BRICS-Plus (Brazil, Russia, India, China, South Africa, and 30 other countries) is a group of 35 countries with emerging economies making up more than half of the world’s population. We explored epidemiological trends of cardiovascular disease (CVD) mortality attributable to modifiable risk factors and its association with period and birth cohort effects and sociodemographic index (SDI) across BRICS-Plus by using joinpoint regression and age-period-cohort (APC) modeling from 1990 to 2019. Between 1990 and 2019, the all-ages CVD deaths increased by 85.2% (6.1 million to 11.3 million) across BRICS-Plus. The CVD ASMR attributable to dietary risks and smoking significantly decreased across BRIC-Plus countries, with some exceptions. However, four-fifth of BRIC-Plus countries observed a remarkable increasing trend of high body mass-index (BMI)-related CVD deaths in particular among younger adults (25-49 years). Early birth cohorts and individuals aged greater than 50 years showed a higher risk of CVD mortality. Both China-ASEAN FTA and Mercosur regions stand out for their successful sociodemographic transition, with a significant reduction in CVD mortality over the study period. Singapore and Brazil achieved great progress in CVD mortality reduction and the other BRICS-Plus countries should follow their lead in adopting public health policies and initiatives into practice.

Teledermatology, the dermatological consultation and diagnosis via digital communication technologies, has become increasingly important in modern healthcare. The integration of teledermatology into clinical practice has gained significant interest, especially during the COVID-19 pandemic. Numerous studies have shown the effectiveness and reliability of teledermatology, with high levels of patient satisfaction and diagnostic accuracy. Pathpoint® eDerma is a cloud-based dermatology platform that aims to streamline the documentation and management of dermatological conditions. It offers several clinical benefits, including faster diagnosis, reduced unnecessary procedures, improved access to care, and cost savings. The platform follows a comprehensive risk management plan and complies with safety regulations. It undergoes regular recertification and reviews to ensure its safety and effectiveness. The clinical evaluation of eDerma confirms its ability to deliver significant clinical benefits while effectively mitigating risks. The benefit-risk ratio of eDerma is highly acceptable, supporting its use in clinical settings to enhance dermatological care.

Lipoproteins are important cardiovascular (CV) risk biomarkers. This study aimed to investigate the associations of lipoprotein subclasses with micro- and macrovascular biomarkers to better understand how these subclasses relate to atherosclerotic CV diseases. One hundred fifty-eight serum samples from the EXAMIN AGE study, consisting of healthy individuals and CV risk patients, were analyzed by nuclear magnetic resonance (NMR) spectroscopy to quantify lipoprotein subclasses. Microvascular health was quantified by measuring retinal arteriolar and venular diameters. Macrovascular health was quantified by measuring carotid-to-femoral pulse wave velocity (PWV). Nineteen lipoprotein subclasses showed statistically significant associations with retinal vessel diameters and nine with PWV. These lipoprotein subclasses together explained up to 26% of variation (R²=0.26, F(29,121)=2.80, p<0.001) in micro- and 12% (R²=0.12, F(29,124)=1.70, p=0.025) of variation in macrovascular health. High-density (HDL-C) and low-density lipoprotein cholesterol (LDL-C) as well as triglycerides together explained up to 13% (R²=0.13, F(3,143)=8.42, p<0.001) of micro and 8% (R²=0.08, F(3,145)=5.46, p=0.001) of macrovascular variation. Lipoprotein subclasses seem to reflect micro- and macrovascular end organ damage more precisely as compared to only measuring HDL-C, LDL-C and triglycerides. Further studies are needed to analyse how the additional quantification of lipoprotein subclasses can improve CV risk stratification and CV disease prediction.

COVID-19 appeared as an infectious disease of global health emergency and the highest public health concern of 21st century for this world due to its high-speed of spread across the globe. The disease started as one single case to a cluster of cases in Wuhan, China (Dec 2019) and within few months with its continuous upsurge of cases spreading globally which has created enormous threat and tension across the global Public health care field. Most significantly to share the fact that, this disease caused high level of Risk Group mortality, high morbidity, health care services burden, panic anxiety, mental trauma and tension, social and economic insecurity, which also collectively surfaced by diverse range of social reaction and political pressure across the world. Also with the appearance of new and unknown pathogenesis of the disease has created the most and significant attention and concern for the scientific community and political leaders as well. The disease also varies much with its pattern of virus, sign, symptoms, characteristics including its epidemiological and public health response (like prevention strategy, diagnoses, case management, treatment pattern) across the countries. However, this variance is comparatively less rather even more in commonality while it comes to basic public health prevention interventions like frequent hand washing, wearing face mask, maintaining social/physical distancing (2 - 6 meter in between), individual isolation and community quarantine for suspected exposure and lockdown in community areas where cases are identified. These are with the most commonly practiced public health interventions to deal with this disease in majority of the epicenters across countries. Also with the progress of the disease with its diverse categorical appearance of sign symptoms which are uniquely portraying this disease is more of a kind of COVID-19 syndrome than as COVID-19. Moreover, various factors including socio economic status, health status, population dynamics, health system and infrastructure, health behavioral pattern, nutrition and food habit and access to information and knowledge made this viral disease one of the historically counted on expensive disease of the modern world to fight for. Specially to mention here, the case fatality rate distinctively vary with the population dynamics and the health system infrastructure and ability factors which have already created clear evidence as explained in this paper how these factors are uniquely distinguished and different from country to country. Apart from the contextual differences, the various kind of ongoing preventive measures (like prevention, diagnosis and treatment) learnt every day from the emerging characteristics and pattern of this viral disease which are most commonly practiced across countries with a variance. According to the Public health prevention practice and interventions, the total world is connected and learning from each other’s public health experiences to fight for the virus. However, the world communities are eagerly waiting to see the result and outcome of the ongoing therapeutics and vaccine trial initiated in several countries, the people of the world are quite optimistic and hopeful that, global scientific community will be able to invent some miraculous and magic solution in upcoming months which ultimately will free the world from this most terrifying COVID-19 pandemic of 21st century.

To systematically investigate the epidemiology of breast cancer risk factors in Iran, we performed a systematic search via PubMed, Scopus, Web of Science and Persian databases for identifying studies published on breast cancer risk factors up to March 2019. Meta-analyses were done for risk factors reported in more than one study. We calculated odds ratios (ORs) with corresponding 95% confidence intervals (CIs) using a fixed/random-effects models.Thirty-nine studies entered into the meta-analysis. Pooling of ORs showed a significant harmful effect for risk factors including family history (OR: 1.80, 95%CI 1.47-2.12), HRT (OR: 5.48, 95%CI 0.84-1.74), ER positive (OR: 1.87, 95%CI 1.41-2.33), PR positive (OR: 1.84, 95%CI 1.38-2.29), stress condition (OR: 2.67, 95%CI 1.84-3.50), passive smokers (OR: 1.68, 95%CI 1.34-2.03), full-term pregnancy at age 30 (OR: 3.41, 95%CI 1.19-5.63), abortion (OR: 1.84, 95%CI 1.35-2.33), sweets consumption (OR: 1.71, 95%CI 1.32-2.11) and genotype Arg/Arg (crude OR: 1.59, 95%CI 1.07-2.10), whereas a significant protective effect for late menarche (OR: 0.58, 95%CI 0.32-0.83), nulliparity (OR: 0.68, 95%CI 0.39-0.96), 13 to 24 months of breastfeeding (OR: 0.68, 95%CI 0.46-0.90), daily exercise (OR: 0.59, 95%CI 0.44-0.73) and vegetable consumption (crude OR: 0.28, 95%CI 0.10-0.46).This study suggest that factors such as family history, HRT, ER and PR positive status, stress condition, passive smokers, late full-term pregnancy, abortion, sweets consumption and genotype Arg/Arg might increase risk of breast cancer development, whereas late menarche, nulliparity, 13-24 months breastfeeding, daily exercise and vegetable consumption had an inverse association with breast cancer development.

This paper contextualises the common queries of "why is crypto crashing?" and "why is crypto down?", the research transcends beyond the frequent market fluctuations to unravel how cryptocurrencies fundamentally work and the step-by-step process on how to create a cryptocurrency. The study examines blockchain technologies and their pivotal role in the evolving Metaverse, shedding light on topics such as how to invest in cryptocurrency, the mechanics behind crypto mining, and strategies to effectively buy and trade cryptocurrencies. Through an interdisciplinary approach, the research transitions from the fundamental principles of fintech investment strategies to the overarching implications of blockchain within the Metaverse. Alongside exploring machine learning potentials in financial sectors and risk assessment methodologies, the study critically assesses whether developed or developing nations are poised to reap greater benefits from these technologies. Moreover, it probes into both enduring and dubious crypto projects, drawing a distinct line between genuine blockchain applications and Ponzi-like schemes. The conclusion resolutely affirms the continuing dominance of blockchain technologies, underlined by a profound exploration of their intrinsic value and a reflective commentary by the author on the potential risks confronting individual investors.

