Transcatheter Aortic Valve Implantation (TAVI) now represents the mainstay in the treatment of severe aortic stenosis. Owing to its exceptional procedural efficacy and safety, TAVI has been extended to include patients at lower surgical risk, thus now encompassing a diverse patient population receiving this treatment. Yet, long-term outcomes also depend on optimal medical therapy for secondary vascular prevention, with antithrombotic therapy serving as a cornerstone. Leveraging data from multiple randomized controlled trials, current guidelines generally recommend single antithrombotic therapy, with either single antiplatelet therapy (SAPT) or oral anticoagulation (OAC) alone in those patients without, or with atrial fibrillation respectively. Yet, individualization of this pattern, as well as specific case uses, may be needed based on individual-patient characteristics and concurrent procedures. This review aims to discuss the evidence supporting antithrombotic treatments in patients treated with TAVI, indications for a standardized treatment, as well as specific considerations for an individualized approach to treatment.

Background: Over the past two decades, the Copenhagen Psychosocial Questionnaire (COPSOQ) has been established as a valid instrument to measure psychosocial stress at work. Currently, the COPSOQ international network is responsible for monitoring and improving COPSOQ. In 2019, a new questionnaire was published, and the Greek version is now being validated. Methods: The measurement qualities of the Greek COPSOQ III have been explored in accordance with the usual requirements of a validation study as defined by DIN EN ISO 10075-3. A sample of observations from 2,189 participants surveyed with the COPSOQ in Greece was used to validate the current version with appropriate statistical analyses. Exploratory factor analysis was used to assess the statistical relationships for many scales. Results: With its 108 items and 40 scales, the Greek COPSOQ III includes all psychosocial work factors that have been internationally validated and remain compatible with approximately 72% of the COPSOQ III German version content. In addition to the primary results, congruence with widely used theoretical approaches such as the demand-control (−support) model (DCM) or the job demands-resources model (JDR) is generally satisfactory. In summary, our validation study for the Greek COPSOQ III version showed adequate reliability and validity, which is in line with the findings of the COPSOQ III questionnaire from other European countries, and it is also compatible with the validation of the German COPSOQ III (Lincke, 2021). Our regression analysis revealed that 34 psychosocial work factors (34 “context” scales) could adequately predict the scores of the satisfactory and health scales (6 “outcome” scales). The analysis also revealed the top five (5) predictors (context variables) for each of the six (6) “effect” scales (outcome variables). Conclusions: With the launch of COPSOQ III in Greece, current and new workplace psychosocial aspects could be explored. COPSOQ III (GR) is a beneficial instrument for enterprise research and risk assessment.

The Internet-of-Things (IoT) enables enterprises to obtain profits from data but triggers data protection questions and new types of cyber risk. Cyber risk regulations for the IoT however do not exist. The IoT risk is not included in the cyber security assessment standards, hence, often not visible to cyber security experts. This is concerning, because companies integrating IoT devices and services need to perform a self-assessment of its IoT cyber security posture. The outcome of such self-assessment needs to define a current and target state, prior to creating a transformation roadmap outlining tasks to achieve the stated target state. In this article, a comparative empirical analysis is performed of multiple cyber risk assessment approaches, to define a high-level potential target state for company integrating IoT devices and/or services. Defining a high-level potential target state represent is followed by a high-level transformation roadmap, describing how company can achieve their target state, based on their current state. The transformation roadmap is used to adapt IoT risk impact assessment with a Goal-Oriented Approach and the Internet of Things Micro Mart model.

Improving HIV testing efficiency saves financial and material resources for health. We conducted a retrospective secondary data analysis of routinely collected HIV risk screening program data in Uganda, from October to November 2019, to determine the performance characteristics of the adolescent and adult HIV risk screening tool in public health facility settings. A total of 19,854 clients had been screened for HIV testing eligibility and tested for HIV. The overall positivity rate (cluster weighted prevalence of HIV) among those screened was 4.5% (95% CI: 4.1%-4.8%) versus 3.71% (95% CI: 3.06-4.50) among those not screened. The sensitivity and specificity of the risk screening tool were 90.7% (95% CI: 88.4%, 92.7%) and 75.8%, (75.2-76.4) respectively. With screening, the number needed to test to identify one PLHIV was reduced from 27 to 22. Although risk screening would have led to a 24.5% (4,825/19,704) reduction in testing volume, 9.3% (68/732) of PLHIV would have been missed, being misclassified as not eligible for testing. The cost per PLHIV identified fell by 3% from $69 without screening to $66.9 with screening. We recommend the use of scientifically validated HIV risk screening tools, and a need to explore the use of HIV self-testing as a test for tirage.

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

The novel coronavirus (COVID-19) was first reported in the U.S. on December 29, 2019 and has spread rapidly throughout the country, affecting individuals with varying severity due to their risk status. According to the Centers for Disease Control and Prevention, it is estimated that 45.4% of US adults are at higher risk for complications from coronavirus disease because of cardiovascular disease, diabetes, respiratory disease, hypertension, or cancer. In this study, we developed a mathematical model to assess the impact of a COVID-19 vaccine among low and high risk groups. Numerical simulations shows vaccinating both low and high risk groups simultaneously, rather than prioritizing the vaccine on high risk group only, further reduces the daily mortality. The result supports the need for an aggressive vaccination program, regardless of whether individuals are within the low or high risk population.

Flood is identified as one of the major disasters in the world; it destroys both human and properties across the world, where lives are lost, properties, public infrastructure, farmlands and agricultural produce with farm crops carted away as a result of flood disaster. Studies revealed that the flood in itself is not the danger, but the level of human vulnerability to flooding disaster risk, which enhances its destructive capabilities. However, based on the challenges poses by flood disaster risk, this research identifies Ala river in Akure as a potential cause of flood, considering its location and other human activities around the river. Therefore, the research used Ala-river a case study to identify and mapped out areas susceptible to flood disaster risk. The research made use of both literature review and conducted goe-data gathering with the application GIS-computer database to retrieve georeferencing relevant data from the fieldwork in the study area of Ala-river basin to mapped out locations vulnerable to achieve the research aim. The research adopted a Geo-mapping of the vulnerable area to Ala-River basin using arc-GIS tool in combination with other software such as IKONAS and OLI (Operation Land Imager) for the production of the study area imagery, ER-ITERIM was used for the collection of rainfall data and FAO was applied for digital soil mapping. These applications produced; the land use/land cover map, digital elevation map, buffer map using 30 meters setback, annual rainfall map, soil types map, vulnerability map and soil textural table for the study area. Analysis of the produced and generated maps shows 316 buildings vulnerability to flood disaster risk; the soil texture and types, and alternative use to which the soil types can be useful. The research recommends that demolition of the identified 316 buildings prone to flood disaster and compliance of building construction to 30 meters setback by developers. Others are the conversion of the future land setback for urban agricultural purposes and preservation of water retention areas for agricultural activities during the dry season among others. The study concludes that relevant government agencies in the State and in particular in Akure South Local Government should ensure prompt compliance and implementation of the recommendations to avoid potential flood disaster risks.

Parkinson’s disease (PD) is the most common cause of movement disorder characterized by the progressive loss of dopaminergic neurons in the substantia nigra. It is increasingly recognized as a complex group of disorders presenting widely heterogenous symptoms and pathology. Except for the rare monogenic forms, the majority of the PD cases result from an interaction between multiple genetic and environmental risk factors. The search for these risk factors and the development of preclinical animal models are in progress hand in hand, providing mechanistic insights into the pathogenesis of PD. This review summarizes the studies that capitalize on modeling sporadic (i.e. non-familial) PD using Drosophila melanogaster and discuss their methodology, new findings and future perspective.

Background: Resistant hypertension (HTN) is associated with high risk of cardiovascular complications. Our study aimed to assess prevalence, characteristics and treatment of patients with resistant HTN; Methods: We screened 4340 consecutive cardiovascular patients and identified 3762 with HTN. Of them 128 fulfilled criteria for resistant HTN and were included in our study. We matched these patients to 128 hypertensive patients with controlled HTN; Results: Resistant HTN patients were 3.4% of all hypertensives. Most of these patients (67.2%) were at high or very high cardiovascular risk compared to controlled HTN patients (40.6%), p<0001. Resistant HTN patients had more frequently concomitant chronic kidney disease (CKD) (60.9%), overweight/obesity (52.3%), dyslipidemias (35.2%), smoking (27.3%) and diabetes (21.9%) compared to controlled HTN patients (37.5%, 29.7%, 28.1%, 14.1% and 7.8% respectively), p<0.001. Regression analysis showed strongest association of resistant HTN with CKD (OR 6.64), stage III HTN (OR 3.07) and obesity/overweight (OR 2.60). In contrast, single-pill combinations (SPCs) were associated with lower likelihood of uncontrolled HTN (OR 0.58); Conclusions: Resistant HTN represented a small proportion of all hypertensives in our study, but it was characterized by high/very high cardiovascular risk. Optimized therapy including increased usage of SPCs could improve blood pressure control and long-term prognosis of these patients.

Third and fourth-degree anal sphincter injuries are among the most severe traumas women can experience during childbirth, often leading to lifelong continence issues. Despite extensive research, current repair techniques are often inadequate, failing to provide long-term solutions. Women with previous severe injuries face a higher risk of recurrence in subsequent deliveries, making caesarean sections a safer option in many cases. The existing WHO classification system is outdated, as it doesn't account for injuries to muscles like the levator ani, which are crucial for continence. Effective repairs require skilled surgeons and often involve more than just fixing the sphincter. Smaller hospitals may not have the necessary expertise and resources for these complex repairs. Delaying repairs to allow specialists to perform them can be just as effective as immediate repairs. Comprehensive care that includes thorough anatomical knowledge and surgical skill is essential. As maternal age increases and birth rates decline, it's crucial for specialized centers to handle severe perineal injuries to ensure the best outcomes and long-term care for patients.

