Abstract: Aim: The aim in this study was to conduct a prospective survey regarding the socio-demographics and lifestyle risk factors for cancer of a population of Caribbean immigrants living in the U.S. Materials and Methods: The data were processed and analysed using SPSS software 27 and Excel. Crosstabulations were performed. The chi-square test was used to evaluate differ-ent hypotheses. Statistical significance was defined as p < 0.05. Results: Statistically significant differences in the country of birth of the Caribbean immigrants were found for sex (p = 0.038) and the cleanness of their neighbourhoods (p = 0.045). We found differences in occupations between men and women (p = 0.001). Men were less unemployed than women (p = 0.011). Sex also showed statistically significant differences in how easily the immigrants balanced their work and per-sonal life (p = 0.044). Age groups depicted differences in the physical health of the immigrants (p = 0.001). The use of alcohol and tobacco was not an important risk factor among participants (p = 0.529). Conclusions: These findings suggest that the sociodemographics risk factors for cancer among a population of Caribbean immigrants were significantly different between the sexes. However, the use of tobacco and alcohol showed insignificant differences among the immigrants.

Despite decades of conflict and political instability, drought has also severely affected Afghanistan’s rural population and agriculture sector. Agriculture is a primary livelihood source in the country, and recurring droughts have put cascading pressures on the agricultural economy and food security. Therefore, understanding the key drivers of all risk components through a comprehensive risk assessment is critical for proactive drought risk management. This study assesses agricultural drought risk from an integrated perspective, emphasizing the combined effects of drought hazard, exposure, and vulnerability. Multi-methods research was conducted, employing remote-sensing-based analysis covering a period from 2001 to 2023. We used the Vegetation Condition Index (VCI) to analyze the drought hazard for the agricultural system during the winter growing season. The vulnerability indicators and exposure levels of the agricultural system were determined through spatial analysis combined with a literature review and expert consultation. An adapted conceptual framework of the Intergovernmental Panel on Climate Change (IPCC) was utilized, which incorporates hazard, exposure, and vulnerability to define risk. The results revealed that droughts occur frequently and in changing patterns throughout the country. All provinces have experienced drought over the past two decades, albeit with varying severities and frequencies. Severe droughts were observed in 2001-2002, 2008, 2011, 2018, and consecutively in 2021-2022-2023. Drought vulnerability and exposure vary widely across the country, particularly in the northern, western, and southern provinces. The final calculated risk shows that most provinces in southern and southwestern zones face a high risk of recurrent droughts, further exacerbating agricultural challenges in these regions. Such analyses under a multimethod approach provide information on spatial patterns of drought risk and drivers of agricultural systems that can support decision-makers and policymakers in formulating strategies to reduce drought risk and adapt to the agricultural sector.

In the former mining district of La Carolina (southern Spain), waste materials were accumulated without first waterproofing the substrate. Additionally, these mining dams were abandoned without any type of restoration, conditions that present a significant risk of contaminating the surrounding soils and waters. Prior to carry out the necessary works for isolating these residues, morphological characterization of the contact with the base substrate is needed. For that purpose, in recent years, different indirect study techniques have been used, among which electrical to-mography stands out. In this work, a less common geophysical technique, magnetometry, both in its magnetic and gra-diometric modalities, is used as an alternative method to analyse the geometry and structure of a mining dam. The results obtained with this methodology are compared with the results provided by electrical techniques, as well as with direct data from mechanical surveys and aerial photo-graphs prior to waste deposition. The magnetic anomaly curves obtained with geometric models generated with the Mag2dc program were also analysed. This comparative study shows the use-fulness of magnetic prospecting in characterizing the base geometry of these mining structures and therefore the interest in its application to environmental characterization studies.

Background: Modulator therapies improve weight and body mass index (BMI) in cystic fibrosis (CF) patients. We aimed to compare the nutritional risk index (NRI) in adult CF patients receiving modulator (MT) or only non-modulator (conventional) therapies (non-MT). Methods: A single-center prospective cohort study was conducted between June-December 2023. The NRI based on weight gain and albumin was calculated at beginning and end of a 12 weeks period in both groups. This design was pragmatic, since based on individual patient access to MT for 12 weeks. Results: 107 patients were included [mean (SD) age: 23.85 (4.98) years, 54.7% male, 46.7% MT]. In the MT group, mean (SD) weight (kg) and albumin (g/dL) increased significantly [changes: +3.09 (2.74) and +0.17 (0.37); p

Due to the growth of tourism, mining and manufacturing, economy of the Hainan Island, southern China has swiftly expanded, but also poses a risk of soil pollution by mercury (Hg) due to the traffic and mineral processing. In order to investigate the characteristics of soil Hg pollution in the Hainan Island and assess the health risk, a total of 239 samples were gathered from five representative regions across the island. A vehicle-mounted potable mercury analyzer was used to measure the atmospheric Hg and soil Hg concentrations in the collected samples. The results indicate that the soil Hg concentration of the five sub-study areas exhibits notable fluctuations, which was found to be influenced by various factors, including wind direction, mining activities, and economic development conditions. The degree of Hg pollution was assessed using both the Single Pollution Index Method and the Geoaccumulation Index Method. The results showed that although nearly half of the sampling points were contaminated, the current soil Hg level does not pose a non-carcinogenic risk to human health.

The stress testing methodology should be implemented and applied to the entity's overall financial system at least annually, and if the organization operates in a volatile economy, it should be performed at least twice a year. Finally, managers should include regular training and development sessions for relevant employees of their organization to be fully informed and more informed and informed, considering the evolving science, theory and practicality of a discrete range of stress testing mechanisms that can be appropriately applied to overall financial framework and system of multiple financial institutions and banks. In addition, stress testing is essentially a methodology that collects and analyzes certain future macro-prudential and micro-prudential economic drivers and indicators, the primary purpose of which is to assess the future financial and economic well-being, level of growth and status quo of a financial institution, bank, organization, credit institution or economy or the nation as a whole. In addition, several of these reviews were specifically focused and incorporated into the paper, which substantially and broadly discussed and summarized the importance, feasibility and implementation and conclusions of different stress testing approaches for financial institutions and banks, especially in European and Chinese countries. region. with the primary intention of assessing the future financial and economic well-being, level of growth and status quo of a group of financial institutions, banks, organizations, credit institutions or the economy or the nation as a whole. In addition, several of these reviews were specifically targeted and incorporated into a paper that substantially and broadly discussed and summarized the importance of the feasibility and implementation and conclusions of different stress testing approaches for financial institutions and banks, especially in European and Chinese countries. region. with the primary intention of assessing the future financial and economic well-being, level of growth and status quo of a group of financial institutions, banks, organizations, credit institutions or the economy or the nation as a whole. In addition, several of these reviews were specifically focused and incorporated into the paper, which substantially and broadly discussed and summarized the importance, feasibility and implementation and conclusions of different stress testing approaches for financial institutions and banks, especially in European and Chinese countries. region. the level of growth and status quo of the financial institutions, banks, organizations, credit institutions or the economy or the nation as a whole. In addition, several of these reviews were specifically focused and incorporated into the paper, which substantially and broadly discussed and summarized the importance, feasibility and implementation and conclusions of different stress testing approaches for financial institutions and banks, especially in European and Chinese countries. region. the level of growth and status quo of the financial institutions, banks, organizations, credit institutions or the economy or the nation as a whole. In addition, several of these reviews were specifically focused and incorporated into the paper, which substantially and broadly discussed and summarized the importance, feasibility and implementation and conclusions of different stress testing approaches for financial institutions and banks, especially in European and Chinese countries.

Background: Hurricanes and other wind events are significant disturbances that affect coastal urban forests around the world. Past research has led to the creation of wind resistance ratings for different tree species which can be used in urban forest management efforts to mitigate the effects of these storms. While useful, these ratings have been limited to species common to one global region (Florida, USA).Methods: Drawing on past ratings and data from a global literature review on tropical storm research, we created a machine learning model to broaden both the geographic coverage and the variety of species currently assessed for their resistance to wind.Results: We were able to assign wind resistance ratings to 281 new species based on the available data and our modelling efforts. The model accuracy and agreement with the original ratings when applied to the testing data set was high with 91% accuracy.Conclusions: The resulting list of wind resistance ratings has been adapted into a spreadsheet-based decision aid for managers, allowing them to assess the overall susceptibility of their urban forest to wind events like hurricanes.

Purpose: This study aimed to identify the risk factors for acute pancreatitis (AP) and its impact on outcomes in Polish children treated for ALL. Methods: The study group included 2303 children who received intensive chemotherapy for ALL. The group was subdivided into patients with at least one episode of AP and those who did not develop AP following treatment for ALL. Results: The cumulative incidence of AP in the study group was 4.08%. Older age was an independent risk factor for AP development (OR 1.05; 95%CI: 1.006 – 1.098; p=0.03). The overall mortality related to AP was 2.13%. The probabilities of disease-free survival (p-DFS) and event-free survival (p-EFS) were 0.84 vs. 0.86, log-rank: p=0.65 and 0.75 vs. 0.80, log-rank: p=0.12, respectively in both subgroups. A total of 22 out of 94 patients (23.4%) with AP were re-exposed to asparaginase (ASP) during the subsequent phases of the treatment. Only one re-exposed to ASP patient (4.5%) developed a second episode of AP. There were no significant differences in p-DFS and p-EFS between patients re-exposed and not re-exposed to asparaginase (0.78 vs. 0.86, log-rank p=0.27 and 0.63 vs. 0.79, log-rank p=0.09 respectively). Conclusions: The incidence of AP in children with ALL is low and related to the patient’s age. AP development doesn’t seem to impact p-DFS and p-EFS in children with ALL. The recurrence of AP following re-exposure to asparaginase in patients with ALL and a history of AP is low (4.5%). Re-exposure to asparaginase after the first episode of AP doesn’t improve either p-DFS or p-EFS in children with ALL.

This research focuses on the use of the HEC-RAS model to estimate flash flood risk. It combines advanced hydraulic modeling techniques and precise data entry. The aim is to contribute knowledge to assess flash flood risk and reduce impacts on communities and infrastructure. The selection of study areas with a history of severe flooding, such as the Lam Saphung Basin, Phrom River Basin, and Lam Chern River Basin Part 1 in Thailand, highlights the importance of thorough flash flood risk assessment. By leveraging the HEC-RAS model, the results of this research inform proactive risk management strategies, improve emergency preparedness and help develop sustainable mitigation measures. The results are important in developing emergency response strategies and overall recovery ability in areas at risk of flash floods. The research combines advanced hydrologic modeling and real-world flash flood data. In addition to the flood condition assessment, the extent of the flood area and associated hazards were assessed using a two-case simulation strategy. The study covers future scenarios related to land use changes and retrospective analysis of past flood events. The results have practical implications for improving emergency response strategies, land use planning, and overall resilience in flash flood-prone areas. The integrated approach emphasizes the research output to providing insights and actionable solutions for communities facing ongoing challenges posed by flash floods.

Background: Ensemble tree-based models such as Xgboost are highly prognostic in cardiovascular medicine, as measured by the Clinical Effectiveness Metric (CEM). However, their ability to handle correlated data, such as hospital-level effects, are limited. Objectives: The aim of this work is to develop a binary outcome mixed effects Xgboost (BME) model that integrates random effects at the hospital level. To ascertain how well the model handles correlated data in cardiovascular outcomes, we aims to assess its performance and compare it to fixed effects Xgboost and traditional logistic regression models. Methods: A total of 227,087 patients over 17 years of age, undergoing cardiac surgery from 42 UK hospitals between 1 Jan 2012 and 31 Mar 2019 were included. The dataset was split into two cohorts: Training/Validation (n = 157196; 2012-2016) and Holdout (n = 69891; 2017-2019). The outcome variable was 30 days mortality with hospitals considered as clustering variable. The logistic regression, mixed effects logistic regression, Xgboost and binary outcome mixed effects Xgboost (BME) were fitted to both standardized and unstandardized datasets across a range of sample sizes and the estimated prediction power metrics were compared to identify the best approach. Results: The exploratory study found high variability in hospital-related mortality across datasets, which supported the adoption of mixed effects models. Unstandardized Xgboost BME demonstrated marked improvements in predictor power over the Xgboost model at small sample size ranges, but performance differences decreased as dataset sizes increased. Generalized linear models (glm) and generalized linear mixed-effects models (glmer) models followed similar results, with Xgboost models excelling also at greater sample sizes. Conclusions: These findings suggest that integrating mixed effects into machine learning models can enhance their applicability in clinical settings where sample size is small such as rare conditions.