Cardiovascular diseases (CVDs) constitute the first cause of death among the population of developing and developed countries. Atherosclerosis, which is a disorder with multifactorial etiopathogenesis, underlies most CVDs. The available literature includes ample research studies on the influence of classic cardiovascular (CV) risk factors. However, environmental exposure to heavy metals, among other substances, is still an unappreciated risk factor of CVDs. This study aimed to assess the concentration of some heavy metals (copper (Cu), zinc (Zn), manganese (Mn), cobalt (Co), and iron (Fe)) in the blood serum of postmyocardial infarction (post-MI) patients and patients free from myocardial infarction (MI) as well as estimate the relationship between the occurrence of MI and increased concentration of heavy metals. The concentration of heavy metals (Cu, Zn, Mn, Co, and Fe) was assessed using the inductively coupled plasma mass spectrometry technique in a group of 146 respondents divided into two groups: post-MI group (study group (SG), n = 74) and group without cardiovascular event (CVE) having a low CV risk (control group (CG), n = 72). The concentration of the analyzed heavy metals was higher in SG. All the heavy metals showed a significant diagnostic value (p < 0.001). The highest value of area under the curve (AUC) was observed for manganese (Mn) (0.955; 95% confidence interval (CI) = 0.922–0.988), while the lowest value was found for zinc (Zn) (0.691; 95% CI = 0.599–0.782). In one-dimensional models, high concentrations of each of the analyzed heavy metals significantly increased the chances of having MI from 7-fold (Cu) to 128-fold (Mn). All the models containing a particular metal showed a significant and high discrimination value for MI occurrence (AUC 0.72–0.92). Higher concentrations of Cu, Zn, Mn, Co, and Fe were found to considerably increase the chances of having MI. Considering the increasingly higher environmental exposure to heavy metals in recent times, their concentrations can be distinguished as a potential risk factor of CVDs.

The widespread integration and growing dependence among currency, stock and commodity markets make these markets often very vulnerable to shocks and at risk of collapse at the same time. As a result, these trends threaten the sustainability of the entire financial system. In this study, we explore the spillovers and nonlinear dependences between the seven major foreign ex-change rates, crude oil and gold prices, a global stock price index, and oil and stock implied volatility indices as proxy variables for global risk factors by em-ploying directional spillover network approach. We also use multi-scale de-composition method and nonlinear causality test between these variables to capture multi-level relationships at short and long horizons. Major findings are summarized as follows. First, from the multi-scale decomposition analysis, we identify that Granger causality test results and the direction and strength of return spillovers change with the level of decomposition. Second, the results of nonlinear causality tests show variation in both the significance and direction of Granger causality relationships between the decomposed currency and other series at different timescales, especially for the decomposed oil, gold, and OVX series. Third, the measured directional spillover indices identify the EUR as the largest contributor of connectedness to the other series. The central role of the EUR is a net transmitter of connectedness to gold, oil, the GBP, JPY, and CHF.

Coastal zones experience increasing climatic and human pressures, which lead to growing risks and tipping points (TPs) under future scenarios and natural resource scarcity. To avoid crossing TPs with irreversible coastal losses, this paper proposes the development of adaptation pathways based on advanced coastal oceanography and engineering knowledge that enables an objective assessment of evolving coastal risks. These pathways feature sequential interventions, combining conventional engineering works with nature-based solutions (NbS), steered by simulations and observations as a function of available coastal resources (space and sediment) and risks for infrastructure and socioeconomic assets. Such an adaptation has been developed for urban and peri-urban Mediterranean beaches, considering conventional coastal engineering together with NbS. Both types of interventions are assessed in terms of key physical variables, which serve to evaluate performance and estimate TPs. This analysis supports the new coastal protection and management plan promoted by the local government and the coastal adaptation plan of the central government. The approach and results illustrate the potential of adaptation pathways for beach sustainability, enhancing the compatibility between short/long-term coastal protection objectives under present/future climate and management scenarios. The adaptation pathways development underpins an increasing stakeholder cooperation to achieve shared decisions for coastal sustainability.

Drinking water, in addition to the best-known chemical and biological agents, contains radionuclides of both natural and artificial origin, which can contribute significantly to the overall effective dose received by the population. The Italian Decree Law 28/2016, implementing 2013/51/EURATOM Directive, establishes the activities for risk management and the parameter values for different radionuclides activity concentrations. In addition to the institutions involved, annually the National Inspectorate for Nuclear Safety and Radiation Protection (ISIN), publishes the monitoring reports of environmental radioactivity in Italy, including radioactivity in drinking water. The purpose of the study was to integrate ISIN reports with 2018 to 2020 data by collecting measurements performed by institutional laboratories to obtain a more complete information and adding, for the Campania region, some data not yet published. This new updated report was not significantly different from ISIN’s one, meaning that those publications are nevertheless extremely representative of the radioactivity in Italian drinking water. However, the study allowed to obtain a more detailed data also including measurements not considered in ISIN reports, for instance, radon-222 activity concentrations. This may be of great usefulness for all radiation protection stakeholders in order to ensure environmental protection, pollution prevention and the population safety.

Decision-making is a complex process of selecting an option from the given choices by analyzing the background information like risk, loss, and gain within the alternative options presented. It has been observed in earlier studies that people are prompt to make less rational decisions when choices are given in a language less known to them. Therefore, to understand the effect of languages on decision-making, we have questioned native Hindi speakers in French and English. French being the foreign language, and English as their second language. Thus, this effect of a non-native language brings to light the important role that the native language plays routinely in judgment and decision-making. In this paper, we developed a Neuropsychological assessment to decipher the effects on decision-making between choices when given in foreign language and second language in comparison with the native language of an individual, which is termed as foreign language effect(Fle). We have explored various possible situations to understand the foreign language effect(Fle) in decision-making and does this change translates when the decision is to be made in the second language. Our study concludes that the Foreign language is least affected by the intuitive biases, followed by the second language, and the native language is most affected by it.

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.

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

Cardiovascular risk factors (CRFs) such as hypertension, high cholesterol, and diabetes are increasingly implicated in cognitive decline and cerebral small vessel disease (cSVD). White matter hyperintensities (WMH), a hallmark of cSVD, are strongly linked to cognitive impairment, but their underlying mechanisms remain unclear. Blood-brain barrier (BBB) dysfunction has been proposed as a potential contributor to WMH development. This study aimed to explore the relationships between CRFs, BBB integrity, and WMH burden. We analyzed 155 participants from the Biomarkers and Cognition Study, Singapore, assessing CRFs through blood tests for glucose and lipid profiles, alongside blood pressure measurements. WMH volume was quantified using MRI, and an in vitro assay evaluated the impact of plasma on BBB integrity using human brain microvascular endothelial cells. Results showed that plasma from participants with higher WMH burden correlated with increased BBB disruption, which was further associated with higher blood pressure, elevated blood glucose, and lipid levels. Both periventricular and subcortical WMH were linked to BBB disruption. These findings suggest that CRFs contribute to BBB dysfunction, promoting WMH development and cognitive decline in cSVD. Further research is needed to clarify the precise mechanisms driving these associations.

Abstract: Floods can be defined as one of the most frequent and destructive disasters, that cause significant damage to people, while droughts present significant challenges in first place to most vulnerable communities. In consequence, state public policies are essential to manage the risk in the face of both phenomena and contribute to the construction of resilient communities. As a request of the National Water Commission of Mexico (CONAGUA) for the Regional Water Plan (PHR), we designed and applied a methodology based on virtual consultation fora in conjunction with digital survey tools to understand the population's perception of these phenomena. The workshops were organized in the five municipalities of Baja California Sur. Then, we performed an interdisciplinary analysis that combines hydrological considerations with the most critical social, economic, environmental, and law components, applying the PESTEL analysis. The results indicate that there is a clear and widespread awareness that floods and droughts increase the risk to the livelihoods of the population; however, there are deficiencies in different areas, which complicates risk management. Timely information and the inclusion of communities in mitigation and adaptation proposals would allow for achieving more successful cases with the efforts to minimize vulnerabilities and increase the resilience of the population in the face of a changing climate. This must be a collaborative work of the entire society, governmental, social, and private stakeholders.

Background: Approximately 75% of all head and neck cancer patients are treated with radiotherapy (RT). RT to the oral cavity results in acute and late adverse events which can be severe and detrimental to a patient’s quality of life and function. The purpose of this study was to explore associations between RT dose to a defined oral cavity organ at risk (OAR) avoidance structure, provider and patient reported outcomes (PROs), opioid use, and hospitalization. Methods: This was a retrospective analysis of prospectively obtained outcomes using multivariable modeling. The study included 196 patients treated with RT involving the oral cavity for a head and neck tumor. A defined oral cavity OAR avoidance structure was used in all patients for RT treatment planning. Validated PROs were collected prospectively. Opioid use and hospitalization were abstracted electronically from medical records. Results: Multivariable modeling revealed the mean dose to the oral cavity OAR was significantly associated with opioid use (p=0.0082) and hospitalization (p=0.0356) during and within 30 days of completing RT. Conclusion: The findings of this study may be valuable in RT treatment planning for patients with tumors of the head and neck region to reduce the need for opioid use and hospitalization during treatment.