Anxiety disorders, characterized by excessive fear and anxiety, are increasingly recognized as significant comorbidities in chronic diseases such as Chronic Obstructive Pulmonary Disease (COPD). This study aimed to evaluate the prevalence of anxiety in COPD patients referred from primary care centers to pulmonology services and identify predictive factors for anxiety. Conducted as a multicentric, observational, and prospective study, 293 COPD patients were recruited, undergoing comprehensive respiratory and smoking histories, spirometry, and anxiety assessments using the Hospital Anxiety and Depression Scale (HADS). These results show: a diagnosis of suspected anxiety in in 85 patients (29.0%): 17 possible and 68 with a strong suspicion. The study found significant associations between anxiety and factors such as gender (women showed a risk 3.5 times higher than men), weight, and body mass index (BMI). Disease severity, smoking status, and clinical manifestations did not significantly influence anxiety prevalence. The findings underscore the need for systematic psychological evaluations in COPD management, advocating for the use of simple diagnostic tools like the HADS to facilitate referrals to mental health services. Addressing anxiety in COPD patients could potentially improve their quality of life and disease outcomes. The study highlights the importance of a multidisciplinary approach involving family medicine, pulmonology, and psychiatry to optimize COPD patient care and suggests future research should focus on the impact of anxiety treatment on COPD progression. These insights call for integrating psychological assessments into routine clinical practice for comprehensive COPD management.

Indices such as Body Mass Index (BMI), Waist Circumference (WC) and Waist to Height Ratio (WHtR) have emerged as tools to assess cardiovascular risks associated with abdominal obesity. The Timed Up and Go Test (TTUG) assesses mobility and the risk of falls, especially in the elderly and individuals with physical limitations. Objective: To correlate anthropometric indicators of cardiovascular risk (BMI, WC, WHtR) and performance in the TTUG in elderly people who practice physical activity. Methods: Cross-sectional study, CAAE: 27116319.1.0000.8044, elderly people, both sexes, average age 68 years. Anthropometric data was collected: BMI, WC, WHtR and TUG test results. Results: Average values: weight (67.8 ± 12.7 kg), height (157.2 ± 8.4 cm), TTUG (10.3 ± 2.5 26 seconds), WC (93.3 ± 10.9 cm), waist-to-height ratio (0.59) and BMI (27.4 ± 4.4): Correlations between 27 TTUG and age (r = -0.086, p = 0.683), TTUG and BMI (r = 0.29, p = 0.892) WC and WHtR (r = 0.927, p 28 < 0.001). Conclusion: This study revealed correlations between anthropometric indicators of cardio vascular risk (BMI, waist circumference, waist-to-height ratio) and performance in the TUG test in the elderly.

Background: Pulmonary embolism (PE) is a common multifactorial disease, but high-risk PE s a life-threatening condition associated with high mortality and morbidity and a heavy prognostic burden. Systemic thrombolysis is the first-line treatment approach for severe high-risk PE, but only few agents are indicated for use by international guidelines. Tenecteplase, a thrombolytic agent, is proven to reduce mortality and right ventricle dysfunction in high-risk PE, but is not approved yet by major recommendations. Aim: We present a series of cases of high-risk PE treated with Tenecteplase, with satisfying hemodynamic and clinical outcomes. Our goal is to encourage the usage of Tenecteplase with secure safety and efficacy in situations of unavailability of guidelines-approved fibrinolytic agents. Cases : Patients were included from January 2022 to January 2024. We report 3 cases of patients with high-risk PE treated with Tenecteplase where rtPA and other second-generations agents were not available. Clinical, biological and imaging data were detailed for each case. Conclusion: Tenecteplase was effective in our patients, without bleeding complications, and should be suggested in settings of unavailability of first-line recommended agents.

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

Background: The practice of self-medication is common worldwide and is an important component of medical self-care. However, the practice can be dangerous and is linked to various risks for the patients and the entire community. This study aimed to estimate the prevalence and factors associated with self-medication among Bangladeshi adults. Methods: A cross-sectional survey was conducted between April and June 2021 among Bangladeshi adults (aged &gt;19 years) using convenient sampling. A total of 1320 data were collected through face-to-face interviews using a standardized questionnaire. Multivariable logistic regression analysis was used to identify factors associated with self-medication practice (SMP). Results: Overall, 41% of adults in our survey reported SMP. The most common illnesses that prompted SMP were common cold/flu (66.4%), gastric problems (65%), and headache (64.4%). The most frequent reasons for SMP were to get better services (30.59%), perceive SMP without side effects (23.28%), and save time with effectiveness (14.56%). Potential risk factors included 10 years (AOR = 1.91; 95% CI: 1.04 - 3.50) and &gt;12 years of schooling (AOR = 5.03; 95% CI: 2.27 - 11.15), being a businessman (AOR = 4.64; 95% CI: 1.74 - 12.37), having ≤6 family members (AOR = 2.13; 95% CI: 1.40 - 3.24), being a member of a social group (AOR = 1.53; 95% CI: 1.10 - 2.12), a health status check after every six months (AOR = 1.52; 95% CI: 1.08 - 2.13), and current ill-health (AOR = 1.41; 95% CI: 1.06 - 1.87). Protective factors identified included ≤30 years of age (AOR = 0.40; 95% CI: 0.17 - 0.93), and practice of modern (AOR = 0.39; 95% CI: 0.22- 0.69) and herbal (AOR = 0.45; 95% CI: 0.21- 0.97) healing types. Conclusion: More than one-third of the study participants reported practicing self-medication. Increasing the community’s awareness of the extreme consequences of SMP and not just the average experience might sway individuals away from SMP, and implementing strict jurisdiction could be a way to minimize the SMP.

Background and Objectives: Although researchers suggested that non-pharmaceutical intervention (NPI) and vaccination together can provide the best protection from the COVID-19 [1], people’s willingness to adopt personal NPIs seems to decrease through the COVID-19 waves. This study seeks for an explanation for this observation based on the framework of risk perception. Materials and Methods: Two cross-sectional surveys (N = 407 in Survey 1 and N = 505 in Survey 2) were administered before and in the first outbreak of COVID-19 in Taiwan. The survey items were designed to measure people’s recognized severity of COVID-19, worry of COVID-19, intention to adopt personal NPIs, and attitude toward COVID-19 vaccines. We established a structural model according to the framework of risk perception, which was applied to fit the data of the two surveys. Results: The multigroup SEM (Structural Equation Modeling) results showed that worry (i.e., emotional component of risk perception) fully mediates the influence of recognized severity of COVID-19 (cognitive component of risk perception) on the intention to adopt NPIs in each survey. Before the outbreak (i.e., Survey 1), people’s attitude toward COVID-19 vaccines has nothing to do with their worry of COVID-19. However, when people have experienced the real outbreak of COVID-d19 (i.e., Survey 2), their attitude toward COVID-19 vaccines negatively predicts their worry of COVID-19, forming an indirectly negative effect on their intention to adopt personal NPIs, suggesting the occurrence of the Peltzman effect. That is, receiving vaccination makes people feel safer, that the other way around relaxes their alert for COVID-19, thus, declining the intention to adopt personal NPIs.

The ingestion of contaminated aquatic products presents a potential risk for human exposure to bisphenols (BPs) residues. Nevertheless, there is little empirical research on this topic. To fill the current data gap, this study used stochastic sampling to gather 245 representative samples of aquatic products from local markets in Shenzhen. The samples comprised eight species and fell into three aquatic product categories: fish, crustaceans, and bivalves. A total of eight BPs were detected from aquatic products, namely, bisphenol A (BPA), bisphenol AF (BPAF), bisphenol AP (BPAP), bisphenol B (BPB), bisphenol S (BPS), bisphenol P (BPP), bisphenol Z (BPZ), and bisphenol F (BPF). All BPs were detected in aquatic products, except for BPAF, indicating pervasive contamination by BPs in aquatic products. BPS demonstrated the highest detection rate both before and after enzymatic hydrolysis, whereas BPAP exhibited the lowest detection rate before enzymatic hydrolysis, and BPB displayed the lowest detection rate after enzymatic hydrolysis. The concentration difference before and after enzymatic hydrolysis proved to be statistically significant. Moreover, 49%-96% of BPs in aquatic products were found in the combined state, underscoring the essentiality of conducting detections on aquatic product samples following enzymatic hydrolysis. While the health risks associated with ingesting BPs residues through aquatic product consumption were found to be minimal for residents at risk of exposure, the results suggest the necessity for more stringent regulations governing the consumption of aquatic products.

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

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

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

Energy, with very low demand and replacement elasticity, is a key component of production as well as a good for consumption. Inflation as a whole is instantly impacted by rising energy prices. After lockdowns were lifted in 2020–2021 and the global economy started to recover, oil prices began to rise. This trend continued with escalating geopolitical tensions and the eventual crisis in Ukraine brought on by Russia's invasion in February 2022. The current paper examines how the tourism industry has been impacted by rising energy commodity prices from the perspectives of travelers and hotel managers. Hereby a qualitative and a quantitative process is being used for a thorough examination of the consequences of inflated prices. More specifically, the three methods which were used are: descriptive analysis, correlation matrices and regression analysis. For the latter, all models appear to explain well the variation of the variables and provide reliable results. This study concludes that, although the overall inflation caused by higher energy prices was impactful for the individuals as well as for the businesses, however the touristic season of 2023 is expected to be one of the most fruitful ones yet, especially for the Greek economy, since strong numbers are reported (in revenues, expenditure and percentage of expected guests), while tourists are seemingly not willing to sacrifice their holidays altogether, but make other modifications in their lifestyle and choices. Finally, it is important to stress that governments should start integrating sustainable energy as a key component.

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

Based on ten months of ethnographic fieldwork in marginal, low-income, Belenino river communities located in Iquitos, a fluvial city in the Amazon basin. By using ethnographic methods and semi-structured interviews, this article traces how risk is associated with life in Belenino communities and how the identity of Beleninos and the river at the heart of a resettlement project are politically constructed rather than empirically constructed. In this case study of resettlement, understandings of risk and development by Belenino river communities and the government both conflicted and overlapped, I identified three elements that help to shape the concept of risk in both groups that highlight the disjunctive meanings provided by culture and demonstrate the complexity of the analysis of both populations. Finally, by putting the state’s weak presence after a developmental project failure under ethnographic approximation, the article reveals an imbalance in validity and power in terms of the perspectives of the river and Belen.

