≤30 days from the vaccination campaign starting (VCS), respectively. Results: over the study period 1717 individuals underwent vaccination: 129 (7%) &gt;60 [1588 (92.5%) ≤60] and 676 (60%) ≤30 days from VCS. A bisexual orientation, a lower education level and a worse perceived physical and mental health were associated with delayed access to vaccination. Being Pre-Exposure Prophylaxis (PrEP) users and, marginally, HIV positive, having a high perceived risk for mpox infection and reporting high-risk behaviors like the use of recreational drugs/chems, sex under the influence of drugs and/or alcohol and higher number of principal sexual partners, were associated with early access to vaccination. Conclusions: according to our data, risk awareness was a major determinant of early mpox vaccination acceptance. Conversely, worse perceived health status and a low educational level were critical factors associated with delayed vaccination.

The interrelatedness of social-structural aspects and psychological features with the vaccination intention provides the context to explore personal psychological fea-tures related to general decision-making and vaccine-related dispositions, and their contribution to the intention to vaccinate, within post-pandemic circumstances, after the imposed possibility of choosing a vaccine brand. The aim of our study was to map the function (promotive, protective, risk, vulnerability) of a set of psychological aspects in the intention to vaccinate, in people with different social roles regarding the vaccination. We surveyed three samples of people: healthcare providers (HPs), parents, and lay people, within the context of the after-pandemic. Negative vaccine attitudes lower intention to vaccinate in all regression models (all βs ranging from -.128 to -.983, all ps < .01). The main results indicate that, regardless of the sam-ple/social role, there is a shared attitudinal core for positive vaccination intention. This core consists of [high] trust in large corporations, government, and healthcare systems, as well as perceived consensus on vaccine safety/efficacy and experience of freedom (protective factors), and [low] vaccination conspiracy beliefs, trust in social media, and choice overload (risk and vulnerability factors, respectively). There are no common promotive factors of intention to vaccinate; for parents, perceived consensus on vaccines, and trust in corporations and the healthcare system play such roles, for HPs experience of freedom is obtained as a unique promotive factor. In contrast, for laypeople, no unique promotive factors were found. These results and guidelines for the promotion of positive vaccination behavior are further discussed.

This paper presents a limited scope dynamic probabilistic risk assessment (D-PRA) on the survivability of commercial of the shelf (COTS) drones tasked with surveilling areas with varying radiation levels after a nuclear accident. The D-PRA is based on a discrete-dynamic event tree (D-DET) approach, which couples with the OpenEPL error propagation framework to model sequences leading to Loss of Mission (LOM) scenarios due to component failures in the drone’s navigation system. Radiation effects are simulated by calculating the total ionizing dose (TID) against the permissible limit per component, and errors are propagated within the electronic hardware and software blocks to quantify navigation system availability per radiation zone. The proposed methods are integrated into the traditional event tree/fault tree approach and the most vulnerable components are radiation-hardened (RAD-HARD) to the extent specified by a predefined mission success criterion. The results demonstrate the usefulness of the proposed approach in performing trade studies for incorporating COTS components into RAD-HARD drone designs.

Manufacturing corporations has the acceptance of the Outsourcing Process (OP) to improve industrial activities as well as to archive the revenue objectives, and with this, Risk Analysis (RA) tools are constantly used to assure expected results. Failure Mode and Effect Analysis (FMEA) is one of preferred RA tools, moreover, it is proven that FMEA adds uncertainty because of the human participation at the RA, afterward it is demonstrated that Pythagorean Fuzzy Dimensional Analysis – FMEA – Value Stream Mapping (PFDA-FMEA-VSM) method removes the uncertainty in RA, likewise it aids to the stakeholders for decision making, giving more advantages improving the use of the resources on the project. This document exhibits a real case scenario in a manufacturing firm applying PFDA-FMEA-VSM method adapted for manufacturing OP. The application of PFDA-FMEA-VSM shows solid RA results, removing the human intervention uncertainty added to the risk ranking, gives advantages to the stakeholders for visualize the main risks in detailed diagram, as well as make easier to take better decisions on where to apply resources and mitigate risks during OP.