In Pakistan, bats are one of the dominant mammals that play an important role in the ecosystem in terms of pollination, seed dispersal, and control of pest insects. Bats have also played an im-portant role in the emergence and transmission of zoonotic pathogens; however, most current studies focus on viral pathogens, not potential bacterial pathogens. This study was designed to estimate the prevalence and antibiotic profiling of Staphylococcus (S.) aureus in oral and rectal samples from bats captured in northern Pakistan and to determine the factors associated with in-fection. Two hundred individual bats of five species: Pipistrellus javanicus (n = 17), Pipistrellus pipistrellus (n = 10), Rhinopoma microphyllum (n = 48), Rousettus leschenaultii (n = 124), and Scotophilus kuhlii (n = 1) were captured for non-lethal collection of oral and rectal samples to iso-late S. aureus. Bats were sampled from three sites: a natural cave, a man-made castle, and an an-imal shed, in Khyber Pakhtunkhwa and Punjab provinces. Oral (n = 200) and rectal (n = 200) swabs were collected from each individual bat using sterile cotton swabs specifically for use in bacteriological studies. Each isolate of bacteria was identified by using phenotypic tests and con-firmed as S. aureus based on PCR assay. Out of a cumulative four hundred samples, 80 swabs were positive for S. aureus including 47 rectal and 33 oral swabs. Prevalence of S. aureus infection varied significantly among species, with Rousettus leschenaultii exhibiting the highest prevalence (n = 77; 37.90%). In addition to bat species, prevalence varied significantly among habitats but not between sex, age class, or reproductive status. This study confirmed the occurrence of S. aureus in oral and rectal microbiota of bats in Pakistan. Importantly, S. aureus isolates showed resistance to tetracycline, gentamicin, and erythromycin and carried resistant genes such as TetK, TetM, Erma, and aacA-D. In this regard, efforts should be taken to educate the local communities on how to minimize exposure to an antibiotic-resistant bacterial pathogen through contact with bats while simultaneously increasing the awareness of protecting bats as a vital component of our ecosystem.

In recent years, more and more attention has been paid to the behavior of tourists and their intention to travel after certain natural disasters or social unrest. The aim of the research was to establish the influence of psychological profiles of tourists on their decision to choose a tourist destination, using three psychographic techniques BFI-10 (Big Five Inventory), AIO (Activities, Interests, Opinions), and VALS 2 (Values and lifestyle), and a freely determined six-level scale of risk and tourist attractiveness of the imagined destinations. By analyzing the results through structural modeling-path analysis, it was determined that almost all psychographic orientations derived from lifestyles negatively perceive destinations with a high degree of risk and attractiveness, while with the VALS 2 technique, only members of the action orientation tend to accept the risk and challenge of visiting high-risk destinations. The results of the research have a degree of innovation in the application of the combination of the mentioned models, as well as in the theoretical and applied aspects in supplementing the building and strategic planning of the future business.

Lumpy skin disease (LSD) vaccination and epidemiological distribution remain unknown in some parts of Ethiopia including the Sidama regional state. With this, an assessment of LSD vaccine-related problems and serological study was performed in selected districts of Sidama regional state representing three agroecological zones from September 2021 to June 2022. A cross-sectional study of qualitative and quantitative studies was used. The result showed a few portion of respondents know about LSD (29.2%), and vaccinate their cattle (23.3%). 20.8% of the respondents stated LSD occurrence in their vaccinated cattle while focus group discussion with the professionals stated the possible reasons related to electric power disruption that impacted LSD vaccine cold-chain. The other study was on sero-epedimiology of LSD which showed an overall animal and herd level sero-prevalence of 40.8% and 81%, respectively. Higher and lower sero-prevalence was observed in lowland (48%) and highland (28%) areas, respectively. Furthermore, risk factor analysis showed the existence of a significant association between management systems, breed, and body condition score (BCS) of cattle. In conclusion, both qualitative and quantitative study results showed the need for intervention in terms of community-based awareness creation about LSD clinical signs, vaccination advantages, and options for electric power supply together with the frequently updated information on LSD prevalence.

Among others, road traffic, industrial emissions, commercial activities, smoking and cooking are considered as major contributing factors for the increasing levels of pollutants in atmosphere. High levels of potentially toxic metals and microbes in atmosphere, especially in indoor air, may pose serious threat to human health. Therefore, concentration and associated health risks of potentially toxic trace metals (Cd, Cr, Cu, Fe, Mn, Pb, and Zn) and their risk to human health, and microbial load in indoor air was assessed using air condition (AC) filter dust samples collected from 5 locations representing residential, agricultural and industrial settings of Eastern Province, Kingdom of Saudi Arabia. The levels of trace metals varied considerably among sampling areas, with the highest levels of Cr and Cd recorded in the Industrial-area sites followed by the Agricultural and Urban-Residential sites. The highest levels of Pb and Fe were found in the Agricultural area sites followed by the Industrial and Urban-Residential area sites. The metals in dust sample, especially Cd, Cr and Pb, showed a considerable health risk through dermal pathway. Among the sites, the highest hazard quotient for these metals was found for Al-Qatif-Industrial areas sites and among the metals it was the highest for Cd. The cancer risk from the metals contained in AC filter dust was negligible. Samples collected from Agricultural and Industrial area sites were substantially contaminated with bacteria and fungi, respectively. Bacterial contaminants were mostly Gram Negative, with considerable antibiotic resistance and haemolytic activity. Thus, indoor air quality as assessed by AC filter dust depicted that a considerable health risk could be posed by the trace heavy metals and microorganisms for a long-term exposure. Furthermore, this study demonstrated that AC filters dust could be a unique and reliable test sample for the assessment of indoor environment.

Subway construction is often in a complex natural and human-machine operating environment, and that complicated setting leads to subway construction more prone to safety accidents, which can cause substantial casualties and monetary losses. Thus, it is necessary to investigate the safety risks of subway construction. The existing literature on the identification and assessment of subway construction safety risks(SCSR) is susceptible to the influence of subjective factors. Moreover, although existing studies have explored the interrelationships between different risks, these studies usually analyze the interrelationships of single risks, lack the study of risk chain transfer relationships, and fail to find out the key path of risk transfer. Therefore, this paper innovatively combines text mining, association rules and complex networks to deep mine subway construction safety incident reports and explore risk transfer process. Firstly, it uses text mining technology to identify subway construction safety risk; Then, association rules are introduced to explore the causal relationships among safety risk; Finally, the key safety risk and important transfer paths of subway construction safety accidents (SCSA) are obtained based on the complex network model. Research results show that (a) improper safety management, unimplemented safety subject responsibilities, violation of operation rules, non-perfect safety responsibilities system and insufficient safety education and training are the key safety risk in SCSA; (b) two shorter key risk transfer paths in the subway construction safety network can be obtained: insufficient safety education and training→lower safety awareness→violation of operation rules→safety accidents; insufficient safety checks or hidden trouble investigations→violation of operation rules→safety accidents; (c) in the process of risk transfer, the risk can be controlled by controlling the key nodes or cutting off the transfer path. The results of the study provide new ideas and methods for SCSR identification and influence element mining, which help safety managers propose accurate subway construction safety risk control measures.

The recent detection of SARS-CoV-2 RNA in feces has led to speculation that it can be transmitted via the fecal-oral/ocular route. This review aims to critically evaluate the incidence of gastrointestinal (GI) symptoms, the quantity and infectivity of SARS-CoV-2 in feces and urine, and whether these pose an infection risk in sanitary settings, sewage networks, wastewater treatment plants, and the wider environment (e.g. rivers, lakes and marine waters). Overall, severe GI dysfunction is only evident in a small number of COVID-19 cases, with 11 ± 2% exhibiting diarrhea and 12 ± 3% exhibiting vomiting and nausea. In addition to these cases, SARS-CoV-2 RNA can be detected in feces from some asymptomatic, mildly- and pre-symptomatic individuals. Fecal shedding of the virus peaks in the symptomatic period and can persist for several weeks, but with declining abundances in the post-symptomatic phase. SARS-CoV-2 RNA is occasionally detected in urine, but reports in fecal samples are more frequent. The abundance of the virus genetic material in both urine (ca. 10²-10⁵ gc/ml) and feces (ca. 10²-10⁷ gc/ml) is much lower than in nasopharyngeal fluids (ca. 10⁵-10¹¹ gc/ml). There is strong evidence of multiplication of SARS-CoV-2 in the GI tract and infectious virus has occasionally been recovered from both urine and stool samples. The level and infectious capability of SARS-CoV-2 in vomit remain unknown. In comparison to enteric viruses transmitted via the fecal-oral route (e.g. norovirus, adenovirus), the likelihood of SARS-CoV-2 being transmitted via feces or urine appears lower due to the lower relative amounts of virus present in feces/urine. The biggest risk of transmission will occur in clinical and care home settings where secondary handling of people and urine/fecal matter occurs. In addition, while SARS-CoV-2 RNA genetic material can be detected by in wastewater, this signal is greatly reduced by conventional treatment. Our analysis also suggests the likelihood of infection due to contact with sewage-contaminated water (e.g. swimming, surfing, angling) or food (e.g. salads, shellfish) is extremely low or negligible based on very low predicted abundances and limited environmental survival of SARS-CoV-2. These conclusions are corroborated by the fact that over eight million global cases of COVID-19 have occurred, but exposure to feces or wastewater has never been implicated as a transmission vector.

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

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

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

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

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

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

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

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

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

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

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

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

TB and HIV continue to increase and constitute major public health concerns worldwide, mainly in resource-limited countries, showing that we are not going to end HIV if we do not also end TB. Herein, we investigated the risk factors related to HIV infection among TB patients in Luanda, the capital city of Angola. This was a retrospective cohort study conducted on the medical records of 117 TB patients from January to September 2016. Overall, the HIV/TB co-infection rate was 12%. The mean age of coinfected patients was 37.7±10.1 years. No statistically significant relationship was observed between sociodemographic or clinical features with HIV/TB co-infection (p>0.05). TB patients aged 30 years or older (OR: 4.13, p=0.072), female (OR: 1.08, p=0.898), residing in urbanized areas (OR: 1.90, p=0.578), with a history of treatment abandonment (OR: 3.74, p=0.083), with polyresistance (OR: 1.62, p=0.603), and MDR-TB (OR: 2.00, p=0.454), were more likely to have HIV/TB co-infection, while latent TB infection (OR: 0.63, p=0.559) and treatment-susceptible TB patients (OR: 0.56, p=0.616), presented a lower chance of HIV/TB coinfection. Our finding showed a slightly high HIV/TB coinfected rate, which suggests that the dual HIV/TB epidemic keeps evolving and poses a huge concern to the public health in Angola. Further studies on features related to HIV/TB coinfection and its impact on disease progression and clinical outcome in adults from high-risk Angolan communities, should be carried out to intensify and strengthen collaborative activities between national TB and HIV programs in Angola.