Background: Currently, completed suicide, suicide ideation, suicide behavior, and suicide attempts are major public health problems worldwide. Major Depressive Disorder (MDD) is one of the most common mental disorders associated with an increased risk of suicide. Since the relationship between suicide and cholesterol levels is still controversial, in this study, we explore the association between SNPs rs754203 and rs4900442 of CYP46A1 with suicide risk in Mexican patients with major depressive disorder. Methods: We evaluated 188 unrelated suicide completers and compared them to 144 non-suicidal individuals (controls) and 126 MDD patients. Genotypes were analyzed using the Real Time-polymerase chain reaction method and two allele-specific probes to detect specific SNP targets. A chi-square test was used to identify a possible risk genotype or allele type for suicide. Results: Statistical analysis showed significant differences between completed suicide and controls in their allelic and genotypic frequencies in rs754203 SNP. The genotype G/G of CYP46A1 rs754203 was significantly associated with suicide. Also, the G allele was associated with an increased risk of suicide (OR= 1.370, 95% CI= 1.002-1.873). No differences in either genotype distribution or allele frequencies of CYP46A1 rs4900442 were observed. Conclusions: The results of the current study report the first association between G allele carriers (A/G + G/G) of rs754203 and increased risk for suicide, especially in males.

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

Human monkeypox, caused by monkeypox virus, has spread unprecedentedly to more than 100 countries since May 2022. Here we summarized the epidemiology of monkeypox through a literature review and elucidated the risks and elimination strategies of this outbreak mainly based on the summarized epidemiology. We demonstrated that monkeypox virus became more contagious and less virulent in 2022, which could result from the fact that the virus entered a special transmission network favoring close contacts (i.e., sexual behaviors of men who have sex with men outside Africa) and the possibility that the virus accumulated a few adaptive mutations. We gave the reasons to investigate whether cattle, goats, sheep, and pigs are susceptible to monkeypox virus and whether infection with monkeypox virus could be latent in some primates. We listed six potential scenarios for the future of the outbreak (e.g., the outbreak could lead to endemicity outside Africa with increased transmissibility or virulence). We also listed multiple factors aiding or impeding the elimination of the outbreak. We showed that the control measures strengthened worldwide after the World Health Organization declared the outbreak a public health emergency of international concern (PHEIC) could eliminate the outbreak in 2022. We clarified eight strategies, i.e., publicity and education, case isolation, vaccine stockpiling, risk-based vaccination or ring vaccination, importation quarantine, international collaboration, and laboratory management, for the elimination of the outbreak.

Every year around 800 000 people commit suicide, this represents one death every 40 seconds. In the search for possible biological biomarkers associated with suicide and/or psychiatric disorders, serum cholesterol levels have been extensively explored. Several studies have indicated that cholesterol and associated proteins, especially apolipoproteins (Apos), may play an important role in the diagnosis, prognosis, and susceptibility of suicide. Here, we describe the current knowledge and findings in the relationship between apolipoproteins and suicide.

Reinforced Concrete (RC) durability is a crucial feature to estimate the long-term quality and structural performance. Since life span estimation is vital for maintenance resource planning, a degradation model of RC component extracts by updating the status of structures and trending the components’ state over time in terms of durability. Surface erosion, spalling, cracks, and other expose defects on the RC component lead to increase factors adversely affecting concrete durability in structures. This research presents an approach based on automated visualization for extracting quantitative indexes beside or instead of visual inspection without subjective interspersion of humans or probable human errors during the inspection. The durability index (D_i) will extract based on damage probability and its growth in order to extract the severity of failure and risk. Measurement operation by automated software has been double-checked by manual measurement tools, and data will verify randomly in this method. The result shows damage growth in this load-bearing component by 24 percentages over the definite time. According to degradation models, it shows this component may pass the relative thresholds as a limit state of operation to fail. This significant difference between expected time and designing time determines the D_i equal to 5 out of 10.

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

Pneumonic plague outbreaks are relatively infrequent in modern times but in the early part of the 20th century, they were commonplace including several well-documented epidemics responsible for the deaths of thousands. The transmissibility of this disease seems to be discontinuous since in some outbreaks few transmissions occur, while in others, the progression of the epidemic is explosive. Modern epidemiological studies explain that transmissibility within populations is heterogenous with relatively few subjects likely to be responsible for most transmissions and that ‘super spreading events’, particularly at the start of an outbreak, can lead to a rapid expansion of cases. These findings concur with outbreaks observed in real-world situations. It is often reported that pneumonic plague is rare and not easily transmitted but this view could lead to unnecessary complacency since future risks such as the spontaneous incidence of anti-microbial strains, climate change leading to a disruption of natural cycles within plague foci and use of plague as a bioweapon cannot be discounted. Carers and first responders are vulnerable, particularly in poorer countries where access to medicines may be limited, out-breaks occur in inaccessible areas or where there is a lack of surveillance due to a paucity of funds.

This paper presents quantitative research results regarding the influence of demographic factors on the earthquake risk perception of the citizens of Belgrade. This research aims to determine how much the citizens of Belgrade are aware of the risk and prepared to react in the event of an earthquake. The relationship between gender, age, level of education, and facility ownership with risk perception was examined. T-test, One-way ANOVA, and Pearson correlation coefficient were used to examine the relationship between the variables and the earthquake risk perception. The survey was conducted using a questionnaire that was given and then collected online among 235 Belgrade respondents during September 2020. The questions were divided into three categories. The first part of the questionnaire was consisted of general questions about the demographic characteristics of the respondents, then the questions that would determine the level of awareness of the respondents about earthquakes, and finally, the questions for determining the respondents' preparedness. The results of the research show that women have a higher perception of risk. It has been proven that the youngest respondents from the age category of 18-30 have the lowest risk perception. The influence of education level in no case showed a statistically significant correlation with risk perception.

Background Pregnancy is a process of maturity for women that requires adaptation to the changes in their new roles. Adjustment to a new role is not easy, especially if the pregnancy is accompanied by risks, so it is necessary to get treatment to minimize complications. Dyad models that optimize husband or family support are very important to prevent the risk of complications and adapt mothers to their new roles. The purpose of this study was to determine the effect of the dyad model on high-risk pregnancies. The method used with a literature review is through the collection of articles from Scopus, ebsco, ProQuest and PubMed. The results obtained were articles from Scopus 9, Ebsco 107, PubMed 214 and ProQuest 85 which carried out identification, screening and eligibility for 25 articles. Overall results mention. Journals are categorized into 4 groups, Dyad Model and social support, high-risk pregnancy, maternal role and Self Efficacy. Conclusion, there is an effect of the dyad model on care for high-risk pregnancies.

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

The data for the study on the epidemiology of bovine mastitis were collected fromNovember 2015 to February 2016 to investigate the prevalence of mastitis in administrative towns of three selected districts of Arsi zone, Oromia Regional State, namely Iteya, Sagure, and Asella, Ethiopia; and to analyze the association between the risk factors and mastitis occurrence. Sample cows were selected and examined for clinical mastitis and at the same time, milk samples were evaluated both clinically and using the California Mastitis Test (CMT). Some parameters of the cows which have biological relation with this disease together with other potential risk factors were collected along with primary data collection. The analysis of the primary data showed that overall mastitis prevalence in the locations covered by the study was 28.6% of which 83.3% was subclinical, while 16.7% were clinical mastitis cases. Analysis related to the investigation of the existence of an association between risk factors and mastitis revealed that there was a significant association between the occurrence of mastitis and two of the risk factors evaluated, breed and age of the cow. The other risk factors investigated (i.e. parity, location, and lactation stage had no significant association with mastitis occurrence). Since mastitis is a complex disease that results from the interaction of different factors, it may be difficult to limit it to only some given factors. Environment and management factors and their combination may also have an additional impact on the epidemiology of the disease. A prevalence with the indicated magnitude together with the added effect of a lower level of awareness of the society about milk-associated zoonoses implies that this disease causes significant public health problems. In addition, mastitis may cause silent economic loss through unnoticed production loss along with reduced milk yield from subclinical and clinical (e.g. blind teats) cases. Due to a lack of awareness about mastitis and/or negligence, farmers in all corners of the country are suffering from economic and public health problems imposed by mastitis. This lack of awareness about mastitis-associated problems and/or negligence could be a possible reason for the use of raw milk which is a common scenario particularly in pastoral areas and the selling of adulterated milk which is becoming increasingly practiced in Ethiopia which is also true in these specific localities.

Abstract: The study aimed to determine the factors associated with the avoidance of dental preventive care in adolescents and their parents in the framework of The Youth and Parents Risk Factor Behavior Survey in Slovakia has been initiated during the years 2015/2016. The data were collected using two separate standardized questionnaires: (i) the questionnaire for adolescents (n=515) and (ii) the questionnaire for parents (n=681). The study group consisted of 57 adolescents (54.4% males) who did not visit the dentist for preventive care in the previous year. The control group consisted of 458 adolescents (35.8% males) who visited a dentist for preventive care at least once in the previous year. A significantly higher number of males (54.4%), older adolescents (21.4%) were not visiting dental preventive care regularly. Incomplete family (56.1%), stressful situations at home (17.5%), and feeling unwell were observed as the factors contributing to the avoidance of dental preventive care. More than 34.5% of adolescents were not visiting either dental preventive care but also pediatric preventive care (AOR=5.14; 95%CI=2.40, 10.99). Divorced mothers and mothers with household income lower than 900 € had significantly higher dental care avoidance in their children. A significantly higher percentage of fathers from the exposed group were not visiting dental preventive care regularly (47.8%; p&lt; .05). The results of the study can be used as an educational intervention steps focusing on the influence of parental and adolescent behavior in dental preventive care.

This paper provides a framework for the assessment of household-level risk, incorporating both a individual social risk perspective and a location-based perspective. We use this framework as a heuristic to explore the effect of social reintegration choices individuals face, which are not be addressed by current policies. For example, we explore how integrating extended family households during COVID-19 without social distancing may affect household and community risk. The goal is to aid individual decision makers, who are seeking to maintain quality-of-life while navigating local policy, with nuance relating to location-specific behavior and disease prevalence.