Obesity has increasingly become a worldwide epidemic, as demonstrated by epidemiological and clinical studies. Obesity may lead to development of a broad spectrum of cardiovascular diseases (CVDs), such as coronary heart disease (CHD), hypertension, heart failure (HF), cerebrovascular disease, atrial fibrillation (AF), ventricular arrhythmias, and sudden cardiac death (SCD). In addition to hypertension, there are other cardiometabolic risk factors (CRFs) such as visceral adiposity, dyslipidemia, insulin resistance, diabetes, elevated levels of fibrinogen, and C-reactive protein and others, all of which increase the risk of CVD events. Mechanisms involved between obesity and CVD mainly include insulin resistance, oxidative stress, inflammation, and adipokines dysregulation, which cause maladaptive structural and functional alterations of the heart, particularly left ventricular (LV) remodeling and diastolic dysfunction. Natural products of plants, provide a diversity of nutrients and different bioactive compounds, including phenolics, flavonoids, terpenoids, carotenoids, anthocyanins, vitamins, minerals, fibers, and others, which possess a wide range of biological activities including antihypertensive, antilipidemic, antidiabetic, and other activities, thus conferring cardiometabolic benefits. In this review, we discussed the main therapeutic interventions using extracts from herbs and plants in preclinical and clinical trials with protective properties targeting CRFs. Molecular mechanisms and therapeutic targets of herbs and plants extracts for the prevention and treatment of CRFs are also reviewed.

Objective: This study aims to construct an early risk warning model to predict the risk of treatment failure in patients undergoing sequential High-Flow Nasal Cannula (HFNC) oxygen therapy following mechanical ventilation weaning. Methods: A retrospective analysis was conducted on clinical data from 145 patients who received HFNC treatment in the Emergency Intensive Care Unit of the Third People's Hospital of Bengbu City from June 2018 to June 2023. A wide range of indicators including general information, comorbidities, laboratory test results, vital signs, disease-related scores, and oxygenation data were collected. Data analysis was performed using R software, starting with the Lasso regression to filter features related to treatment outcomes. Patients were divided into a training set (70%) and a validation set (30%) using random grouping software. The Random Forest algorithm was then employed to evaluate and rank the important features related to outcome indicators. The predictive efficiency and stability of the model were assessed through the Receiver Operating Characteristic (ROC) curve, calibration curve, and decision curve analysis, culminating in the construction of an early risk warning nomogram. Results: The study found that the Random Forest model exhibited high predictive accuracy in the training set (AUC=0.98) and good stability in the validation set (AUC=0.84). Key feature variables identified by the model, such as APACHE II score, BNP, NLR, mROX, and SOFA, were found to significantly impact the prediction of HFNC treatment failure. Based on these variables, an early warning nomogram was further developed, providing clinicians with a convenient and effective risk assessment tool. Conclusion: This study has constructed an early risk warning model based on the Random Forest algorithm, capable of effectively predicting the risk of HFNC treatment failure. The model's high predictive efficiency and stability offer strong support for clinical decision-making, contributing to personalized treatment and improved patient outcomes. Future research should aim to expand the sample size, perform multicenter validation, and explore the integration of the model into Clinical Decision Support Systems for real-time risk assessment and intervention.

(1) Background: Heart rate variability (HRV) has emerged as a potential prognostic tool in cardiovascular diseases, offering individualized insights into autonomic nervous system activity. However, real-time HRV data during the acute phase of STEMI, particularly during percutaneous coronary intervention (PCI), was not previously explored. (2) Methods: This single-center, observational cohort study included 104 STEMI patients undergoing primary percutaneous coronary intervention (PCI). HRV parameters were measured using a wearable device (CE marked) during PCI, capturing dynamic responses. The association between HRV parameters and adverse outcomes, including in-hospital mortality and major adverse cardiovascular events (MACE), were assessed. (3) Results: HRV parameters significantly decreased after myocardial revascularization, particularly SDNN, RMSSD, pNN50, HF, SD1, and SD2/SD1 ratio. Significant associations were found between reduced SD2/SD1 ratio, approximate entropy, and adverse outcomes, including increased in-hospital mortality and MACE. The SD2/SD1 ratio was significantly lower in patients who died during the hospital stay (p = 0.008) compared to survivors. Approximate entropy was also significantly lower in deceased patients (p = 0.019). (4) Conclusions: Real-time HRV monitoring using wearable technology offers valuable data regarding dynamic physiological changes during primary PCI. The integration of HRV into routine clinical practice, facilitated by wearable devices, could improve the risk stratification and event prediction in STEMI patients.

This study introduces an integrated method for managing process risks in a Business Process Reengineering (BPR) project, using Robust Data Envelopment Analysis (RDEA) and machine learning (ML). The goal is to prioritize risks based on three standard factors of PFMEA: Severity, Occurrence, and Detection (S-O-D), and incorporating two additional factors (Breakdown Cost and Breakdown Duration) seen as undesirable outputs. The model also accounts for the effect of uncertainty on expert-estimated values by applying disturbance percentages in the linear PFMEA-RDEA model. A machine learning model is proposed to predict new values if partial or total modifications have been made to the processes. The approach was implemented in an au-tomotive sector company, and the results showed the impact of uncertainty on values by com-paring different approaches such as RPN, PFMEA-DEA, and PFMEA-RDEA. A new reduced risk categorization was achieved, who allowed for decision-makers to focus on necessary actions for reengineering.

Cardiovascular diseases (CVDs) and their risk factors are a major cause of illness and death worldwide, especially in low- and middle-income countries like Cameroon. Physiotherapist-led health promotion (PLHP) has proven effective in improving health and reducing CVD risks. Understanding patient perspectives is crucial for designing effective, context-specific PLHP interventions. This study explored patients' views, experiences, perceived usefulness, acceptability, and preferred methods of PLHP through a sequential explanatory mixed-methods approach. The quantitative data highlights a significant burden of CVD conditions and risk factors among patients seen in physiotherapy services. Qualitatively, three themes were identified and included: 1) perspectives and experiences of people at risk or with CVDs (pwCVDs) on PLHP; 2) Perceived usefulness and acceptability of PLHP; 3) Preferred delivery methods of PLHP. Participants reported positive feedback on PLHP and physiotherapy services. Barriers to effective PLHP included high workloads for physiotherapists, limited service access in rural areas, and prohibitive costs. Despite these challenges, participants expressed strong confidence in physiotherapists' competence, though they also called for improved regulation and ongoing professional development. PLHP components, especially physical treatment and dietary advice, were deemed highly useful and acceptable. Patients suggested various delivery methods, including peer support groups, home visits, and mass media interventions. This study highlights the need to improve the scope of practice, competence of physiotherapists and accessibility of physiotherapy services in Cameroon for pwCVDs. It is necessary to adopt multidisciplinary approaches to achieve better outcomes for risk factors like diabetes and hypertension in context.

The Western Balkans region is persistently vulnerable to natural hazards, inadequate infrastructure, and limited institutional capacities, necessitating a collaborative approach to disaster risk management. This paper presents a comprehensive project led by the Scientific-Professional Society for Disaster Risk Management (NSD-URVs) in Belgrade, aiming to establish and strengthen a regional network of experts in disaster risk management. The project focuses on building expertise, facilitating knowledge exchange, promoting expert coordination, and enhancing cross-border collaboration. Key activities include developing a web platform, organising an international conference, and advocating for regional policies that integrate best practices and innovations in disaster risk management. The expected outcomes are the establishment of a cohesive network, enhanced expertise and coordination, and improved preparedness and responsiveness to disasters. By leveraging collective expertise and resources, this initiative aims to fortify the region's resilience against potential disasters. Addressing the identified gaps and implementing the proposed policy recommendations can significantly enhance the region's resilience to natural hazards. Future research should focus on the implementation and impact of these recommendations to ensure continuous improvement in disaster preparedness and response.

Abstract: Background/Objectives: Schizophrenia (SZ) is a severe psychiatric disorder characterized by a complex interplay of genetic, developmental, and environmental factors that significantly increase the risk of suicidal ideation (SI) and suicide attempts (SAs). This systematic review synthesizes current research on the developmental predictors of SI in individuals with SZ, aiming to delineate the multifactorial etiology of suicide within this population. Methods: A comprehensive search across Medline, PsycINFO, and EMBASE databases identified 23 eligible studies, emphasizing the varied methodological approaches and the global distribution of research efforts. Results: These studies demonstrate a robust association between early life adversities, particularly childhood trauma such as physical neglect, emotional abuse, and sexual abuse, and the increased prevalence of SI and SAs in SZ. This review also highlights the significant genetic factors associated with development of suicidality in SZ, suggesting that polymorphisms in inflammation-related genes and neurodevelopmental abnormalities may influence susceptibility to SI. Notably, family history of psychiatric conditions may exacerbate the risk of SI through both hereditary and environmental mechanisms. Environmental factors, including socioeconomic status and social support, are also implicated, underscoring the role of broader socio-environmental conditions influencing outcomes. Conclusions: This review supports the integration of biopsychosocial models in understanding SI in SZ, advocating for interventions addressing the complex interplay of risk factors and the need for longitudinal studies to elucidate the dynamic interactions between risk factors over time. This comprehensive understanding is crucial for developing targeted preventative strategies and enhancing the clinical management of SZ, aiming to reduce suicidality in this vulnerable population.

Background: Autonomic balance measurement (ABM) is a valuable tool in clinical practice for assessing the functioning of the autonomic nervous system (ANS), which controls involuntary bodily functions. Here we summarize the current understanding of the utility of autonomic balance measurement in clinical practice. Methods: A narrative review of relevant literature was conducted, focusing on studies investigating the use of autonomic balance measures in various clinical settings. Results: ABM holds potential benefits in clinical practice, including aiding in diagnosing autonomic dysfunction, monitoring treatment efficacy, and predicting potential health complications. ABM can be crucial for diagnosing various conditions, including cardiovascular diseases (Heart failure, arrhythmias, and hypertension), neurological disorders (Parkinson's disease, Alzheimer's disease, and diabetic neuropathy), in sports medicine athletes can undergo ABM to optimize training regimens, enhance performance, assessing the impact of training stress, preventing overtraining, and promoting overall well-being and probably to assess potential health risks, in metabolic syndromes ABM can aid in the early detection of autonomic neuropathy, a diabetes-related complication, allowing for timely intervention and better management of the disease, and psychiatric disorders (Anxiety, depression, and post-traumatic stress disorder). In addition, ABM can be helpful in monitoring of treatment efficacy, by tracking changes in autonomic balance, clinicians can assess if treatments for conditions impacting the autonomic nervous system are effective. ABM can also be helpful in predicting outcomes by facilitating early recognition of future health complications in certain populations. However, limitations exist, including non-specificity, variability in measurements, and limited evidence for routine use in specific clinical settings. Conclusion: Incorporating autonomic balance measurement into routine clinical assessments provides a more comprehensive understanding of a patient's health. It complements traditional diagnostic methods, offering additional insights into the body's regulatory mechanisms. While autonomic balance measurement offers potential benefits, careful interpretation and consideration of its limitations are crucial for its effective use in clinical practice. ABM remains a valuable and versatile tool in clinical practice for a deeper understanding of the autonomic nervous system, enabling early detection, targeted interventions, and improved management of various medical conditions across different specialties.

This review of current research into at-risk programs serves to categorise and characterise existing programs and to evaluate the contribution of these programs to assisting students at-risk from marginalised backgrounds. This characterisation questions the (sometimes) implicit assumptions and the consequences of those assumptions inherent in and behind these various accounts. This involves a synthesis and reformulation, based on epistemological standpoints, both explicit and implied, of the various researchers. Using as a lens the (various and varied) understandings of social justice and the goals of education (Gale & Densmore, 2000; 2003) I identify three sometimes overlapping and sometimes contesting standpoints in relation to at-risk students, characterised as instrumentalist or rational technical, social constructivist or individualist and critical transformative or empowering. I argue that programs ‘which simply seek to achieve change in the individual young people are doomed to failure’ (Stewart, 1998, 4) and that a critical transformative understanding of at-risk may deliver improved outcomes for young people by challenging ‘the school context in which the young people are located’ (Stewart, 1998, 4).