Cryptocurrencies are now the most popular investment instruments among millenials. Crypto offers great returns in a short period of time. Prior to COVID-19, Crypto experienced significant price fluctuations accompanied by an increase in the number of high transaction volumes. This situation was disrupted by the presence of the COVID-19 which made the world economy devastated, marked by the decline of stock prices in the world, especially in Indonesia. A paired test was conducted in this study to compare the state of Crypto before and during COVID-19 with the variables of Risk, Transaction Volume, Return, and Sharpe Performance. The results showed that there was a significant difference in the variables of Transaction Volume and Return. However, there was no significant difference in the Risk and Sharpe performance before and during COVID-19. This study shows that despite the COVID-19 pandemic, the enthusiasm of investors who transact crypto assets is not affected and they still get returns in accordance with the investments made. The high risk will be followed by a high standard deviation, so that the Sharpe Performance is small. Cryptocurrencies still have many gaps to research, such as regulation, so that many countries have not legalized Crypto transactions. If there is no regulation for Crypto, it is certain that an increase in cybercrime harms crypto investors and threatens global financial stability. Nevertheles, with or without COVID-19, investment transactions gain and lose based on confidence in the limited market. Therefore, the success of confidence fluctuations in crypto encourages the emergence of alternative coins created by investors to conduct an Initial Coin Offering (ICO).

COVID-19 national spikes had been reported at varying temporal scales as a result of differences in the driving factors. Factors affecting case load and mortality rates have varied between countries and regions. We investigated the association between various socio-economic, demographic and health variables with the spread on COVID-19 cases in Eswatini using the maximum likelihood estimation method for count data. A generalized Poisson regression (GPR) model was fitted with the data comprising of fifteen covariates to predict COVID-19 risk in Eswatini. The results showed that variables that were key determinants in the spread of the disease were those that included the proportion of elderly above 55 years at 98% (95% CI: 97%-99%) and the proportion of youth below 35 years at 0.08% (95% CI: 0.017%-38%) with a pseudo R-square of 0.72. However, in the early phase of the virus when cases were fewer, results from the Poisson regression showed that household size, household density and poverty index were associated with COVID-19. We produced a risk map of predicted COVID-19 in Eswatini using the variables that were selected at 5% significance level. The map could be used by the country to plan and prioritize health interventions against COVID-19. The identified areas of high risk may be further investigated in order to find out the risk amplifiers and assess what could be done to prevent them.

Background: Necrotizing enterocolitis (NEC) is one of the leading causes of death in newborns, however, little is understood of which patients can be treated medically or require surgery. The purpose of our study is to analyze the associated factors of surgically treated patients compared to patients requiring only medical treatment. Methods: Patients diagnosed with necrotizing enterocolitis over a period of 14 years in a single children’s hospital were retrospectively enrolled. Demographics and clinical data patients were collected and analyzed. Results: A total of 189 patients with NEC were included. Surgically treated patients had a lower gestational age (P = .018), body weight at birth (P = .034), and percentage of exclusive breast milk feeding (P= .001). They had increased comorbidity with respiratory distress syndrome (RDS) (P = .005), number of days of antibiotic use (P = .014), and length of hospital stay (P = .000). In multivariate logistic analysis, a lower percentage of exclusive breast milk feeding (OR = 0.366, 95% CI: 0.164-0.817) and a longer hospital stay (OR = 1.010, 95% CI: 1.001- 1.019) was associated with surgical NEC. Conclusion: Comparing medical and surgical NEC, a significantly lower percentage of surgical NEC patients were exclusively fed breast milk and their hospital stays were longer.

In recent years, rainfall-induced waterlogging has become a common hazard in the highly urbanized coastal city of Chattogram, Bangladesh resulting in high magnitude of property damage and economic loss. Therefore, the primary objective of this research is to prepare a waterlogging inventory map and understand the spatial variation of the risk by means of hazard intensity, exposure, and vulnerability of waterlogging. In this research, the inventory map and factors influencing waterlogging hazard were determined from a participatory survey and other spatial data including land elevation, population, and structural data were collected from secondary sources. Analytical Hierarchy Process was applied to measure the hazard intensity and the exposure and vulnerability were estimated by overlaying the spatial data onto the hazard intensity map. A total of 58 locations in 22 wards have been identified as waterlogging affected, which covers ~8.42% of the city area. Obtained waterlogging vulnerability index map suggests that ward no. 5, 6, 16, 17, and 33 are greatly vulnerable to waterlogging in terms of their social, infrastructure, critical facilities, economic and environmental vulnerability. We show that ~2.71% of the study area is at very high risk, while the risk score is considerably higher for ward no. 5, 8, 17, 19, and 33.

Based on a previous risk calculation study along a road corridor, risk is recalculated using stochastic simulation by introducing variability for most of the parameters in the risk equation. This leads to an exceedance curve comparable to that of catastrophe models. This approach introduces uncertainty into the risk calculation in a simple way, which can be used for poorly documented cases to fulfil lack of data. This approach seems to tend to minimize risk or to question risk calculations.

Introduction and objectives: a close association between metabolic syndrome among subjects with erectile dysfunction has been addressed, since mechanisms underlying metabolic syndrome compromise the blood flow to the penis in numerous ways. This study aims to analyze the relationship between erectile dysfunction and metabolic syndrome in a group of Mexican patients, to study the influence of other morbidity factors on erectile dysfunction, and to define the specific metabolic syndrome components most associated with erectile dysfunction severity. Methods: a descriptive and cross-sectional study was completed in a group of 86 adult Mexican patients with previous diagnosis of erectile dysfunction. Participants were classified as with or without metabolic syndrome. Erectile dysfunction severity, alcohol or tobacco consumption, and depressive behavior were identified through validated questionnaires and compared between both groups, as well as anthropometric, biochemical, and clinical parameters. Results: anthropometric measures, laboratory values, clinical characteristics and the Beck Depression Inventory score were significantly different among both groups. Additionally, more patients affected by severe and moderate erectile dysfunction were identified in the group with metabolic syndrome. Among the metabolic syndrome components, HbA1c >5.7% and fasting glucose >110 mg/dl were significantly associated to the development of erectile dysfunction (p = 0.004 and 0.04, respectively). Conclusions: metabolic syndrome components aggravate erectile dysfunction, particularly the lack of glycemic control manifested by Hb1Ac >5.7% and/or fasting glucose >110 mg/dL. The inclusion of fasting glucose and HbA1c as a complementary biochemical screening among patients with erectile dysfunction should be assessed.

Dengue virus (DENV) is the most common arbovirus disease, with wide spectrum of presentation. Spinal cord involvement in dengue infection (DF) is rare. However, the risk of transverse myelitis (TM) following Dengue has not been systematically assessed. Methods: We undertook a systematic review of the English literature published from January 1974 to December 2017 to assess risk of TM and outcomes following DF. Data sources included MEDLINE, EMBASE Cochrane library, and references within identified articles. Results: We identified 242 potential studies, 62 were duplicates. A further 136 were excluded on the basis of title and abstract and 19 studies did not meet the eligibility criteria on full text screening. We included 25 publications involving 2672 cases of DF. 10.8% (289/2672) had neurological complications, of which 2.3% (61/2672) was TM. For articles reporting epidemiological data, the neurological complication was twice in males compared to female 67.7% (130/192) vs 32.7% (62/192) and 1.5 fold increase TM for males 59.3% (32/54) vs 40.7% (22/54). The mean age at presentation was 33.1years (Range 0.75 – 61), with onset at 11.7days. The method of diagnosing TM due to DF was mainly IgM seropositivity 92% (n=23/25) and the commonest treatment modality was steroid 78.3% (n=18/23). Only half had full recovery 50.8% (n=31/61). There was no mortality following dengue, however, the crude case fatality rate following TM was 3.3% (n=2/61). Conclusion: This review highlights the risk of TM following dengue. Although neurological complications are rare, especially TM, once set in, it is associated with a significant morbidity.

Sulfotransferases (SULTs) family plays a significant role in the biotransformation of a variety of xenobiotics and endogenous compounds by which carcinogenesis and mutagenicity of different malignancies are increasingly affected. Recent data identified various genetically polymorphic SULTs enzymes with significant variations in the enzyme activity. This study aimed to investigate the impact of SULT1A1 gene polymorphism and and its potential risk on females with breast cancer in Jordan using a PCR-RFLP and Sanger Sequencing methods. The analysis showed that 24.7% of the patients and 25.3% of the controls were homozygous for the SULT1A1*1 allele (SULT1A1*1/SULT1A1*1) compared to 8.8% and 5.7% homozygous for the SULT1A1*2 allele (SULT1A1*2/SULT1A1*2) for patients and controls respectively. Most of the patients and controls were heterozygous for SULT1A1*1 allele (SULT1A1*1/SULT1A1*2) with rates of 66.5% and 69.0% in patients and controls respectively. In addition, the frequencies of the mutant SULT1A1*2 allele were 0.42 and 0.4 in the patient and control groups respectively. No significant difference in genotype and allele distribution was noted between the breast cancer and control groups. The risk of breast cancer in individuals carrying the SULT1A1*2 allele was determined by combining the SULT1A1*1/SULT1A1*2 and ULT1A1*2/SULT1A1*2 genotypes. No association was observed between SULT1A1 polymorphism and breast cancer incidence (P = 0.63; OR, 0.93; 95% CI, 0.68–1.26). However, SULT1A1*2 allele was found to increase the risk of breast cancer by 1.26-fold.