All transmission disease depends on the transmission opportunity or medium like humans in COVID-19. Due to globalization and regular movement of people from one country to another, spread of COVID 19 reached to 208 countries till May 10, 2020. For any society health is major concern for humanity as well as administration. Any pandemic is declared as and when it reached at a particular severity level and control vice versa. So, we have continued the daily COVID 19 cases analysis and segregated till May 10, 2020. We have included at least 25 countries for the analysis purpose due to limitation of number of observations in the analysis. Maximum number of day’s data available for China is for 100 days, followed by Iran for 81 days, minimum number of days data is for 16 days for Western Sahara and Tajikistan.

This paper models and estimates the volatility of nonfinancial, innovative and hi-tech focused stock index, the Nasdaq-100, using univariate symmetric and asymmetric GARCH models. We employ GARCH, EGARCH and GJR-GARCH using daily data over the period January 4, 2000 through March 19, 2019. We find that the volatility shocks on the index returns are quite persistent. Furthermore, our findings show that the index has leverage effect, and the impact of shocks is asymmetric, whereby the impacts of negative shocks on volatility are higher than those of positive shocks of the same magnitude.

Stemming from the urgency of the actual situation, commercial banks need an effective credit risk management tool to limit risks. The authors went to survey, study and propose a set of factors affecting the ability of debt repayment of individual customers and conducting surveys. The topic uses data sets including 240 observation samples. Using the SPSS software to clean data and run the model based on Maddala's Binary logistics regression published in 1984 to find out the impact of each individual element of customers affecting their ability to repay such debts. Come on. The authors also specify the order of influence of each factor determining the ability to repay individual customers, thereby helping bank managers have a better visual view to make decisions for borrowing accurately, limiting risks.

Based on a rich data set of recoveries donated by a debt collection business, recovery rates for non-performing loans taken from a single European country are modelled using linear regression, linear regression with Lasso, beta regression and inflated beta regression. We also propose a two-stage model: beta mixture model combined with a logistic regression model. The proposed model allows us to model the multimodal distribution we find for these recovery rates. All models are built using loan characteristics, default data and collections data prior to purchase by the debt collection business. The intended use of the models is to estimate future recovery rates for improved risk assessment, capital requirement calculations and bad debt management. They are compared using a range of quantitative performance measures under K-fold cross validation. Among all the models, we find that the proposed two-stage beta mixture model performs best.

Contract between grower and integrator has been used extensively in broiler industry all over the world. One important advantages of contract is risk management, in which contract shifts a portion of grower risk to integrator. Thus, this paper attempted to measure the amount of risk shifted from grower to integrator and the consequences of this benefit to grower. Using a panel data of actual production records of 46 Indonesian broiler growers for the period of January 2014 through December 2017, we systematically measure the amount of risk shifted to integrator and its consequences to grower. The results showed that 78.43% grower risk is shifted to integrator. However, to acquire this benefit grower receive 15% less income. Furthermore, grower face the possibility of losing their asset and stopping their production as the consequences of entering contract.

The effects of buckwheat intake on cardiovascular diseases (CVD) have not been systematically investigated. The aim of the present study was to comprehensively summarise studies in humans and animals evaluating the impact of buckwheat consumption on CVD risk markers and to conduct a meta-analysis of relevant data. Thirteen randomised, controlled human studies, two cross-sectional human studies and twenty-one animal studies were identified. Using random effects models, the weighted mean difference of post-intervention concentrations of blood glucose, total cholesterol and triglycerides were significantly decreased following buckwheat intervention compared with controls [differences in blood glucose: -0.85 mmol/L (95% CI: -1.31, -0.39), total cholesterol: 0.50 mmol/L (95% CI: -0.80, -0.20) and triglycerides: 0.25 mmol/L (95% CI: -0.49, -0.02)]. Responses of a similar magnitude were seen in two cross-sectional studies. For animal studies, nineteen of twenty-one studies showed a significant reduction in total cholesterol of between 12 and 54%, and fourteen of twenty studies showed a significant reduction in triglycerides of between 2 and 74%. All exhibited high unexplained heterogeneity. There was inconsistency in HDL cholesterol outcomes in both human and animal studies. It remains unclear whether increased buckwheat intake significantly benefits other markers of CVD risk, such as weight, blood pressure, insulin, and LDL-cholesterol, and underlying mechanisms responsible for any effects are unclear.

The current study aimed to: i) Monitor levels of PM₁₀, at Shebika, Haram, Masfala, Azizia, Awali and Mina in Makkah city, KSA during the period of 01 Shawwal 1436H – 27 Rabi Al-Awwal 1437H, by using LVS instruments; and; 2) assess health risk (non-cancer and cancer risks) on humans (children and adult) exposed to PM₁₀ in ambient air of Makkah city.The results showed that: the high PM₁₀ levels were found in Haram site, while the lower levels were found in Awali site. These levels were lower than that set for PM₁₀ by PME (Daily limit of 340 µg/m³). Vehicles emissions and constructions sources may be the main source of PM₁₀ levels in Makkah city. The human health risk assessments showed that: the daily exposure doses of PM₁₀ were ranked in the order: D_ing > D_dermal > D_inh for children and adult in Makkah city. Ingestion of PM₁₀ particles was the main exposure pathway for both children and adults. The HIs and cancer risk values were within the safe level, indicating that (non-carcinogenic and carcinogenic) risks for humans exposed to PM₁₀ in Makkah city were negligible.

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

This paper aims to develop a hierarchical risk assessment model using the newly-developed evidential reasoning (ER) rule, which constitutes a generic conjunctive probabilistic reasoning process. In this paper, we first provide a brief introduction to the basics of the ER rule and emphasize the strengths for representing and aggregating uncertain information from multiple experts and sources. Further, we discuss the key steps of developing the hierarchical risk assessment framework systematically, including (1) formulation of risk assessment hierarchy, (2) representation of both qualitative and quantitative information, (3) elicitation of attribute weights and information reliabilities, (4) aggregation of assessment information using the ER rule and (5) quantification and ranking of risks using utility-based transformation. The proposed hierarchical risk assessment framework can potentially be implemented to various complex and uncertain systems. A case study on the fire/explosion risk assessment of marine vessels demonstrates the applicability of the proposed risk assessment model.

Severe early childhood caries remains the most common chronic disease affecting children. Its multifactorial etiology has established a controversy about which risk factors were more significant to its development. Therefore our study aimed through meticulous statistical analysis to arrange the “well agreed upon” common risk factors in order of significance, to aid the clinician in tailoring an adequate preventive program for this affected age group. The study reshuffled the risk factors contributing to severe early childhood caries and placed them in the order of their significance as follows: snacking of sugary food several times a day, increased number of siblings to 3 or more, night feeding, child self-employed brushing, mother caries experience, 2 siblings, on demand feeding, once/day sugary food, sharing utensils, 1 Sibling, male gender, father’s education, late first child dental visit, brushing time, mother’s education, no dental visit, decreased brushing frequency & no night brushing.

Even though Greece is considered a vulnerable region in terms of climate hazards, public perception and attitude do not always identify climate change as an important environmental area of concern, especially when compared to socio-economic issues. The key issue of this paper is to investigate and analyse public perception in Greece as regards to climate change risk. Through a questionnaire survey this paper analyses trends that exist, peoples’ opinion and awareness with regards to climate risk and how willing they are to change current lifestyle, to pay or to act to minimize or to prevent the risk. Conventional wisdom of this paper is to highlight factors that influence individual perception and point out drivers of behavior change that can support efficiently future adaptation plans.

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

This article offers a theoretical framework to contextualise the concept of "Safety Culture" in the field of public safety and Disaster Risk Reduction (DRR), with the aim of supporting its understanding and measurement in our communities and finally attaining more disaster resilient societies. The work discusses the role of cultural dimensions in risk management and DRR and highlights the relevance of building knowledge and practices based on the consideration of culture and cultural variability in all phases of the risk management process. After an overview of the Safety Culture concept, including its origins, developments and applications, the text explores the transferability of this concept to the context of public safety. Then, based on the existing Safety Culture models, metrics and indicators from other sectors, the paper proposes an original definition of Safety Culture for the DRR context, shaped on a series of elements and dimensions specifically outlined for this context. Finally, the expected benefits of the application of Safety Culture concepts and techniques for further advances in DRR is discussed.

Risk modelling along with multi-objective optimization problems have been at theepicenter of attention for supply chain managers. In this paper, we introduce a datasetfor risk modelling in sophisticated supply chain networks based on formal mathematical models. We have discussed the methodology and simulation tools used to synthesize the dataset. Additionally, the underlying mathematical models are discussed in granular details along with providing directions to conducting statistical analyses or neural machine learning models. The simulation is performed using MATLAB ™Simulink and the models are illustrated as well.

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

A novel approach for designing acceptance sampling plans is presented. It is based on the Bayesian conformity assessment framework from JCGM 106. In particular, the concept of conformance probability plays a central role in the new approach. The new approach takes into account both the producer's and the consumer's perspective by allowing each to have their own prior. In parallel, the JCGM 106 framework allows the definition of Bayesian consumer's and producer's risks which complement the "classical" risks defined in the ISO 2859 and ISO 3951 series. The new approach also casts a new light on the plans from the ISO standards.

Community-Based Disaster Risk Reduction (CBDRR) plays a vital role in strengthening the resilience of local communities against both natural and human-made disasters. This paper seeks to examine the role of CBDRR in enhancing the resilience of local communities to both natural and man-made disasters. It underscores the critical importance of active community involvement across all stages of disaster management, from preparedness and mitigation to response and recovery. The paper also explores the key factors that contribute to the successful implementation of CBDRR, including institutional backing, capacity development, inclusive strategies, and the use of modern technologies. Additionally, it discusses the challenges and opportunities in building strong partnerships between local communities and external stakeholders, which are crucial for ensuring the sustainability of these efforts. Finally, the paper offers recommendations aimed at improving the effectiveness of CBDRR initiatives, drawing on insights gained from past disaster experiences. The findings of this study point to the importance of continuous monitoring and evaluation of CBDRR programs to maintain their relevance and ensure their effectiveness as risks evolve. Incorporating lessons learned from past disasters into future planning also plays a crucial role in helping communities enhance their resilience over time. Ultimately, by encouraging collaboration between communities, governments, and various organizations, CBDRR lays the foundation for a comprehensive disaster management framework that is equipped to meet future challenges and supports long-term sustainable development.

