Patients with advanced chronic liver disease (ACLD) or cirrhosis undergoing surgery have an increased risk of morbidity and mortality in contrast to the general population. Retrospective, observational study of ACLD patients to evaluate the predictive capacity of previous surgical risk scores in a European cohort of patients. ACLD was defined by the presence of thrombocytopenia <150.000/uL and splenomegaly; AST-to-Platelet Ratio Index >2; nodular liver edge by ultrasound; transient elastography >15 kPa and/or signs of portal hypertension. We assessed variables related to 90-day mortality and the discrimination and calibration of current surgical scores (Child-Pugh, MELD-Na, MRS, NSQIP, and VOCAL-Penn). Only patients with ACLD and major surgeries included in VOCAL-Penn were considered (n=512). The mortality rate at 90 days after surgery was 9.8%. Baseline disparities between H. Mar and VOCAL-Penn cohorts were identified. Etiology, obesity, or platelet count not were associated with mortality. The VOCAL-Penn showed the best discrimination (C-statistic90D= 0.876) and overall predictive capacity (Brier90D= 0.054) but calibration was not excellent in our cohort. VOCAL-Penn was suboptimal in patients with diabetes (C-statistic30D= 0.770), without signs of portal hypertension (C-statistic30D= 0.555), or with an abdominal wall (C-statistic30D= 0.608) or urgent (C-statistic180D= 0.692) surgeries. Our European cohort has shown a mortality rate after surgery similar to those described in American studies. However, some variables included in the VOCAL-Penn score were not associated with mortality, and VOCAL-Penn’s discriminative ability decreases in patients with diabetes, without signs of portal hypertension, and with abdominal wall or urgent surgeries. These results should be validated in larger multicenter and prospective studies.

Epithelioid hemangioendothelioma (EHE) is an extremely rare vascular sarcoma with variable aggressive clinical behavior. In this retrospective study we aimed to investigate prognostic factors based on clinicopathologic findings in a molecular/immunohistochemical confirmed nationwide multicenter cohort of 57 EHE. Patients had unifocal disease (n=29), multifocal disease (n=5), lymph node metastasis (n=8) and/or distant metastasis (n=15) at the time of diagnosis. The overall survival rate was 69.6% at 1 year and 50.5% at 5 years. Survival did not correlate with sex, age or histo-pathological parameters. No survival differences were observed between multifocal and metastatic disease suggesting that multifocality represents early metastases and treatment options are limited in comparison to unifocal disease. In unifocal tumors, survival could be predicted using the risk stratification model of Shibayama et al. dividing the cases into low (n=4), intermediate (n=15) and high (n=3) risk-groups. Larger tumor size (>3cm) and higher mitotic count (>1/10HPF) was asso-ciated with progressive unifocal disease course. Lymph node metastases at time of diagnosis oc-curred in 14.0% of the cases and was mainly associated with tumor localization in the head and neck area proposing lymph node dissection. In conclusion, our results demonstrate the aggressive behavior of EHE, emphasize the prognostic value of a previous described risk stratification model and may provide new insights regarding tumor focality, therapeutic strategies and prognosis.

In modern automobiles, Infotainment High-Performance Computing (HPC) systems play a vital role in enhancing the capabilities of drivers and passengers by providing advanced features consisting of music, navigation, communication, entertainment, etc. However, as the use of information technology in vehicles increases, it results in cybersecurity threats such as data breaches and the loss of sensitive information. To improve the security of the infotainment system in automotive vehicles, the research conducted threat modeling at the component level using Microsoft’s STRIDE tool and performed risk assessment by using SAHARA (Safety-Aware Hazard Analysis and Risk Assessment) and DREAD methodologies to evaluate associated risks. It provides a systematic representation of threats, associated risks, and generic mitigation strategies to counter cybersecurity attacks. Through the threat modeling process, 34 potential security threats were identified. The study also provided a comparative analysis to calculate the risk values of the threats to prioritize for treatment. These identified threats and associated risks need to be considered to avoid potential cyberattacks, before deploying the infotainment HPC system in real-world automotive vehicles.

Cardiovascular diseases (CVD) are prevalent and lead to high morbidity and mortality globally. Physiotherapists regularly interact with patients with or at risk of CVDs (pwCVDs). This study aimed to assess the nature of existing evidence, interventional approaches used, and the population groups included in physiotherapy-led health promotion (PLHP) for pwCVDs. The scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Medline, PubMed, Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, and PEDro databases were searched from inception until June 2023. Two reviewers independently screened the titles, abstracts, full text and conducted data extraction. All conflicts were resolved with a third reviewer. A total of 4992 records were identified, of which 20 full-text articles were included in the review. The studies had varied populations, including those with stroke, coronary artery diseases, peripheral artery diseases, hypertension, diabetes, and multiple CVD risk factors. The interventions ranged from exercise and physical activity programs, dietary interventions, education, and counselling sessions with various supplementary approaches. Most interventions were short-term, with less than 12 months of follow-up. Interventions were personalised and patientcentred to promote adherence and health behaviour change. Among the included studies, 60% employed experimental designs, with the remainder using quasi-experimental designs. Although a wide range of PLHP strategies have been used for pwCVDs, exercise and physical activity were employed in 85% of included studies. Other components of health promotion, such as sleep, smoking, and alcohol abuse, should be investigated within PLHP.

The study aimed to identify football players at high risk (HR) for anterior cruciate ligament (ACL) injury via a four-test battery and assess possible factors affecting classification. Ninety-one professional and semi-professional athletes participated in a field-based preseason screening. Aknowledged inter-limb asymmetry limits for quadriceps and hamstrings isometric strength, and Single Leg Triple Hop for distance, in addition to the Landing Error Scoring System (LESS) comprised the test-battery. Additional assessment of hip adductors and core stability completed the global functional profile of the players. Sixty-one players were identified as HR and 30 as low-risk (LR) for ACL injury. Test-battery classified adequately 78,0% of them (Chi-square= 27,485 p=,000), identifying only 4 misclassified cases in the LR group, this low number being important for avoiding improper treatment of injury-prone athletes. All partcipants were considered healthy, and history of a previously rehabilitated injury did not interfere with the results. LESS seems to be the optimal criterion for classification and also the best predictor of both the initial grouping and the secondary one with the wrong vs correct classification cases. The proposed test-battery provides a promising option for field-based preseason ACL-risk assessment of football players and needs to be studied prospectively.

Malaria is a disease spread by female mosquitos of the Anopheles genus. It is acutely prevalent in Sub-Saharan Africa, where 90% of malaria deaths occur annually. One Sub-Saharan African country historically impacted by malaria is Ethiopia. In the past twenty years, malaria prevalence has decreased throughout Sub-Saharan Africa; yet, anthropogenic environmental changes are changing the landscape of malaria. Scholarly literature has cited a positive relationship between hydroelectric dams and malaria in Sub-Saharan Africa. Ethiopia is currently expanding their hydroelectric infrastructure. The Gilgel Gibe III Dam is located on the Omo River in Southwestern Ethiopia. It began generating electricity in 2015 and its reservoir has a capacity of 14,700 million m3 of water. This research utilized Geographic Information Systems and Remote Sensing to identify populations at an increased risk of malaria due to Gilgel Gibe III Dam. Two different techniques were employed: the proximity approach and the remote sensing approach. The proximity approach was based on distance from the reservoir. It identified all populations living within three kilometers of the reservoir as being at an increased risk. The remote sensing approach evaluated the slope, elevation, water content, and land surface temperature of the study area to create a mosquito breeding habitat risk map. Then, populations living within three kilometers of the two main High-Risk areas were identified. This study suggests that mosquito breeding habitat risk is not equally distributed throughout the Gilgel Gibe III Reservoir. This causes certain populations to be at a heightened risk of malaria.

Parkinson's disease (PD) is a common neurodegenerative disorder characterized by the loss of dopaminergic neurons and the buildup of misfolded alpha-synuclein proteins. While its exact cause remains unknown, several factors may influence its development. This review examines how factors like chronic constipation, head injuries, cholesterol and uric acid levels, pesticide exposure, smoking, NSAIDs, and caffeine intake may affect PD risk. Chronic constipation appears to be linked to a higher risk of PD, potentially serving as an early warning sign. Head injuries, especially mild-to-moderate ones, may also play a role in increasing PD risk. Surprisingly, higher levels of cholesterol seem to protect against PD, while lower levels of uric acid might increase the risk in the presence of some differences according to gender type. Exposure to certain pesticides is associated with a higher PD risk. NSAIDs, on the other hand, may or may not have a protective effect, with conflicting evidence. Interestingly, caffeine and tobacco smoking appear to lower the PD risk. Further studies are needed to fully understand the complex interplay between these factors and PD. It's also important to remember that these are just general trends, and individual risk factors will vary depending on a person's unique genetic makeup, medical history, and overall health.

The assessment of soil contamination in the vicinity of integrated siderurgical plants is of outmost importance for agroecosystems and human health, and sensitive techniques should be employed for accurate assessment of chemical elements (metals, potential toxic elements, rare earths, radioelements) in soil and further evaluation of potential ecological and safety risk. In this paper a total of 45 major, minor and trace elements (Al, As, Au, Ba, Br, Ca, Cd, Ce, Co, Cr, Cs, Cu, Dy, Eu, Fe, Hf, Hg, I, K, La, Mg, Mn, Mo, Na, Nd, Ni, Pb, Rb, Sb, Sc, Sm, Sn, Sr, Ta, Tb, Th, Ti, Tm, U, V, W, Y, Yb, Zn and Zr) were quantified in soils located around a large siderurgical works (Galati, SE Romania) using instrumental neutron activation analysis (INAA) in combination with X-ray fluorescence (XRF) and inductively coupled plasma mass spectrometry (ICP-MS). The statistical analysis results and vertical distribution patterns for three depths (0-5 cm, 5-20 cm, 20-30 cm) indicate inputs of toxic elements in the sites close to the ironmaking and steelmaking facilities and industrial wastes dumping site. For selected elements, a comparison with historical, legislated and world reported concentration values in soil was performed and depth migration, contamination and toxic risk indices were assessed. The distribution of major, rock forming elements was closer to the Upper Continental Crust (UCC), and to the Dobrogea loess, finding confirmed by the ternary diagram of the incompatible trace elements Sc, La and Th, as well as by the La to Th rate. At the same time, the La/Th vs. Sc and Th/Sc vs. Zr/Sc bi-plots suggested a felsic origin and a weak recycling of soils mineral components.

In this study, we attempted to verify the hypothesis that total metals bound to dust of different particle sizes may reflect pollution levels, but cannot predict its bioavailability and risks in human health assessments. Dust samples were collected using active sampling method; during the dry season months of November, 2014 to March, 2015 at different locations in Akure (7˚10ʹN and 5˚15ʹE). The samples were sorted into different particle sizes (< 10µm, 10 – 50 µm, >50µm), analyzed for some physicochemical properties and assessed for metals bioavailability using two-step physiological extraction method. The amount of metals (Cd, Cu, Cr, Ni, Pb, Zn and Mn) released in each particle sizes were determined using Perkin-Elmer 6000 Inductively Coupled Plasma - Atomic Emission Spectrometry (ICP-AES) analysis. The results showed that bioavailability of some metals (Cd, Ni, Pb, and Zn) decreases with increasing particle sizes, however, the reverse trend was observed for Mn, Cu and Fe concentrations. This may be attributed to some combination of physicochemical characteristics of the dust and metal speciation. Hence, it was concluded that metal bioaccessibility in dust can best be described by the knowledge of physicochemical characteristics. The exposure dose of the metals showed that cancer risks due to inhalation were very high when compared to other exposure routes (ingestion and dermal contact). The calculated non-cancer (HQ) and cancer risk (HI) for humans in the area showed values higher than unity, indicating possibility of the metals’ body burden.