This study investigates the factors influencing consumers' intentions to purchase overseas travel packages via social media in Thailand, with a focus on consumer trust and perceived risks. A mixed-methods approach was employed, combining qualitative and quantitative research techniques. In the qualitative phase, the Fuzzy Set Delphi Method was applied to gather expert consensus from 19 participants. For the quantitative phase, a survey was conducted among 600 individuals who had experience purchasing overseas travel packages on social media in Thailand. First-order and second-order confirmatory factor analyses were used to examine the relationships between eight identified factors: social media influencer, e-WOM, trust, perceived risk, brand image, rating review, personal attitude, and destination image. The results indicate that trust and perceived risk are the most significant factors affecting purchase intention. Trust plays a crucial role in customers' decision-making processes, while perceived risk influences their tendency to avoid purchasing packages if the risk is perceived as high. The insights gained from this study contribute to the understanding of factors influencing purchase intentions for overseas travel packages through social media in Thailand, providing valuable information for travel agencies to develop effective marketing strategies.

Introduction: Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline and memory loss, predominantly affecting older adults. Understanding the multifaceted factors contributing to AD is crucial for developing effective prevention and intervention strategies. This narrative review synthesizes current literature on the various factors influencing the development and progression of AD in older adult populations.Methods: A comprehensive search was conducted across electronic databases including PubMed, Web of Science, and PsycINFO using relevant keywords such as "Alzheimer's disease," "risk factors," "genetics," "environmental factors," and "lifestyle." Studies published between 2000 and 2023 were included, focusing on factors associated with AD in individuals aged 65 years and older.Results: The review identified several key factors contributing to AD in older adults. Genetic predisposition, particularly the presence of apolipoprotein E (APOE) ε4 allele, emerged as a significant risk factor. Environmental factors such as air pollution, pesticides, and heavy metals were also implicated. Furthermore, lifestyle factors including physical inactivity, poor diet, and smoking were associated with increased AD risk. Chronic conditions such as diabetes and cardiovascular diseases were found to exacerbate cognitive decline in older adults.Conclusion: This narrative review highlights the complex interplay of genetic, environmental, and lifestyle factors in the development and progression of Alzheimer's disease among older adults. Understanding these factors is crucial for targeted interventions aimed at reducing AD risk and improving cognitive health outcomes in aging populations. Future research should focus on longitudinal studies and personalized medicine approaches to elucidate specific mechanisms underlying AD pathogenesis and to develop effective preventive strategies.

In today's highly digitized and globalized financial environment, the need to protect payment systems from risk is more urgent than ever. Artificial intelligence (AI) technology is rapidly becoming a key tool in this space, with machine learning algorithms, big data analytics, and real-time monitoring enabling AI to effectively detect and prevent fraudulent activity, optimize risk management processes, and deliver intelligent services. AI not only improves the security and efficiency of payment systems, but also significantly improves customer satisfaction and loyalty. With the continuous development of AI technology and financial payment technology, the financial payment industry will usher in more innovations and changes in the future, further optimizing the payment process, improving payment efficiency, and ensuring payment security.

The aim of this study was to determine the impact of information technology in management of risks in the capital market-listed company is in Tehran Stock Exchange. The purpose of the present study is an applied descriptive approach. The target population for the survey, companies that from 2009 to the first half of 2015 have been a member of the Tehran Stock Exchange, through Cochranʼs sample size of 140 companies, respectively. We used cluster sampling method. In order to collect data from two questionnaires: risk management questionnaire Foakeh (2013) has 38 items and a standard questionnaire Chanvyas (2006) has 40 items, the whole five-item Likert scale questionnaire is above has been used. Data gathered through the questionnaire, sign the application was 21spss. For inferential analysis of the variables and to analyze the data from different statistical tests and regression was used Kolmogorov-Smirnov test. The results showed that information technology on risk management and its dimensions (primary market risk, market risk and the risk of secondary non-financial) impact.

(1) Background: The prediction of cervical lesions evolution is a challenge for clinicians. The prospective study aimed to determine and compare the predictive accuracy of cytology, HPV genotyping, and p16/Ki67 dual staining alone or in combination with personal risk factors for the prediction of progression, regression or persistence of cervical lesions in human papillomavirus (HPV)-infected patients; (2) Methods: This prospective study included HPV-positive patients with or without cervical lesions that underwent follow-up. Descriptive statistics and sensitivity analysis for individual or combined index tests were used for data analysis; (3) Results: The highest predictive performance for the progression of cervical lesions was achieved by a model that comprised a Pap smear suggestive of high-grade squamous intraepithelial lesion (HSIL), the presence of 16/18 HPV strains, a positive p16/Ki67 dual staining result along with the presence of at least 3 clinical risk factors, which had a sensitivity (Se) of 74.42%, a specificity of 97.92%, an area under the receiver operating curve (AUC) of 0.961, and an accuracy of 90.65%. The prediction of cervical lesions regression or persistence was modest; (4) Conclusions: Multiple testing or new biomarkers should be used to improve HPV-positive patient surveillance, especially for cervical lesion regression or persistence prediction.

Preterm birth accounts for about 10% of births worldwide. Studying risk factors for perinatal brain damage is essential, as findings suggest that almost 20% of disabilities are linked to risks in the early stages of development. This research aimed to study longitudinal changes in intelligence from 6 to 8 years of age in a sample of 39 preterm children with a history of risk of brain damage and a control group of 35 children born at term. The Wechsler Intelligence Scale (WISC-IV) was used for cognitive measurement. The results showed that the preterm group obtained significantly lower scores than the control group. The working memory indicator significantly affected the interaction between age and prematurity. We consider that it is crucial to expand the knowledge we have about the neurocognitive development of premature infants both in specific cognitive domains and in age ranges so that the information obtained helps to predict the probability of presenting cognitive alterations from early stages and, therefore, to implement intervention strategies and programs based on scientific evidence and complemented in their design by clinical experience, empirical and theoretical knowledge of the different professionals involved in infant cognitive intervention.

Flooding is one major environmental problem facing urban cities causing varying degree of damages to properties and disruptions to socio-economic activities. Nigeria is the most populated African country and Kano metropolis is the second largest urban center in Nigeria and the most populated in Northern Nigeria. The aim of the paper is to conduct flood risk assessment of Kano metropolis. The city is divided into two hydrological basins; Challawa and Jakara Basins. Flood frequency analysis for 2 to 100-year return periods were carried out for both the basins using Log-Pearson Type III distribution and flood inundation and hazard mappings were carried out. Social vulnerability to flood of both basins were carried out using MOVE framework. Assessment of flood risk were carried out using map algebra spatial analyst tool in ArcGIS 10.7. The result shows that an area of 50.91 and 40.56 km2 were vulnerable to a 100-year flood. The flood risk map for the two basins show that 10.50 km2 and 14.23 km2 of land in Challawa and Jakara basins respectively are affected by the risk of a 100-year flood out of which 11.48 km2 are built-up area. As the city is densely populated, with a population density of well over 20,000 persons per square kilometer in the highly built-up locations, this means that much more than 230,000 persons will be affected by the flood risk in the two basins

Insurance companies need to calculate solvency capital requirements in order to ensure that they can meet their future obligations to policyholders and beneficiaries. The solvency capital requirement is a risk management tool essential for, when extreme catastrophic events occur, resulting in a high number of possibly interdependent claims. This paper studies the problem of aggregating the risks coming from several insurance business lines and analyses the effect of reinsurance in the level of risk. Our starting point is to use a Hierarchical Risk Aggregation method, which was initially based on 2-dimensional elliptical copulas. We then propose the use of copulas from the Archimedean family and a mixture of different copulas. Our results show that a mixture of copulas can provide a better fit to the data than an individual copula and consequently avoid over or underestimating of the capital requirement of an insurance company. We also investigate the significance of reinsurance in reducing the insurance company’s business risk and its effect on diversification. The results show that reinsurance does not always reduce the level of risk, but can also reduce the effect of diversification for insurance companies with multiple business lines

The increasing rearrangement is a rewarding instrument in financial risk management. In practice, risk must be managed in different perspectives. A common example is portfolio risk which often can be seen from at least two perspectives: market value and book value. Different perspectives that is different distributions can be coupled by increasing rearrangement. One distribution is regarded as underlying, and the other distribution can be expressed as increasing rearrangement of the underlying distribution. Then, the risk measure for the latter can be expressed in terms of the underlying distribution. Our first objective is to introduce the increasing rearrangement for application in financial risk management and apply the increasing rearrangement to the class of distortion risk measures. We derive formulas to compute risk measures in terms of the underlying distribution. Afterwards, we apply our results to a series of special distortion risk measures, namely Value at Risk, Expected Shortfall, Range Value at Risk, Conditional Value at Risk, Wang's risk measure. Finally, we present the connection of increasing rearrangement to inverse transform sampling, Monte Carlo simulation, and cost-efficient strategies. Butterfly options serve as illustrative example for the method.

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

The impact of financial risks extends beyond the normal operation and survival of industrial and commercial enterprises and financial institutions. They also have the potential to impede the stable development of a country's and even the world's financial economy. This is clearly demonstrated by the severe consequences of the frequent financial crises that have occurred in recent years. It thus follows that the prevention of financial risks has become one of the core tasks of the operation and management of industrial and commercial enterprises and financial institutions. Portfolio optimization techniques are employed in the construction of a variety of asset allocation models, with reinforcement learning algorithms used to dynamically adjust investment strategies with the objective of maximizing returns and minimizing risks. The preliminary construction of an asset allocation model is achieved through the utilization of a genetic algorithm. Genetic algorithms emulate the processes of natural selection and genetic variation to identify the optimal portfolio of assets that will yield the greatest returns at a pre-established level of risk. Subsequently, the Deep Q-Learning algorithm is introduced to facilitate dynamic adjustments and optimization of the asset allocation, based on the initial construction. Deep Q-learning employs deep neural networks to forecast the prospective returns of disparate investment strategies, thereby optimizing the decision-making process through continuous learning and updating. The combination of genetic algorithms and deep Q-learning enables the system to identify the optimal investment strategy under a diverse range of initial conditions and to adapt it in real-time to respond to market fluctuations and uncertainties. The experimental analysis demonstrates that the proposed method exhibits an exemplary capacity for risk control and a robust ability to generate stable income growth across diverse market environments. In simulation experiments, portfolios constructed using this method demonstrate lower volatility and higher average returns than those generated through traditional methods.

Floods are a common natural disaster whose severity in terms of duration, water resource volume, peak and accumulated rainfall-based damage are likely to differ significantly for different geographical regions. In this paper, we first propose a novel hourly flood index (SWRI24−hr−S), derived from normalising the existing 24-hourly water resources index (WRI24−hr−S) in literature, to monitor flash flood risks on an hourly scale. The proposed SWRI24−hr−S is adopted to identify a flood situation and derive its characteristics, such as the duration (D), volume (V) and peak (Q). The comprehensive result analysis establishes the practical utility of SWRI24−hr−S in identifying flood situations at seven study sites in Fiji between 2014 and 2018 and deriving their characteristics (i.e., D, V, and Q). Secondly, this study develops a vine copula-probabilistic risk analysis system that models the joint distribution of flood characteristics (i.e., D, V, and Q) to extract their joint exceedance probability for the seven study sites in Fiji, enabling probabilistic flood risk assessment. The vine copula approach, particularly suited to Fiji’s study sites, introduces a novel probabilistic framework for flood risk assessment. The results show moderate differences in the spatial patterns of joint exceedance probability of flood characteristics in different combination scenarios generated by the proposed vine copula approach. In the worst-case scenario, the probability of any flood event occurring where the flood volume, peak and duration are likely to exceed the 95th-quantile value (representing an extreme flood event) is found to be less than 5% for all study sites. The proposed hourly flood index and the vine copula approach can be feasible and cost-effective tools for flood risk monitoring and assessment. The methodologies proposed in this study can be applied to other data-scarce regions where only rainfall data is available, offering crucial information for flood risk monitoring, assessment, and the development of effective mitigation strategies.

Background/Objectives: With breast cancer (BC) survival improving due to optimized therapy, enhancing quality of life has become increasingly important. Both diagnosis and treatment, with their potential side effects, pose risks to mental well-being. Our study aimed to analyze the inci-dence and potential risk factors for mental disorders in BC patients. Methods: This retrospective analysis used claims data from AOK Baden-Wuerttemberg, including 11,553 BC patients diagnosed via ICD code C50 between 2010 and 2020 and 31,944 age-matched controls. Patients with mental disorders in the 12 months prior to diagnosis were excluded. Mental disorders were cat-egorized into eight groups based on ICD codes: anxiety, obsessive-compulsive disorder, adjust-ment disorder, dissociative disorder, hypochondriac disorder, affective disorder, mania, and other neuroses. Results: Mental disorders were significantly more common in BC patients than in controls (64.2% vs. 38.1%, p

Extreme climates such as droughts and hot extremes, may result in marked damage to crop yields and threaten regional and global food security. Maize is a major grain crop in Liaoning Province, severely affected by drought and hot events. The objective of this study is to advance an approach to estimate the risk of crop yield reduction under the compound dry-hot events (CDHE) in Liaoning Province. Results show that the ratio of stations experiencing compound dry-hot events during the twelfth leaf and maturity stage tended to increase on the time scale. On a spatial scale, the frequency of compound dry-hot events in central Liaoning Province was relatively low during the whole and various reproductive periods of maize. In addition to the twelfth leaf, western Liaoning Province is prone to compound dry-hot events. The high-risk area for the occurrence of the compound dry-hot events in maize is Chaoyang City, located in the western part of Liaoning Province, and the cities in the low-risk area account for about 64.3% of the total number of cities in Liaoning Province, mainly in the central and northern parts of Liaoning Province. Generally, this study emphasizes focusing on the impacts of compound dry-hot events on agricultural production and provides an index to assess the risk of compound dry-hot events on maize production.