This qualitative study explores the multifaceted strategies organizations employ to build resilient supply chains through effective procurement risk management. Conducted over a six-month period in 2024, the research involved semi-structured interviews with 25 industry professionals from sectors including manufacturing, retail, healthcare, and technology, alongside document analysis and case studies. The study identifies four key themes: risk identification and assessment, supplier relationship management, digitalization in risk management, and strategic resilience practices. The findings reveal that organizations face diverse risks, including supplier, supply market, and external environmental risks, necessitating comprehensive risk assessment methodologies. Supplier relationship management emerges as a critical factor in mitigating risks, with practices such as regular audits, collaborative risk management, long-term partnerships, and supplier diversification being crucial. The adoption of digital technologies like predictive analytics, blockchain, advanced analytics, and artificial intelligence enhances risk management capabilities, providing data-driven insights and fostering transparency. Strategic resilience practices, including inventory buffering, flexible sourcing, redundancy, and scenario planning, are essential for maintaining supply chain continuity amidst disruptions. The study underscores the importance of an integrated and proactive approach to procurement risk management that leverages robust assessment, strong supplier relationships, digital tools, and strategic planning. These findings contribute to a deeper understanding of how organizations can effectively manage procurement risks and build resilient supply chains in a dynamic global environment. The insights offer valuable guidance for procurement professionals and organizational leaders in developing resilient and adaptable supply chain strategies to navigate the complexities of today's market.

Atherosclerotic cardiovascular disease, a leading cause of morbidity and mortality worldwide, is a chronic inflammatory disease, linked to a state oxidative stress, with several well-identified culprits, of which low-density-lipoprotein cholesterol (LDL-C) and lipoprotein(a). No specific treatment is currently available to lower lipoprotein(a). It is, therefore, of paramount importance to identify nutritional factors that could lower lipoprotein(a). Growing evidence shows that although reducing saturated fatty acid (SFA) intake decreases LDL-C, it could increase lipoprotein(a). Optimal dietary recommendations may therefore differ depending on an in-dividual’s baseline lipoprotein(a) and LDL-C levels. Assessing the diet-induced true LDL-C response and net balance of these two atherogenic entities is difficult because LDL-C measurement is confounded by lipoprotein(a) cholesterol content. We have estimated, for the first time, the net atherogenic result of diet-induced variations of both LDL-C and lipoprotein(a), thanks to our new concept of LDLapoB risk equivalent=apoB+lp(a)x5 (in nmol/L). This is illustrated, via the rare case of a physician with very high lipoprotein(a) and hypobetalipoproteinemia. She experiences twice a considerable lipoprotein(a) increase (+32%, + 28mg/dL, + 67nmol/L) and higher LDLapoB risk equivalent (138mg/dL versus 123mg/dL) on a mediterranean diet, low in SFA. A reasonable SFA intake, despite causing marginal LDL-C increase, may be advisable in patients with high lipoprotein(a) who need personalized dietary recommendations.

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

Arrhythmic sudden cardiac death (SCD) has an annual prevalence of 1 per 1000 while 75% of the victims suffer from ischemic and 10% from non-ischemic or hypertrophic cardiomyopathy. Altogether, these three entities account for more than 80% of the total SCD victims. Guidelines for implantable cardiac defibrillators are still dominated by LVEF<30% from the MADIT II study. In terms of arrhythmic risk stratification, the PRESERVE-EF study restored in clinical practice the two-step arrhythmic risk stratification approach based on Electrocardiographic non-invasive risk factors (NIRFs) guiding to electrophysiological study. In our times with the multiple cardiac imaging methods and artificial intelligence applications availability, this two-step approach based on integrated arrhythmia mechanisms detection, emerges as an efficient SCD risk stratification paradigm for these three entities but also for the patients with congenital heart disease.

Phytoplasma diseases pose a substantial threat to diverse crops of agricultural importance. Management measures are usually implemented only after the disease has already occurred. Early detection of such phytopathogens, prior to disease outbreak, has rarely been attempted but would be highly beneficial for phytosanitary risk assessment, disease prevention and mitigation. In this study we present the implementation of a recently proposed proactive disease management protocol (DAMA: Document, Assess, Monitor, Act) for a group of vector-borne phytopathogens. We used insect samples collected during a recent biomonitoring program in southern Germany to screen for the presence of phytoplasmas. Insects were collected with Malaise traps in different agricultural settings. DNA was extracted from these mass trap samples and subjected to PCR-based phytoplasma detection and COI sequence metabarcoding. In about 1% of the analyzed samples, phytoplasma DNA was detected. Phytoplasma group identification was performed by 16S rRNA gene sequence analysis and the detected phytoplasmas could be assigned to the 16SrI subgroups B and L. Insect species in the sample were identified by DNA metabarcoding. By using established databases, checklists, and archives, we documented historical associations and records of phytoplasmas and its hosts in the study region. For the assessment in the DAMA protocol, phylogenetic triage was performed in order to determine the risk for tri-trophic interactions (plant-insect-phytoplasma) and associated disease outbreaks in the study region. A phylogenetic heat map constitutes the basis for risk assessment and was used here to identify a minimum number of seven leafhopper species suggested to be monitored by stakeholders in this region. A proactive stance in monitoring changing patterns of association between hosts and pathogens can be a cornerstone in capabilities to prevent future phytoplasma disease outbreaks. To our knowledge, this is the first time that the DAMA protocol has been applied in the field of phytopathology and vector-borne plant diseases.

In the Mediterranean, the probability of tsunamis is lower than in other coastal areas such as the Pacific Ring, where tsunamis are more familiar and memory of past events and anticipatory signals and protective measures is preserved by local culture, along with media and scientific sources, therefore tsunami risk is more likely to be downplayed or neglected. Past research identified socio-demographic and spatial factors that may affect tsunami risk perception. This research is based on a sample of 5842 CATI interviews to investigate whether and how risk perception and risk knowledge were affected by a major event such as the 1908 Reggio Calabria Messina tsunami, by making a comparison between areas hit by that event and unaffected areas, also providing some explanatory hypotheses. Despite differences between Calabria and Sicily, data anyway show higher levels of tsunami risk perception in the area affected by the 1908 event, along with a major role of interpersonal sources, playing a relevant role in information gathering and understanding. Research also suggests the need to better integrate different sources of knowledge to improve people’s understanding as to effectively cope with tsunami risk.

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

Unrecorded alcohol comprises all types of alcohol that is not registered in the jurisdiction where it is consumed. In some countries in Central and Eastern parts of Europe as well as the Balkan, the major amount of unrecorded alcohol consumption may derive from homeproduction of fruit spirits. Some studies found a high prevalence of lead and cadmium in such spirits. This article provides a quantitative comparative risk assessment using the margin of exposure (MOE) methodology for lead and cadmium, compared to ethanol, for unrecorded fruit spirits. For average concentration levels, the lowest MOE (0.8) was calculated for ethanol (alcohol itself). For lead, the MOE was 13 for moderate daily drinking and 0.9 for the worst case. For cadmium, the MOE was 1982 for moderate daily drinking and 113 for the worst case. The results of this study are consistent with previous comparative risk assessments that ethanol itself comprises by far the highest risk of all compounds in alcoholic beverages. Regarding the metal contaminants, the risk of cadmium appears negligible, however, lead may pose an additional health risk in heavy drinking circumstances. Strategies to avoid metal contamination in settings of artisanal homeproduction of spirits need to be developed.

Background: Decision, whether to de-label patient with suspected BL hypersensitivity, is based on the risk stratification. The aim of the study was to prepare a characteristic of diagnostic risk groups and to create a model enabling the identification of the low-risk diagnostic group. Methods: We analyzed medical records of patients hospitalized due to suspected hypersensitivity to BL antibiotics. Based on the history data, patients were divided into three diagnostic risk groups, using the criteria proposed by Shenoy et al. Univariate and multivariate analysis model were used to create a diagnostic tool. Results: Among 263 patients referred for BL hypersensitivity diagnosis, 88 (33.5%) were qualified to group I, 129 (49%) to group II, and 46 (17.5%) to group III. There were significant differences between diagnostic risk groups regarding history of hypersensitivity to penicillins (p<0.001), cephalosporins (p<0.001), >1 BL (p<0.05), several episodes of BL hypersensitivity (p<0.001), medical intervention (p<0.001), documented hypersensitivity (p<0.001), time from drug intake to symptoms (p<0.001), time from hypersensitivity to diagnosis (p<0.001). 81 patients (30.8%) were de-labeled: 52 (59.8%) in group I, 27 (20.9%) in group II and 2 (4.3%) in group III. In univariate analysis, model of the low diagnostic risk group applied to the de-labeled part showed 90% specificity and 21.93% sensitivity. NPV and PPV were estimated at 72.04% and 49.53%, respectively. Multivariate model had high specificity but low sensitivity; its NPV was 76% with 68% PPV. Conclusions: The tool enabling the identification of low diagnostic risk patients based on anamnesis is not sensitive enough, to de-label patients on its basis.

Background/Objectives: Skin cancer is becoming increasingly common due to increasing risk factors such as excessive UV radiation, genetic predisposition, fair skin, and a history of sunburn. Melanoma accounts for only 1% of cases but causes the majority of skin cancer deaths. Dysplastic nevi (DN) are important precursors of melanoma. The aim of this study was to investigate the influence of these risk factors on the pathogenesis, incidence, and stage of skin cancer.; Methods: The study included 591 patients aged 18 to 64 who visited the Clinic in 2022–2023 for skin examinations. Each patient completed a questionnaire regarding the risk factors for melanoma and atypical melanocytic nevi and then underwent a dermatoscopic examination of the whole body using a digital videodermatoscope. Statistical analysis of the collected data was performed.; Results: Dermatoscopic examination revealed a lesion suggestive of melanoma in 1,69% of the patients. Risk factors for developing melanoma included male gender, family history of melanoma, number of skin moles, sunburns in childhood, sun-dependent hobby, using tanning bed, using cream with low SPF, not avoiding sun exposure and co-occurrence of actinic keratosis.; Conclusions: Risk factors for melanoma and dysplastic nevi are still common among patients, but the situation has been improving over the years. Early intervention and education on sun safety can play pivotal roles in reducing the incidence of atypical moles and potentially preventing malignant transformations. Keywords: dysplastic nevum; melanoma; risk factors; dermoscopy; prevention

Urinary tract infections (UTI) are a significant health concern, particularly among the elderly, often leading to hospitalization. A comprehensive study conducted at the "Dr. Carol Davila" Central Military Emergency University Hospital in Bucharest analyzed 948 adult patients hospitalized for symptomatic UTI. The findings revealed that the majority of admitted patients were elderly, presenting with high comorbidity rates and severe dependence. The study also identified common risk factors for multidrug-resistant pathogens, with one-third of patients hospitalized within 30 days preceding their current admission. The research uncovered several independent predictors of prolonged hospital stay, including the degree of dependence and comorbidity, female sex, obesity, and the presence of bacteremia. These findings underscore the changing landscape of UTI epidemiology and presentation in hospitalized patients. This study emphasizes the need for improved management strategies, particularly in areas such as urinary incontinence care, judicious use of catheterization, and preventive measures. As the elderly population continues to grow, healthcare providers must adapt their approaches to effectively address the evolving challenges associated with UTIs in this vulnerable population.