Smartphone Addiction is a social issue caused by excessive smartphone use, affecting decision-making processes. Current research on the risky decision-making abilities of smartphone addicts is limited. This study used the fNIRS brain imaging technique and a Sequential Risk-Taking Task experimental paradigm to investigate the decision-making behavior and brain activity of smartphone addicts under varying risk levels. Using a mixed experimental design, the research assessed decision-making ability and brain activation levels as dependent variables across two groups (addiction and control), two risk amounts (high and low), and two outcomes (gain and loss). The study included 42 participants, with 25 in the addiction group and 17 in the control group. Results indicated that risk level significantly impacted the decision-making ability of smartphone addicts, with high-risk levels leading to weaker decision-making ability and increased risk-taking. However, at low risk levels, decision-making abilities between addicts and healthy individuals showed no significant difference. Furthermore, brain imaging results using fNIRS revealed stronger brain activation in the dlPFC region for smartphone addicts under loss outcome conditions, with no significant differences between the two groups in terms of brain activation at varying risk volumes. These findings are critical in promoting healthy smartphone use, guiding clinical treatment, and advancing brain mechanism research.

The aim of this study was to determine the most common maternal and neonatal complications related to cesarean section at Sultan Qaboos University Hospital (SQUH) and to compare the outcomes between emergency and elective cesarean sections. A retrospective cohort study was conducted in the department of Obstetrics and Gynecology at SQUH from 1st January 2016 to 31st December 2016. This comparative study involved 300 women who underwent cesarean section, 150 in elective cesarean section group and 150 in emergency cesarean section group. Data was collected from the delivery ward maternity registry and Electronic Patient Records. SPSS software version 23 was used to analyze the data.The mean maternal age was 29.66 (± 4.96) and 33.22 (± 4.63) years in the elective and emergency cesarean section groups respectively (p=001). The main risk factor for both the groups was maternal diabetes and the most common indication for both was previous cesarean section. Hypotension related anesthetic complication was noted more in elective cesarean section (15.3%) than in emergency cesarean section group (4.0%) with p value=0.002. The most common major intraoperative complication in both groups was postpartum hemorrhage, 66.9% women in emergency group and 63.0% women in elective group. Post-partum fever was seen in 12.0% of women in emergency group as compared to 4% in elective group (p=0.019). Anemia was observed in 79.2% and 65.3% in emergency and elective groups respectively (p=0.011). Respiratory distress syndrome and transient tachypnea of the newborn were the main neonatal complications in both groups. There was no significant difference between emergency and elective cesarean section related maternal and neonatal complications except for transient intraoperative hypotension, maternal postoperative febrile morbidity and anemia. Future prospective studies including larger sample size and multiple centers is recommended.

Waterlogging induced by rain in urban areas has a potential risk impact on property and safety. This paper focuses on the impact of rain on waterlogging and evaluates the waterlogging risk in the central city of Shanghai. A simplified waterlogging depth model is developed in different areas with different drainage capacity and rainfall in consumption of simplifying the effect of complex terrain characteristics and hydrological situation. Based on urban waterlogging depth and its classification collection, a Rain-induced Urban Waterlogging Risk Model(RUWRM) is further established to evaluate waterlogging risk in the central city. The results show that waterlogging depth is closely linked with rainfall and drainage, with a linear relationship between them. More rainfall leads to higher waterlogging risk, especially in the central city with imperfect drainage facilities. Rain-induced urban waterlogging risk model can rapidly gives the waterlogging rank caused by rainfall with a clear classification collection. The results of waterlogging risk prediction indicate that it is confident to get the urban waterlogging risk rank well and truly in advance with more accurate rainfall prediction. This general study is a contribution that allows the public, policy makers and relevant departments of urban operation to assess the appropriate management to reduce traffic intensity and personal safety or strategy to lead to less waterlogging risk.

The present study was conducted to estimate the exposure and risk characterization of the children population of Serbia to Aflatoxin M1 (AFM1) from milk and milk-based food. A total of 3404 samples comprising of milk and different milk-based food samples were collected from various regions of Serbia from 2017 to 2019. Evaluation of the AFM1 exposure was carried out using the deterministic method, whereas risk characterization was evaluated with the calculation of the Margin of Exposure (MOE) and the risk of Hepatocellular Carcinoma (HCC). Detection rates for AFM1 in milk and milk-based food samples ranged between 2% and 79%, with the highest incidence (79%) and mean level (22.34  0,018 ng kg-1) of AFM1 was detected in pasteurized and UHT milk. According to the three consumption estimates, the values of EDI were higher for toddlers as compared with children. Children aged 1–3 years had the highest risk of exposure to AFM1 in milk, with an estimated daily intake of 0.164 and 0.193 ng kg-1 bw day-1 using a lower bound (LB) and the upper bound (UB) exposure scenarios, respectively. Such difference could result from the higher consumption versus weight. Based on the EDI found in this study, the risk of AFM1 due to consumption of milk and milk-based food was low since MOE values obtained were 10000. In addition, the risk of HCC cases/year/105 individuals of different age groups showed that the value of HCC using potency estimates of 0.0017 (mean) was maximum (0.00034) in the age group 1–3 years which indicates no health risk for the evaluated groups. The present study revealed the importance of controlling and preventing AFM1 contamination in milk through continuous monitoring and regular inspection to reduce the risk of AFM1 exposure, especially in children.

The rapid development of the regional economy in China has led to the rise of local ecological risks. It is very important to provide enjoyable ecosystem services to residents while reducing ecological risks. In order to understand spatial relationships between ecosystem services and ecological risks, we took Chongqing as an example in this study to assess the spatial relationship between ecosystem services and ecological risks at the county scale based on the ES-DPSIR system. The main findings include: (1) significant variation in the spatial distribution of the comprehensive ecosystem service index, where the lowest ecosystem service index (0.013) was found in the main urban area of Chongqing and the scores gradually increased outward from this center, reaching 0.689 in the outermost areas, (2) the increase of the comprehensive ecological risk index from east to west, ranging from -0.134 to 0.333, (3) the spatial relationship between ecosystem services and ecological risks was prominent, with 52.63% of the districts and counties being imbalanced or mild imbalanced, and (4) the significant differences between development trends of ecosystem services-ecological risks, including 60.53% being imbalanced districts and 30.47% mildly balanced. Overall, it was necessary to improve the relationship between ecosystem services and ecological risks in Chongqing by reducing ecological risks., and these research results could provide effective approaches and technical support for improving regional ecological security and enhancing ecosystem service capabilities.

The past is an important lesson for facing the future with greater awareness. In this context, school plays a key role to spread knowledge on natural phenomena and to promote behavior change. Together with researchers, teachers can be strong allies to build more resilient future citizens. The Istituto Nazionale di Geofisica e Vulcanologia (INGV) school training activities provide tools to get ready for the next earthquake and/or tsunamis. About 5000 students from both Middle schools (ISCED 2) and High schools (ISCED 3) were involved in active learning activities based on a flipped-up approach during special online scientific events in the Pandemic. Online lab activities were conducted respectively during the European Researchers’ Night (“Earthquakes: history teaches us the future: researchers for a day with experimentation in didactics for ESL”) and during the World Water Day 2021 and the World Earth Day 2021 (“Tsunamis: history teaches us the future researchers for a day with experimentation in didactics for ESL”). These two Episodes of Situated Learning (ELS) experiences triggered students’ interest, favoring remote learning, developing life skills, focusing on historical seismic studies of both past earthquakes and tsunamis.

Seawater contamination is a global challenge due to its hazardous effects on marine organisms and human health. Twenty-three surface seawater samples were collected from Al Lith intertidal area along the Saudi Red Sea coast to evaluate the ecological risks and document the potential sources of Cr, Cd, Fe, Zn, and Pb. Contamination factor (CF), contamination degree (Cd), water quality index (WQI), and heavy metal pollution index (HPI), as well as multivariate tools were applied. The averages of HMs (μg/L) had the following order: Zn (6.616) &gt; Pb (0.284) &gt; Cd and Cr (0.268) &gt; Fe (0.197). Results of CF showed moderate contamination of seawater with Cd and low contamination for Cr, Fe, Zn, and Pb. However, 26.09% of the samples showed considerable contamination for Cd. Average Cd values revealed low contamination for HMs, while 17.39% of the samples showed moderate contamination. HPI average values indicated medium pollution for Al Lith seawater, meanwhile 13 samples reported high pollution. The higher HPI values were reported in samples characterized by higher concentration of HMs, particularly Cd and Zn. Correlation matrix and principal component analysis suggested anthropogenic sources for Pb and Zn, mostly from industrial and agricultural effluents, landfilling and domestic wastewaters, apart from their natural sources.

Hyperkalemia burden in non-dialysis CKD under nephrology care is undefined. We prospectively followed 2443 patients with two visits (referral and control with 12-month interval) in 46 nephrology clinics. Patients were stratified in four categories of hyperkalemia (sK≥5.0 mEq/L) by sK at visit 1 and 2: Absent (no-no), Resolving (yes-no), New Onset (no-yes), Persistent (yes-yes). We assessed competing risks of ESKD and death after visit 2. Age was 65±15 y, eGFR 35±17 mL/min/1.73 m2, proteinuria 0.40 (0.14-1.21) g/24h. In the two visits sK was 4.8±0.6 and levels ≥6 mEq/L were observed in  4%. Hyperkalemia was absent in 46%, resolving 17%, new onset 15% and persistent 22%. Renin-angiotensin-system inhibitors (RASI) were prescribed in 79% patients. During 3.6-year follow-up, 567 patients reached ESKD and 349 died. Multivariable competing risk analysis [sub-hazard ratio-sHR, 95%Confidence Interval-CI] evidenced that new onset [sHR 1.34, 95%CI 1.05-1.72] and persistent [sHR 1.27, 95%CI 1.02-1.58] hyperkalemia predicted higher ESKD risk versus absent, independently from main determinants of outcome including eGFR change. Conversely, no effect on mortality was observed. Results were confirmed by testing sK as continuous variable. Therefore, in CKD under nephrology care, mild-to-moderate hyperkalemia status is common (37%) and predicts per se higher ESKD risk but not mortality.

Some of the recent large-scale national projects in South Korea are delayed or suspended due to belated responses to risk occurring on site. Currently, the Far East District (FED) project is being implemented to relocate the US Army bases from Yongsan to Pyeongtaek. Because of lack of experience and understanding about the characteristics of such a project, the deadline of taking over to the US Army Korea has been missed. This study identifies problems of each participant in the Yongsan Relocation Plan (YRP) of the US Army Korea with respect to construction project management and establishes a risk management strategy reflecting characteristics of FED project. To derive significant risk factors influencing YRP, various field data like weekly and monthly reports and other reports on construction condition are analyzed, and experts’ advices are collected and a survey is conducted. Mediators and latent variables are ultimately obtained. Furthermore, a structural equation model is used to both analyze and evaluate complex causal relations among many variables of YRP. The impact of risk factors on the schedule, quality and cost of the project is analyzed. In particular, the case of Site A is examined to see how the project is affected by those risk factors.