Based on a wealth of evidence, aspirin is one of the cornerstones of secondary prevention of cardiovascular disease. However, despite several studies showing efficacy also in primary prevention, an unopposed excess risk of bleeding leading to a very thin safety margin is evident in subjects without a clear acute cardiovascular event. Overall, the variability in recommendations from different scientific societies for aspirin use in primary prevention is a classic example of failure of simple risk stratification models based on competing risks (atherothrombosis vs. bleeding), perceived to be opposed but intertwined at the pathophysiological level. Notably, cardiovascular risk is dynamic in nature and cannot be accurately captured by scores, which do not always consider risk enhancers. Furthermore, the widespread use of other potent medications in primary prevention, such as lipid-lowering and anti-hypertensive drugs, might have reduced the benefit of aspirin in recent trials. Some authors, drawing from specific pathophysiological data, have suggested that specific subgroups might benefit more from aspirin. This includes patient with diabetes and those with obesity, as well as considering sex-based differences. Moreover, molecular analysis of platelet reactivity has been proposed. A beneficial effect of aspirin has also been demonstrated for the prevention of cancer, especially colorectal. This review explores evidence and controversies concerning the use of aspirin in primary prevention, considering new perspectives in order to develop a personalized approach.

Indoor air quality (IAQ) is a critical determinant of human health, with fungal contamination posing significant risks. In 2023, a total of 160 samples were collected from 40 selected rooms. These samples were cultured on Sabouraud Dextrose Agar (SDA) medium using a portable air sampler and incubated at 28°C for 7 days. Initial identification of fungal isolates was performed based on their morphology. Suspected isolates underwent further analysis using internal transcribed spacer (ITS) rDNA analysis. The results revealed 11 species across 8 genera in various rooms. The most prevalent fungi were Aspergillus niger (183 CFU) , Penicillium chrysogenum (139 CFU) and Cladosporium halotolerans (135 CFU). On the other hand, Curvularia hawaiiensis and A. ustus were rarely isolated (10 and 19 respectively). Effective treatment involves a combination of preventive measures, such as controlling humidity and ensuring proper ventilation, alongside targeted interventions like antifungal treatments and thorough cleaning. Continuous monitoring and management of indoor environments are essential to reduce fungal contamination, enhance air quality, and protect human health from the harmful effects of airborne fungi. This abstract underscore the importance of addressing indoor fungal contamination to promote safer, healthier living and working spaces.

The effects of climate change health impacts on urban health care systems and vulnerable populations are a researched topic with foundations on urban risk management, urban health methodologies, and sustainable urbanization. As climate change is a dynamic and transformative global issue the gap between adaptation and mitigation efforts and urban planning relies, among other things, in the limitations of previous studies of risk management structures tailored to the existing strategy to calculate the uncertainties and predict their influence on urban systems and subsystems. Moreover, as climate and health is a well-researched issue, it is also complex as the methodologies and strategic approach to minimize health risks of climate change is intrinsically contingent to risk methodologies and policy-making processes that are efficient with support of knowledge-based information. This paper emphasis the need for focusing on urban health risk management methods that serves to identify potential opportunities, and then manage and take action to prevent adverse health effects. It also emphasizes the probability of events and their consequences, which are measurable both qualitatively and quantitatively.

Background: Research has consistently shown increased drug use among lesbian, gay, bisexual, transgender, intersex, queer/questioning, and asexual (LGBTQIA+) individuals. This is particularly the case among LGBTQIA+ adolescents. Substance use within this vulnerable community can propagate mental health issues leading to psychiatric disorders, self-harm and even suicide. Therefore, the objective of this scoping review was to evaluate the determinants of drug use among LGBTQIA+ adolescents. Methods: A comprehensive search of mainly primary research was conducted using several databases. Peer-reviewed articles published between 2018 and 2023 were included. The scoping review was conducted using the framework outlined by Joanna Briggs Institute (JBI) and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses- Extension for Scoping Reviews (PRISMA-ScR) statement. Results: A total of 29 articles (including 400194 participants) were included in the analysis. The articles reported that the main determinants of drug use among LGBTQIA+ adolescents include homelessness, peer-peer interactions, mental health, and protective factors. The articles reported that mental health issues, which are mainly triggered by rejection, were the main determinants of drug use among LGBTOIA+ adolescents. Conclusion: Findings from this scoping review provide relatively reliable evidence that homelessness, mental health, peer-peer interactions, and protective factors are the main determinants of illicit drug use among LGBTQ+ adolescents. Rigorous studies that include large sample sizes, and systematic reviews are needed to further confirm these findings and assist in developing interventions to combat the unusually high level of drug use among this group.

The use of chemical pesticides in agriculture contributes to soil, water and air pollution, biodiversity loss and can harm non-target species. The European Commission has already established a Harmonized Risk Indicator to quantify the progress in reducing the risks linked to pesticides. Therefore, there is an increasing need to promote biopesticides or so-called low-risk pesticides (LRP). Extract from Melaleuca alternifolia – tea tree oil (TTO) is known for its antiseptic, antimicrobial, antiviral, antifungal, and anti-inflammatory properties. Tea tree oil has been extensively studied in pest management as well as in the pharmaceutical and cosmetic industry and there are already products based on its active substances on the market. This review focuses on the overall evaluation of tea tree oil in terms of effectiveness and safety as a biopesticide for the first time. The collected data can be an added value for further evaluation of tea tree oil in terms of the authorization extension as a fungicide in 2026.

Abstract: Integration of Medical Cyber Physical Systems (MCPS) and Internet-of-Medical Devices (IoMT) with conventional hospital networks have facilitated easy and speedy data collection, vertical and horizontal connectedness and collaborations among healthcare providers. Federated identity management (FIM) provides a solution towards the identity management challenge arising from this integration of millions of MCPSs to get personalized care and frictionless experiences for the patients, doctors, and employees. FIM protocols such as OAuth, Security Assertion Markup Language (SAML) are highly susceptible to cyber attacks like theft of barrier token, replay attack, message insertion, and Man-in-Middle attacks. IoMT devices have vulnerabilities in their firmware, operating systems, data encryption, data at store and data transmission. Combined vulnerabilities of FIM framework and IoMT devices creates major cyber risks for the current digital healthcare system. Therefore, a comprehensive and evidenced based cyber risk assessment is an urgent need for a cyber-safe digital health care system that can avoid frequent life threatening situations. This paper proposes a comprehensive and evidenced based cyber risk assessment approach for FIM and IoMT based collaborative digital healthcare systems. The novelty of the proposed approach is that it considers three dimensional vulnerabilities arising from existing IT communication protocols and infrastructure, IoMT and MCPS medical devices, protocols of FIM and their combined impact on hospitals and provides corresponding recommendations of security controls. The proposed approaches combine two industry standards including Cyber Resilience Review (CRR) asset management, NIST SP 800-30 to take advantage of both approaches. We have used a large number of IoMT and MCPS devices from multiple providers for threat modelling and produced evidence based cyber-risks using attack trees and detailed attack sequence diagrams to validate proposed approaches. The corresponding recommendation of security controls will support healthcare professionals and providers significantly for improving both the patient and medical device safety management within the FIM enabled healthcare ecosystem.

In a systematic explorative study of genetic patterns on chromosome 19, we discovered a pattern comprised of 23 SNP alleles that is significantly associated with late-onset Alzheimer’s disease (AD). This association is validated using two independent data sets. The pattern includes THOP1, which has a long and disputatious relationship with AD. It also spans SLC39A3 and SGTA and is upstream from DIRAS1. We utilized population data to observe the frequencies of this genetic pattern for 11 different ancestries and note that it is highly common for Europeans and relatively infrequent for Africans. This research provides a distinct genetic signature for AD risk as well as insights into the complicated relationship between this disease and THOP1.

Alternative fertilizations are essential to minimize the deteriorating effects of chemical fertilizers on soil and water quality/health. Accordingly, the present work investigated the effects of combined organic-inorganic fertilization (COIF) on wheat and rice yields, soil nutrients, and soil Cd accumulation. Hence, seven different treatments were set up: control (CK); conventional fertilization (CF); optimized fertilization (OF); organic fertilizer replacing 25% (T1) and 50% (T2) of OF; and organic nitrogen (N) replacing 25% (M1) and 50% (M2) of OF-N. Overall, significant increases occurred in the yields of COIF crops. Compared with the CF, the highest wheat and rice yields happened in M1 treatment (approximately by18.5%) (P &lt; 0.05). COIF slightly alleviated soil acidification, and improved the cation exchange capacity (CEC) of the study soils. Besides, COIF treatments significantly increased the contents of total phosphorus, total potassium, available phosphorus, and available potassium by 6.35 to 16.9 %, 3.17 to 10.9 %, 5.53 to 28.7 %, and 2.6 to 12 %, respectively (P &lt;0.05). Nevertheless, negligible increases took place in Cd content of COIF soils compared with the CK. Altogether, our results concluded on 25% replacement of OF-N by organic N (M1) to effectively improve the fertility/ecological sustainability of the study soils.

The research explores the impact of financial indicators on the credit ratings of companies listed on the S&amp;P 500, employing a Sys-GMM Model to address endogeneity concerns. The study investigated three independent variables categorized as market and survival factors alongside with seven control variables sourced from leverage, liquidity, interest coverage, profitability, market, survival, and macroeconomic domains. The sample comprised 2398 observations from Capital IQ Pro, spanning nine years (2013 to 2021) and encompassing 240 public companies. The findings suggest that neither Tobin's Q (TQ) and Total Shareholder Return (TSR) lack significant correlations with credit ratings, implying that stock market performance and total shareholder return do not directly impact credit ratings. In contrast, the Altman Z-score (AZS) emerged as a significant predictor, indicating its importance in assessing credit risk. These insights enhance understanding of financial indicators' impact on credit ratings, aiding financial institutions and companies in prudent lending and financing decisions.

The Arctic is a remote region that has become increasingly globalised yet remains extremely vulnerable to many risks. The COVID-19 pandemic presented new challenges to the region. Using the Search, Appraisal, Synthesis and Analysis (SALSA) approach to conduct a meta-synthesis of the academic and grey literature on the impacts of the pandemic, an assessment is conducted of the types of risks that have been presented by the COVID-19 pandemic, the scales, and the national response strategies for mitigating the risks. Two case studies are explored, Iceland and Greenland, island nations that exemplify the extremes of the Arctic and reliance on tourism, a sector that was nearly entirely suspended by the pandemic. An evaluative matrix is employed which combines five different scales of risk – nano, micro, meso, macro and cosmic – with a sustainability categorisation of impacts. The risks of the pandemic cut across the respective scale and categories, with the potential for macro-scale events (systemic risk) to unfold linked to economic spillover effects driven by the curtailment of tourism and various supply chain delays. Both Iceland and Greenland have exemplified risk mitigation strategies which prioritise health over wealth, very strictly in the case of the latter. Strict border controls and domestic restrictions have enabled Iceland and Greenland to have much lower case and death numbers than most nations. In addition, Iceland has led the way, globally, in terms of testing and accumulating scientific knowledge concerning the genetic sequencing of the virus. The academic contribution of the paper concerns its broadening of understanding concerning systemic risk, which extends beyond financial implications to includes sustainability dimensions. For policymakers and practitioners, the paper highlights successful risk mitigation and science-based measures that will be useful for any nation tackling a future pandemic, regardless of whether they are island states, Arctic nations or another country.