The COVID-19-induced strain on global supply chains led to significant market imbalances and unprecedented inflation, particularly affecting urban economies. Containment policies and stimulus packages resulted in unpredictable demand shifts, challenging urban supply chain planning and resource distribution. These disruptions underscored the need for robust risk management models, especially in cities where economic activity and population density exacerbate supply chain vulnerabilities. This study develops a comprehensive risk model tailored for G-7 urban economies, analyzing the causal and cointegration relationships between key economic indicators. Using Granger causality tests and a factor-augmented vector autoregression (FAVAR) approach, the study examines complex time series and high-dimensional variables, focusing on urban-specific indicators such as the Composite Leading Indicator (CLI) and Business Confidence Indicator (BCI). Our results indicate strong causal relationships among these indicators, validating CLI as a reliable early predictor of urban economic trends. The findings confirm the viability of this urban supply chain risk management model, offering potential pathways for strengthening urban resilience and economic sustainability in the face of future disruptions. This approach positions the study within the context of urban science, emphasizing the impacts on cities and how urban economies can benefit from the developed risk model.

Shrews (Soricidae) are common small wild mammals. Some species of shrews, such as Asian house shrews (Suncus murinus), have a significant overlap in their habitats with humans and domestic animals. Currently, over 190 species of viruses in 32 families, including Adenoviridae, Arenaviridae, Arteriviridae, Astroviridae, Anelloviridae, Bornaviridae, Caliciviridae, Chuviridae, Coronaviridae, Filoviridae, Flaviviridae, Hantaviridae, Hepadnaviridae, Hepeviridae, Nairoviridae, Nodaviridae, Orthoherpesviridae, Orthomyxoviridae, Paramyxoviridae, Parvoviridae, Phenuiviridae, Picobirnaviridae, Picornaviridae, Polyomaviridae, Poxviridae, Rhabdoviridae, Sedoreoviridae, Spinareoviridae, and three unclassified families, have been identified in shrews. Diverse shrew viruses, such as Borna disease virus 1, Langya virus, and severe fever with thrombocytopenia syndrome virus, cause diseases in humans and/or domestic animals, posing significant threats to public health and animal health. This review compiled fundamental information about shrews and provided a comprehensive summary of the viruses that have been detected in shrews, with the aim of facilitating a deep understanding of shrews and the diversity, epidemiology, and risks of their viruses.

Background/Objectives: Nail technicians frequently have musculoskeletal pain, which impairs their job performance. A high-risk profession linked to back discomfort that causes morbidity is nail technician. QEC is a tool used for observing and assessing risks in a work environment. The goal of this research is to assess the ergonomic risks, pain, and their relationship with posture among manicurists. Methods: The 35 nail technicians filled the assessment form which consists of occupational information, pain, European Community Respiratory Health Survey, Nordic Musculoskeletal Questionnaire and QEC worker part. Physicians assessed nail technicians’ workspace and QEC outcomes. Results: It was stated that they worked an average of 61.92±11.09 hours per week, served an average of 11±5 customers per day, and their condition lasted 53.96±36.51 months. There is a strong significant correlation between discomforts, time spent in occupation (p=0,000) and working hours. Manicure, pedicure, unwanted hair removal, correction of eyebrow were considered for ergonomic risk evaluation. Each occupation accompanied repeated bad postures. Most of them were scored in very high risk categorization for back static positions (more than 29 point). Conclusions: This study may be useful for nail technicians seeking ergonomic improvements in the areas of engineering, administration, behavior, or personal.

Background: Cardiometabolic risk factors (CRFs) are significant health concerns among adults with overweight and obesity. Resistance training (RT) is known to manage CRFs, but the impact of moderate-frequency RT (two to three times weekly) remains unclear. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing moderate-frequency RT with non-exercise control or usual care in overweight and obese adults. Searches were performed in PubMed, Web of Science, EMBASE, and Cochrane Library up to February 2024, following the PRISMA 2020 guidelines. Eligible studies included non-athletic adults (BMI ≥ 25) aged 18 years or older, with RT interventions lasting 7 weeks or longer. Results: Fifteen RCTs were included. Moderate-frequency RT significantly reduced systolic blood pressure by -4.66 mmHg (95% CI -9.34 to 0.02, p=0.01) and mean arterial pressure by -6.48 mmHg (95% CI -10.63 to -2.33, p=0.002) compared to controls. Additionally, RT significantly lowered fasting insulin levels by -12.52 mmol/L (95% CI -24.17 to -0.88, p=0.04) and HOMA-IR by -1.49 (95% CI -1.63 to -1.35, p＜0.00001). Improvements were more pronounced in participants with dietary control. Conclusion: Moderate-frequency RT effectively improves CRFs in overweight and obese adults, suggesting its potential as a beneficial intervention for this population. PROSPERO registration number: CRD42022343167.

This study proposes a risk analysis model based on the principles of ISO 31000 and decision theory for biological agents with potential for offensive use in Brazil. Bibliographic research was conducted on the main models already published on the subject. The German risk classification system was adopted as the main reference because it is adjustable and adopts a semiquantitative approach. After translating and adapting this model to the Brazilian context, the analytic hierarchy process (AHP) was applied to generate a hierarchical tree with criteria and subcriteria to be considered in the risk assessment. A questionnaire was administered to a group of experts to evaluate the relevant criteria and subcriteria and the risks related to three biological agents (Bacillus anthracis, Yersinia pestis and Francisella tularensis), which were selected in an exploratory manner to exemplify the application of the model. According to the results, the criterion of impact of a biological attack was given greater importance when compared with the probability of occurrence of this event. According to the subcriteria, the greatest weight was attributed to human health when compared with agriculture, the environment, or the economy. Finally, in the evaluation of the three pathogens, B. anthracis was identified as having the highest risk for offensive use in Brazil. This research is focused on a practical approach and can be implemented by competent agencies to foster their capacity for biological defense by determining which pathogens represent the greatest risk to society.

Abstract: Online services have transformed into a boon for various industries and globalization as a whole. One of the ventures reliant upon the Web is finance. Pattern prediction and risk reduction in the stock market and other financial decisions are made possible by some technologies. These technologies promise to expand innovation, knowledge, and efficiency opportunities in the financial sector. Finance frequently uses machine learning technology to identify risks based on probabilistic statistics and historical data to support investment decisions. Additionally, it can be utilized for risk assessment and risk management planning. Internet technology, which enables real-time data analysis, streamlined transactions, and improved customer communication, has particularly benefited the financial sector. However, these advancements come with significant challenges, such as the need for robust online credit protection and security threats. This study looks at how advanced machine learning methods are used in the financial sector and focuses on how they have changed credit scoring, algorithmic trading, and predictive modeling.

Jamaica has one of the highest teenage pregnancy rate and therefore identifying the context of adolescent sexual and reproductive health is important, especially since there is paucity of research on preadolescents in the Jamaican context. The study was a nationally representative cross-sectional, interviewer administered, school-based survey of 10 -15 year olds. Summary statistics of the demographics and bivariate analyses were performed to assess the association of sexual initiation and given risk and resiliency factors. 1,422(47.4%) males, 1,581 (52.6%) females, mean age (SD) 12.5 (1.6) years were surveyed. Mean age of first sex was 11.0 (±2.5) years. Factors significantly with sexual initiation were, female sex (OR 0.17; 95% CI 0.12-0.23), caring relationships inside the home (OR 0.85; 95%CI 0.83-0.97) rare church attendance (OR1.36; 95%CI1.0-1.8), age (OR 1.75; 95%CI1.6-1.9) and community disorganization (OR 1.02 95% CI 1.01-1.07). Sexual initiation of early adolescents is positively influenced by environmental factors such as family connectedness and religious involvement. The negative correlates are societal risk factors such as community disorganization. Empowerment through learned sexual negotiation skills, should be incorporated into the education programme of pre-adolescents to facilitate adolescents embracing their intrinsic power to delay sexual debut and if sexually active to insist on condom use.

Background: Donor shortage limits the utilization of heart transplantation making it available for only a fraction of the patients on the transplant wait list. Continuous flow left ventricular assist devices have therefore risen in importance as a standard of care for end-stage heart failure. Short, mid and long-term survival rates as well as quality of life are now being studied with newer and more sophisticated machines. This study attempts to assess the impact of several commonly associated risk factors on long-term survival of LVAD recipients. Methods The TriNetX dataset comprises de-identified patient information across healthcare organizations. The study assesses the impact of demographics, infections, comorbidities, types of cardiomyopathies, arrhythmias, and end-organ dysfunction on long-term LVAD survival. The Log-rank test was used to assess post-implant survival effects, while Cox regression was used in univariate analysis to obtain Hazard Ratio (HR). Patients with unknown lab results were removed before the univariate analysis and K-M survival curves were generated. Samples with missing values or data errors (e.g., implantation is after recorded death) were excluded. All analyses were conducted using the Python programming language and the lifelines library. This study is IRB-exempt Results This study identified common risk factors that significantly impact survival such as CMV, hepatitis A exposure, atrial fibrillation, paroxysmal ventricular tachycardia, ischemic cardiomyopathy, renal dysfunction, diabetes, COPD, mitral valve disease, and hypertension. Conclusions This is the first report of a detailed long-term survival assessment of several risk factors that impact the LVAD population.