Background: Whilst lack of concentration is a known symptom of anaemia, its association with post-stroke dementia is unclear. Methods: We used data from a UK regional stroke register. To be eligible, patient must have survived to discharge and had anaemia by WHO criteria. Dementia status and other prevalent co-morbidities were assessed using ICD-10 codes. Patients were followed till May 2015 (mean follow-up 3.7 years, total person years = 27,769). Hazard Ratio for incident dementia was calculated using Cox-proportional hazards model controlling for potential confounders. Fine and Gray model was additionally constructed using mortality as the competing risk. Results: A total of 7,454 stroke patients were included with mean age (SD) of 75.9(12.3) years (50.2% men). Those with anaemia were older, has higher disability and co-morbidity burden prior to stroke. We observed a large amount of variation in the dementia incidence rates over time and that the hazard ratio increased every year. The significant association between anaemia and dementia incidence was lost after controlling for pre-stroke Modified Rankin score (HR1.17(0.97,1.40)). With every 20g/dL increase in Hb was associated with a significant reduction in the risk of dementia after adjustment for age, sex, stroke factors and disability but lost significance after adjustment for vascular risk factors. Competing risk analyses showed similar results. Conclusion: Whilst we found no evidence of anaemia as a risk factor for post-stroke dementia, the findings may be limited by potential under recognition of post stroke dementia.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Background and Aim. Recently made analysis for anti-HBcor prevalence within Kazakhstan blood donors population concluded 17.2% rate. Considering these data are among the highest of infectivity results worldwide, an objective of this study was to define an association of positive Hepatitis B serology markers with risk and behavior factors. Methods. The blood donors’ samples were tested for anti-HBcore total (IgG/IgM) and anti-HBs, by CLIA on the Architect i2000SR platform (Abbott). Surrogate alanine transferase (ALT) markers for all blood donors were tested by kinetic method on the Biosystems A25 analyzer. A questionnaire was developed for socio-demographic characteristics, donors’ nutrition habits, cholesterol levels and history of smoking, alcohol consumption. Informed consent was obtained from all study participants. Statistics was calculated using the R software program (version 4.1.1, USA, 2021). Results. A group of 5709 blood donors participated in the study. Participants with positive anti-HBcore scores were on average older (41.8 vs 34.4 years, p<0.001), Kazakh (88.7% vs 83.0%, p<0.001), married (74.0% vs 55.6%, p<0.001), had a secondary education (70.1% vs. 59.4%, p=0.03), smoked (27.9% vs. 24.3%, p=0.05), had a longer smoking history (13.6±9.5 years vs. 9.8±8.5 years, p<0.001), and various hypercholestesterolaemia (6.2% vs 3.9%, p=0.02). Predominantly their main meal was dinner (17.0% vs 14.2%, p=0.03). Analysis for associations of socio-demographics characteristics, risk factors, nutrition with anti-HBs, showed that those who have secondary education level (70.1%) were more likely to be anti-HBs-positive (p=0.03). No other significant correlations for anti-HBs were observed. Conclusions. The risk factors and behavior analysis highlighted the blood donors’ overall health status. Positive Hepatitis B markers associated with statistically significant characteristics from socio-demography, nutrition habits or risk factors could support further pathogenesis studies looking for HBV treatment guides fulfilling the existing gaps.

Background. Increasing evidence demonstrate that concentration of protein in infant formula >1.9g/100Kcal with high levels of insulinogenic aminoacids is associated with accelerated weight gain, increased fat mass accumulation and risk of adiposity. Purpose of this study was to conduct a systematic review to determine the metabolic effects in infants feed with infant formula optimized in protein. Methods. Systematic review was conducted according PRISMA Statement. RCTs with one intervention group (infant formula with 1.6-1.9gr of protein/100Kcal) and at least one comparative control group (infant formula with >1.9gr of protein/100Kcal) were included. Standardized mean differences (SMD), through random model were calculated. Results. 15 RCT were included. Optimized protein in infant formula was associated with less gain of BMI at 24 months of follow-up (SMD -0.25, IC95% -0.36 to -0.13, p 0.01) and less fat mass accumulation (SMD -0.68, IC95% -0.98 to -0.37, p 0.01). Optimized protein was also associated to less gain of weight, weight/age Z-score, weight/length Z-score, BUN (mmol/dL) and IGF1 (ng/ml). No effect on length/age Z-score was observed. Conclusions. Robust evidence showed optimized protein (1.6gr/100Kcal to 1.9gr/100Kcal) in infant formula is associated with metabolic benefits in infants with less weight gain, BMI and fat mass accumulation.

Sustainability is a characteristic manifested in the ability to maintain the necessary level of performance for construction companies when risk factors arise during the implementation of investment and construction projects. The risk factors that arise during the implementation of in-vestment and construction projects differ in nature, degree of influence, and other characteristics. Ignoring these factors and measures to manage them often leads to critical consequences in the form of disruptions in the timing of work. Risk is a combination of the probability and consequences of the occurrence of adverse events. The article considers the concept of risk as a potential possibility of occurrence of adverse situations and related consequences when exposed to these factors. Risk factors are characterized by surprise, discreteness of changes, the presence of threshold values, upon reaching which a transition to a different mode of operation is required. The article discusses the risk factors arising at the construction stage, their classification. A methodology has been developed that includes conducting a survey in the form of a questionnaire in order to collect information about risk factors that affect the implementation of investment and construction projects. Experts with experience in the construction sector were involved in the survey. The processing of the survey results made it possible to assess the significance of various risk factors in investment and construction projects. Thus, statistical and expert methods were used in the study. The results showed that financial, technical, legal, economic, managerial and natural factors have the greatest impact on investment and construction projects. It is recommended to pay special attention to the listed factors when developing measures aimed at preventing risks and their consequences. The methodology described in the study can be used by construction companies in strategic planning. The analysis of the stability of construction companies, depending on their use of various ways to counteract risk factors, allowed us to develop a number of practical recommendations to reduce the impact of the studied factors on achieving the goals of investment and construction projects.

Background: Falls risk assessment tools are used in hospital inpatient settings to identify pa-tients at increased risk of falls (which may be related to muscle loss/sarcopenia) to guide and target interventions for falls prevention. In 2022, Western Health, Melbourne, Australia, intro-duced a new falls risk assessment tool, the Western Health St. Thomas’ Risk Assessment Tool (WH-STRATIFY), a modified version of The Northern Hospital’s risk tool (TNH-STRATIFY), which replaced the Peninsula Health Risk Screening Tool (PH-FRAT). Aims: To determine the predictive accuracy of three falls risk assessment tools (PH-FRAT, TNH-STRATIFY and WH-STRATIFY) on admission to Geriatric Evaluation Management (GEM) units. Method: A retrospective observational study was conducted on four GEM units. Data was col-lected on 54 consecutive patients who fell during admission and 62 randomly sampled patients who did not fall between December 2020 and June 2021. Participants were scored against three falls risk assessment tools. The event rate Youden (Youden IndexER) indices were calculated and compared using default and optimal cut points to determine which tool was most accurate for predicting falls. Results: Using default cut points to compare falls assessment tools, TNH-STRATIFY had the highest predictive accuracy (Youden IndexER = 0.20, 95% confidence interval CI = 0.07, 0.34). The PH-FRAT (Youden IndexER = 0.01 and 95% CI = -0.04, 0.05) and WH-STRATIFY (Youden IndexER = 0.00 and 95% CI = -0.04, 0.03) were statistically equivalent and not predictive of falls compared to TNH-STRATIFY. When calculated optimal cut points were applied, predictive accuracy im-proved for PH-FRAT (Cut point 17, Youden IndexER = 0.14 and 95% CI = 0.01, 0.29) and WH-STRATIFY (Cut point 7, Youden IndexER = 0.18 and 95% CI = 0.00, 0.35). Overall, all tools had low predictive accuracy for falls. Conclusion: TNH-STRATIFY had the highest predictive accuracy for falls. The predictive accu-racy of WH-STRATIFY improved and was significant when the calculated optimal cut point was applied. The optimal cut points of falls risk assessment tools should be determined and validated in different clinical settings to optimise local predictive accuracy, enabling targeted falls risk mitigation strategies and resource allocation.

Stochastic mortality models seek to forecast future mortality rates; thus, apparently the objective variable should be the mortality rate expressed in the original scale. However, the performance of stochastic mortality models - in terms, that is, of their goodness-of-fit and prediction accuracy - is often based on the logarithmic scale of the mortality rate. In this article, we examine whether the same forecast outcomes are obtained when the performance of mortality models is assessed based on the original and log scales of the mortality rate. We compare four different stochastic mortality models: the original Lee-Carter model, the Lee-Carter model with (log-)normal distribution, the Lee-Carter model with Poisson distribution and the median Lee-Carter model. We show that the preferred model will depend on the scale of the objective variable, the selection criteria measure and the range of ages analysed.

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

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

Temporomandibular joint disorders (TMD) are characterized by their multifactorial etiology and pathogenesis. A 3-year prospective study was conducted in a Portuguese TMD department to study the prevalence of different TMD signs and symptoms and their association with risk factors and comorbidities. Five hundred ninety-five patients were included using an online database: EUROTMJ. Most patients were female (80.50 %), with a mean age of 38.20±15.73 years. The main complaints were temporomandibular joint (TMJ) clicking (13.26%), pain (12.49%), and masticatory muscle tension (12.15%). The main clinical findings were myalgia (74%), TMJ clicking (60-62%) and arthralgia (31-36%). Risk factors such as clenching (60%) and bruxism (30%) were positively associated with TMJ pain and myalgia. Orthodontic treatment (20%) and wisdom tooth removal (19%) were positively associated with TMJ clicking, while jaw trauma (6%) tracheal intubation (4%) and orthognathic surgery (1%) were positively associated with TMJ crepitus, limited man-dibular range of motion and TMJ pain, respectively. 42.88% of TMD patients had other associated chronic diseases, most of them were mental behavioral or neurodevelopmental disorders (33.76%), namely, anxiety (20%) and depression (13%). The authors also observed a positively association of mental disorders with the degree of TMJ pain and myalgia. Online database seems to be a relevant scientific instrument for healthcare providers who treat TMD. The authors expect that EUROTMJ database can serve as a milestone for other TMD departments.

The perceived risk of being infected at work (PRIW) with COVID-19 represents a potential risk factor for workers during the current COVID-19 pandemic. In line with the job demands-resources (JD-R) model applied to safety at work, in this longitudinal study we propose that PRIW can be conceptualized as a job demand, whereas communication (i.e., the exchange of good-quality information across team members) can be conceived as a job resource. Accordingly, we hypothesized that PRIW at Time 1 (T1) would positively predict psychophysical strain at Time 2 (i.e., four months later). Furthermore, we hypothesized that communication at T1 would negatively predict psychophysical strain at T2. Overall, 297 workers took part in the study. The hypothesized relationships were tested using multiple regression analysis. Results supported our predictions: PRIW positively predicted psychophysical strain over time, whereas communication negatively predicted psychophysical strain over time. Also, results did not change after controlling for age, gender, and type of contract. Overall, this study suggests that PRIW and communication can be considered as a risk and a protective factor for work-related stress, respectively. Hence, to promote more sustainable working conditions, interventions should encourage organizations to optimize the balance between job demands and job resources related to COVID-19.

Background: Vitamin B12 is a water-soluble vitamin with important cellular functions and is an essential vitamin. The aim of this study is to determine the B12 levels of children in the period from the 6th month when they start taking additional foods to the age of 7 and the risk factors affecting them. Methods: One hundred pediatric patients aged 6-72 months who were diagnosed with vitamin B12 deficiency and their parents who agreed to participate in Istanbul Atlas University, Medical Faculty, “Medicine Hospital” Pediatric Clinic between September 2022 and June 2023 were prospectively included in this study. Results: B12 deficiency was significantly higher in the 6-11 (25%) month group than those in the 12-23 (5.8%) and 24-47 (2.8%) month groups. Homocysteine levels were highest in those with insufficient B12 levels compared to the other groups. There was no statistically significant difference in weekly dairy and meat consumption levels between age groups. B12 levels were lower in the 6-11-month group than in the other groups. Homocysteine levels were highest in those with insufficient B12 levels [<200 pg/mL (148 pmol/L)]. Folic acid levels were lower in the 24-47 month and 48-72 month groups than in the 6-11 month and 12-23 month groups. Conclusions: The results obtained in this study showed that low vitamin B12 and increased homocysteine levels seem to be important risk factors in children, especially from the 6th month when they start taking additional foods. The diagnosis of B12 deficiency can be confirmed by elevated serum total homocysteine levels, which are evidence of functional cobalamin deficiency.