Authorities and governmental bodies strongly emphasize the importance of residents preparing for natural disasters, particularly underscoring the significance of readiness for geophysical hazards like earthquakes. In this study, which represents comparative quantitative research, the levels and predictors of the impact on preparedness for earthquake-induced disasters in South-Eastern Europe countries such as Montenegro, North Macedonia, and Serbia are examined. Using the snowball sampling technique (online questionnaire), a survey of 1245 respondents (Montenegro (n = 400), North Macedonia (n = 345), and Serbia (n = 500) was conducted from February 2023 to February 2024. The paper is based on the central hypothesis that the most significant predictor of earthquake preparedness in Montenegro, North Macedonia, and Serbia is age, followed by gender and education. Multivariate regression analysis was used to determine the extent to which five scores of the subscales (household preparedness, community preparedness, disaster preparation, earthquake risk awareness, reinforced house) were associated with seventh demographic and socio-economic variables. In addition to the mentioned analysis, other statistical analyses such as T-test, one-way ANOVA analysis, and Pearson correlation were also utilized. The results indicate that age emerges as a predictor in various aspects of earthquake-induced disaster preparedness and awareness in most models, followed by education. These findings confirm the significance of respondents' age in determining levels of preparedness and earthquake awareness. Overall, in North Macedonia, respondents recorded the highest ratings (M = 3.52) for household preparedness for earthquakes, compared to Montenegro (M = 2.98) and Serbia (M = 3.26), where the lowest ratings were recorded. Research findings, taking into account cultural characteristics, can serve as a basis for the development of targeted interventions, strategies, policies, and programs aimed at improving the level of societal preparedness for earthquake-induced disasters.

Background: Despite their generally favorable prognosis, hepatic fibrosis remains a possible complication for hepatitis B virus (HBV) inactive carriers. This study aimed to estimate the prevalence of significant fibrosis and associated risk factors among Omani HBV inactive carriers. Methods: A retrospective study was conducted of 200 Omani HBV inactive carriers visiting a tertiary hospital in Muscat, Oman, between January 2017 and December 2018. Significant fibrosis (stage F2 or higher) was identified using two-dimensional shear-wave elastography. Baseline clinical, laboratory, and radiological data were analyzed to determine associations. Results: Of the total sample, 106 patients (53%) were male, and the mean age was 44.6 ± 9.3 years. The prevalence of significant fibrosis was 20% (n = 40). Male gender (p = 0.007), age ≥60 years (p = 0.024), and fatty changes in liver ultrasound (p = 0.044) were found to be independent factors for significant fibrosis. Conclusion: the prevalence of significant fibrosis was relatively high among a sample of Omani HBV inactive carriers, with several sociodemographic and clinical risk factors identified. Periodic assessment of liver function is needed for patients with these risk factors; moreover, routine biochemical parameters could be useful predictors of disease prognosis. Further research is recommended to substantiate these findings.

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

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

Georgia is ranked fifth highest among states for rates of HIV diagnosis. About 4% of persons living with HIV infection in the United States reside in Georgia, and almost 19% of these people do not know their HIV status. The present study examined the trends and associated factors of HIV testing among adults in Georgia between 2010 and 2014 by analyzing data of the Behavioral Risk Factor Surveillance System (BRFSS). A total of 30,791 persons aged ≥18 years were identified who responded to the question “Have you ever been tested for HIV?” Overall, there were 11,543 respondents who had been tested for HIV, with a decrease in percentage from 49.4% in 2010 to 43.7% in 2014 (p<0.001). Factors associated with HIV testing were being black (p<0.001), being younger than 55 years (p<0.001), single (p=0.02), attaining education level above high school (P<0.001), engaging in HIV high-risk behaviors (p<0.001), and not having healthcare coverage (p=0.03). Overall in Georgia, there has been a decline in the temporal trend of HIV testing, and more than half of adults have never been tested for HIV. For reducing HIV transmission in Georgia, enhancing access and utilization of HIV testing should be a public health priority.

Nature-based solutions (NbS) have gained global attention for addressing societal challenges, benefiting biodiversity, and promoting human well-being. NbS have been increasingly recognized for their role in mitigating climate change impacts, such as coastal flooding. However, despite their integration into policy frameworks in Europe and parts of Africa, there remains limited empirical evidence regarding their effectiveness. This study seeks to address this gap by exploring the factors influencing perceptions and awareness of the effectiveness of NbS in coastal communities. A structured survey questionnaire was administered in three coastal communities—Kula, Oyorokoto, and Bonny—examining how perception, knowledge, and socio-economic factors affect the effectiveness of NbS. Results show that socio-economic factors such as age, education, and occupation significantly influence the perceived effectiveness of NbS. Additionally, awareness was found to have a stronger impact on effectiveness than perception. The study concludes that awareness-raising initiatives, particularly those focused on the protective benefits of mangroves, are crucial for enhancing the effectiveness of NbS. Conservation, afforestation, and restoration of coastal ecosystems are recommended as key strategies for promoting NbS and their role in climate resilience.

The aim of this study was to develop, implement, and evaluate a new auxiliary enterprise risk management framework and process to serve as an enabler to the global ISO 31000 risk framework and ISO 31010 processes. This framework has been designed particularly for use within high-risk environments and those characterized by volatility, uncertainty, complexity, and ambiguity (VUCA). This paper proposes a methodology for optimization of structured sharing and grass-roots management of all available risk-sentience information with the assessed potential to develop into an identifiable risk in the future. The author introduces new risk terminology including risk-sentience, risk-sentience information, and risk-sentience management. The process involved the development of the Theory of Risk-Sentience (ToRS), Risk-Sentience Auxiliary Framework (RSAF) and a risk-sentience management process referred to as LUOMEAR (Learning from Uncertainties, Others Mistakes, Experiences and Anecdotal Reporting). Manchester Patient Safety Framework (MaPSaF), SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis, and a newly developed Risk-Sentience Fertility Checklist were used to conduct pre and post-trial evaluations. The findings include positive adjustments in safety culture, components of commitment to quality, communication and team-working around safety issues, access to evolving risk-information, and efficient sharing and management of recorded risk-information. Recommendations are made for more extensive application of both the proposed auxiliary risk framework and process within high-risk sectors to further explore its effectiveness and scope.

Pregnancy is a complex biological process which is associated with significant metabolic and hemodynamic changes of the maternal body which allow a normal fetal growth. The inability to adapt to these changes can affect the cardiovascular health. During pregnancy, women may experience mood swings, anxiety and emotional ambivalence. These symptoms can lead to stress and have a negative impact on the mental well-being of expectant mothers. It is crucial to know the aspects that can influence the development of cardiovascular problems among pregnant women in order to manage these cases properly. The current narrative review explores and summarizes the evidence regarding the impact of stress and anxiety on cardiovascular health in pregnant women. Understanding the physiological adaptations that the body undergoes throughout pregnancy is crucial for educating and supporting individuals as well as healthcare professionals. This enables them to recognize any risk factors or pathological conditions that may exacerbate pregnant women's health. In order to reduce maternal morbidity and mortality from cardiovascular disease, a psychological and cardiovascular risk factor screening that is done either before or during pregnancy may be able to identify situations that call for particular medical and/or psychological therapies.

In today's interconnected global business landscape, companies face numerous risks, particularly from their supply chains. Supplier disruptions can cause financial damages, inefficiencies, and reduced competitive edge, highlighting the need for robust supplier risk management. This paper scrutinizes recent studies on supplier risk management spanning 2020 to 2023. This review examines supplier risk management, focusing on supplier evaluation, payment terms, contract duration, and buyer-supplier collaboration as critical factors influencing risk mitigation and control in the procurement of goods and services. Through a systematic literature review, the study identifies the multifaceted nature of supplier risks, including production delays, quality issues, and financial challenges. It underscores the importance of proactive risk identification, comprehensive supplier evaluation, strategic payment terms, appropriate contract durations, and robust buyer-supplier collaboration. Despite the benefits, challenges remain, such as understanding regulatory impacts and ensuring methodological consistency. This review contributes to the discourse on supplier risk management, offering insights for future research and practical applications to enhance resilience and operational efficiency in global supply chains. Based on the findings, future studies should concentrate on formulating holistic supplier risks management approaches that nurture buyer-supplier collaboration and harness innovative technologies to enhance risk management practices.

Background: Colorectal cancer (CRC) can significantly impact mental health, increasing suicide risk. Variables such as pain and threat perception may be crucial. This study aims to identify predictors of suicide risk in individuals with CRC. Methods: A total of 71 participants (76.06% men) aged 27 to 88 years (M = 65.18, SD = 12.02) were assessed using the SF-36 for pain, the Brief Illness Perception Questionnaire (B-IPQ) for threat perception, the Hospital Anxiety and Depression Scale (HADS) for emotional distress, and the Plutchik suicide risk scale for suicide risk. Descriptive, comparative, and correlational analyses were performed, followed by a linear regression analysis. Results: Nearly 20% of participants exhibited high suicide risk. There was a moderate to high association between suicide risk and the perception of threat, pain, and emotional distress. The linear regression model explained 39% of the variance in suicide risk, with threat perception, pain, and emotional distress as significant predictors. Conclusions: These results indicate the need for multidisciplinary care for individuals with CRC, including emotional support from health psychologists, and holistic, human-centered care from nursing and medical professionals. Future research is necessary to further explore these relationships and improve patient care strategies.

Objectives: To develop and validate the Communities Geriatric Mild Cognitive Impairment Risk Calculator (CGMCI-Risk), aimed at aiding community healthcare workers in the early identification of individuals at high risk of Mild Cognitive Impairment (MCI); Methods: Based on nationally representative community survey data, backward stepwise regression was employed to screen the variables, and logistic regression was utilized to construct the CGMCI-Risk. Internal validation was conducted using bootstrap resampling, while external validation was performed using temporal validation. The area under the receiver operating characteristic curve (AUROC), calibration curve, and decision curve analysis (DCA) were employed to evaluate the CGMCI-Risk in terms of discrimination, calibration, and net benefit, respectively; Results: The CGMCI-Risk model included variables such as age, educational level, sex, exercise, garden work, TV watching or radio listening, Instrumental Activity of Daily Living (IADL), hearing, and masticatory function. The AUROC was 0.781 (95% CI = 0.766 to 0.796). Calibration curve showed strong agreement, and the DCA suggested substantial clinical utility. In external validation, the CGMCI-Risk model maintained similar performance with an AUROC of 0.782 (95% CI = 0.763 to 0.801); Conclusions: CGMCI-Risk is an effective tool for assessing cognitive function risk within the community. It uses readily predictor variables, allowing community healthcare workers to identify the risk of MCI in older adults over a three-year span.

This study investigates the evolving corporate governance mechanisms within the context of an emerging economy. Addressing a literature gap, we analyse the influence of corporate governance and earnings quality on idiosyncratic risk in an emerging economy. In particular, this research explores the impact of corporate governance practices and earnings quality on idiosyncratic risk. For this purpose, we utilise a sample of 75 non-financial firms listed on the Pakistani equity market over nine years from 2010 to 2018. Employing the generalised method of moments, the findings of our empirical analysis reveal that firms with robust governance mechanisms and higher earnings quality experience minimal idiosyncratic risk. These outcomes provide valuable insights for standard setters, regulatory authorities, policymakers, and other stakeholders, emphasising the importance of governance mechanisms and earnings management in mitigating idiosyncratic return volatility.

Background: Molecular genetic events are among the numerous factors affecting the clinical course of papillary thyroid carcinoma (PTC). Recent studies have demonstrated that aberrant expression of miRNA, as well as different thyroid-related genes, correlate with the aggressive clinical course of PTC and unfavorable treatment outcome, which opens up new avenues for using them in personalization of the treatment strategy for patients with PTC. In the present work, our goal was to assess the applicability of molecular markers in preoperative diagnosis of aggressive variants of papillary thyroid cancer. Methods: The molecular genetic profile (expression levels of 34 different markers and BRAF mutation) was studied for 108 cytology specimens collected by fine-needle aspiration biopsy in patients with PTC having different clinical manifestations. Results: Statistically significant differences with adjustment for multiple comparisons (p &lt; 0.0015) for clinically aggressive variants of PTC were obtained for four markers: miRNA-146b, miRNA-221, FN1, and CDKN2A. Weak statistical correlation (0.0015&lt; р&lt;0.05) was observed for miRNA-31, -375, -551b, -148b, -125b, mtDNA, CITED1, TPO, HMGA2, CLU, NIS, SERPINA1, TFF3, and TMPRSS4. Conclusions: The recurrence risk of papillary thyroid carcinoma can be preoperatively predicted using miRNA-221, the fibronectin and cyclin-dependent kinase inhibitor 2A genes.