Traditional edible barbecue products use with lemon juice not only make the barbecue more delicious but also reduce the risk of PAHs in the barbecue products. One of the major economics crops in Taiwan, the waste from citrus fruits was very tremendous mass. However, the peelings of citrus fruits are rich in essential oil, especially, the limonene is the major. Whether the anti-carcinogenesis activities of terpene, such as limonene, in citrus fruits essential oil extraction. This study to demonstrate the PAHs content in fish skin increased markedly after being roasted at 210℃ for 20 minutes and greater mutagenicity risk of roasted fish skin was observed by Ame's test. The reduction of mutagenicity risk of roasted fish skin, which the antimutagenic abilities of substances in descending order were limonene > cold pressure oil > lemon >grapefruit. The antimutagenicity rate and ability of the three extracts were limonene: 18–23%; cold-pressed lemon oil: 18–22%; and steam distilled lemon essential oil: 8–16%. The obvious anti- mutagenicity effects against the PAHs mutagenicity of roasted fish skins can be found in citrus fruits essential oil extraction.

Assessing the economic supply of biomass in a geospatial context while accounting for risk from natural disasters was studied. Risk levels were estimated from a component of factors which included: population density, road density, federal ownership, U.S. Environmental Protection Agency ecoregions, and Presidential Disaster Declarations. The Presidential Disaster Declarations included risks due to: coastal storm, drought, fire, flood, freezing, hurricane, mud land slide, severe ices, severe storms, snow, tornado, and tropical storm. Presidential Disaster Declarations included summaries based on a short-term time period from 2000-2011, and on a long-term time period from 1964-2011. Risk categories were developed as a function of the number of disaster declarations, agricultural-to-forest land ratio, average road density, and average population density. A significant contribution of the research was the allocation of spatially explicit data using GIS technology at the 5-digit zip code tabulation area. The average area for 5-digit ZCTAs in the Eastern U.S. study region was approximately 169 kilometers². Long-term risk (1964-2011) from disaster declarations had a greater impact on the economic availability of biomass supply relative to short-term declarations (2000-2011). The greatest risk to biomass supply came from population density relative to the other risk factors studies. Of the 25,044 total ZCTAs, 12,256 ZCTAs were in locations that did not include population density ≥ 150/km², road density ≥ 14 km/km², federal ownership, and US Environmental Protection Agency Level III ecoregions. Of the remaining 12,256 ZCTAs, 26.8% were considered to be moderate-to-high risk based on short-term declarations (2000-2011) and 29.4% were considered to be moderate-to-high risk based on long-term declarations (1964-2011). Lower risk locations for procuring biomass supply for both short-term and long-term declarations, across all risk factors, were in southern Georgia, South Carolina, and Texas.

The management of existing water distribution system (WDS) is challenged by ageing of infrastructure, population growth, increasing of urbanization, climate change impacts and environmental pollution. Therefore, there is a need for integrated solutions that support decision makers to plan today, while taking into account the effect of these factors in the mid and long term. The paper is part of a more comprehensive project, where advanced hydraulic analysis for WDS is coupled with a dynamic resources input-output analysis model. The proposed modeling solution can be used to optimize the performance of a water supply system while considering also the energy consumption and consequently the environmental impacts. Therefore, as a support tool in the management of a water supply system also in the intervention planning. Here a possible application is presented for rehabilitation/replacement planning while maximizing the network mechanical reliability and minimizing risk of unsupplied demand and pressure deficit, under given economic constraints.

The aim of this study was a large-scale ecological analysis of nutritional and other environmental factors potentially associated with the incidence of cardiovascular diseases (CVDs) in the global context. Indicators of CVDs from 158 countries were compared with the statistics of mean intake (supply) of 60 food items between 1993 and 2011, obesity rates, health expenditure and life expectancy. This comparison shows that the relationship between CVD indicators (raised blood pressure, CVD mortality, raised blood glucose) and independent variables in the global context is influenced by various factors such as short life expectancy, religiously conditioned dietary customs, the imprecision of some statistics and undernutrition. However, regardless of the statistical method used, the results always show very similar trends and identify high carbohydrate consumption (mainly in the form of cereals and wheat in particular) as a dietary factor most consistently associated with the risk of CVDs. These findings are in line with the changing view of the causes of CVDs. Because only the statistics of raised blood glucose include people using medications and reflect true prevalence that is independent of healthcare, more objective data on the prevalence of CVDs are needed to confirm these observed trends.

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.

Background: Irish dance is growing in popularity, evolving to a more athletic and demanding dance style. Aims: To conduct a systematic review, previously registered with PROSPERO, to identify prevalence, incidence, and injury pattern among Irish dancers and analyse associated risk factors. Methods: Six online databases, plus two dance-specific science publications were searched systematically. Studies were included if the pattern of injuries among Irish dancers were evaluated or the factors associated with injury were analysed, published in English or Portuguese, in peer-reviewed scientific journals. Four reviewers assessed the quality and level of evidence using the Downs and Black criteria and a modified Oxford Centre of Evidence-Based Medicine 2009 model, respectively. Results: Eleven articles were included, 8 level 3c (cross-sectional) and 3 level 3b (prospective). Mean DB percentage score was 63% ± 7,2%. Prevalence ranged from 72,2% to 92,6%, affecting mostly the foot/ankle complex. Only 2 articles reported incidence, which ranged from 3,4–10,6 injuries/1000 hours danced depending on injury definition. Psychological factors, elite level, and insufficient/poor sleep were associated with musculoskeletal injury. Conclusions: Injury prevalence and incidence is high in Irish dancers, with the foot and ankle more affected. Due to heterogeneity in injury definitions, methods, and populations, along with the need for improvement in studies quality, recommendations were made for future research.

Background and aim: To explore the discriminant accuracy of Cytokeratin 18 (CK18, including M65 and M30 forms) for an elevated fatty liver index (FLI) as a validated proxy of Non-Alcoholic Fatty Liver Disease (NAFLD), and cardiovascular disease (CVD) risk in the general population. Methods: Both serum CK18 forms were measured using a commercial immunoassay in randomly selected samples from 312 participants of the PREVEND general population cohort. FLI ≥60 was used to indicate NAFLD. Framingham Risk Score (FRS) and the SCORE2 were used to estimate the 10-year risk of CVD. Receiver Operating Characteristic (ROC) curve, linear/logistic regression models and Spearman's correlations were used. Results: Intricate associations were found between CK18, FLI and CVD risk scores. While M30 was the only independent predictor of FLI≥60, M65 discriminated best NAFLD individuals at very-high 10-years CVD risk according to SCORE2 (AUC:0.71; p=0.001). Values above the predefined manufacturer cut-off (400 U/l), were associated with an independent 5-fold increased risk (adjusted odds ratio: 5.44, p=0.01), with negative predictive value of 93%. Conclusions: Confirming that NAFLD is associated with an increased CVD risk, our results point to CK18 M65 as a candidate biomarker to identify NAFLD individuals at low CVD risk in European general population.

A brief overview of the past and present trajectories made by the A(H5N1) avian influenza virus among domestic birds, avian and mammalian wildlife species and humans is presented here, thereby taking into special account the 2.3.4.4b clade of the virus recently emerged in several geographic areas of the globe.

We examine the global legal entity identifier (LEI) system for the identification of participants in financial markets. Semi-structured interviews with data professionals reveal the many ways in which the LEI can improve both business process efficiency and counterparty and credit risk management. Larger social benefits, including monitoring of systemic financial risk, are achievable if it becomes the accepted universal standard for legal entity identification. Our interviews also review the substantial co-ordination and investment barriers to LEI adoption. To address these, a clear regulatory-led road map is needed for its future development with widespread application in regulatory reporting.

A study of the water quality of the Adolfo López Mateos Reservoir (ALMD) was developed through different indicators from a spatial and seasonal perspective. Variables related to the general characteristics of water quality, trophic level and ecological risk were assessed through the water Quality Index (WQI_NSF-BROWN), Trophic State Index (TSI_CARLSON) and the Ecological Risk Index (RI_HAKANSON). Using data from physical, chemical and biological parameters obtained from four sampling points in the ALMD, the water quality was assessed in each model used. The results indicated that the reservoir presents a water quality classified as “medium” (WQI_NSF-BROWN = 70), where significant variations in the concentrations of some parameters are observed. The reservoir showed a general trophic state classified as “Mesotrophic” (TSI_{GENERAL-AVERAGE} = 43.04). The ecological risk analysis achieved the best classification of the methodology, discarding contamination by heavy metals in surface waters. Through this type of applied methodologies will help as decision making tools in the dam, as well as for application in other dams in the region.