Risk management of electric power transmission lines requires knowledge from different areas such as environment, land, investors, regulations, and engineering. Despite the widespread availability of databases for most of those areas, integrating them into a single database or model is a challenging problem. Instead, in this paper, we use a single source, the Brazilian National Electric Energy Agency’s (ANEEL) weekly reports, which contains decisions about the electrical grid, comprising most of the areas. Since the data is unstructured (text), we employed NLP techniques such as stemming and tokenization to identify keywords related to common causes of risks provided by an expert group on energy transmission. Then, we used models to estimate the probability of each risk. Our results show that we were able to estimate the probability of 97 risks out of 233.

Urban flood risk mapping is an important tool for the mitigation of flooding in view of human activities and climate change. Many developing countries, however, lack sufficiently detailed data to produce reliable risk maps with existing methods. Thus, improved methods are needed that can improve urban flood risk management in regions with scarce hydrological data. Given this, we estimated the flood risk map for Rasht City (Iran), applying a composition of decision-making and machine learning methods. Flood hazard maps were produced applying six state-of-the-art machine learning methods such as classification and regression trees (CART), random forest (RF), boosted regression trees (BRT), multivariate adaptive regression splines (MARS), multivariate discriminant analysis (MDA), and support vector machine (SVM). Flood conditioning parameters applied in modeling were elevation, slope angle, aspect, rainfall, distance to river (DTR), distance to streets (DTS), soil hydrological group (SHG), curve number (CN), distance to urban drainage (DTUD), urban drainage density (UDD), and land use. In total, 93 flood location points were collected from the regional water company of Gilan province combined with field surveys. We used the Analytic Hierarchy Process (AHP) decision-making tool for creating an urban flood vulnerability map, which is according to population density (PD), dwelling quality (DQ), household income (HI), distance to cultural heritage (DTCH), distance to medical centers and hospitals (DTMCH), and land use. Then, the urban flood risk map was derived according to flood vulnerability and flood hazard maps. Evaluation of models was performed using receiver-operator characteristic curve (ROC), accuracy, probability of detection (POD), false alarm ratio (FAR), and precision. The findings showed that the CART method is most accurate method (AUC = 0.947, accuracy = 0.892, POD = 0.867, FAR = 0.071, and precision = 0.929). The results also demonstrated that DTR, UDD, and DTUD played important roles in flood hazard modeling; whereas, the population density was the most significant parameter in vulnerability mapping. These findings indicated that machine learning methods can improve urban flood risk management significantly in regions with limited hydrological data.

Published in July 2018, TAILORx aimed to establish non-inferiority of endocrine therapy (ET) compared to addition of chemotherapy (CHT-ET) in hormone receptor positive, human epidermal receptor 2 negative (HR+/HER2-) breast cancer (BC) patients with a 21-gene intermediate (11-25) recurrence score (RS). While this hypothesis proved correct, the study did show benefit of addition of chemotherapy (CHT) in a subgroup of women under 50 years of age, and particularly in the RS 16-25. The aim of this present study was to look at how TAILORx findings, including changes in RS categories, impacted CHT implementation at one oncologic center in Basel, Switzerland, and to identify main factors leading to these changes. Methods: We conducted a retrospective study on HR+/HER2-, BC patients who underwent 21-gene genomic testing between 2010-2021, at our center. Patients with metastatic disease were not included. We identified 326 eligible patients, of which 165 had a BC diagnosis before TAILORx (cohort A) and 161 after TAILORx publication (cohort B). Results: Demographic and tumor characteristics were similar in the two cohorts, although cohort B included significantly more women under the age of 50 when compared to A (34% vs. 24%, p<0.001). Median age and mean RS results were comparable 59 (IQR 16) in A and 58 (IQR 19) years in B and 17.72 (SD9.59) in A and 17.89 (SD9.53) in B, respectively. Patients in cohort A were slightly more overweight when compared to B (55% vs. 40% respectively, p<0.001). Most patients had stage II tumors of NST histologic type. Tumors in cohort B had higher Ki-67 than cohort A (39% vs. 32%, p=0.010). When compared based on manufacturer’s and based on TAILORx thresholds there were no significant differences in RS distribution. However, changes in score category led to shifts in patient population distribution, leading to a 40% drop in the low RS (from 60% to 20%), a doubling in the intermediate RS (from 30% to 60%) and an increase of 5% in the high RS (from 8-10% to 15%). Most patients had conservative surgery, adjuvant radiotherapy (RT) and ET. Overall CHT recommendation and application did not differ significantly in B vs. A. There was a reduction of 1% in the intermediate RS (11-25) and an increase of 13% CHT-ET application in the high RS (>26) category. In cohort B we noticed an increase in CHT-ET application among women <50 years old (by 12.5%), in lobular carcinomas (by 10%), grade 3 tumors (by 2%), node positive BC (by 3%) and node negative (by 2%). Tumor board recommendation for CHT dropped by 1% in the post TAILORx era, with a notable reduction of 5% in the intermediate RS (11-25) category. However, overall CHT administration rate was 19% in cohort A and 22% in B (p=0.763). Tumor Board recommended CHT for 90% of the BC patients that would have otherwise been assigned to CHT according to new RS guidelines in A and for 85% in B, showing a trend for undertreatment. Logistic regression analysis showed significance of age in both cohort A (OR 1.05, 95% CI 1.01-1.11, p=0.03) and cohort B (OR 0.89, 95% CI 0.84-0.94), p<0.001), and of nodal status in both cohort A (=R 3.32 95% CI 1.09-10-06, p=0.034) and cohort B (OR 3.31, 95% CI 1.29-8.53, p=0.013), while intermediate and high RS seem to be more relevant in cohort A (OR 0.12, 95% CI 0.03-0.43, p=0.01 and OR 0.04, 95% CI 0.01-0.21, p<0.01). Overall logistic regression analysis showed relevance of age (OR 0.93, 95% CI 0.08-0.97, p=0.001), pN (OR 4.77, 95% CI 2.03-11.22, p<0.001) and RS categories (RS 11-25: OR 0.02, 95% CI 0.01-0.07, p<0.001; RS>26: OR 617.93, 95% CI 57.97-6587.16, p<0.001). Conclusion: Our findings are similar to those reported across several studies: while tumor board recommendation for CHT decreases in the intermediate RS category, there is an increase being reported in the high RS category, leading to overall minor changes in CHT application. Administration of CHT-ET seems to be increasing among younger women, with unfavorable histo-pathological factors, such as lobular carcinoma and G3 histologic grade. Before TAILORx there is a tendency for undertreatment (-10%), especially among older BC patients, which seems to be maintained and even deepened (-15%) in the post TAILORx era, pointing to a personalized decision-making approach among Swiss oncologists.

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

Purpose: Pancreatic cancer (PAAD) is one of the most lethal malignancies. Immunotherapy is largely ineffective in PAAD. T-cell exhaustion contributes to the resistance for immunotherapies. We investigated the prognostic potential of T cell exhaustion-related genes (TEXGs). Methods: Single-cell RNA (scRNA) sequencing dataset from TISCH, and bulk sequencing datasets from TCGA and GTEx were applied to screen differently expressed TEXGs. Kaplan-Meier survival, LASSO regression, and Univariate/Multivariate Cox regression analysis were performed to construct TEXGs risk model. This model was used to predict the prognosis, tumor immune microenvironment, and immunotherapy response. PAAD cohorts from ICGC and GSE71729 datasets were used to validate this risk model. Pan-cancer expression of SPOCK2 was performed in TISCH database. Results: A six-gene (SPOCK2, MT1X, LIPH, RARRES3, EMP1, and MEG3) risk model was constructed. Low-risk PAAD patients had longer survival time in both training dataset (TCGA-PAAD, n=178) and validation datasets (ICGC-PACA-CA, ICGC-PAAD-US, and GSE71729, n=412). Multivariate Cox regression analysis demonstrated that the risk score was an independent prognostic variable for PAAD. High-risk patients correlated with cancer-related KEGG pathway enrichment, higher mutation frequency of KRAS and TP53 genes, and immunosuppressive status. Immunohistochemistry staining confirmed the changes of TEXGs in clinical samples. Moreover, pan-cancer scRNA sequencing datasets from TISCH analysis indicated that SPOCK2 might be a novel marker of exhausted CD8+ T cells. Conclusion: In conclusion, we established and validated a T cell exhaustion-related prognostic signature for PAAD patients. Moreover, our study suggests that SPOCK2 may be a novel marker of exhausted CD8+ T cells.

Aortic dissection (AD) is a critical heart condition with potentially severe outcomes. Our study aims to investigate the existence of a "weekend effect" in AD by examining the correlation between patient outcomes and the timing of their treatment during weekdays vs weekends. Specifically, we assessed prospectively the effects of the timing of treatment on patient outcomes for acute aortic dissection, both before surgical intervention and during hospitalization, as well as during the follow-up period. The mean age of the study population used here was 62.5 years with a high degree of variability. We recorded a rate of mortality before surgery of 8.65% for the weekend group and 15% for the weekday group, with no significant differences noted in the results of statistical tests. During hospitalization, mortality was found to be 50% (n=52) in the weekend group and 25% (n=5) in the weekday group, again with no significant differences observed in the results of the same statistical tests. Patient mortality after discharge was 9.61% (n=10) in the weekend group and 5% (n=1) in the weekday group. Our findings suggest that there is no significant difference in mortality rates between patients admitted to the hospital on weekends versus weekdays. Therefore, the period of the week when a patient presents to the hospital with aortic dissection appears to not affect their mortality outcomes.

Combination treatment, i.e., the use of two or more drugs for the same condition, is frequent in medicine if monotherapy yields an insufficient therapeutic response. We here review and challenge clinical study designs and formats of reporting outcomes for the evaluation of the benefit/risk ratio of combination treatment over monotherapy. We demonstrate that benefits of combination treatment at the group level over-estimate the probability of benefit at the single patient level based on outcome simulations under almost any imaginable setting. Based on these findings we propose that studies testing combination treatment should always report on percentages of responders to monotherapy and combination treatment. We provide equations that allow calculation of the percentage of patients truly benefitting from combination (responders to both monotherapies) and that of patients exposed to risk of harm from adverse effects without a reasonable expectation of individual benefit. These considerations are explained based on real clinical data, mostly from the field of functional urology (male lower urinary tract symptoms).

Background: Myocardial infarction (MI) is a major cause of mortality worldwide. Its presentation as ST-segment elevation MI (STEMI) and non-ST-segment elevation MI (NSTEMI) is influence by atherosclerosis risk factors. Aim: To assess the patterns of presentation and predicting risk factors of acute MI in Kosovo. Methods: This is a cross sectional study from the Clinic of Cardiology of the University Clinical Center of Kosovo, which included all patients hospitalized with acute MI over a period of 7 years (January 1st, 2014 to December 31st, 2020). Data was collected using a structured questionnaire and epidemiological patterns and risk factors were analyzed. Results: Among 7353 patients admitted with acute MI (age 63 ± 12 years, 29% female), 4366 (59.4%) patients had STEMI, and 2987 (40.6%) NSTEMI. Patients age was not different between the two groups (p=0.077). NSTEMI patients smoked less (48.3% vs. 54%, p<0.001), but were more diabetics (37.8% vs. 33.6%, p<0.001), more hypertensives (69.6% vs. 63%, p<0.001), frequently had family history for coronary artery disease (CAD) (40% vs 38%, p=0.009), and included more females compared to STEMI patients (32% vs 27%, p<0.001). The two groups of patients, did not differ in the prevalence of significant CAD on angiography (66.8% vs. 67.8%, p = 0.396), but NSTEMI patients underwent less primary percutaneous interventions compared with STEMI patients (43.6% vs. 55.2%, p < 0.001). Conclusion: In Kosovo, STEMI is commoner than NSTEMI, who were mostly males, more likely to have diabetes, hypertension and family history for CAD compared to those with NSTEMI. Smoking and arterial hypertension proved the strongest predictors of acute MI, in Kosovo, thus highlighting the urgent need for better atherosclerosis risk control and education strategy.