To identify factors associated with interstitial lung disease (ILD) in patients with systemic sclerosis (SSc) and build an algorithm to better define this association, for a personalized application in clinical practice. Methods. 78 SSc patients underwent HRCT to assess ILD. Demographic, clinical and laboratory variables were collected, focusing on those associated either directly or indirectly with lung involvement. The discriminant value of each variable was determined using the operating characteristic curves (ROC) and included in a model to estimate the strength of ILD association in SSc. Results. Thirty-three (42.31%) patients showed ILD on HRCT. DLco, M-Borg, GERD-Q, and capillary density were significantly associated with the presence of ILD-SSc. A model including these variables had a coefficient of determination (R2) of 0.697. DLco had an AUC of 0.861 (p&lt;0.001) with a cut-off ≤72.3% (sensitivity 78.8%, specificity 91.1%, +LR 8.86). The m-Borg scale showed an AUC of 0.883 (p&lt;0.001) with a cut-off &gt;2 (sensitivity 84.8%, specificity 82.2%, +LR 4.77), GERD-Q had an AUC of 0.815 (p&lt;0.001) with a cut-off &gt;7 (sensitivity 72.7%, specificity 86.7%, +LR 5.45). The capillary density showed an AUC of 0.815 (p&lt;0.001) with a cut-off ≤4.78 (sensitivity 87.9%, specificity 68.9%, +LR 2.82). Based on the pre-test probability values, these four variables were applied to Fagan's nomogram to calculate the post-test probability of this association. Conclusions. Our study identified four associated clinical factors of ILD in SSc patients. Moreover, their inclusion in an algorithm for the post-test probability, tailored to the specific patients’ characteristics, significantly increases the ability to find out the presence of SSc-ILD.

Background: Colorectal cancer (CRC) patients experienced multiple chemotoxicity affecting treatment compliance, survival, and quality of life (QOL). Prior research shows clinician-reported chemotoxicity (i.e., grading scales or diagnostic codes) predicts rehospitalization and cancer survival. However, a comprehensive synthesis of clinician-reported chemotoxicity is still lacking. Objectives: We conducted a systematic review and meta-analysis to determine the chemotoxicity's prevalence and risk factors in CRC. Methods: A systematic search from 2009 to 2024 yielded 30 studies for review, with 25 included in the meta-analysis. Results: Pooled prevalences of overall, non-hematological, and hematological moderate-to-severe toxicities were 45.7%, 39.2%, and 25.3%, respectively. The most common clinician-reported chemotoxicities were gastrointestinal (GI) toxicity (22.9%) and neuropathy or neutropenia (17.9%). Significant risk factors at baseline were malnutritional status, frailty, impaired immune or hepato-renal functions, short telomere lengths, low gut lactobacillus levels, age, female sex, aggressive chemotherapy, and low QOL. Age was associated with neutropenia (β: -1.44) and GI toxicity (β:1.85) (Ps 65 y.o.) had higher prevalences of overall (OR: 1.14) and GI (OR: 1.65) toxicities, but a lower prevalence of neutropenia (OR: 0.65) than younger adults (Ps

Workers involved in scaffolding erection and dismantling activities are exposed to various physical risk factors. However, no existing study indicates that awkward working postures in scaffolding activities lead to musculoskeletal system disorders (MSDs). This study explores the ergonomic risks intrinsic to scaffolding tasks in refinery construction using the Ovako Working Posture Analysing System (OWAS).In the refinery, the utilized scaffolding encompasses an area of 319674 square meters and a volumetric extent of 603294 cubic meters. Observations were conducted on the postures of 500 scaffolding group workers across 5210 locations within the site, culminating in capturing 2000 photographic records. The mass of each scaffolding component was meticulously determined. After three months of observation, medical records were consulted for further insights. A statistical analysis employing the Pearson correlation technique was conducted to scrutinize the relationship between the ages of the scaffolding workers and the incidence of MSDs, alongside patterns of absenteeism. This analysis elucidated a robust and statistically significant correlation between the age of the workers and the prevalence of MSD associated with their occupational activities.As a result of the results of the OWAS ergonomic risk assessment, a number of regulatory changes were made to the scaffolding workforce, and then medical records were looked over again. This re-evaluation revealed a marked reduction in MSDs. The OWAS method's reliance on simple observational techniques holds substantial merit for its application within construction environments. Our research underscores the exposure of workers engaged in scaffolding tasks within continuous projects, such as refinery construction, to substantial ergonomic risks.

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

This study aimed to investigate whether non-fasting plasma triglycerides were associated with diabetes mortality. It included 7,312 US adult participants. Diabetes mortality data were obtained via linkage to the National Death Index (NDI) records. Hazard ratios of non-fasting plasma triglycerides for diabetes mortality were assessed using Cox proportional hazards models, adjusting for age, gender, ethnicity, obesity, poverty-income ratio, education levels, physical activity, alcohol consumption, cigarette smoking status, survey period, hypercholesterolemia, hypertension, diabetes, and family history of diabetes. Among these participants, 1,180 had diabetes. A total of 420 diabetes-caused deaths were recorded during a mean follow-up of 16.8 years. A 1-natural-log-unit increase in non-fasting plasma triglycerides was associated with a 41% higher diabetes mortality risk (hazard ratio, 1.41; 95% confidence interval, 1.19-1.67). Participants with non-fasting plasma triglycerides in the highest quintile, versus those in the lowest quintile, had a 144% higher diabetes mortality risk (hazard ratio, 2.44; 95% confidence interval, 1.49-4.02). The positive association of non-fasting plasma triglycerides with diabetes mortality was independent of diabetes status at the baseline. In conclusion, this study demonstrated that non-fasting plasma triglycerides were positively associated with diabetes mortality, independent of diabetes status at the baseline. Non-fasting triglycerides may be a therapeutic target for diabetes-related complications.

Background and Objectives: ARNE score was developed for the prediction of difficult airway for both general and ENT surgery with a universal cut-off value. We tested the accuracy of this score in the case of laryngeal surgery and provided an insight of its combination with flexible laryngoscopy. Materials and Methods: This prospective pilot clinical study included 100 patients who were being scheduled for microscopic laryngeal surgery. We have calculated ARNE score for every patient and flexible laryngoscopy was provided preoperative. Difficult intubation was assessed according to intubation difficulty score (IDS). Results: A total of 33% patients had difficult intubation according to IDS. ARNE score showed to be accurate for prediction of difficult intubation in laryngology with P&lt;0.0001 and AUC 0.784. Flexible laryngoscopy showed to be an independent parameter with P&lt;0.0001 and AUC 0.766. We have defined a new cut-off value of 15.50 for laryngology, according to AUC curve. After the patients were divided in two groups, according to the new cut-off value and provided cut-off value, AUC improved to 0.707 from 0.619 respectively. Flexible laryngoscopy improved the prediction model of ARNE score to AUC 0.882 and of new cut-off value to AUC 0.833. Conclusions: It is recommended to use flexible laryngoscopy together with ARNE score in difficult airway prediction in patients with laryngeal pathology. Also, universally recommended cut-off value of 11 can not be effectively used in laryngology and a new cut-off value of 15.50 is recommended.

Background: Annual influenza epidemics are a serious public health problem, causing particularly severe morbidity and mortality in high-risk groups. The study aimed to understand Poles' attitudes and beliefs towards influenza vaccinations in the flu season of 2022–2023, analyze preferences and unmet needs regarding influenza vaccinations, and examine the perception and acceptance of the influenza vaccine among individuals at risk of flu complications. Methods: A cross-sectional survey-based study was carried out on a sample of 1446 respondents. The Google Forms questionnaire was created and disseminated electronically using social media and e-mail. The pre-test was performed at the beginning of the project. Results: The majority of respondents (71%) could identify "high-risk groups" recommended for influenza vaccination. Furthermore, it was observed that individuals aged 21 to 59 demonstrated a higher level of knowledge in this regard compared to those below 20 and above 65 years old, and individuals with higher and medium education levels were much better at identifying risk groups for influenza virus infection. The majority of respondents (52.01%) reported receiving influenza vaccination at some point in the past, with 32.12% receiving it in the 2022–2023 flu season and 41.09% in the 2021–2022 season. The majority of respondents declaring acceptance of the vaccine for the 2022-2023 season were in the high-risk group. Only 17.28% of respondents declared receiving both influenza and SARS-CoV-2 vaccines in the 2022-2023 season, with the vast majority being respondents from the "high-risk group" (p

This study aimed to examine the association of blood triglyceride levels with fasting blood glucose levels and type 2 diabetes (T2D) prevalence in Chinese adults with normal triglyceride levels (<1.7 mmol/L), using linear regression and binary logistic regression, respectively. This cross-sectional study included 16,706 Chinese adults, among which 1,067 had T2D. Triglycerides were positively associated with fasting plasma glucose after multivariate adjustment (β=0.034, P<0.001). One natural log unit increase in blood triglycerides was associated with a 61% higher multivari-ate-adjusted risk of T2D (odds ratio [OR], 1.61; 95% confidence interval [CI], 1.19-2.17; P=0.002). The positive associations remained when participants who were treated with lipid-lowering or an-ti-diabetic drugs were excluded. The optimal cut-off of triglycerides for T2D was 1.09 mmol/L (obtained using Receiver Operating Characteristic curve analysis). Participants with triglycerides of ≥1.09 mmol/L had a 28% higher risk of T2D (OR, 1.28; 95% CI, 1.07-1.53; P=0.006) compared to those with triglycerides below the cut-off. In conclusion, this study showed that, in people with normal triglyceride levels, triglycerides at the upper normal range correlated with increased T2D diagnosis risk, with an optimal cut-off of 1.09 mmol/L. Therefore, adults with high “normal” triglyceride levels (1.09-1.69 mmol/L) may need to be closely monitored for the development of T2D.