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

Type 2 Diabetes Mellitus (T2DM) is associated with a high risk of atherosclerotic cardiovascular (CV) disease. Contributing pathophysiologic factors include endothelial dysfunction caused by excessive production of reactive oxygen species (ROS), increased activity of nuclear factor kB (NFkB), altered macrophage polarization, and reduced synthesis of endothelial progenitor cells (EPC). Consequently, there can be a potentially rapid progression of the atherosclerotic disease with a higher propensity to unstable plaque, leading to increased cardiovascular mortality. Management is aimed at prevention, early diagnosis, and treatment of hyperglycemia and vascular complications. Innovative therapeutic approaches for T2DM seek to customize the antidiabetic treatment to each patient in order to optimize glucose-lowering effects, minimize hypoglycemia and adverse effects, and prevent cardiovascular events. The newer drugs (Glucagon Like Peptide-1 Receptor Agonists, GLP-1 RAs; Sodium GLucose coTransporter-2 inhibitors, SGLT2is; DiPeptidyl Peptidase-4 inhibitors, DPP4is) impact body weight, lipid parameters, and blood pressure, as well as endothelial function, inflammatory markers, markers of oxidative stress, and subclinical atherosclerosis. The present review summarizes the results of trials that evaluated the cardiovascular safety of these drugs and found them to be safe from the CV standpoint.

The number of individuals meeting criteria for genetic counseling and testing for hereditary cancer syndromes (HCS) is far less than the number that actually receive it. To facilitate identification of patients at risk for HCS, Counsyl developed a digital identification tool (digital ID tool) to match personal and family cancer history to National Comprehensive Cancer Network (NCCN) BRCA-related Hereditary Breast and Ovarian Cancer (HBOC), Lynch syndrome, and polyposis testing criteria in one-to-one, automated fashion. The purpose of this study was to validate the ability of the digital ID tool to accurately identify histories that do and do not meet NCCN testing criteria. Methods: Third-party recorded three-generation pedigrees were retrospectively reviewed by a certified genetic counselor (CGC) to determine if independent events included in pedigree histories met NCCN guidelines, and were then sorted into groups: high risk events (meets criteria) and low risk events (does not meet criteria). Events were entered into the digital ID tool to determine the extent of its concordance with events sorted by CGC review. Statistical tests of accuracy were calculated at a 95% confidence interval (CI). Results: 197 pedigrees were reviewed consecutively representing 765 independent events for analysis across groups. 382/382 (100%) high risk events identified by the digital ID tool and 381/383 (99.47%) low risk events identified by the digital ID tool were concordant with CGC sorting. The digital ID tool had a sensitivity of 100% (99.04-100% CI) and specificity of 99.48% (98.13-99.94% CI). The overall accuracy of the digital ID tool was estimated to be 99.74% (99.06-99.97% CI), reflecting the rate at which the digital ID tool reached the same conclusion as that of CGC review of pedigree events for the recommendation of genetic testing for individuals at risk for HCS. Conclusions: The digital ID tool accurately matches NCCN criteria in one-to-one fashion to identify at-risk individuals for HCS and may be useful in clinical practice, specifically for BRCA-related HBOC and Lynch Syndrome.

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

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

The city administration of China planned numerous metro projects and more metros can hardly avoid undercrossing a bridge. While metro shield construction when undercrossing a bridge (MSCUB) is frequently located in complicated natural and social context, which made the construction process more susceptible to safety accidents. Therefore, it is crucial to look into safety risk of MSCUB. The paper identified the safety risk factors during SSCUR by using literature review and experts’ evaluation, proposed a novel safety risk assessment model by integrating CFA and FER, and then selected a project case to test the validity of the suggested model. Research results show that (a) a safety risk factors list of MSCUB was identified, including 4 first-level safety risks and 37 second-level safety risk factors; (b) the proposed safety risk assessment model can be used to measure the risk values of the overall worksite safety risk, the first-level safety risks and the safety risk factors of MSCUB; (c) environment-type safety risk and personnel-type safety risk have higher risk values when shield construction undercrossing a bridge; (d) when compared to worker-type safety risk, manager-type safety risk is the higher risk value. The research can enrich the theoretic knowledge of MSCUB safety risk assessment and provide references to safety managers for conducting scientific and effective safety management on the construction site when subway undercrossing a river.

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

The epistemology of the traditional risk assessment examined has a taxonomy based upon deterministic, behaviouristic and compatibilist methodologies which are likely driven by neo-liberal market related requirements for bigger, faster cheaper wind-turbines. Analysis of available risk assessments suggested that there is no conscious effort to deceive the reader although the intended audience is unclear. The language, and scoring mechanisms utilized indicates the presence of conformity bias, confirmation bias, and numerical inconsistency leading to data ossification. By reverse engineering risk assessment content, Pragmatic and Social Psychological aspects can be investigated, and the adequacy of the document can be evaluated using evidence-based models.