Nowadays, environmental circumstances and business rules of organizations are complicate, active and uncertain, so, they cannot assurance their long- term survival through some actions such as, structural changes and methods or relying on creativity of some people in organization. Companies and organizations should prepare conditions to institutionalize entrepreneurial culture in their organization. Corporate entrepreneurship can improve the value of the organization. The entrepreneurial oriented organizations are more responsive for environment and market changes. Opportunity recognition is the base of being successful. The research is applied and in terms of method is descriptive. Data were analyzed, using Linear Regression and Multiple Moderated Regression (MMR) and SPSS software. In this research the effects of organizational entrepreneurship (innovation, proactiveness and risk-taking) on performance of the centers influenced by environmental factors (government’s strategies, competitiveness and technology) as moderating variables, were studied. Furthermore, the study presents that there is a significant positive relationship between organizational entrepreneurship and performance. Although the study does not show any significant moderating effect of environmental factors (Government’s strategies, competitiveness and technology) on the relationship between organizational entrepreneurship and performance, however, the result of the study manifests direct relationship between environmental factors and performance of such centers.

The sinking of cavities in urban areas is a very important geological risk to which many towns in Puglia are exposed. The study, mapping, geological and speleological description, classification and cataloging of forms and types of cavities is of fundamental importance for each urban center because it is linked to past local anthropic and natural processes, unique to each site. All this could lead to an enhancement of existing underground cavities in urban areas through conservation and continuous monitoring. Unfortunately in many cases these underground cavities have been used as landfills and subsequently abandoned. One of these cavities at the end of March 2007 collapsed in the inhabited center of Gallipoli causing damage to the structures and fortunately not to human lives. In the area relating to the collapsed cavity, a series of geophysical investigations were undertaken with the use of ground penetrating radar methodology in an attempt to delimit the area of collapse and understand the possible types of interventions for restoring the area. In the same area the measures were repeated 16 years later (December 2022) due to another collapse. The results show a much more widespread danger situation.

Heavy metals are toxic, persistent and non-degradable. After sedimentation and adsorption, they accumulate in water sediments. The aim of this study was to understand the heavy metal pollution of Qinjiang River sediments on the ecological environment and apportioning sources. The mean total concentrations of Mn, Zn, Cr, Cu, and Pb are 3.14, 2.33, 1.39, 5.79, and 1.33 times higher than the background values, respectively, except for the Co, Ni, and Cd, which are lower than the background values; Fe, Co, Ni, Cd, Cr, Cu, and Pb are all primarily in the residual state, while Mn and Zn are primarily in the acid-soluble and oxidizable states, respectively. Igeo, RI, SQGs and RAC together indicate that the pollution status and ecological risk of heavy metals in Qinjiang River sediments are generally moderate; among them, Fe, Co, Ni, Cd, Cr, and Pb are not harmful to the ecological environment of the Qinjiang River. Cu is not readily released because of its higher residual composition, depicting that Cu is less harmful to the ecological environment. Mn and Zn, as the primary pollution factors of the Qinjiang River, are harmful to the ecological environment. This heavy metal pollution in surface sediments of the Qinjiang River primarily comes from manganese and zinc ore mining. Manganese carbonate and its weathered secondary manganese oxide are frequently associated with a significant amount of residual copper and Cd, as a higher pH is suitable for the deposition and enrichment of these heavy metals. Lead-zinc ore and its weathering products form organic compounds with residual Fe, Co, Cr, and Ni, and their content is related to salinity. The risk assessment results of heavy metals in sediments provide an important theoretical basis for the prevention and control of heavy metal pollution in Qinjiang River.

Some herbicides exert hormetic or biphasic non-monotonic dose-response (NMDR), which is one of the major challenges for ecological risk assessment (ERA) of pesticides pollution. In this study, fish embryo toxicity test (FET) with Javanese medaka (Oryzias javanicus) to sublethal concentration of diuron was determined. Inverted U-shape heart rate was observed at 3 days post-exposure (dpe) and 7 dpe. However, at 13 dpe the heart rate (104 ± 2.90 heartbeat/min.) decreased in 10.00 mg.L-1 exposed-embryos. At 20 dpe, hatchability and survival rate were reduced in 5.00 mg.L-1 and 10.00 mg.L-1 exposed groups. Hormetic developmental deformities were observed in embryo-larvae of Javanese medaka. The results revealed a biphasic effect of low concentrations of diuron on some morphological and physiological features of Javanese medaka embryo-larvae, which might be attributed to endocrine disruption of this herbicide. Further studies to support these effects were recommended.

The purpose of the present study was to determine the relationship between healthy lifestyle behaviors, physical fitness and coronary risk factors in university students. 320 male and female (n_m:171; n_f:149) students from a university participated in this study voluntarily. For the determination of body composition and Body Mass Indexes (BMI), subjects’ height, body weight, and skinfold thickness were taken and body fat percentage (%Fat) was determined. Healthy lifestyle behaviors were determined using the healthy lifestyle behaviors questionnaire. Indicators of physical fitness included flexibility (sit-up) (F), muscle strength and endurance (isometric knee (KS), back strength (BS) and a total of shuttle (TS), sprint performance, BMI, and body fat percentage (%fat). Coronary heart disease risk factors included mean arterial blood pressure (systolic (SBP) and diastolic (DBP)), fasting blood levels of triglycerides (TG), total cholesterol (TC), hematocrit (HT), and hemoglobin (HM). Results indicated subjects have normal body mass index, body fat percentage, SBP, DBP, TG, TCF, BS, KS. The results of the Pearson Product Moment Correlation Analysis, indicated that SBP, DBP, TG, TCF, BS, KS for male and female was significantly correlated with flexibility (sit-up) (F), muscle strength and endurance (isometric knee (KS), back strength (BS) and total of shuttle (TS)), sprint performance. (p<0.01; p<0.05), In conclusion, the findings of the present study indicated that physical fitness and healthy lifestyle behaviors play a determinant role in coronary heart disease risk factors for male and female students from a university.

This study aims to contribute to the characterization of Katangese Copperbelt's mining wastes and soils polluted with trace metals, using pollution indices and direct concentration measurements. The study also evaluated the use of these indices in assessing the success of remediation projects. Analytical data from previous studies and samples collected from six types of discharge and one polluted soil were used to address the first objective. Soil and plant samples were collected at Kipushi and Penga Penga for the second objective. The results revealed very high concentrations of As, Cd, Co, Cu, Mn, Pb, and Zn in all mine tailings and polluted soils, compared with local references. The degree of contamination (DC) values (from 72 to 5440) and potential ecological risk (RI) values (from 549 to 162 091) indicate very high-risk situations associated with polluted discharges and soils. Regarding revegetation trials, the results show lower concentrations and RIs in tree rhizospheres compared with unamended areas at both sites. However, trace metal concentrations are higher in tree rhizospheres compared with local references, and RI values are in the considerable risk range for Penga Penga (RI = 533) and very high (&gt;1500) for Kipushi. Bioconcentration factor values are below 1, indicating low accumulation in roots, wood, and leaves, and low risk of contamination of the trophic chain. In this context, it seems that the pollution indices used are unsuitable for assessing the effectiveness of phytotechnology processes based on metal stabilization. Direct plant performance measurements combined with direct measurements of metals in substrates and plants to assess transfer and efficiency are more appropriate.

(1) Background: Cameron County, which is located in the Rio Grande Valley, holds historical records for storm surges with noticeable property damage, fatalities, and injuries; (2) Methods: using storm surge hazard datasets from the National Oceanic and Atlantic Agency (NOAA), and American Community Survey (ACS) 2019 datasets and Geographic Information System (GIS), the study estimates at-risk population and their socio-demographic attributes; (4) Conclusions: Estimated water levels of a storm surge could be reached up to 5 feet in category 1 event, 9 feet in category 2, 17 feet in category 3, and above 20 feet in category 4 and 5. In the category 5 event, there is an estimated 37% (159,659) of the total county’s population (434,294) will be under flooded water. Suggestions are made to better prepare and successfully evaluate.

Having sustained, over the course of more than two decades, record-breaking natural catastrophe losses, American insurers and reinsurers are justifiably questioning the potential linkage between anthropogenic climate change and extreme weather. Here, we explore issues pertaining to this linkage, looking at both the likely short-term implications for the insurance industry, as well as potential longer-term impacts on financial performance and corporate resilience. We begin our discussion with an overview of the implications that climate change is likely to have on the industry, especially as it relates to how catastrophic risks are construed, assessed, and managed. We then present the rudiments of an econometric analysis that explores the financial resilience of the property/casualty (P/C) industry in the face of both natural and man-made catastrophes. In this analysis, we explore the profitability consequences of several illustrative scenarios involving large-scale losses from extreme weather—specifically, a sequence of storms like those striking the U.S. in 2004—and a scenario that explores the prospect of a Katrina-scale storm in combination with a mass terror attack on the scale of 9/11. At systemic levels of aggregation, our analysis suggests a high degree of macro-resilience for the insurance industry. Moreover, we find that insurer resilience is higher for larger impacts, considering both the speed of recovery, as well as the inverse of the area under the unaffected system profile. We conclude with a summary of our findings and a closing commentary that explores the potential implications of these results for P/C insurers moving forward.

Methanol is a natural ingredient with major occurrence in fruit spirits, such as apple, pear, plum or cherry spirits, but also in spirits made from coffee pulp. The compound is formed during fermentation and the following mash storage by enzymatic hydrolysis of naturally present pectins. Methanol is toxic above certain threshold levels and legal limits have been set in most jurisdictions. Therefore, the methanol content needs to be mitigated and its level must be controlled. This article will review the several factors that influence the methanol content including the pH value of the mash, the addition of various yeast and enzyme preparations, fermentation temperature, mash storage, and most importantly the raw material quality and hygiene. From all these mitigation possibilities, lowering the pH value and the use of cultured yeasts when mashing fruit substances is already common as best practice today. Also a controlled yeast fermentation at acidic pH facilitates not only reduced methanol formation, but ultimately also leads to quality benefits of the distillate. Special care has to be observed in the case of spirits made from coffee by-products which are prone to spoilage with very high methanol contents reported in past studies.

The effects of climate change on yield and quality for different climate regions had high uncertainty. Risk assessment is an effective measure to assess the seriousness of the projected impacts for decision-makers. The modified quality model was used to simulate integrated impacts of climate change, environment and management on wheat yield and quality. Then, the Canadian Earth System Model (CanESM2) was used to forecast the daily meteorological data, and Statistical Down Scaling Model was used for downscaling. CERES-Wheat was combined with the forecasted meteorological data to simulate the future wheat yield and grain protein concentration (GPC). The risk of wheat yield and quality in three climatic regions of Shaanxi combined with two climate change scenarios of CanESM2 were assessed. Temperature increased 0.22-3.34 °C and precipitation increased 10-60 mm for RCP4.5 and RCP8.5. Elevated temperature and precipitation had positive effects on yield in all regions. The yield risk of most regions with climate change decreased 3.8%-25.1%. The GPC risk of all regions with climate change decreased 7.3%-27.2%. Irrigation decreased yield risk greatly in all regions, while had totally different effects for the three climatic regions. Yield risk with irrigation decreased 37.7%-52.1% in different climate. In contrast to previous studies, GPC risk with irrigation increased greatly 25.8%-28.9% in humid region, 3.9%-8.8% in sub-humid region, and decreased 37.7%-52.1% in semi-arid region. Climate change decreased yield risk and GPC risk together. While irrigation decreased yield risk greatly in all regions, had totally different effects for the three climatic regions.