Consumer preference for products made from transgenic technology has been widely studied, yet few studies exist exploring the factors influencing producers’ adoption of transgenic technology. Based on field surveys in Chinese provinces of Shanxi, Henan and Shandong, we employed a gambling experiment to capture producers’ risk preferences by estimating their risk aversion coefficients. We further estimated producers’ risk amplification and risk perception of GM technology. Using ordered logit model and Poisson model we identified the major factors influencing producers’ adoption of transgenic technology. We found the factors impacted the decision of producers from different regions in different ways. The results showed that over 60% of participants amplified the risk of transgenic crops. When there was potential risk, producers might not be rational even if they had high level of knowledge and cognition about the technology. Our results shed light on government policies aiming to increase the adoption of new technologies by producers.

Longevity risk constitutes an important risk factor for life insurance companies and it can be managed through longevity-linked securities. The market of longevity-linked securities is at present far from being complete and does not allow to find a unique pricing measure. We propose a method to estimate the maximum market price of longevity risk depending on the risk margin implicit within the calculation of the technical provisions as defined by Solvency II. The maximum price of longevity risk is determined for a survivor forward (S-forward), an agreement between two counterparties to exchange at maturity a fixed survival-dependent payment for a payment depending on the realized survival of a given cohort of individuals. The maximum prices determined for the S-forwards can be used to price other longevity-linked securities, such as q-forwards. The Cairns-Blake-Dowd model is used to represent the evolution of mortality over time, that combined with the information on the risk margin, enables us to calculate upper limits for the risk-adjusted survival probabilities, the market price of longevity risk and the S-forward prices. Numerical results can be extended for the pricing of other longevity-linked securities.

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

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

Emergency Medical Response Systems (EMRS) play a vital role in delivering medical aid during disasters. In Serbia, these systems encounter several obstacles due to economic limitations, scarce resources, and ongoing healthcare reforms, all of which affect their performance. This study focuses on examining the risk factors and effectiveness of Serbia's EMRS, identifying systemic issues, and proposing enhancements to improve emergency preparedness for disasters. A survey was conducted across healthcare institutions in Serbia to gather comprehensive insights. The survey explored various aspects, including organizational structures, resource distribution, communication systems, and the speed of emergency responses. Statistical methods such as Pearson's correlation, multivariate regression analysis and chi-square tests were utilized to interpret data collected from 172 healthcare institutions. The multivariate regression analysis of EMS organization identified that factors such as the structuring of working hours and shift patterns are significant predictors, contributing to small but meaningful variations in various EMS outcomes. In contrast, other factors, such as financial resources and the availability of ambulance vehicles, showed more targeted significance depending on the specific EMS aspect being analyzed. Institutions with written mass casualty plans and procedures demonstrate superior effectiveness in EMS activities, excelling in resource allocation, operational continuity, and emergency preparedness, particularly through enhanced coordination and specialized systems for managing large-scale emergencies. The findings highlighted notable disparities in how EMRS are organized, with only 46% of institutions having specific emergency departments. Resource limitations were evident, as many facilities operated with minimal staff and outdated equipment. The communication systems revealed weaknesses, with just 54% having established protocols for handling emergency calls. Response times frequently surpassed international standards, which negatively affected patient outcomes. Additionally, the study found training deficiencies, with 68% of participants expressing a need for further education. Serbia’s EMRS are significantly impacted by systemic issues such as insufficient funding, disjointed service delivery, and inadequate training. Overcoming these challenges necessitates a comprehensive approach that includes boosting financial support, implementing standardized protocols, and fostering enhanced collaboration across different sectors.

Credit scoring is a cornerstone of financial risk management, enabling financial institutions to assess the likelihood of loan default. However, widely recognized contemporary credit risk metrics, like FICO or Vantage scores, remain proprietary and inaccessible to the public. This study aims to devise an alternative credit scoring metric that mirrors the FICO score, using an extensive dataset from Lending Club. The challenge lies in the limited insights available on both the precise analytical formula and the comprehensive suite of credit-specific attributes integral to the FICO score's calculation. Our proposed metric leverages basic information provided by potential borrowers, eliminating the need for extensive historical credit data. We aim to articulate this credit risk metric in a closed analytical form with variable complexity. To achieve this, we employ a symbolic regression method anchored in Genetic Programming (GP). Here, Occam's razor principle guides evolutionary bias towards simpler, more interpretable models. To ascertain our method's efficacy, we juxtapose the approximation capabilities of GP-based symbolic regression with established machine learning regression models, such as Gaussian Support Vector Machines (GSVMs), Multi-Layer Perceptrons (MLPs), Regression Trees and Radial Basis Function Networks (RBFNs). Our experiments indicate that GP-based symbolic regression offers comparable accuracy with these benchmark methodologies. Moreover, the resultant analytical model offers invaluable insights into credit risk evaluation mechanisms, enabling stakeholders to make informed credit risk assessments. This study contributes to the growing demand for transparent machine learning models by demonstrating the value of interpretable, data-driven credit scoring models.

This qualitative study explores supplier selection criteria from the perspectives of procurement professionals across diverse industries. Supplier selection is crucial for organizational efficiency and performance, influenced by factors beyond traditional cost considerations. The research aims to uncover nuanced criteria such as quality assurance, supplier reliability, innovation capability, sustainability practices, strategic alignment, relational dynamics, and risk management strategies. These criteria reflect a shift towards holistic evaluation frameworks that integrate economic, social, and environmental dimensions in procurement decision-making. Methodologically, the study employed semi-structured interviews with 30 procurement professionals, ensuring depth and diversity in perspectives. Thematic analysis was used to identify recurring themes and patterns, illuminating the complexities and strategic importance of supplier selection processes. Findings highlight the strategic role of suppliers in driving innovation, enhancing supply chain resilience, and supporting organizational goals. Moreover, the study underscores the significance of sustainable sourcing practices, ethical considerations, and effective supplier relationships in fostering long-term partnerships and mitigating operational risks. Practical implications suggest that organizations should adopt integrated approaches to supplier selection, leveraging data-driven insights and technological advancements to optimize decision-making. By prioritizing strategic alignment, fostering collaborative partnerships, and implementing robust risk management strategies, organizations can navigate uncertainties, capitalize on market opportunities, and sustain competitive advantage.

The dynamic and unpredictable nature of modern supply chains necessitates the development of resilient systems capable of withstanding various disruptions. This qualitative study examines the impact of collaborative practices on supply chain resilience, providing an in-depth analysis of their contributions to the robustness and adaptability of supply chains. Through extensive interviews with industry professionals, including supply chain managers, logistics coordinators, and strategic planners, the study identifies key collaborative practices—such as information sharing, joint decision-making, and coordinated response strategies—that significantly enhance resilience. These practices facilitate proactive risk management, improve response times during disruptions, and foster innovation through shared knowledge and resources. Thematic analysis of the collected data reveals that strong relationships among supply chain partners and integrated approaches that leverage each participant's strengths are crucial for effective risk mitigation and recovery. Additionally, the study underscores the role of technology in enabling real-time information sharing and decision-making, which are essential for effective collaboration. The findings highlight the importance of investing in robust collaborative networks and adopting supportive technologies to enhance communication and coordination. This research contributes to the existing body of knowledge by offering a nuanced understanding of how strategic implementation of collaborative practices can build more resilient supply chains. It provides practical recommendations for businesses seeking to improve their resilience, emphasizing the qualitative aspects of collaboration and its impact on supply chain management. Overall, this study presents a comprehensive exploration of how collaboration can bolster supply chain resilience, offering valuable insights for practitioners and scholars focused on creating stable and sustainable supply chain operations in the face of growing uncertainties.

Supply chain risk management (SCRM) is a critical aspect of contemporary business operations, necessitated by the complex and interconnected nature of global supply chains. This qualitative research delves into the intricacies of SCRM through in-depth interviews with industry experts, aiming to unravel the multifaceted nature of supply chain risks and the strategies employed for mitigation. Key themes emerged, including the diverse sources of risks encompassing operational, financial, environmental, and geopolitical factors, highlighting the need for a comprehensive approach to risk management. Challenges such as limited visibility, resource constraints, and organizational silos were identified, underscoring the importance of addressing these barriers to enhance SCRM effectiveness. Strategies for risk mitigation encompassed technological investments for enhanced visibility and predictive capabilities, collaboration and information sharing among supply chain partners, and the integration of sustainability principles into risk management practices. Leadership, organizational culture, and continuous learning emerged as critical factors in driving effective SCRM practices, emphasizing the need for proactive and adaptable approaches to navigate evolving risks. Overall, this study contributes to the existing body of knowledge on SCRM by providing valuable insights for practitioners and academics, and underscores the importance of holistic and proactive approaches to enhance supply chain resilience and agility in today's dynamic business environment.

This report presents a framework for analysing the risk of alien taxa under South Africa's National Environmental Management: Biodiversity Act of 2004, and the Alien and Invasive Species Regulations of 2014. While the report was initially designed to meet a specific South Africa need, the risk analysis processes developed can, we believe, be transferred to any specified geographic region. In outlining a series of questions related to a taxon’s likelihood of invasion and the consequences thereof, i.e. the potential impacts, the report provides a structure for collating data relevant to the process of listing taxa as well as a process for developing recommendations that is both mathematically sound, transparent, and that explicitly takes uncertainty into account. The framework is based on collating information according to international standards in biological invasions (specifically the IUCN Environmental Impact Classification of Alien Taxa Scheme, the CBD's scheme for classifying invasion pathways, and the Unified Framework for Biological Invasions proposed by Blackburn et al. 2011). The risk analysis framework is currently being implemented in South Africa in an effort to underpin national regulatory lists of invasive species.

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.

Brucellosis is a zoonoses caused by bacteria of the genus Brucella, which causes economic losses in livestock and threatens public health. A cross-sectional study was conducted to determine the prevalence of Brucella species and risk factors in smallholder dairy cattle in six regions of Tanzania from July 2019 to October 2020. Dairy cattle (n=2048) were sampled from 1371 farms. DNA ex-tracted from blood and vaginal swabs was tested for Brucella using qPCR targeting the IS711 gene and positives were tested for the alkB marker for B. abortus and BMEI1172 marker for B. melitensis. The molecular prevalence was 3.5% (95% CI: 2.8-4.4) with the highest prevalence 8.1% (95%CI: 4.6-13.0) in Njombe region. B. melitensis was the predominant species detected (66.2%). Logistic regression revealed PCR positivity in dairy cattle was higher in the animals with a history of abortion (OR: 3.17, 95%CI: 1.05-9.62) and farms without dogs around (OR: 2.68, 95%CI: 1.12-5.90). Further studies are recommended to understand the source of B. melitensis and the implications to veterinary public health. Livestock keepers should be informed of the risks and biosecurity practices to reduce introduction and control Brucella. Cattle and small ruminant vaccination pro-grams could be implemented to control brucellosis in high-risk populations in the country.

Climate change is increasing the occurrence of disastrous events in the world, but several disparities in population vulnerability are being registered. One of the causes of these variances is different public risk perception also due to the degree of education and knowledge of the population. In this study, some of the results obtained in a risk perception survey are presented. The survey was carried out in an area of Calabria (Southern Italy) hit by geo-hydrological events that have occurred in recent years with damage to roads, tourism facilities and private houses. A statistical interpretation of the results highlights the importance of education and knowledge to risk perception on the part of the population investigated.

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

Hyperlipidemia is an identified risk factor for metabolic syndrome, obesity and cardiovascular complications characterized by elevated levels of lipids in blood. The present study aimed to inhibit HMG-CoA reductase with 15-oxoursolic acid through in-vivo and in-silico assessments. HFD-induced hyperlipidemia in rats was developed with a marked increase in total cholesterol (58.34 ± 0.21 mg/dl), triglycerides (45.45 ± 0.39 mg/dl), LDL-c (66.12 ± 0.10 mg/dl), VLDL-c (19.34 ± 0.16 mg/dl), and a decrease in HDL-c (10.34 ± 0.18 mg/dl). The oral administration of 15-oxoursolic acid at a concentration of 30 mg/Kg b.w significantly reduced the serum concentration of total cholesterol (42.65 ± 0.54 mg/dl), triglycerides (32.33 ± 0.16 mg/dl), LDL-c (50.34 ± 0.15 mg/dl) and VLDL-c (13.15 ± 0.45 mg/dl) respectively and an increased in the serum HDL-c (18.56 ± 0.34 mg/dl). 15-oxo ursolic acid also caused a decrease in the coronary risk index and atherogenic risk index. In-silico studies of 15-oxoursolic acid with HMG-CoA reductase showed significant interaction capability with binding energy (-9.26805 Kcal/mol). It is concluded that 15-oxoursolic acid could significantly reduce the total cholesterol, triglycerides and LDL levels in HFD-induced hyperlipidemia rats which might lead to new medication with significant hypolipidemic potential.