Patients with pT1 high-grade (HG) bladder cancer (BC) and a very high risk of progression might benefit from immediate radical cystectomy (RC), but this option remains controversial. Validation of a standardized method to evaluate the extent of lamina propria (LP) invasion (with recognized prognostic value) in transurethral resections (TURBT) specimens is still needed. The Rete Oncologica Lombarda (ROL) system showed a high predictive value for progression after TURBT in recent retrospective studies. Our aim was to validate ROL system on a large mono-institutional prospective series of primary urothelial carcinomas. From 2016 to 2020, we adopted ROL for all patients with pT1 HG BC on TURBT. We employed a 1.0-mm threshold to stratify tumors in ROL1 and ROL2. A total of 222 pT1HGBC were analyzed. Median age was 74 years, with male predominance (73.8%). ROL was feasible in all cases: 91 cases were ROL1 (41%) and 131 ROL2 (59%). At a median follow up of 26.9 months (IQR 13.8-40.6), we registered 80 recurrences and 40 progressions. ROL was a significant predictor of tumor progression at both univariable (HR 3.53; CI 95% 1.56 – 7.99; p&lt;0.01) and multivariable (HR 2.90; CI 95% 1.25 – 6.75; p=0.01) Cox regression analyses. At Kaplan-Meier estimates, ROL showed correlation with both PFS (p=0.0012) and RFS (p=0.0167). Our results confirmed the strong predictive value of ROL for progression on a large prospective series. We encourage the application of ROL for reporting the extent of LP invasion, substaging T1 HG BC, and improving risk tables for urological decision making.

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

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

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

The Global Burden of Disease Study (GBD) 2019 reveals an increasing prevalence of Type 2 Diabetes Mellitus (T2DM) from 1990 to 2019. This study delves into the role of dietary risk factors across different demographic and socioeconomic groups. Utilizing data from the GBD 2019, it analyzes age-adjusted T2DM metrics—death counts, Disability-Adjusted Life Years (DALYs), and Age-Standardized Rates (ASR)—stratified by age, sex, and region. The study employed Estimated Annual Percentage Changes (EAPCs) to track trends over time. Results show that in 2019, 26.07% of T2DM mortality and 27.08% of T2DM DALYs were attributable to poor diets, particularly those low in fruits and high in red and processed meats. Geographic variations in T2DM trends were significant, with regions like Southern Sub-Saharan Africa and Central Asia experiencing the most substantial increases in Age-Standardized Mortality Rate (ASMR) and Age-Standardized DALY Rate (ASDR). A positive correlation was noted between Socio-Demographic Index (SDI) and T2DM burden due to dietary risk factors. The study concludes that targeted public health initiatives promoting dietary changes could substantially reduce the global T2DM burden.

The electronic cigarette or e-cigarette is the new alternative method to deliver nicotine. In 2007, the United States introduced vaping devices on the market. Due to their attractive taste and lack of adverse effects, these vaping devices have gained popularity among youth and adults. However, there has been increasing evidence that vaping can cause severe lung injury, and these devices release toxic chemicals into the body. E-cigarettes are recognized as a global threat to public health. Nicotine, the most prevalent chemical in vaping devices, is associated with neurological problems and cognitive decline. Long-term use of e-cigarettes can cause adverse health problems, including respiratory illnesses, asthma, bronchitis, and lung inflammation. In 2019, the Centers for Disease Control and Prevention (CDC) officially declared vaping-associated illness EVALI (e-cigarette or Vaping Product Associated Lung Injury). The US Surgeon General published an alarm in December 2016 that e-cigarette consumption among adolescents and teens in the US is a "major public health concern" and that more young people are now vaping than smoking traditional cigarettes and cigars. Since its commercial introduction in 2003, modern electronic cigarettes (or E-cigarette s) have become increasingly popular with smokers, non-smokers, and those who used to smoke who have switched to them. With such a rise in consumption, people are becoming more aware of the irritating, harmful, and perhaps cancer-causing effects on the lungs. (Chadi et al., 2019; Dinardo & Rome, 2019; Lyzwinski et al., 2022; Marrocco et al., 2022; O’Callaghan et al., 2022)