Cash crops are agricultural crops intended to be sold for profit as opposed to subsistence crops, meant to support the producer, or to support livestock. Since cash crops are intended for future sale, they translate into large financial value when considered on a wide geographical scale, so their production directly involves financial risk. At a national level, extreme weather events including destructive rain or hail, as well as drought, can have a significant impact on the overall economic balance. It is thus important to map such crops in order to set up insurance and mitigation strategies. Using locally generated data -such as municipality-level records of crop seeding- for mapping purposes implies facing a series of issues like data availability, quality, homogeneity etc. We thus opted for a different approach relying on global datasets. Global datasets ensure homogeneity and availability of data, although sometimes at the expense of precision and accuracy. A typical global approach makes use of spaceborne remote sensing, for which different land cover classification strategies are available in literature at different levels of cost and accuracy. We selected the optimal strategy in the perspective of a global processing chain. Thanks to a specifically developed strategy for fusing unsupervised classification results with environmental constraints and other geospatial inputs including ground-based data, we managed to obtain good classification results despite the constraints placed. The overall production process was composed using ``good-enough" algorithms at each step, ensuring that the precision, accuracy, and data-hunger of each algorithm was commensurate to the precision, accuracy, and amount of data available. This paper describes the tailored strategy developed on the occasion as a cooperation among different groups with diverse backgrounds, a strategy which is believed to be profitably reusable in other, similar contexts. The paper presents the problem, the constraints and the adopted solutions; it then summarizes the main findings including that efforts and costs can be saved on the side of Earth Observation data processing when additional ground-based data are available to support the mapping task.

Previous reviews have investigated machine learning (ML) models used to predict the risk of developing preeclampsia but have not described how the ML models are intended to be deployed throughout pregnancy or feature performance. The aim of this study is to provide an overview of the existing ML models and their intended deployment patterns and performance along with identified features of high importance. This review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. PubMed, Engineering Village, and the Association for Computing Machinery were searched between January and February 2024. A total of 86 studies were found of which 14 were included. Out of 12 studies, eight showed the intent to use the ML model as a single-use, two intended a dual-use, and two intended multiple-use. A total of seven studies listed the features of the highest importance. Systolic and diastolic blood pressure were listed along with mean arterial pressure to be of high importance. Out of four studies intending to use the ML model more than a single-use, three of them were conducted in the years 2023 and 2024, whereas the remaining study is from 2011. No ML model emerged as superior across the subgroups of PE. Utilizing body mass index and either mean arterial pressure or diastolic blood pressure and systolic blood pressure may benefit the performance. The deployment patterns are mainly single use being within the gestation weeks 11+0 to 14+1.

Survival models have become popular for credit risk estimation. Most current credit risk survival models use an underlying linear model. This is beneficial in terms of interpretability but is restrictive for real-life applications since it cannot discover hidden nonlinearities and interactions within the data. This study uses discrete time survival models with embedded neural networks as estimators of time to default. This provides flexibility to express nonlinearities and interactions between variables, and hence allows for models with better overall model fit. Additionally, the neural networks are used to estimate Age-Period-Cohort (APC) models so that default risk can be decomposed into time components for loan age (maturity), origination (vintage) and environment (e.g., economic, operational and social effects). These can be built as general models, or as local APC models for specific customer segments. The local APC models reveal special conditions for different customer groups. The corresponding APC identification problem is solved by a combination of regularization and fitting the decomposed environment time risk component to macroeconomic data, since the environmental risk is expected to have a strong relationship with macroeconomic conditions. Our approach is shown to be effective when tested on a large publicly available US mortgage data set. This novel framework can be adapted by practitioners in the financial industry to improve modelling, estimation and assessment of credit risk.

Purpose: To identify factors linked with nutritional risk via the Malnutrition Universal Screening Tool scale assessment among critically ill patients from a hospital in Cali (Colombia). Materials and methods: A retrospective, analytical observational study was conducted with patients admitted to an intensive care unit (ICU). Sociodemographic, clinical, hematological, and biochemical parameters were analyzed, as well as their association with nutritional risk and patient mortality. Binary logistic regression was applied to outline nutritional risk. Results: Overall, 28.4% prevalence of elevated nutritional risk was observed. An association was found between nutritional risk and hemoglobin and hematocrit values, primary diseases accounting for ICU admission, gastrointestinal symptoms, and nutritional support route (p < 0.05). Mortality was 11.6% and it was correlated with nutritional risk, hemoglobin, and blood urea nitrogen. Conclusions: Gastrointestinal symptoms and the type of nutritional support received during hospitalization may increase nutritional risk, whereas polycythemia was a protective factor. We found an associative model to determine nutritional risk with high specificity and an adequate diagnostic validity index.

Pollution of urban surface dust with hazardous elements (HEs) is a serious environmental issue due to its toxicity and potential hazardous effects. Surface dust samples were collected from core urban, urban, and suburban gradients in the Urumqi city of the arid NW China, and the concentrations of six HEs, such as arsenic (As), cadmium (Cd), nickel (Ni), lead (Pb), mercury (Hg), and chromium (Cr), were determined. The pollution load index (PLI) and the US EPA health risk assessment model were applied to analyze and compare the pollution levels and potential health risk of HEs in surface dusts in different urbanization gradients. The obtained results indicate that the average concentrations of Hg, Cd, and Ni in surface dust decrease in the order of core urban > urban > suburban, whereas the average concentrations of As, Cr, and Pb decrease in the order of urban > core urban > suburban. The PLI of HEs in surface dust decreased in the order of core urban > urban > suburban. The concentrations of HEs in the core urban and urban gradients are relatively higher than in the suburban gradient. Furthermore, the total non-carcinogenic and carcinogenic risk index of investigated HEs in surface dust decrease in order of urban > core urban > suburban, for both adults and children. In addition, the pollution of surface dust with HEs in all urbanization gradients is more harmful to the children's health than to the adults. Overall, the potential non-carcinogenic and carcinogenic health risks of the investigated HEs, instigated primarily by oral ingestion of surface dust, are found to be within the acceptable range. However, urbanization can effects the accumulation of HEs in surface dust, and Cr is the main non-carcinogenic risk factor, whereas Cd is the main carcinogenic risk factor among the analyzed HEs in surface dust in all urbanization gradients.

The long-term laboratory aspects of the effects of COVID-19 on liver function are still not well understood. Therefore, this study aimed to evaluate the hepatic clinical-laboratory profile of patients with up to 20 months of long-term COVID-19. A total of 243 patients of both sexes aged 18 years or older hospitalised in the acute phase of COVID-19 were included in this study. Liver function analysis was performed. Changes were identified in the mean levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), gamma-glutamyl transferase (GGT), and ferritin. Inflammatory markers such as ferritin > 300 U/L were observed in the group that presented more changes in liver function markers (ALT, AST, and GGT). Age ≥ 60 years, male sex, AST > 25 U/L, and GGT ≥ 50 or 32 U/L were associated with ALT > 29 U/L. There was a correlation between ALT and AST, LDH, GGT, and ferritin. Our findings suggest that ALT and AST levels may be elevated in patients with long-term COVID, especially in those hospitalised in the acute phase. In addition, ALT > 29 U/L was associated with other markers of liver injury, such as LDH, GGT, and ferritin.

In this study, we used the natural and anthropogenic characteristics of a coastal region to generate risk maps showing vulnerability and potential hazards, and proposed design criteria for coastal defense and land use for the various kinds of risks faced. The Yunlin coast: a first-level protection area in mid-west Taiwan, was then used as an example to illustrate the proposed design criteria. The safety of the present coastal defenses and land use of the Yunlin coastal area was assessed, and coastal protection measures for hazard prevention were proposed based on the generated risk map. The results can be informative for future coastal management and the promotion of sustainable development of coastal zones.

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.

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

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

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

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

OBJECTIVE: To investigate the value of serum inflammatory factor levels in acute ischemic stroke patients after revascularization therapy in assessing acute prognosis. METHODS: 94 patients with acute ischemic stroke who underwent revascularization therapy admitted to our hospital from January 01, 2022 to January 01, 2024 were studied. The main evaluation index was modified Rankin Scale score (mRS) after 3 months, and patients with mRS score >2 were categorized into the poor prognosis group, and the rest were the good prognosis group. As well as the treatment of revascularization in all patients was used as a division into a thrombus extraction group and an intravenous thrombolysis group. Logistic regression analysis was applied to explore the independent risk factors for the prognosis of patients treated with recanalization for acute ischemic stroke. RESULTS: Two groups with good (59 cases) and poor (35 cases) prognosis were divided according to the mRS score. There were some differences in age, gender, emergency GLU, INR, whether they had diabetes or hypertension and other contents between the two groups, but the differences were not statistically significant. The NIHSS score, hospitalization days, previous cardiac history, hospitalization days, LDL, fasting glucose, IL-6, and TNF-a at the time of admission were lower than those in the poor prognosis group, and the difference was statistically significant. In the patients in the embolization group, there were some differences in age, gender, emergency GLU, INR, whether they had diabetes or hypertension and other contents between the two groups, but the differences were not statistically significant. The pre-hospital NHISS score, IL-6, and TNF-a of patients in the good prognosis group were lower than those in the poor prognosis group, and the difference was statistically significant. CONCLUSION: IL-6 and TNF-α may be used as predictors of prognosis after revascularization therapy for acute ischemic stroke, and this conclusion also applies to patients in the embolization group.

The pathophysiology of bipolar disorder (BD) remains mostly unclear. Yet, a valid biomarker is necessary to improve early detection of this serious disorder. Patients with manifest BD display reduced volumes of the hippocampal subfields and amygdala nuclei. In this pre-registered analysis, we used structural MRI (N=271, 7 sites), to compare volumes of hippocampus, amygdala, and their subfields/nuclei between help-seeking subjects divided in risk groups for BD as estimated by BPSS-P, BARS and EPIbipolar. We performed between-group comparisons using linear mixed effects models for all three risk assessment tools. Additionally, we aimed to differentiate the risk groups using linear support vector machine. We found no significant volume differences between the risk groups for all limbic structures during the main analysis. However, the SVM could still classify subjects at risk according to BPSS-P criteria with a balanced accuracy of 66.90% (95% CI 59.2– 74.6) for 10-fold cross-validation and 61.9% (95% CI 52.0– 71.9) for leave-one-site-out. Structural altera-tions of hippocampus and amygdala may not be as pronounced in young people at risk, nonetheless, ma-chine learning can predict estimated risk for BD above chance. This suggests that neural changes may not merely be a consequence of BD and may have prognostic clinical value.

The aim of the present study was to evaluate the association between television viewing/physical activity (TVV/PA) interactions and cardiometabolic risk in an adult European population. A total of 2,155 subjects (25-64 years) (45.2% males), a random population-based sample were evaluated in Brno, Czechia. TVV was classified as low (&lt;2hours/day), moderate (2-4), and high (≥4). PA was classified as insufficient, moderate, and high. To assess the independent association of TVV/PA categories with cardiometabolic variables, multiple linear regression was used. After adjustments, significant associations were: high TVV/insufficient PA with body mass index (BMI) (β=2.61,SE=0.63), waist circumference (WC) (β=7.52,SE=1.58), body fat percent (%BF) (β=6.24,SE=1.02), glucose (β=0.25,SE=0.12), triglycerides (β=0.18,SE=0.05), and HDL-C (β=-0.10,SE=0.04); high TVV/moderate PA with BMI (β=1.98,SE=0.45), WC (β=5.43,SE=1.12), %BF (β =5.15,SE=0.72), triglycerides (β =0.08,SE=0.04), total cholesterol (β=0.21,SE=0.10), LDL-c (β=0.19,SE=0.08), and HDL-c (β=-0.07,SE=0.03); and moderate TVV/insufficient PA with WC (β=2.68,SE=1.25), %BF (β=3.80,SE=0.81), LDL-c (β=0.18,SE=0.09), and HDL-c (β=-0.07,SE=0.03). Independent of PA levels, higher TVV was associated with higher amounts of adipose tissue. Higher blood glucose and triglycerides were present in subjects with high TVV and insufficient PA, but not in those with high PA alone. These results affirm the independent cardiometabolic risk of sedentary routines even in subjects with high-levels of PA.