Oil has become the object of global exploits and fierce competition among the major world powers as it is a key strategic non-renewable resource. Transnational petroleum investment is therefore an important mechanism available to countries and international corporations to control oil resources even though there are numerous inherent uncertainties and risks. A new risk assessment index system is proposed in this paper based on use of the Delphi expert scoring system and fuzzy comprehensive evaluation that aims to minimize the potential risks inherent to multinational petroleum investment. This approach encapsulates political, legal, socioeconomic, and infrastructural factors to develop a technical method that can be used for transnational petroleum investment risk assessment. An evaluation of oil investment risk within a case study area is also presented; results provide reference data that can be applied by national and international oil companies to mitigate risks of transnational oil investment.

China's gradually increasing assertiveness at the international level marked the beginning of several influential geopolitical projects. The biggest of these is the Belt and Road Initiative, which will be the subject of this post. The Chinese government initiated the BRI in 2013 to revive the historic Silk Road. The name of the new initiative was chosen based on well-known historical parallels, emphasizing the ideological component of China's current position. At the same time, neo-mercantilism prevails in China, and we can say that all roads lead to China, which means that the current nature of Chinese strategic planning corresponds to the increasingly important role of the state in international relations and strengthens its position in the world economy. The aim of the paper is to use the methods of analysis, synthesis, deduction, induction, comparison, and explanation to analyse Chinese investments that flow into various sectors worldwide, but especially into the countries participating in the Belt and Road Initiative from 2013 to the present. The largest such sector is the energy sector, which we will look at in more detail in the post. Finally, the contribution will be focused on predicting the development of further investments based on the available information as well as our own suggestions and recommendations to make them more efficient.

Since the exploitation of mineral resources results in the release of radionuclides, and consuming radionuclides affects public health in the short and long term. A case study of the environmental radiation impact from coal mining and germanium processing was carried out in southwest China. The coal mines contain germanium and uranium and have been exploited for more than 40 years. The farmlands around the site of coal mining and germanium processing have been contaminated by the solid waste and mine water in some extend since then. Samples of crops have been collected from contaminated farmlands in research area. The research area covers a radius of 5 km, in which there are 2 coal mines located. 210Pb and 210Po have been analyzed as the key radionuclides during monitoring program. The average activity concentrations of 210Pb and 210Po in the crops were 1.38 and 1.32 Bq/kg in cereals, 4.07 and 2.19 Bq/kg in leafy vegetables and 1.63 and 1.32 Bq/kg in root vegetables. The annual effective doses due to the ingestion of 210Pb and 210Po in consumed crops have been estimated for adult residents living in research area. The average annual effective dose was 0.336mSv/a, while the minimum was 0.171 mSv/a and the maximum was 0.948 mSv/a. The results show that crops grown on contaminated farmland contained an enhanced level of radioactivity concentration. Ingestion doses of local residents in research area were significantly higher than the China average level of 0.112 mSv/a, and the world average level of 0.042 mSv/a through 210Pb and 210Po in crops intake respectively.

COVID-19 had a significant impact on construction projects due to labor shortages and COVID-19 restrictions, yet little is known about the impact it had on construction safety. To address this gap, an Australian construction project was selected to study the impact of COVID-19 on safety performance, safety climate and safety leadership. The study collected data from safety climate surveys, leading and lagging safety indicators and used linear regression to compare safety performance pre and post the onset of COVID-19. Our results showed after the onset of COVID-19 there was a significant reduction (Pr&gt;F at 0.05%) in incident rate, an improvement in supervisor safety leadership and safety climate, and satisfaction with organisational communication. The study identified the increase level of safety awareness due to COVID-19 did not result in an increase in the level of engagement in safety leadership. Interestingly, participation in the safety leadership activities did not improve until a change of Project Manager occurred. The study determined leaders who establish a positive safety climate within a project could negate the safety performance impact of COVID-19. The study confirms the importance of site safety leadership in maintaining engagement in risk management and the value of focused safety communication.

Manufacturing firms need to streamline their initiatives in line with 17 sustainable development goals (SDGs) 2030 as a means for improving performance. This research adapts SDG’s goals 8 decent job and economic growth’ as a measure of performance, in examine the effect of corporate sustainability strategies on performance of manufacturing firms. Census sampling technique was used in cross sectional survey of 900 multi-industry managers from one hundred and fifty (150) manufacturing firms in Kano, Nigeria. A five Likert scale, well-structured questionnaire was used in collecting data, analysed by Structural Equation Modelling SEM PLS Package. The study shows positive and significant effect of eco-efficiency, and positive and insignificant effect of both legitimation and risk mitigation strategies on performance respectively. The study concluded that the positive and significant effects of eco efficiency initiatives could be due to benefits derived from total quality management system, energy monitoring, and process safety management reflected in sustainability oriented visionary leadership of the managers. The positive and insignificant effects of legitimation initiatives could be as a result of huge spending on sustainability reporting, and corruption. The positive and insignificant effect of risk mitigation could be due to pro-activeness of the firms’ managers in tackling risk through sustainability oriented visionary leadership. The study recommended firms should adopt conservative eco-efficiency initiatives for improving performance and stop adopting extroverted legitimation and introverted risk mitigation strategies as both have no significant effect on performance. Future researchers should use longitudinal research design using financial metrics adopting the same independent variables in other economic sectors.

Over a year into the COVID-19 pandemic, there is growing evidence that SARS-CoV-2 infections among dogs are more common than previously thought. In this study, the prevalence of SARS-CoV-2 antibodies was investigated in two dog population. The first group was comprised of 1069 dogs admitted to the Veterinary Teaching Hospital for any given reason. The second group included dogs that shared households with confirmed COVID-19 cases in humans. This study group numbered 78 dogs. In COVID-19 infected households, 43.9% tested ELISA positive, and neutralisation antibodies were detected in 25.64% of dogs. Those data are comparable with the secondary attack rate in the human population. With 14.69% of dogs in the general population testing ELISA positive, there was a surge of SARS-CoV-2 infections within the dog population amid the second wave of the pandemic. Noticeably seroprevalence of SARS-CoV-2 in the dog and the human population did not differ at the end of the study period. Male sex, breed and age were identified as significant risk factors. This study gives strong evidence that while acute dog infections are mostly asymptomatic, they can pose a significant risk to dog health. Seropositive dogs had a 1.97 times greater risk for developing central nervous symptoms.

Type-2 diabetes mellitus (T2DM) have been strongly associated with single nucleotide polymorphisms (SNPs) in the TCF7L2 gene. This study investigated the association between rs12255372, rs7903146 and T2DM in a Ghanaian population. A case-control study design was used for this study. A total of 106 T2DM patients and 110 control participants were selected. Basic data collected included body mass index, blood pressure and socio-demographics. Fasting blood samples were collected and used for serum lipid analysis, HbA1c, plasma glucose estimation and DNA extraction. Common and allele-specific primers were designed for genotyping using the Modified Tetra-Primer Amplification assay. Associations were evaluated using logistic regression models. The rs7903146 risk variant was significantly associated with 2.16 vs 4.06 increased odds for T2DM in patients <60 years vs ≥60 years. Both rs7903146 and rs12255372 are significantly associated with increased odds of T2DM in women, overweight/obese; T2DM negative family history (T2DM-NFH) and low-HDL-C. In a multivariate model, rs7903146 but not rs12255372 was significantly associated with 2.18, 5.01 and 2.25 increased odds of T2DM, under the codominant, recessive and additive model, respectively (p<0.05). The association between rs7903146 and rs12255372 with T2DM is more highly associated in a subgroup- women and those with T2DM-NFH, yet have cardiometabolic risk.

Understanding that organizational communication is crucial for the consistent functioning of any establishment, this research assesses its influence on work-life balance, organizational climate, and job satisfaction among Portuguese firefighters, a rarely studied group. Effective organizational communication is identified as a potential pathway for nurturing a favorable work setting and bolstering employee contentment, essential elements of work-life balance. Data compiled from a group of 102 firefighters, using a sociodemographic questionnaire, the Work Social Climate Scale, and Portuguese versions of the ICA Communication Audit Survey Instrument and the Labor Satisfaction Questionnaire S20/23, unveil multiple significant correlations among various dimensions of the ICA, the Work Social Climate Scale, and communication metrics. Explicitly, correlations were discerned between received and sent communications and aspects of implication, support, and cohesion. Links were also evident between desired communications and the control dimension. Positive and statistically significant relationships were further observed between received and sent communications, all five satisfaction dimensions, necessary outgoing communications and the physical environment, and required outgoing communications and benefits, highlighting the pivotal role of adept communication in augmenting work-life balance, organizational climate, and job satisfaction among firefighters.

Research interest in the occurrence, distribution, fate, and toxicity of N-(1,3-Dimethylbutyl)-N’-phenyl-p-phenylenediamine (6PPD) quinone, a derivative of the tire amino antioxidant 6PPD in urban environments, has surged. While several studies have found that 6PPD quinone exhibits acute, reproductive, and behavioral toxicity as well as mutagenicity and hepatotoxicity in aquatic and terrestrial animals, its environmental exposure data are fragmented and lack coherence across the source-to-exposure continuum, making it difficult to use for risk assessment and regulatory purposes. The present work developed an aggregate exposure pathway (AEP) framework to integrate the exposure data. An AEP network was developed for the atmospheric deposition of 6PPD quinone from tire wear in the Pearl River Delta, which led to human exposure. The 6PPD quinone research was organized, visualized, and evaluated with pertinent knowledge gaps identified using the weight of evidence assessment. Eight key exposure states were identified, with only two having high confidence levels and three having low confidence levels. Empirical support for the key transitional relationships decreased from High to Low from the source to the target site, indicating an urgent need for downstream mechanistic data. The proposed AEP framework integrated diverse 6PPD quinone research, facilitating a mechanistic understanding of the source-to-outcome continuum, as well as the development of quantitative predictive models for future research and environmental regulation.