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

Background: Macrophage inflammatory protein-1 alpha (MIP-1α) and C-reactive protein (CRP) are pro-inflammatory biomarkers that quantify clinical and subclinical inflammation in cardiac ischemia in cardiac inflammation and disease. Adiponectin is an anti-inflammatory marker associated with good health. The susceptibility of periodontitis patients to cardiovascular events needs to be evaluated. Objective: This study aims to assess the levels of biomarkers in periodontitis patients with and without acute myocardial infarction (AMI) compared to controls. Material and methods: Pro-inflammatory and anti-inflammatory analytes were examined by collecting unstimulated saliva from three groups (n = 20/each): healthy individuals, individuals with stage III periodontitis, and post-myocardial infarction patients with stage III periodontitis. The samples were collected within 48 hours of AMI. Results: Adiponectin levels were significantly lower in patients with periodontitis with and without AMI compared to controls, while CRP and MIP-1α were significantly higher in patients with periodontitis with and without AMI compared to controls. The highest titers for MIP-1α and CRP were detected among patients with periodontitis with and AMI. Conclusion: Our study provides evidence of the association between periodontitis and salivary analytes that occur in tandem with cardiovascular disease. The lower levels of Adiponectin and higher levels of CRP and MIP-1α in patients with periodontitis indicate that this condition is a potential risk factor for cardiovascular disease. The findings emphasize the importance of early detection and intervention for periodontitis patients to prevent cardiovascular events.

The paper discusses how joint damage and deterioration affect the seismic response of existing reinforced concrete frames with sub-standard beam-column joints. The available simplified modeling techniques are critically reviewed to propose a robust, yet computationally efficient technique for simulating the nonlinear behavior of substandard beam-column joints. Improvements over the existing models include simulation of the cyclic deterioration of joint stiffness and strength as well as pinching in the hysteretic response, implemented considering a deteriorating hysteretic rule. A fibre-section forced-based inelastic beam-column element is developed; considering improved material models and fixed-end rotation due to bond failure, rebars-slip and inelastic extension, to simulate the deteriorating cyclic behavior of existing pre-cracked beam-column members. For the assessment of frames with substandard exterior beam-column joints, a nonlinear model for the exterior joint is developed and validated through a full-scale quasi-static cyclic test performed on a substandard T-joint connection. The proposed model allows considering structural performance in risk assessment while accounting for true inelastic mechanisms at the joints.

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

Lung cancer (LC) is the second most common cancer and the leading cause of cancer deaths in the U.S. Insulin therapy, a key treatment for managing Type 2 Diabetes Mellitus (T2DM), may increase LC risk. The impact of non-insulin antidiabetic drugs, particularly GLP-1 receptor agonists (GLP-1RAs), on LC risk is not well understood. This study evaluated LC risk in T2DM patients comparing seven non-insulin antidiabetic agents to insulin. Using the TriNetX Analytics platform, we analyzed de-identified electronic health records of 1,040,341 T2DM patients treated between 2005-2019, excluding those with prior antidiabetic use or LC diagnoses. We calculated hazard ratios and confidence intervals for LC risk and used propensity score matching to control for confounding factors. All non-insulin antidiabetic drugs, except alpha-glucosidase inhibitors, significantly reduced LC risk compared to insulin, with GLP-1RAs showing the greatest reduction (HR: 0.49, 95% CI: 0.41, 0.59). GLP-1RAs were consistently associated with lowered LC risk across all histological types, races, genders, and smoking statuses. These findings suggest that non-insulin antidiabetic drugs, particularly GLP-1RAs, may be preferable for managing T2DM while reducing LC risk.

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

Cryptocurrencies have obtained a crucial position in the international financial landscape. The cryptocurrency market has been perceived as a highly volatile market since the inception of Bitcoin. This study investigates the relevant performance of extreme value models (EVM) in estimating the Value-at-Risk (VaR) of Bitcoin and Ethereum returns. The extreme value mixture models, GPD-Normal-GPD (GNG) and GPD-KDE-GPD models are fitted to the returns of Bitcoin and Ethereum and the Kupiec likelihood backtesting procedure is performed on the VaR estimates to assess the fits. Both models’ results showed that the fits were a much more decent representation of the observed data when compared to the Normal distribution. The backtesting results showed that the GPD-KDE-GPD model’s fit was superior to that of the GPD-Normal-GPD for both sets of returns at all VaR risk levels except at the 99% level. The results of this study may assist with understanding the dynamics and risks associated with cryptocurrencies and can serve as a beneficial tool for decision-making and risk management to investors, traders, financial institutions and many other participants in the cryptocurrency ecosystem.