This study is the first to examine whether the performance of credit rating, one of the most important data-based decision-making of banks, can be improved by using banking system log data that is extensively accumulated inside the bank for system operation. This study uses the log data recorded for the mobile app system of Kakaobank, a leading internet bank used by more than 14 million people in Korea. After generating candidate variables from Kakaobank's vast log data, we develop a credit scoring model by utilizing variables with high information values. Consequently, the discrimination power of the new model compared to the credit bureau grades was significantly improved by 1.84% points based on the Kolmogorov–Smirnov statistics. Therefore, the results of this study imply that if a bank utilizes its log data that have already been extensively accumulated inside the bank, decision-making systems, including credit scoring, can be efficiently improved at a low cost.

Past exploration for U deposit in the Philippines discovered the mineralization of radioactive allanite in Palawan. The allanite occurs as sand component in the heavily populated beach of Erawan, San Vicente, Palawan. This work assessed the risks associated with the radionuclides in Erawan beach by in situ ground radiometric survey of K, U, and Th in 694 sampling points. Principal component analysis (PCA) and Pearson correlation coefficient were used to determine the similarity between the radionuclides and to identify other probable anthropogenic sources of radionuclides. Our results show that the mean activity concentrations of K (597.8 Bq kg^-1) and Th (93.15 Bq kg^-1) are equivalent to 1.5 and 3.1 times of the world average natural radioactivity levels in soil, respectively, while the mean U (34.7 Bq kg^-1) is similar to the world average. The mean radiological risk assessments like radium equivalent, gamma specific activity index, external hazard index, internal hazard index, absorbed gamma dose rate, annual effective dose equivalent, annual gonadal equivalent dose, and excess lifetime cancer risk are 213.96 Bq kg^-1, 0.78, 0.58, 0.67, 97.24 nGy h^-1, 119.25 µSv y^-1, 684.39 µSv y^-1, and 0.42 (10^-3), respectively. Th consistently correlated most to the risks. We attribute the occurrence of Th to the presence of allanite, K to fertilizer use for farming, and U to both the allanite and farming. The results of our study can provide important baseline data for future detailed studies or monitoring of the long-term effects of elevated radiation levels to the local population of Erawan.

Due to the high effectiveness of cancer screening and therapies, the diagnosis of second primary cancers (SPCs) has increased in women with endometrial cancer (EC). However, there’s no previous literature mentioned about adequate evidence to support screening for SPCs in endometrial cancer. This study was aimed to develop effective risk prediction models of second primary endometrial cancer in women with obesity (Body-mass index; BMI > 25) and this study includes datasets of the incidence of SPCs and the other risks of SPCs in 4480 primary cancer survivors by a hospital-based cancer registry database. In our study, we found the obesity played a key role in SPCs. There’re 10 independent variables used as predicting variables, which corelated to obesity should be monitored for the early detection of SPCs in endometrial cancer. In conclusion, it is a promising SPCs prediction. The proposed scheme can support the important influence of obesity and clinical data representations in all cases after primary treatments. Our results suggested that obesity is still a crucial risk factor to SPCs in endometrial cancer.

Understanding African swine fever virus (ASFV) transmission is essential for strategies to minimize virus spread during an outbreak. ASFV can survive for extended time periods in animal products, carcasses, and the environment. While ASFV genome was found in the environment around infected farms, data on the virus survival in soil are scarce. We investigated different soil matrices spiked with ASFV-positive blood from infected wild boar to see if ASFV can remain infectious in the soil beneath infected carcasses. As expected, ASFV genome detection was possible over the entire sampling period. Soil pH, structure, and ambient temperature played a role for the stability of infectious ASFV. Infectious ASFV was demonstrated in specimens originating from sterile sand for at least three weeks, from beach sand for up to two weeks, from yard soil for one week, and from swamp soil for three days. Virus was not recovered from two acidic forest soils. All risk mitigation experiments with citric acid or calcium hydroxide resulted in complete inactivation. In conclusion, stability of infectious ASFV is very low in acidic forest soils but rather high in sandy soils. However, given the high variability, treatment of carcass collection points with disinfectants should be considered.

This work analyzes the severity and risk associated with Automatic Dependent Surveillance-Broadcast (ADS-B) message drop out in Detect and Avoid (DAA) function of Unmanned Aircraft System (UAS). Performance assessment of the Universal Access Transceiver (UAT) ADS-B message implies that in some cases ADS-B fails to update within a specified update interval, which is referred to as drop out in this work. ADS-B is a fundamental surveillance sensor for both class 1 and class 2 DAA systems. Message loss or drop out has been found as one of the common limitations of the ADS-B system. The key feature of this study is incorporating the update rate of real ADS-B data transmitted from the manned aircraft. The data were received from the Grand Forks International Airport, North Dakota. Monte Carlo method has been adopted to resolve encounter scenarios in the presence of drop out. The change in the alert triggered by the UAS DAA in the presence of ADS-B drop out has been investigated. Furthermore, the risk matrices are created to quantify the associated risk with drop out affected alerts. Simulation results depict that both the duration of drop out and DAA look-ahead time affect the alert-triggering function of UAS. With a small look- ahead window and longer duration of drop out, the number of warning alerts increases. Also, alerts are affected more during an overtaking encounter than that of a head-to-head encounter. A system-level analysis is also carried out to recognize the potential reasons behind the ADS-B drop out.

Although the European reports highlight an increase in community-acquired Legionnaires’ disease cases, the risk of Legionella spp. in private houses is underestimated. In Pisa (Italy) we performed a three-year survey on Legionella presence in 121 buildings with an independent hot water production (IB); 64 buildings with a central hot water production (CB); and 35 buildings with a solar thermal system for hot water production (TB). From all the 220 buildings Legionella spp. was researched in two hot water samples collected either at the recirculation point or at on the first floor and on the last floor, while the potable water quality was analyzed in three cold water samples collected at the inlet from the aqueduct network, at the exit from the autoclave, and at the most remove remote? tap. Legionella pneumophila sg1, Legionella pneumophila sg2-16 and not-pneumophila Legionella species were detected in 26% of the hot water networks, mostly in CB and TB. In these buildings we detected correlations between the presence of Legionella and the total chlorine concentration decrease or/and the increase of the temperature. Cold water resulted free from microbiological hazards, with the exception of Serratia liquefaciens and Enterobacter cloacae isolated at the exit from two different autoclaves. We observed an increase in total microbial counts at 22 and 37°C between the samples collected at the most remote taps compared to the ones collected at the inlet from the aqueduct. The study highlights a condition of potential risk for susceptible categories of population and supports the need for measures of risk assessment and control.

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.

This study sought to spatially characterise and explain the differences of peoples’ perceptions on the impact of COVID-19 based on the socio-economic disparities in Gauteng, using choropleth mapping and Geographically Weighted Regression (GWR). Results indicate that respondents from relatively vulnerable municipalities like Merafong, Mogale City and Lesedi reported life being worse, information scant, and overall despondency being high since COVID-19. These are areas that fall under the High to Very High categories in terms of the Socio-economic Risk Index. GWR results, however, did not show a high explanatory power on the COVID-19 variables se-lected for the research, based on R2 values. For instance, the residual in overall satisfaction with life after COVID-19 was the lowest (-0.5 to 0.5) in the less affluent districts of the Rand West City and Sedibeng. Residual variables on life changes after COVID-19 were also the lowest in the southern parts of the same districts, with other low values almost evenly distributed throughout the province for the variable ‘Government information on COVID-19 was scant’. Although overestimation and underestimation existed, most were relatively low falling between -1.5 to -0.5 and distributed evenly across the province. In sum, however, the findings point to the complexity of socio-economic factors in spatially characterising social risk and vulnerability. Additionally, the negative sentiments expressed by people from the more vulnerable locations in the province emphasise the need for more targeted interventions by government to cushion the residents of the province to the continued negative impacts of COVID-19.

In the overall context of national eco-conservation civilization development and considering the hills in the Beijing-Tianjin-Hebei-Shanxi region, the local forest coverage rate is gradually on the rise, and so is the risk of forest fire. Every year, satellites can monitor and detect hundreds of fire spots on average. In recent years, serious fire took place for several times, leading to loss of life and personal injury. Then the fire-fighting work consumed huge amount of labor and material resources, exerting negative social impacts in many ways. Thus, the analysis of fire climate background in this region and the forecast based on fire weather indexes constitute an important part in the forest fire risk management. Located in the tropical monsoon climate zone, four provinces and municipalities of Beijing, Tianjin, Hebei and Shanxi are similar in terms of climate characteristics. This study tries to analyze the characteristics about fire spots under satellite monitoring, fire climate and fire weather index. The probability distribution analysis of weather index about fire spots in history and key meteorological observation stations as well as the weather index analysis in the early stage of typical fire indicate that the Fine Fuel Moisture Content (FFMC) and the Initial Spread Index (ISI) in the Fire Weather Index (FWI) system is applicable to the fire risk analysis in the Beijing-Tianjin-Hebei-Shanxi region, which can also effectively indicate the fuel moisture and spread conditions. As regards to the average level in Beijing-Tianjin-Hebei-Shanxi, when the FFMC is smaller than 93.5 and the ISI is also smaller than 5.0, there is a low risk of fire; when the FFMC is above 94 and the ISI is larger than 10.0, there is a high risk of fire; and the fire risk will be extremely high if the FFMC is over 96 and the ISI is above 13.0. In the practical fire-fighting management, the fire danger class can be released in reference to the ISI classes and threshold values of key meteorological observation stations under analysis provided by this study.

Obesity has become a rising global health problem affecting adults’ quality of life. The objective of this study was to describe the prevalence of obesity in Indonesian adults based on the cluster of islands. The study was also aimed to identify the risk factors of obesity in each island cluster. This study analysed secondary data of Indonesian Basic Health Research 2018. Our data for analysis comprised 688,638 adults (>=15 years) randomly selected using proportionate to population size throughout Indonesia. We included 20 variables for sociodemographic and obesity-related risk factors for analysis. Obese status was defined using Body Mass Index (BMI) >= 27.5 kg/m2. Our current study defined seven major islands cluster as the unit analysis consisting of 34 provinces in Indonesia. Descriptive analysis was conducted to determine the characteristics of the population and to calculate the prevalence of obesity within provinces in each of the island’s clusters. Multivariate logistic regression analyses to calculate odds ratios (ORs) was performed using R version 3.6.3. The study results showed that all island clusters had at least one province with an obesity prevalence of more than 20%. Six out of twenty variables, comprising four diet factors (consumption of sweet food, high-salt food, meat food, and carbonated drinks) and two other factors (mental health disorders and smoking behaviour), varied across the island clusters. In conclusion, there was a variation of obesity prevalence of the provinces within and between island clusters. Variation of risk factors raised in each cluster island suggested the government rethink and reframe the intervention to address obesity.

Several treatment guidelines for sporadic, nonmetastatic nonfunctioning neuroendocrine tumors of the pancreas (NF-pNETs) have recommended resection, however, tumors ≤ 2 cm do not necessarily need surgery. This study aimed to establish a surgical treatment plan for NF-pNETs ≤ 2 cm. From 2000 to 2017, 483 patients who underwent resection for NF-pNETs ≤ 2cm in 18 institutions from Korea and China were enrolled and their medical records were reviewed. Median age was 56 (range 16- 80) years. The 10-year overall survival rate (10Y-OS) and recurrence-free survival rate (10Y-RFS) were 89.8 and 93.1%, respectively. In multivariable analysis, tumor size (> 1.5cm; p = 0.001) and nodal metastasis (p = 0.013) were independent adverse prognostic factors for OS. Perineural invasion (p = 0.008) and high Ki-67 index (≥3%; p < 0.001) were independent prognostic factors for poor RFS. NF-pNETs ≤ 2 cm showed unfavorable prognosis after resection when the tumor was larger than 1.5cm, Ki-67 index ≥ 3%, or nodal metastasis was present. NF-pNET patients with tumors ≤ 1.5cm can be observed if the preoperative Ki-67 index is under 3%, and if nodal metastasis is not suspected in preoperative radiologic studies. These findings support the clinical use to make decision about small NF-pNETs.