According to the World Health Organization, cardiovascular disease (CVD) is the leading cause of death among women worldwide, yet its magnitude is often underestimated. Biological and gender differences affect health, diagnosis, and healthcare in numerous ways. The lack of sex and gender awareness in health research and healthcare is an ongoing issue and affects not only research, but also treatment and outcomes. The importance of recognising the impact of both sex and gender on health and of knowing the differences between the two in healthcare is beginning to gain ground. There is more appreciation of the role that biological differences (sex) and sociocultural power structures (gender) have, and both sex and gender affect health behaviour, the development of diseases, their diagnosis, management, and long-term effects of an illness. An important issue is the knowledge and awareness of women about vascular diseases. The risk of cardiovascular events is drastically underestimated by women themselves, as well as by those around them. The purpose of this review is to draw attention to improving the medical care and treatment of women with vascular diseases.

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

To evaluate whether the extent of cardiac damage in severe aortic stenosis (AS) might be associated with the occurrence of conduction system disorders after TAVI. A total of 153 symptomatic patients with severe AS who had a TAVI were categorized before the procedure according to the extent of cardiac damage: stage 1 (13.5%): no or LV damage; stage 2 (58.8%): left atrial/mitral valve damage, atrial fibrillation (AF); stage 3 (27.7%): low-flow state, pulmonary vasculature/tricuspid valve/RV damage. After TAVI, 34% of patients exhibited LBBB and 10% high-degree atrioventricular block (HD-AVB). No patient in group 1 developed HD-AVD whereas new LBBB was frequent in groups 2 and 3. Twenty-one patients presented with resolutive paroxysmal AF with a higher rate for each group increment (group 1: n=0, 0%; group 2: n=11,15.7%; group 3: n=10, 30.3%) (p = 0.012). Patients in group 3 had the higher rate of permanent pacemaker implantation (PPMI) (group 1: n=1, 6.3%; group 2: n=7,10%; group 3: n=9, 27.3%) (p=0.012). No patient in group 1 died during the hospital stay. In conclusion, cardiac damage staging of AS might help identify patients at higher risk of conduction disorders and PPMI requirement after TAVI.

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

Introduction. Congenital muscular torticollis (CMT) is an asymmetrical head positioning resulting from structural changes in the sternocleidomastoid muscle (SCM) that occurs early in a child’s development period or due to perinatal trauma. Children with CMT exhibit a marked imbalance in tension between the SCMs. When the clinical picture is typical, an ultrasound scan is performed to reveal characteristic lesions, such as tissue fibrosis or post-traumatic changes. Early diagnosis of CMT in newborns and implementation of treatment offer the chance of a complete cure. Torticollis treatment aims to rebuild the SCM's normal function by restoring its anatomical length, normal cervical spine mobility and muscle flexibility to enable regular head movements. Surgical treatment is performed when conservative methods fail to improve the patient’s condition. Indications for surgery include marked shortening of the SCM, persistent fibrosis in the muscle, constant head and facial asymmetry, and rotation or lateral flexion in the cervical spine restricted by > 15°. After hip dislocations and foot deformities, pediatric orthopedics addresses torticollis as the third most common congenital anomaly. Aim. This study was a retrospective analysis of 111 children diagnosed and treated due to CMT. Methods. The following were determined: the relationship between the side of CMT location and the type of delivery (cc vs. natural), between the body weight at birth and the side of CMT location, between the extent of SCM thickening and the type of delivery, and the incidence of CMT depending on the order of delivery. Results and conclusions. The analysis showed that CMT was more common in boys 61(54%) than in girls 51(46%), which may be related to the greater birth weight in boys. Of the pediatric patients with CMT, 76% were primiparous. More often, children born via natural delivery had left-sided torticollis with a more significant broadening of the SCM on ultrasound scans than right-sided torticollis. Theories of torticollis development pathophysiology should be deepened, systematized, and further researched.

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

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

In recent years, a large-scale afforestation campaign has taken place in Inner Mongolia, China, to control desertification and soil erosion. However, the water consumption associated with large-scale afforestation significantly impacts the water resources in Inner Mongolia, resulting in a substantial ecological risk. This study aimed to evaluate the ecological risk of water resources caused by afforestation in the region. In this study, based on land cover data, Normalized Difference Vegetation Index (NDVI) data, and meteorological data, used trend analysis, water balance equation, and Water resources Security Index (WSI) index to analyze the ecological risks of water resources caused by afforestation in Inner Mongolia from 2000 to 2020. The results show that:(1) The afforestation area in Inner Mongolia was 5.37×104 km2 in 2000-2020; (2) Afforestation in arid and semi-arid areas leads to the reduction of water resources. (3) Afforestation reduces water resources in the study area by 0.76×108m3/year; (4) ~76% of afforestation regions face ecological risks of water resources.

Background: Cardiovascular disease (CVD) increases the risk of mortality and morbidity in patients with rheumatoid arthritis (RA). Patients with RA have a 50-60% increased risk for CVD compared with the general population. Cardiovascular risk is commonly meas-ured using the Systemic Coronary Risk Estimation 2 calculator modified for patients with RA. Traditional modifiable risk factors for CVD include arterial hypertension, dyslipidemia, insulin resistance, diabetes, cigarette smoking, and low physical activity. In this study, we analyzed the effects of smoking and the risk of CVD in patients with RA. Methods: This was a prospective, clinical, cohort study with an eight-year follow-up pe-riod. A total of 201 patients, 124 with RA (study group) and 77 with osteoarthritis (OA) (control group), were included in this study. However, only 137 patients (82 with RA and 55 with OA) completed the study. Fifty-eight patients (41 with RA and 17 with OA) died during the study period. We compared the prevalence of smoking and its association with the risk for CVD and RA. Results: The prevalence of smoking in the RA group was higher than that in the OA group (p<0.0001). Trends in the prevalence of smoking in both groups did not change signifi-cantly during the follow-up period. In the RA group, smoking was associated with the in-cidence of CVD in current smokers (p=0.028) and in patients with a history of smoking (p=0.016). These results suggest that smokers have an increased risk for RA. The trend of continued smoking in patients with RA may be attributed to attempts to reduce stress caused by RA symptoms. Conclusions: Previous studies have shown that current and former smokers with RA have more severe symptoms, more joint damage, and poorer response to therapy than those who have never smoked. However, the reason underlying the trend of continued cigarette smoking in patients with RA remains unclear. Further studies are needed to clarify the trend of continued smoking in patients with RA.

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

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

Taxes on the consumption of certain products have played a key role in public revenue analysis in European countries. This work aims to assess the differences in tax planning on new non-combustion products across some European territories. Through theoretical analysis, the paper has three distinct aspects. Firstly, we show the taxpayer profile in different countries. Secondly, the study analyzes the risks for the health system and the individual. Thirdly, the design of the land tax is based on previous experience and planning in Europe. This paper concludes with a case study for different countries: 1) Spain “vapers” and “smokers”, where the analysis is based on micro-data from the European Health Interview Survey 2020. 2) Sweden with the analysis of snus, shows it as a practice to reach economic savings while decreasing economic costs thanks to the nudging of consumers towards better products. The results show taxation and, specially, land taxation, should consider differences in planning in the case of new products, such as the non-combustion products, given the user per capita income and the potential lower health risks involved.

Primary Biliary Cholangitis (PBC) is a chronic, cholestatic liver disease with a heterogeneous presentation, symptomatology, disease progression, and response to therapy. The current risk stratification assessment, aimed at identifying patients with a higher risk of disease progression, encompasses an in-depth analysis of demographic data, clinical and laboratory findings, antibody profiles, and the evaluation of liver fibrosis using both invasive and non-invasive techniques. Treatment response scores after one year of therapy remain to date a major factor influencing the prognosis of PBC patients. While the initial therapeutic approach with ursodeoxycholic acid (UDCA) is universally applied, new second-line treatment options have recently emerged, with many others under investigation. Consequently, the prevailing one-size-fits-all approach is poised to be supplanted by tailored strategies, ensuring high-risk patients receive the most appropriate treatment regimen from diagnosis. This will require the development of a risk prediction model to assess, at the time of diagnosis, the course, outcome, and response to first and additional treatments of PBC patients. This manuscript provides a comprehensive overview of the current and emerging tools used for risk stratification in PBC and speculates on how these developments might shape the disease landscape in the near future.

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

Small ruminant lentivirus (SRLV) are infected and transmitted among ovine and caprine species. This disease is a severe problem for small ruminant production, not only for animals’ wellbeing but also for the herd’s efficiency. The main aim of this research was to quantify the seroprevalence and associated risk factors for SRLV infection in the north region of Portugal. Collected samples from a total of 150 herds, of which 129 (86.0%; 95% CI: 80.67% - 91.33%) had at least one seropositive animal. Out of 2607 individual blood samples, 1074 (41.2%) were positive for SRLV. The risk factors associated with SRLV infection were: specie (caprine), age (&gt; 2 years old), herd size (&gt; 100 animals), production system (intensive), production aptitude (milk), type of activity (professional), participation in livestock competitions (yes), buy replacement young ewe (yes) and rearing (natural). This knowledge empowers the implementation of effective preventive measures. Overall, biosecurity measures should be promoted and implemented to aim reducing viral transmission, with the main goal of reducing the prevalence of this disease. Completely, we understand that government authorities should promote and audit voluntary control and eradication programs in small ruminant herds in the region studied.

Children from rural areas face numerous possibilities for neurodevelopmental conditions that may compromise their well-being and optimal development. Neuropsychology and electroencephalography (EEG) have shown strong agreement in detecting correlations between these two variables and suggest an association with specific environmental and social risk factors. The present meta-analysis aims to integrate the qualitative and quantitative EEG findings, their relationship with cognitive impairment in children living in vulnerable or rural environments, and the main risk factors influencing EEG abnormalities. The method for this purpose was based on a systematic string-based review from Ebscohost and Web of Science, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Qualitative and quantitative analyses were conducted from the outcomes that complied with the selected criteria. A total of 92 records were identified; however, only 20 were eligible, considering 11 for qualitative and 9 for quantitative analysis. The findings highlight a significant amount of literature on EEG and its relation with cognitive impairment from studies in children with epilepsy and malnutrition. In general, there is evidence about the advantages of implementing EEG diagnosis and research techniques in children living under risk conditions. Further research is needed to better describe and integrate the state of the art regarding EEG features extraction.

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

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

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

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