Urbanization induced land use land cover (LULC) changes intensify the urban heat island effects. It magnifies the risk of urban dwellers and sometimes causes the loss of human life, defined as heat-related health risk (HRHR). Hence, urban LULC planning plays a crucial role. Present study analyses the impact of composition and configuration of urban LULC defined as urban landscape metric (ULM) on HRHR in Delhi at the ward level. Firstly, the HRHR is measured by using satellite thermal and other digital data. Then, measured HRHR is validated by conducting a rapid field survey. Thirdly, ULM measured at ward level using Fragstat 4 software. Finally, both, HRHR and ULM linked with bi-variate Moran's I and impacts of ULM are assessed using ordinary least square (OLS) and spatial error (SE) regression. The result indicates the high risk is found as clustered in north-east, central and middle of south-west Delhi. Built-up density intensifies HRHR and abundance of vegetation reduce it; however, it is not similar for all vegetation patches. Larger vegetation patches surrounded by dense built-up might not able to reduce the risk as much as a large vegetation patch could in other regions. Findings can be helpful for heat resilient city planning.

Retrogressive breach failures or coastal flow slides occur naturally in the shoreface in fine sands near dynamic tidal channels or rivers. They sometimes retrogress into beaches, shoal margins and river banks where they can threaten infrastructure and cause severe coastal erosion and flood risk. Ever since the first reports were published in the Netherlands over a century ago, attempts have been made to understand the geo-mechanical mechanism of flow slides. In this paper we have established that events, observed during the active phase, are characterized by a slow and steady retrogression into the shoreline, often continuing for many hours. This can be explained by the breaching mechanism, as elaborated in this paper. Recently, further evidence has become available in the form of video footage of active events in Australia and elsewhere, often publicly posted on the internet. All these observations justify the new term ‘retrogressive breach failure’ (RBF event). The mechanism has been confirmed in small-scale flume tests and in a large-scale field experiment. With a better understanding of the geo-mechanical mechanism, current protection methods can be better understood and new defense strategies can be envisaged. In writing this paper, we hope that the coastal science and engineering communities will better recognize and understand these intriguing natural events.

Ice formation on aircraft surfaces poses significant safety risks, and current detection systems often struggle to provide accurate, real-time predictions. This paper presents the development and comprehensive evaluation of a smart ice control system using a suite of machine learning models. The system utilizes various sensors to detect temperature anomalies and signal potential ice formation. We trained and tested supervised learning models (Logistic Regression, Support Vector Machine, Random Forest), unsupervised learning models (K-means clustering), and neural networks (Multi-Layer Perceptron) to predict and identify ice formation patterns. Experimental results demonstrate that our smart system, driven by machine learning, accurately predicts ice formation in real-time, optimizes de-icing processes, and enhances safety while reducing power consumption. This solution holds the potential for improving ice detection accuracy in aviation and other critical industries requiring robust predictive maintenance.

Patients with Peripheral-artery-disease (PAD) are prone to risks of major-adverse-limb-events (MALE), and major-adverse-cardiovascular-events (MACE). CHA2DS2-VASc is a prognostic score for Atrial fibrillation stroke risk, however, no study exists that evaluated its predictability for MALE and MACE in PAD patients. In this study, patients with PAD were stratified into four risk groups based on CHA2DS2-VASc score. Cox-proportional hazards models,10-fold cross-validation and Receiver operating characteristic (ROC) analyses were utilized to evaluate the predictability of CHA2DS2-VASc for predicting MALE, MACE, and MALE+MACE. Kaplan-Meier analysis estimated the survival-probability of risk-groups. CHA2DS2-VASc was found to be a significant predictor of MACE (hazard ratio (95% confidence interval; P) = 3.47 (0.99 - 12.18; 0.052), 4.12 (1.19 - 14.14; 0.024), and 5.06 (1.48 – 17.28; 0.009), for moderate-, high- and very-high-risk groups, respectively, while for MALE and MALE+MACE significance was achieved only for high-risk group. MACE demonstrated AUC > 0.8, good-discrimination (c-index > 0.8) and good-calibration. However, MALE and MALE+MACE models failed to achieve good performances. Based on all findings, CHA2DS2-VASc could potentially serve as a risk stratification score for predicting MACE in patients with PAD but failed to qualify as a good predictor for MALE.

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