Zoonotic abortive diseases represent a significant health and economic risk for national public health. This cross-sectional survey was conducted from April to October 2021 among 200 selected small ruminant farmers in the three northern regions of Cameroon. Data collection was done through questionnaires administered by exchange with the herder and responses were coded and recorded on an Excel spreadsheet. The data were then analyzed with R software, version 2.13.0. An ANOVA test was used to assess significant differences in mean of Knowledge, Attitudes, Practices and Perception of zoonotic risks (KAPP) scores between regions. Pearson correlations were used to calculate the association between KAPP scores within regions. Small ruminant farmers surveyed had low mean scores for knowledge of abortive Toxoplasmosis and Chla-mydophilosis (0.1 ± 0.2), desirable attitude (0.32 ± 0.07), appropriate practice (0.36 ± 0.13) in managing abortion, and positive perception of zoonotic risks of Toxoplasmosis and Chlamydo-philosis in small ruminants (0.12 ± 0.33), respectively. KAPP was significantly (p<0.01) and posi-tively associated with knowledge (r=0.98) and risk perception (r=0.99). However, attitudes (r=0.06), practices (r=0.05) and risk perception of toxoplasmosis (r=0.07) and Chlamydophilosis (r=0.08) were not associated with farmers' knowledge. This study revealed significant knowledge gaps, low levels of desired attitudes, and high-risk behavioral practices. These results therefore call for capacity building of health professionals and farmers to better integrate the One Health concept in the management of neglected zoonotic diseases.

Exploring the contribution of proximal family risk factors on SLC6A4 DNA methylation in children with a history of maltreatment

Objective: This study aimed to explore potential interventions or preventive measures to reduce the incidence of falls among the elderly in the Madinah region, and to provide recommendations for healthcare professionals, policymakers, and community stakeholders to enhance fall prevention strategies and improve the overall well-being of the elderly population in this area. Methods: The study adopted a cross-sectional study design, and was carried out in the Madinah region using convenient physical assignment among of Saudi and non-Saudi local residents aged 65 years and over. Questionnaire surveys were circulated and demographic characteristics were collected, including participants’ fall experience and health status data over the past year, in order to assess the incidence of falls among the elderly population. This design allows for the collection of data at a single point in time, aiming to evaluate the prevalence, risk factors, and consequences of falls among the target population. Results: A total of 189 participants were recruited to the study, and the data indicated that the prevalence of falls among those aged 65 years and older in the past year was 41.5%. We found that 73% of the participants had experienced falls and post-fall injuries within the past 12 months. There were minimal differences in terms of physical handicapped cases found between those with and without a fall history. Logistic regression analysis revealed a significant link between fall experience and maximum bite force. Conclusion: There is a high prevalence of falls in the elderly population in the Madinah region. Our study reveals that 50.79% of our elderly participants had experienced more than one fall during the preceding year. Some preventable risk factors were identified in an analysis of their daily routines. The impacts of these risk factors have potential consequences for their healthy lives.

This study probes the probabilistic features of major fire hazards in enclosed spaces to establish their importance to the occurrence of fires onboard ro-ro passenger ships and in turn to raise effective operational countermeasures. Distinct from the previous studies, the present research employs Bayesian Network (BN) analysis to determine the probabilities of fire hazards more effectively. The findings of the research include five critical basic events (BE) identified namely, vehicle engine fire (fuel system fault), vehicle electric fire (electrical equipment defect or short circuit), used car electrical fire, reefer units electrical fire (electrical appliances defects or short circuit), and cargo spontaneous combustion. Additionally, the risk of fire for lithium - ion battery powered vehicles is also highlighted in the process of BN analysis, which prompts the authors to propose preventive measures for mitigating the possibility of fire occurrence on this type of electric vehicles. It is hoped that these measures can be essential justifications for establishing relevant rules regarding carrying LIB vehicles in enclosed spaces on international level.

Background:Peripheral neuropathy (PN) can result in either partial or complete loss of distal sensation resulting in an increased fall risk. Walkasins^® uses a shoe insert to detect the magnitude and direction of sway and sends signals to a leg unit that provides sensory balance cues. The objective of this case report is to describe the long-term influence of the Walkasins^® lower limb sensory neuroprosthesis on balance and gait for an individual with diabetic PN.Case Description:A fifty-one-year-old male with a 3-year history of PN and a 10-year history of type II diabetes mellitus was fitted with Walkasins^® and utilized the shoe inserts 8-10 hours/day for more than 1 year. Although, vibration and tactile thresholds were severely impaired at his 1^st metatarsophalangeal joint and the lateral malleolus bilaterally he could perceive tactile stimuli from the Walkasins^® above the ankles.Outcomes:Following Walkasins^® use, his Activities-specific Balance Confidence Scale (ABC) scores improved from 33% to 80%. His mean Vestibular Activities of Daily Living (VADL) scores decreased from 3.54 to 1. His Functional Gait Assessment (FGA) scores increased from 13/30 to 28/30 and his miniBESTest scores improved from 15/28 to 26/28. Gait speed increased from 0.23 m/sec to 1.5 m/sec. The patient described a decrease in pain and cramping throughout his lower extremities and an increase in function.Discussion:Gait and balance improved with the use of the Walkasins^® and participation in the Neuro Wellness Program. This improvement suggests that the use of sensory substitution devices, such as the Walkasins^®, may replace sensory deficits related to gait and balance dysfunction experienced by patients with PN. Further research is needed to determine if other patients will have a similar response and what the necessary threshold of sensory function is to benefit from use of the Walkasins^®.

This study aims to evaluate the patient’s dose exposure from Computed Tomography Pulmonary Angiography (CTPA) examination and to estimates the cancer risk induced from the examinations based on the patient’s size. One hundred patients were recruited, and data information was collected retrospectively. A multi-detector (MDCT) (Philips Brilliance 128, USA) scanner were utilized for the CTPA examination, and dose data were obtained from the system. The effective diameter of each subjects’ image was measured for the Size-specific dose estimates (SSDEs). All subjects divided into Group 1 (19 – 25 cm), Group 2 (25-28 cm) and Group 3 (28-38 cm), where the association between gender were analysed. Effective dose (E), SSDE, organ dose and cancer risk of each group were evaluated and compared statistically using independent t-test and one-way ANOVA. The range of mean CTDI_vol, DLP and E values were (6.44 – 17.42 mGy), (239 – 631 mGy), (5.19 – 13.90 mSv), respectively. In respective with the patient’s effective diameter, the mean SSDE value for Group 1, Group 2 and Group 3 were 9.93 ± 3.89 mGy, 13.70 ± 9.04 mGy and 22.29 ± 7.35 mGy. The organ dose and cancer risk attained for breast, lung and liver were 17.05 ± 10.40 mGy (194 per one million procedure), 17.55 ± 10.86 mGy (192 per one million procedure) and 15.04 ± 9.75 mGy (53 per one million procedure), respectively. Lung and breast with more massive patient’s effective diameter received the highest dose exposure which increases the probability of the cancer risk. CTDI_vol was found to be underestimated, and SSDE provides more accurate in describing the radiation dose and cancer risk. Body effective diameter found to be significant on the estimation except for gender. Therefore, it is essential to apply optimised protocols in order to reduce patient’s exposure during CTPA examination.

The world is currently experiencing the fourth industrial revolution driven by the newest wave of digitisation in the manufacturing sector. The term Industry 4.0 (I4.0) represents at the same time: a paradigm shift in industrial production, a generic designation for sets of strategic initiatives to boost national industries, a technical term to relate to new emerging business assets, processes and services, and a brand to mark a very particular historical and social period. I4.0 is also referred to as Industrie 4.0 the New Industrial France, the Industrial Internet, the Fourth Industrial Revolution and the digital economy. These terms are used interchangeably in this text. The aim of this article is to discuss major developments in this space in relation to the integration of new developments of IoT and cyber physical systems in the digital economy, to better understand cyber risks and economic value and risk impact. The objective of the paper is to map the current evolution and its associated cyber risks for the digital economy sector and to discuss the future developments in the Industrial Internet of Things and Industry 4.0.

(1) Background: This study, drawing from the theoretical framework of the Theory of Planned Behavior (TPB), examines the structural relationship among attitudes, subjective norms, perceived behavioral control (PBC), and behavioral intention. The study focuses on investigating how the perceived risk associated with particulate matter moderates the relationships between 'attitudes and behavioral intention,' 'subjective norms and behavioral intention,' and 'PBC and behavioral intention' within the context of individuals engaged in outdoor sports; (2) Methods: The data were collected from outdoor sports gatherings facilitated through a popular South Korean sports meetup application. Confirmatory factor analysis was employed to establish the construct validity of the measurement scale, assess factor loadings, averaged variance extracted (AVE), and construct reliability (CR). We also ensured the reliability of the measurement scale through Cronbach's α analysis. To achieve our research objectives, we utilized structural equation modeling with maximum likelihood estimation to examine the positive relationships under investigation. Additionally, we performed moderation analysis using the statistical software Jamovi.; (3) Results: The findings demonstrate the significant impacts of attitudes, subjective norms, and PBC on behavioral intention and reveal that perceived risk acts as a moderator, influencing the relationship between PBC and behavioral intention.; (4) Conclusions: Therefore, the government will need to exert substantial efforts to mitigate particulate matter levels.

Fire risk can be defined as the probability that a fire will spread. Reliable monitoring of fire risk is essential for effective landscape management. Compilation of fire risk records enable identification of seasonal and inter-annual patterns and provide a baseline to evaluate the trajectories in response to climate change. Typically, fire risk is estimated from meteorological data. In regions with sparse meteorological station coverage environmental proxies provide important additional data stream for estimating past and current fire risk. Here we use a 60-year record of daily flows from two rivers (Franklin and Davey) in the remote Tasmanian Wilderness World Heritage Area (TWWHA) to characterize seasonal patterns in fire risk in temperate Eucalyptus and rainforests. We show that river flows are strongly related to landscape soil moisture estimates derived from down-scaled re-analysis of meteorological data available since 1990. To identify river flow thresholds where forests are likely to burn, we relate river flows to known forest fires that have occurred in the previously defined ecohydrological domains that surround the Franklin and Davey catchments. Our analysis shows that the fire season in the TWWHA is centered on February (70% of all years below the median threshold), with shoulders on December-January and March. Since 1954 forest fire can occur in at least one month for all but four summers in the ecohydrological domain that includes the Franklin catchment, and since 1964 fire fires could occur in at least one month in every summer in the ecohydrological domain that includes the Davey catchment. Our analysis shows that mangers can use river flows as a simple index that provide a landscape-scale forest fire risk in the TWWHA.

Research subjects of this study are four representative locations in the industrial complex, in the city of Banja Luka, Republic of Srpska, Bosnia and Herzegovina. 16 polycyclic aromatic hydrocarbons (PAHs) (∑16PAHs), humus and pH were determined. The main objective of the paper is to determine the concentration levels, to assess the probable sources of PAHs contamination in soil and groundwater and to determine the ecological risk. The ∑16PAHs in soil (at depths of 30 cm, 100 cm, 200 cm, 300 cm and 400 cm) ranged from 0.99 to 2.24 mg/kg, from 0.34 to 0.46, from 0.24 to 0.32, from 0.13 to 0.27 and from 0.13 to 0.47, with mean values of 1.70 mg/kg, 0.40 mg/kg, 0.28 mg/kg, 0.20 mg/kg and 0.26 mg/kg, respectively. The ∑16PAHs in groundwater ranged from 0.23 to 4.50 mg/m³, with a mean value of 1.42 mg/m³. Surface soil and groundwater are heavily contaminated. All values of ∑PAHs in soil layers were lower in the depths of the soil. Factor analysis indicates three sources of contamination, i.e. principal component (PC) PC1 (pyrogenic), PC2 (petrogenic) and PC3 (biomass), with 52.39%, 26.14% and 8.46% of the total variance, respectively. ∑PAH and PAHs indicate high ecological risk for most PAHs, which decreases with soil depth.