We assessed the association between cirrhosis and severe COVID-19-related outcomes among people with laboratory-diagnosed COVID-19 infection in British Columbia, Canada. We used data from the British Columbia (BC) COVID-19 Cohort, a population-based cohort that integrates data on all individuals tested for COVID-19 with data on hospitalizations, medical visits, emergency room visits, prescription drugs, chronic conditions, and deaths in the Canadian province of BC. We included all individuals, aged ≥ 18 who tested positive for SARS-CoV-2 by real-time reverse transcription-polymerase chain reaction, from January 01, 2021, to December 31, 2021. Multivariable logistic regression models were used to assess the associations between cirrhosis status and COVID-19-related hospitalization and ICU admission. Of the 162,509 individuals who tested positive for SARS-CoV-2 and were included in the analysis, 768 (0.5%) had cirrhosis. In the multivariable models, cirrhosis was associated with increased odds of hospitalization (aOR=1.97, 95% CI: 1.58 – 2.47) and ICU admission (aOR=3.33, 95% CI: 2.56 – 4.35). In the analyses stratified by age, we found that the increased odds of ICU admission among people with cirrhosis were present in all the assessed age-groups. Cirrhosis is associated with increased odds of hospitalization and ICU admission among COVID-19 patients.

The hazard and the carcinogenic risks due to the exposure to some potentially toxic elements by the Santiago Island (Cape Verde) population where calculated, considering soil ingestion, inhalation and dermal contact as exposure pathways. The topsoil of Santiago Island is enriched in Co, Cr, Cu, Ni, V, Zn, Mn and Cd to upper crust values. Hazard indices (HI) were calculated for these metals and As exposures, of Santiago Island population and the calculations were performed for children and adults. For children HI are higher than 1 for Co, Cr and Mn. So there is indication of potential non-carcinogenic risk for children, due to the high Co (HI=2.995), Cr (HI=1.329) and Mn (HI=1.126), values in soils. For the other elements and for adults there is no potential non-carcinogenic risk. Cancer risk was calculated for As, Cd, Cr and Ni exposures, for adults and children and the results are always lower than the carcinogenic target risk of 1x10-6, for As, Cd, and Ni. However, cancer risk are higher than the carcinogenic target risk for Cr, for adults. Regarding As, for children the fraction due to Riskingestion represents 51.6%, while Riskinhalation represents 48.0% and Riskdermalcontact represents only 0.4% of total risk. For adults Riskinhalation represents 81.3%, Riskingestion represents 16.6% and Riskdermal contact represents 2.1%. These results reflect the higher daily ingestion dose for children and the higher inhalation rate and higher dermal contact surface for adults. For the other elements and for adults the cancer risk due to Cr, Ni and Cd inhalation is always higher than for children, reflecting the higher inhalation rate for adults.

In this paper we present an understanding of cyber risks in the Internet of Things (IoT), we explain why it is important to understand what IoT cyber risks are and how we can use risk assessment and risk management approaches to deal with these challenges. We introduce the most effective ways of doing Risk assessment and Risk Management of IoT risk. As part of our research, we also developed methodologies to assess and manage risk in this emerging environment. This paper will take you through our research and we will explain: what we mean by the IoT; what we mean by risk and risk in the IoT; why risk assessment and risk management are important; the IoT risk management for incident response and recovery; what open questions on IoT risk assessment and risk management remain.

No consensus exists on whether acute aerobic exercise alters the glomerular filtration rate in older adults. Objective: To assess the immediate effects of three aerobic exercise intensities on the estimated glomerular filtration rate (eGFR) in healthy, sedentary older adults. Methods: Eighteen healthy, sedentary older adults (12 men and eight women) voluntarily participated in the study. The participants underwent three standardized aerobic exercise tests (100%, 80%, and 60% of the maximal heart rate) on a bicycle ergometer. Blood samples were collected to determine cholesterol, triacylglycerol, glucose, serum creatinine (Cr), Cystatin C (CysC) concentrations, and eGFR. Results: eGFR and serum concentrations of Cr and CysC were not modified at any exercise intensity. There was a negative correlation between blood total cholesterol vs. eGFR (R= -0.512, R= -0.582, R= -0.531; p &lt;0.05) at rest, 60%, and 100% of the maximal heart rate, respectively. Besides, a negative correlation existed between age vs. eGFR at 60% of the maximal heart rate (R= -0.516; p &lt;0.05). Conclusion: Short-time aerobic exercise of low, moderate, and vigorous intensity did not significantly affect eGFR and is considered safe for kidney function in healthy, sedentary older adults.

Simple summary This reassessment of the findings from our Phase I/II study seeks to evaluate the effectiveness of SBRT for treating local intermediate-high risk prostate cancer in the absence of androgen-deprivation therapy due to patient’s refusal, with a median follow-up of 6.5 years. Our primary focus is on analysing the treated areas compared to recurrence patterns in the seven patients who experienced local relapse. Additionally, we provide updated data on late toxicities of grade 2 or higher, both genitourinary and gastrointestinal. Abstract Objectives: We investigated spatial patterns between primary and recurrent tumor sites and assessed long-term toxicity after dose escalation stereotactic body radiation therapy (SBRT) to the dominant intraprostatic nodule (DIN). Materials and methods: In 33 patients with intermediate-high risk prostate cancer (PCa), doses up to 50 Gy were administered to the DIN. Recurrence sites were determined and compared to the original tumor development sites through multiparametric MRI and 68Ga-labelled prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (68Ga-PSMA-PET/CT) images. Overlap rates, categorized as 75% or higher for full overlap, and 25-74% for partial overlap, were assessed. Long-term toxicity is reported. Results: All patients completed treatment, with only one receiving concomitant androgen deprivation therapy (ADT). Recurrences were diagnosed after a median of 33 months (range: 17-76 months), affecting 13 out of 33 patients (39.4%). Intraprostatic recurrences occurred in 7 patients (21%), with ≥ 75% overlap in two, a partial overlap in another two, and no overlap in the remaining three patient. Notably, 5 patients with intra-prostatic recurrences had synchronous bone and/or lymph node metastases, while six patients had isolated bone or lymph node metastasis without intraprostatic recurrences. Extended follow-up revealed grade 2 or higher late GU and GI toxicity in 18% (n=6) and 6% (n=2) of the patients. Conclusions: Among patients with intermediate-high risk PCa undergoing focal dose-escalated SBRT without ADT, DIN recurrences were infrequent. When present, these recurrences were typically located at the original site or adjacent to the initial tumor. Conversely, relapses beyond the DIN and in extra-prostatic (metastatic) sites were prevalent, underscoring the significance of systemic ADT in managing this patient population. Advances in knowledge: focal dose escalated prostate SBRT prevented recurrences in the dominant nodule, however extra-prostatic recurrence sites were frequent.

The issue of climate change represents a significant global risk that demands immediate attention. However, higher education frequently fails to incorporate global perspectives and intricate transdisciplinary matters. In order to integrate global and transdisciplinary aspects into the curriculum of a technical university with a focus on computer science, a Master's programme has been developed. The programme's objective is to situate global risk at the core of the curriculum, thereby encouraging scientists to work beyond the boundaries of their respective disciplines. The paper considers the challenges that science and higher education must address to facilitate pathways towards a peaceful and sustainable future. It argues for a shift in focus from short-term and localised issues to a more holistic approach, emphasising the importance of considering universal problems. The curriculum, as developed, may be regarded as a guide for future university efforts in the fields of global risk and climate change.

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

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

Floods, recognized for their erratic behavior and devastating effects, are a significant threat as a natural disaster. In Brunei Darussalam, the impact of climate change is becoming increasingly evident through higher temperatures and an expected increase in annual rainfall (5.0mm per year from 2021 to 2050), highlighting the critical need for updated flood risk management techniques. In line with the climate resilience and adaptation objectives of WAWASAN 2035, this paper introduces an innovative approach—a cutting-edge flood risk management framework that utilizes the capabilities of big data analytics, sophisticated machine learning algorithms, and smart Internet of Things (IoT) sensors. Traditional methods, which rely on numerical and physical data modeling, often do not provide precise short-term flood forecasts. Our suggested framework uses machine learning to analyze real-time flood forecasting, sensor data and enhance warning systems, addressing the shortcomings of traditional approaches. The key advantage of this approach is its potential to drastically decrease flood-related damages, protect lives, and boost infrastructure resilience. This proposal is not only in aligns with Brunei's vision for a safe and climate-adaptable future but also marks a significant step forward in adopting innovative and sustainable flood risk management solutions amidst an evolving climate.

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

The present study aims to find out the financial risk tolerance scores of the rural residents of Ludhiana district. Also, how drivers such as socio-demographic factors, namely, gender, age, education, annual income, existence of loan, occupation, employment status and psychological factors, namely, deliberative thinking, optimism and personality type A/ B impact financial risk tolerance of rural residents. The study is important for financial policy makers as they will become aware about scenario of rural residents and frame policies accordingly. Stepwise regression analysis was carried on. The result was found out that optimism positively and deliberative thinking negatively impacted financial risk tolerance, but personality type A/B did not have a significant impact on financial risk tolerance. Socio-demographic factors such as existence of loan, full-time salaried individuals, marital status significantly impacted financial risk tolerance. Other factors failed to have impact on financial risk tolerance of rural residents in the current study.

This qualitative study explores the challenges and successes in supplier development from the perspectives of procurement managers across diverse industries. Through in-depth interviews, key themes emerged, highlighting the critical role of communication, trust, performance measurement, capacity building, risk management, innovation, regulatory compliance, and technology integration in supplier relationship management. Procurement managers emphasized the importance of clear, continuous communication and trust-building activities to align objectives and foster collaborative partnerships. Performance measurement was crucial for evaluating and improving supplier performance, supported by capacity-building initiatives to enhance supplier capabilities. Risk management strategies focused on identifying and mitigating risks, while compliance efforts aimed to ensure adherence to industry standards. Innovation and technological integration were pivotal for driving efficiency and competitiveness, enabling faster time-to-market and improved product quality. Cultural sensitivity and relationship strengthening emerged as essential for navigating diverse cultural contexts and enhancing partnership effectiveness. Overall, the findings underscored positive outcomes including enhanced quality, cost efficiencies, and increased resilience within supply chains. This research contributes valuable insights into effective supplier management practices, emphasizing the strategic importance of supplier development initiatives for sustainable growth and competitive advantage in today's dynamic business environment.

In today's globalized economy, supply chain disruptions present significant challenges, impacting businesses' operational continuity and efficiency. This study delves into the ways businesses navigate these disruptions, with a particular emphasis on qualitative insights into risk management practices. The complexity and interconnectivity inherent in modern supply chains make them vulnerable to a broad spectrum of disruptions, ranging from natural disasters and geopolitical conflicts to technological failures and pandemics. Effective supply chain risk management requires a structured approach to identifying potential risks, evaluating their likelihood and potential impact, and formulating robust mitigation strategies. Employing a qualitative research methodology, this study gathers in-depth insights from semi-structured interviews with supply chain managers, industry experts, and executives. The findings underscore the necessity of proactive risk identification and comprehensive assessment processes. Advanced technologies, including artificial intelligence (AI), the Internet of Things (IoT), and blockchain, are highlighted as crucial tools for enhancing visibility and responsiveness within supply chains. Strategies such as diversifying suppliers and maintaining safety stock emerge as vital components of risk mitigation, ensuring supply continuity in the face of disruptions. Strong relationships with suppliers are pivotal, facilitating better information sharing and collaborative problem-solving. Leadership commitment to risk management and fostering a culture of resilience within organizations is also critical. Training programs and simulation exercises are identified as effective means of preparing employees to handle disruptions. Furthermore, adherence to regulatory compliance and a focus on sustainability are integral to maintaining long-term stability and reducing the risk of future disruptions.