Plantation-based farmer cooperatives play an important role in promoting agricultural modernization and increasing farmer income, and the management of business risks of such cooperatives not only influences the development of the cooperatives themselves, but also concerns the interests of farmers. Based on the survey data of 226 sample cooperatives from Guizhou province, this article uses factor analysis to measure business risks of plantation-based farmer cooperatives and carries out empirical tests on influence factors of business risks through structural equation model. According to the research results, the ordering of business risks of plantation-based farmer cooperative based on their significance is as follows: market risk > policy risk > natural risk > technical risk > management risk. Influence factors including policy environment, economic environment, social service environment, technical environment, resource endowment of the cooperative and manager characteristics have significant positive influence on the cooperative, with economic environment and manager characteristics generating relatively stronger influence and social service environment generating relatively weaker influence. Through this research, several policy implications on driving high-quality development of plantation-based farmer cooperative are made, including specifying supportive policies of plantation-based farmer cooperative, improving economic environment of agricultural market, upgrading agricultural infrastructure, depending reform of land transfer system, and enhancing internal management of the cooperative.

Wastes from social economic activities had great impact on water quality thereby limiting water usability for domestic purposes. Sewages discharge from people activities, usually consist of undesirable concentrations of soluble chemicals that infiltrate into the surrounding surface and underground water, and then constitute health risk to the populace. In order to investigate the concentration characteristics and health risk for the local residents in Nandong Underground River Watershed (NURW), eleven common heavy metals in the water body analysis were conducted. Health risk assessment (HRA) was taken to analyze eleven heavy metals of 84 water samples from surface and underground waters in NURW: 36 samples underground water and 48 samples surface water. Our results showed that the heavy metals concentration order is that of Fe > Al > Mn > Zn > As > Cd > Pb > Cr > Ni > Cu > Hg. Correlation analysis indicates that these eleven metal elements have certain similarity on material source and migration transformation. The health risks for local residents exposed to metal elements in the water of NURW mainly from carcinogenic risk (10−6～10−4 a−1) through drinking way, and the health risk of heavy metals exposed to children through drinking way was much higher than adults. The maximum exposing health risks of Cr in both underground and surface water were higher than the recommendation standard (5.0×10-5 a-1) from ICRP, and all the values over the standard (5.0×10-6 a-1) recommended by the Swedish Environmental Protection Agency and the Dutch Ministry of Construction and Environment and the British Royal Society. The results of health risk assessment shows that Cr in the water of NURW was the mainly source of carcinogenic risk for the local residents, following by Cd and As. Consequently, it is necessary to control the three carcinogenic metals when the water was used as drinking water source.

Lump sum contracts are specific contracts used in the construction industry to give owners financial certainty and decrease risk while incentivizing contractors to finish projects on schedule and within budget. This article discusses the usage of lump sum contracts in construction projects, covering the types of projects appropriate for lump sum contracts, critical considerations for entering a lump sum contract, and the tender and preliminary expenses involved. The article also covers lump sum contracts' benefits and drawbacks and how owners and contractors allocate risk. Finally, the difficulties of implementing lump sum contracts, such as potential disagreements over scope changes and quality issues, are investigated. In general, lump sum contracts can be a valuable tool for managing construction projects, but their execution necessitates careful planning and collaboration to ensure successful completion.

This study employed a deductive research approach and a survey strategy to assess risk perception and its influencing factors among construction workers in Malawi. Three specific construction hazards and their associated risks were selected. The hazards were ‘working at height (WAH) ‘manual handling of loads (MHL)’ and ‘heavy workload or intense pressure to be more productive (HWP)’. The study engaged multistage sampling of 376 subjects. Univariate analysis, factor analysis and multiple linear regressions were performed in order to determine the main influencing factors among the independent variables. The study established that workers were aware of risks posed by their work. They perceived the risk associated with WAH, MHL and HWP as very high (62.7%, = 8.80 ± 1.95); (48.5%, = 8.10 ± 2.38); (57.9%, = 8.49 ± 2.22) respectively. The study identified six factors as variables that showed significant effect on workers’ perception of risk (p < 0.05). These factors were “dreaded factor”, “avoidability and controllability”, “expert knowledge”, “personal knowledge”, education level and age. It is concluded that contractors in the Malawian construction industry should integrate analysis of behaviors and risk perception of the workers and other players to guide the identification of better health and safety interventions at their worksites.

Purpose: Expanded carrier screening (ECS) informs couples of their risk of having offspring affected by certain genetic conditions. Limited data exists assessing the actions and reproductive outcomes of at-risk couples (ARCs). We describe the impact of ECS on planned and actual pregnancy management in the largest sample of ARCs studied to date. Methods: Couples who elected ECS and were found to be at high risk of having a pregnancy affected by at least one of 176 genetic conditions were invited to complete a survey about their actions and pregnancy management. Results: Three hundred ninety-one ARCs completed the survey. Among those screened before becoming pregnant, 77% planned or pursued actions to avoid having affected offspring. Among those screened during pregnancy, 37% elected prenatal diagnostic testing (PNDx) for that pregnancy. In subsequent pregnancies that occurred in both the preconception and prenatal screening groups, PNDx was pursued in 29%. The decision to decline PNDx was most frequently based on the fear of procedure-related miscarriage, as well as the belief that termination would not be pursued in the event of a positive diagnosis. Conclusions: ECS results impacted couples’ reproductive decision-making and led to altered pregnancy management that effectively eliminates the risk of having affected offspring.

This study aimed to investigate the occurrence of the artificial sweetener aspartame (E951) in a wide range of foods and beverages sampled by food control authorities in Germany between 2000 and 2022. The dataset was obtained through the Consumer Information Act. The results showed that aspartame was present in a wide range of product groups tested, most commonly in powdered drink bases (84%) and flavored milk drinks (78%). In the solid food groups, the highest mean aspartame content was found in chewing gum (1543 mg/kg, n=241), followed by sports foods (1453 mg/kg, n=125), fiber supplements (1248 mg/kg, n=11), powdered drink bases (1068 mg/kg, n=162), and candies (437 mg/kg, n=339). Liquid products generally had the highest aspartame content in diet soft drinks (91 mg/l, n=2021), followed by regular soft drinks (59 mg/l, n= 574), flavored milk drinks (48 mg/kg, n=207), and mixed beer drinks (24 mg/l, n=40). These results suggest that aspartame is widely used in foods and beverages in Germany and that certain product groups contain higher concentrations of the sweetener than others. However, the levels of aspartame found were generally within the legal limits set by the European Union. These findings provide the first comprehensive overview of aspartame in the German food market and may be particularly useful in informing the forthcoming working groups of the WHO International Agency for Research on Cancer (IARC) and the WHO/FAO Joint Expert Committee on Food Additives (JECFA), which are in the process of evaluating the human health hazards and risks associated with the consumption of aspartame.

In the event of an abrupt sunlight reduction scenario there is a time window that occurs between when food stores would likely run out for many countries (~6 months or less) and ~1 year when resilient foods are scaled up. A promising temporary resilient food is leaf protein concentrate (LPC). Although it is possible to extract LPC from tree biomass (e.g. leaves and needles), neither the yields nor the toxicity of the protein concentrates for humans from the most common tree species has been widely investigated. To help fill this knowledge gap, this study uses high-resolution mass spectrometry and an open source toolchain for non-targeted screening of toxins on five common North American coniferous species: Western Cedar, Douglas Fir, Ponderosa Pine, Western Hemlock, and Lodgepole Pine. The yields for LPC extraction from the conifers ranged from 1% to 7.5%. The toxicity screenings confirm that these trees may contain toxins that can be consumed in small amounts and additional studies including measuring the quantity of each toxin are needed. The results indicate that LPC is a promising candidate to be used as resilient food, but future work is needed before LPCs from conifers can be used as a wide-scale human food.

This study delves into heterosexual identity-behavior discordance, exploring the interaction between sexual identification and behavior in U.K. Analyzing representative 2010 data from the British population (N=12,472), the research categorizes participants into different groups: nonheterosexual, concordant heterosexual, and three discordant heterosexual categories (closeted, experimenters, and desisters). These groups were compared in terms of sociodemographics, attitudes towards sexuality, risk behaviors and health indicators. Discordance was associated with permissive social attitudes, including behaviors such as adultery and one-night stands, and with increased substance abuse and risky sexual behaviors, especially among the closeted. Surprisingly, physical and mental health of discordant heterosexuals was similar to concordant heterosexuals, in contrast to the poorer health of nonheterosexuals. Due to the significant variations in lifestyles and health indicators among different groups, this study highlights the importance of providing targeted services and interventions.

Several recent epidemiological studies attempted to identify risk factors for Alzheimer's disease. Age, family history, genetic factors (APOE genotype, Down syndrome), physical activity, and a low level of schooling are significant risk factors. In this review, we summarize the known psychosocial risk factors for the development of Alzheimer's disease in Down syndrome patients and their association with neuroanatomical changes in the brains of people with Down syndrome. We completed a comprehensive review of the literature on PubMed, Google Scholar, and Web of Science about psychosocial risk factors for Alzheimer's disease, for Alzheimer's disease in Down syndrome, and Alzheimer's disease in Down syndrome and their association with neuroanatomical changes in the brains of people with Down syndrome. Alzheimer's disease causes early pathological changes in Down syndrome patients, especially in the hippocampus and corpus callosum. The field needs more data about the neuroanatomical changes during childhood, how they change with increasing age, and the presence or absence of psychosocial risk factors. Further neuroimaging and psychosocial assessment-focused research is needed to understand the mechanisms leading to Alzheimer's disease at an early age and create more sensitive and relevant clinical, memory, and reasoning assessments for people with Down syndrome.