This study explores the multifaceted role of culture in supply chain collaboration, focusing on how cultural differences shape communication, trust-building, negotiation, conflict resolution, risk management, and ethical standards. Utilizing a qualitative methodology, semi-structured interviews were conducted with 25 supply chain professionals from diverse cultural backgrounds and industries. The findings reveal that high-context cultures favor indirect communication and nuanced information exchange, which can lead to misunderstandings with partners from low-context cultures who prefer direct and explicit communication. Trust-building practices vary significantly, with high uncertainty avoidance cultures emphasizing formal agreements and procedural rigor, while low uncertainty avoidance cultures prioritize personal relationships and demonstrated reliability. Negotiation strategies also diverge, reflecting the underlying values of collectivism versus individualism, impacting the tactics and outcomes of supply chain negotiations. Conflict resolution approaches differ, with high power distance cultures favoring hierarchical and mediated solutions, and low power distance cultures preferring direct and egalitarian methods. The study highlights the need for adaptability to cultural changes and the development of cultural intelligence as essential competencies for managing cross-cultural supply chains. Additionally, cultural differences in risk management approaches and governance mechanisms affect the coordination and resilience of supply chains, while varying ethical standards influenced by cultural norms necessitate culturally sensitive strategies for promoting corporate social responsibility. The insights gained from this research underscore the importance of understanding and leveraging cultural differences to build stronger, more productive supply chain relationships, contributing to the broader literature on culture and supply chain management and offering practical implications for enhancing global supply chain collaboration.

Background: Obesity is a global health crisis with a rapidly increasing prevalence among university students. Medical students are a unique population that may be at a higher risk of obesity due to the demanding nature of their studies and the associated stress. Objective: This study aimed to determine the prevalence of overweight, obesity, and the associated risk factors among medical students at Jazan University in Saudi Arabia. Methods: A cross-sectional study was conducted among 228 medical students from their 2nd to 6th academic years at the Faculty of Medicine, Jazan University. A self-administered questionnaire was used to collect data regarding sociodemographic characteristics, physical activity, dietary habits, comorbidities, medication use, family history, and lifestyle factors. Anthropometric measurements including height, weight, and waist circumference were recorded. Chi-square test and binary logistic regression were used to identify the risk factors associated with obesity. Results: The prevalence of overweight and obesity among the participants was 13.3% and 15% respectively. Hence, the combined prevalence of overweight and obesity is 28.3%. The mean weight was 63.39 ± 18.93 kilograms, and the mean height was 163.48 ± 9.78 centimeters. On the other hand, 17.3% of participants had underweight whereas 54.4% had normal BMI. Most of the participants (61%) did not engage in regular exercise. A high proportion consumed fruits (82.9%) and vegetables (58.8%) 3 or fewer days per week, and 84.2% consumed 3 or fewer meals per day. Fast food consumption more than 3 days per week was reported by 42.1% of participants. Obesity was not significantly associated with sociodemographic factors, physical activity, dietary habits, comorbidities, medication use, or family histories. However, those with a monthly family income of 15,000-24,999 riyals had significantly lower odds of obesity than those in the lowest income group (OR 0.230, p = 0.045). Conclusion: The prevalence of overweight and obesity among medical students at Jazan University is high. Although no significant associations were found between obesity and most risk factors, this study highlights the need for interventions that promote healthy lifestyles among medical students. Further research is needed to identify effective strategies for preventing and managing obesity in this population.

Enterprise risk management (ERM) was introduced in the 1990s and has become an expectation by boards of directors and regulators as a sign of good management and good corporate governance. However, many organizations struggle to implement ERM, and still seek practical ad-vice on ERM implementation. This article explains many of the reasons why organizations are unsuccessful in their efforts at implementation and provides practical solutions by an experienced risk manager and consultant, an ex-Chief Risk Officer, and an academic, all who has writ-ten extensively in the subject. This article should be of interest to practitioners involved in implementing ERM, to consultants in ERM, and to academics teaching courses on ERM, risk management, and related topics. This article also provides a base against which further future re-search can be done as ERM best practices continue to evolve.

The population’s mobility in urban areas is a necessary variable in the modeling of risk scenarios caused by atmospheric contamination. The inclusion of this concept makes static models more dynamic while considering people within a city to be an entity with complex mobility processes. We propose a conceptual and methodological tool to make the representation of the social, economic and territorial components, as well as the patterns in the population´s mobility to delimitate risk areas for human health by exposure of contaminants. In the volatile organic compounds (VOC), benzene, ethylbenzene, toluene and xylene (BTEX) are amongst the most dominant substances in fugitive vapor emissions in gas stations (GS). In urban areas, the exposure to BTEX by residential proximity and proximity to other facilities, which cause intra-urban agglomeration, can impact and affect human health. This model seeks to facilitate the focalization, identification and prioritization of risk areas by BTEX environmental contamination. This article goes beyond de conceptual framework. It suggests methodological and instrumental aspects to be applied in other cities. The government agencies must consider these results when establishing rules, permissions and procedures to reduce environmental pollution for managing the risk in a complex urban environment.

Falls are the third-leading cause of disabilities among the elderly population worldwide. In Pakistan, the prevalence is 44%; out of them, 8% develop injuries, placing them at high risk for hospitalization or even premature death. Interestingly, fall is multifactorial, and fall risk depends on individual characteristics (intrinsic factors) and environmental features (extrinsic factors), which can be different from context to context. Therefore, regular assessment of fall risk factors is required to develop a strategy for fall prevention. This study aimed to identify intrinsic risk factors for falls in Pakistani elders living in the communities, and provide evidence for preventive strategies of falls in elderlies. Data were collected from 140 Muslim elders from two residential areas of Peshawar, Khyber Pakhtunkhwa, from July 2022 to August 25, 2022, after taking permission from Zhengzhou University Ethical Review Board (ZUIRB #202254), and District Health Department Office (DHO #14207).Participants were informed and concern was taken before collect data. Data were collected using the Time Up and Go Test (TUGT), the Mini-Mental Status Examination, and interviews regarding the prayer practice. Factors associated with falls were; age, gender, education, cognitive status, TUGT level, incorrect prayer postures, poor vision, and history of falls with a significance of (P.<0.05). Poor cognition, low vision, poor walking speed, and prayers without body movements have good membership with falls risk prediction as (P<0.005) in Omnibus, Lemeshow score (0.77). Hence, our study provides a road map for future risk assessment for falls by adding the four mentioned risk factors as offered in the proposed model to facilitate taking timely action to prevent fall-related ailments in Pakistani elders.

Background This study aimed to identify the prominent risk factors that may trigger danger signals of early onset of vascular deregulation in T1D. The risk factors we have identified may serve as dual-purpose biomarkers of rapid diagnosis that offer prospective tailor-made resolution therapeutics. Methods The healthy control (HC) was compared with individuals diagnosed with T1D for the risk factors of vascular deregulation in published research studies from year 2013 to 2023. The PubMed, Web of Science and Google Scholar databases were searched from 1/1/2013 to 1/9/2023. The risk of bias was assessed with the Cochrane (ROBINS-I ) tool, which is relevant to clinical subjects. A random effect model for continuous data was followed and analysed by RevMan 5.4 and GraphPad Prism software. Results 80 relevant case-control studies having 5293 HC and 7492 T1D patients were included. The age and sex-matched HC consisted of persons free of disease and not under any medication while clinical subjects of all age groups were included. 28 risk factors were grouped into six primary outcome models, all of which favoured the T1D synonymous with a high risk of CVD. Conclusions Our findings have strong implications for improving the quality of life and health economics related to vascular disease in T1D. HbA1c% is the most effective biomarker, followed by FBG, LDL-C, and AI% which the clinicians could evaluate using a simple blood test or non-invasive techniques. (Protocol registered at https://www.crd.york.ac.uk/prospero/ CRD42022384636).

Rising incidences of cutaneous melanoma have fueled the development of statistical models that predict the individual melanoma risk. Our aim was to assess the validity of published prediction models for incident cutaneous melanoma using a standardized procedure based on PROBAST (Prediction model Risk Of Bias ASsessment Tool). We included studies that were identified by a recent systematic review and updated the literature search to ensure that our PROBAST rating included all relevant studies. Six reviewers assessed the risk of bias (ROB) for each study using the published “PROBAST Assessment Form” that consists of four domains and an overall rating of ROB. We further examined a temporal effect regarding changes in overall and domain-specific ROB rating distributions. Altogether 42 studies were assessed, of which a vast majority (n=34; 81%) was rated as having high ROB. Only one study was judged as having low ROB. The main reasons for high ROB ratings were the use of hospital controls in case-control studies and the omission of any validation of prediction models. However, our results of the temporal analysis showed a significant reduction in the number of studies with high ROB for the domain analysis. Nevertheless, the evidence base of high-quality studies that can be used to draw conclusions on the prediction of incident cutaneous melanoma is currently much weaker than the high number of studies on this topic would suggest.

In metropolitan regions, which are particularly vulnerable to seismic damage, numerous reinforced concrete (RC) buildings are being constructed. Public safety has been an important consideration to safeguard and protect people, buildings, and infrastructure from the potential effects of earthquakes. The assessment of seismic vulnerability within urban areas encompassed an analysis of both building vulnerability and the scale of seismic hazards prevalent in the locality. This assessment aimed to ascertain the likelihood of building damage resulting from ground motion induced by an earthquake of a specific magnitude. In recent decades, considerable efforts have been made to develop and improve methods for assessing earthquake damage to reinforced concrete (RC) buildings. These efforts included the creation of seismic hazard and seismic risk indices that were used to quantify the potential destruction of individual building components or the entire building. This scholarly review article presents an in-depth analysis and concise summary of the primary techniques (including qualitative or empirical, quantitative, analytical, and experimental test methods) devised for appraising the seismic vulnerability of reinforced concrete frame buildings, pre- and post-earthquake occurrences. It is a valuable reference for policymakers, engineers, researchers, and specialists engaged in earthquake risk mitigation efforts.

Advanced air treatment systems have the potential to reduce airborne infection risk, improve indoor air quality (IAQ) and reduce energy consumption, but few studies reported practical implementation and performance. PlasmaShield®, an advanced multi-modal HVAC-integrated system was directly compared with a standard MERV-13 system in a post-surgical pediatric healthcare setting. The evaluation entailed monitoring of multi-size airborne particles, bioaerosols and key IAQ parameters. Measurements were made of outside air, recovery room supply air and air in the occupied space for 3 days prior to, and after, installation of the PlasmaShield system. Compared with the existing arrangement, very significant reductions in particle number concentrations were observed in the occupied space, especially with virus-like submicron particles. Significant reductions in airborne culturable bacteria and fungi were observed in the supply air, with more modest reductions in the occupied space. In the case of virus-like particles, there was an 8-fold improvement in equivalent clean air, suggesting a 5-fold infection risk reduction for long range exposure. The data suggest multiple benefits of airborne particle and biaerosol reduction, with applications beyond healthcare. Long term studies are recommended to confirm the combined IAQ, health and energy benefits.

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

1. Background: Cardiovascular diseases (CVDs) are India’s leading cause of mortality. This study aimed to recalibrate the original Framingham Risk Score (FRS) equations among adults in Kerala state. 2. Methods: Baseline survey data from the Kerala Diabetes Prevention Program were analyzed: 921 males and 567 females for lipid-based FRS scores and 1042 males and 646 females for BMI-based FRS scores. Recalibration of the original FRS scores was performed using local data on CVD risk factors and CVD mortality. 3. Results: Among males, the median 10-year CVD risk with the recalibrated lipid-based FRS score was 7.34 (IQR 4.33-12.42), compared with the original score of 8.88 (5.23-14.87) (p<0.001). For BMI-based FRS scores, the median 10-year CVD risk was 7.40 (4.27-11.83) with the recalibrated score, compared to 9.32 (5.40-14.80) for the original score (p<0.001). In females, the median 10-year CVD risk was 4.83 (2.90-8.36) with the recalibrated score, compared to 2.85 (IQR 1.71-4.98) with the original score (p<0.001). Similarly, the median 10-year CVD risk was 4.66 (2.74-8.81) with the recalibrated BMI-based FRS score, compared to 2.95 (1.72-5.61) with the original score (p<0.001). 4. Conclusions: Recalibrated FRS scores estimated a significantly lower 10-year CVD risk in males and a higher risk in females than the original FRS scores.

Limited accessibility in some parts of Indonesia causes difficulties in logistic distribution, especially for emergency and medical supplies. Emerging drone cargo technology is a potential solution to improve logistic distribution in those areas. However, implementing drone cargo technology involves unknown risks, both in technical and non-technical aspects. Since data on drone operations in Indonesia is limited, a new method is explored to build a Bayesian Network (BN) model for risk analysis of drone crashes in Indonesia’s outermost and underdeveloped areas. The method optimizes the modelling process, in which significant risk factors are selected based on three drone operator companies’ experiences, which include wind speed, rain intensity, and system component failure or malfunction. Real wind speed and rain probability data are then implemented in the model. The operator’s data shows that wind speed contributes to drone crashes, which can be appropriately modelled in the BN model. The model produced a probability of safe operation of 94.1%, comparable to the annual operator’s data. The result shows that most operations are safe, with a minimum case of crashing and no case of harming human life.

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.

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

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

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