Coronavirus disease 2019 (COVID-19) fatal outcomes have been associated with multiple cardiovascular risk factors. In new epidemic areas, such as Latin America, there is a lack of studies about this. Here, we evaluated those factors in a retrospective cohort of patients in a national reference hospital of Lima, Peru. Design. A retrospective cohort observational study was done. For this study, information was obtained from clinical records of the hospital for the cases that were laboratory-diagnosed and related, during March 6^th and April 30^th, 2020. rRT-PCR was used for the detection of the RNA of SARS-CoV-2 following the protocol Charité, Berlin, Germany, from nasopharyngeal swabs at the National Institute of Health. Calculation of the odds ratio (OR) with the respective 95% confidence interval (95% CI) was done, also logistic regression for adjusted OR (multivariate) was done. Values of p < 0.05 were considered significant for all analyses. Results. One hundred six hospitalized patients were evaluated. The mean age of patients was 61.58 years (SD 16.81). Cardiovascular risk factors among them were hypertension (46.2%), diabetes (28.3%), and obesity (28.3%), among others. Fifty-six patients died (52.8%). Mortality associated factors at the multivariate analysis were arterial hypertension (OR=1.343, 95% 1.089-1.667), myocardial injury (OR=1.303, 95% 1.031-1.642), and mechanical ventilation (OR 1.262, 95% 1.034-1.665), as associated factors. Conclusion. As observed in other regions of the world, cardiovascular risk factors represent a significant and independent threat to be considered in patients with COVID-19. Further studies and interventions in Peru and Latin America are expected.

Chromosomal instability (CIN), defined by variations in the number or structure of chromosomes from cell to cell, is recognized as a distinctive characteristic of cancer, associated with the ability of tumors to adapt to challenging environments. CIN has been recognized as a source of genetic variation that leads to clonal heterogeneity (CH). Recent findings suggest a potential association between CIN and CH with the prognosis of BC patients, particularly in tumors expressing the epidermal growth factor receptor 2 (HER2+). In fact, information on the role of CIN in other BC subtypes, including luminal B BC, is limited. Additionally, it remains unknown whether CIN in luminal B BC tumors, above a specific threshold, could have a detrimental effect on the growth of human tumors, or if low or intermediate CIN levels could be linked to a more favorable BC patient prognosis when contrasted with elevated levels. Clarifying these relationships could have a substantial impact on risk stratification and the development of future therapeutic strategies aimed at targeting CIN in BC. This study aimed to assess CIN and CH in tumor tissue samples from ten patients with luminal B BC, and compared them with established clinicopathological parameters. The results of our study show that luminal B BC patients exhibit intermediate CIN and stable aneuploidy, both of which correlated with lymphovascular invasion. These findings suggest that evaluating CIN, CH and aneuploidy could improve risk stratification, the prediction of clinical outcomes and future therapeutic approaches in luminal B BC patients.

The current study explores the problem of illiquidity in the corporate bond market and examines a broad set of liquidity proxies through empirical investigation. Purpose: The purpose of this paper is to give solution to the global issue of illiquidity in the corporate bond market. The problem is identified by many researchers and this paper attempts to find out the viable solution of the "fungibility route" as an alternative to the "liquidity route". Design/ Methodology: An Analysis of a sample size of 2,34,772 trade data of corporate bonds and a sample size of 2,00,607 trade data of G-securities is done to identify the problem. Findings / Solution proposed: A mathematical model based on credit risk differential and sensitivity differential is proposed to find out the fair value at which an illiquid bond can be swapped by a liquid bond. To arrive at the fair value of the illiquid bond, we have calculated risk adjusted discount rate using modified duration and credit risk differential. With our solution, it is possible to enhance the liquidity of the bond not directly but through fungibility route. Originality: the research is first of its kind in which solution is given to the global problem of corporate bond illiquidity. To execute the trade in the fungibility route, proposed parties involved are the Fungibility platform, the initiator, and the bidder. The derived fair value would facilitate trade and serve as an exit strategy for illiquid bond holders worldwide.

Both academic literature and global organizations have emphasized the need for responsible water consumption, as stated in the Sustainable Development Goal 12. However, individuals’ water-saving behaviors in their current state are not enough. This situation entails a resistance to change (RC) in consumer habits and a lack of perceived risk of scarcity. The novelty of this study lies in examining the influence of RC (through its emotional, cognitive, and confidence components) and perceived risk on water-saving intention. Interviews (n = 384) were conducted in the southeast Mediterranean area of Spain by interviewers using a paper-and-pencil questionnaire. The results of the structural equation modeling show that the perceived risk and the components of cognitive rigidity and negative emotions exert a direct influence on water-saving habits and an indirect influence on water-saving intention. None of the components of RC directly influence intention, and a lack of confidence in the outcomes of water saving does not influence water-saving habits or water-saving intention. In addition to the results obtained, the novelty of the work lies in the idea that in order to influence the perception of the risk of water scarcity through awareness campaigns, it is better to use an emotional message rather than showing facts or information, because this does not drive water saving behavior.

To assess contamination levels, sources, and ecological health risks of potentially toxic elements (PTEs) in the sediments of Al Lith on the Saudi Red Sea coast, 25 samples were collected and analyzed for Zn, V, Cr, Cu, Ni, As, Pb, and Fe using ICP-AES. The average concentrations of PTEs (μg/g) were found in the following order: Fe (14259) > V (28.30) > Zn (22.74) > Cr (16.81) > Cu (12.41) > Ni (10.63) > As (2.66) > Pb (2.46). Contamination indices indicated that Al Lith sediments exhibited either no or minimal enrichment of PTEs, with concentrations below the low effects range. This suggests that the primary source of these PTEs is the basement rocks of the Arabian Shield and that they are unlikely to pose a substantial risk to benthic communities. The hazard index (HI) values for PTEs in both adults and children were below 1.0, indicating no significant non-carcinogenic risk. Lifetime cancer risk (LCR) values for Pb, As, and Cr in both adults and children were within acceptable or tolerable levels, posing no significant health threats. However, a few samples showed LCR values exceeding 1 × 10-4, indicating potential risks.

In the present work, a study has been carried out on the contamination of heavy metals in urban dust deposited on the roads of the city of Cartagena (Spain), in order to know the content of metals such as Ni, Zn, Pb, Cd, Cr and Cu. Likewise, the possible relationship of the concentration of heavy metals with the color of the sample, level of magnetism and traffic density was studied. Contamination was evaluated using several indices such as contamination factor (CF), enrichment factor (EF), geoacumulation index (Igeo), pollutant load index (PLI) and ecological risk index (RI). A total of 88 samples were taken in the urban area of Cartagena, and the metals were determined by acid digestion and measured by inductively coupled plasma mass spectrometry. The concentration of heavy metals in urban dust from Cartagena was Zn (672 mg/kg) &gt; Cu (248.9 mg/kg) &gt; Pb (227 mg/kg) &gt; Cr (82.7 mg/kg) &gt; Ni (47.7 mg/kg) &gt; Cd (4.1 mg/kg). Contamination levels were high in Pb, Zn, Cd and Cu, according to environmental indices. A correlation was found between magnetism and metal concentration, which was repeated for all metals except Cd. Dark-colored samples contained higher metal concentrations than light-colored samples. Meanwhile, streets with medium and low traffic intensity were found to have higher concentrations of heavy metals. This study's objective was to identify pollution hotspots caused by heavy metals in dust in the urban ecosystem of Cartagena city.

Rapid proliferation of traditional gold mining sites in Kédougou a Southeast region in Senegal, led to mass population migration from the neighboring West African countries and rapid expansion of small mining villages with poor hygiene and sanitation conditions. An outbreak of hepatitis E was reported in 2014 with several cases of febrile jaundice among traditional mine workers. In this study, we analyzed both HEV IgM and IgG seroprevalence and the associated risk factors of infection by testing any suspected case and contacts collected from February 2012 to November 2014. RNA-negative sera from suspected cases and contacts were tested for anti-HEV IgM and anti-HEV IgG. A total of 799 sera were collected from 290 suspected cases, 470 contacts and 39 individuals with missing information. The median age of the cohort study was 19 years (1-88 years) with a male/female sex-ratio of 1.9. We found an overall prevalence of 43.68% (332/760) of anti-HEV IgM and 38.15% (290/760) of anti-HEV IgG sera. Our data provide new insights into the HEV epidemiology and point to the crucial need to estimate the disease’s burden in Kédougou and assess the viral mechanisms driving the disease’s severity in pregnant women.

The prevalence of cardiometabolic risk factors has increased in Slovakian adolescents as a result of serious lifestyle changes. This cross-sectional study aimed to assess the prevalence of insulin resistance (IR) and the associations with cardiometabolic and selected lifestyle risk factors in a sample of Slovak adolescents. In total, 2,629 adolescents (45.8% males) aged between 14 and 18 years were examined in the study. Anthropometric parameters, blood pressure, and resting heart rate were measured, fasting venous blood samples were analysed, and HOMA-IR was calculated. The mean HOMA-IR was 2.45±1.91 without a significant intersexual difference. IR (cut-off point for HOMA-IR=3.16) was detected in 18.6% of adolescents (19.8% males, 17.6% females). IR was strongly associated with overweight/obesity (especially central) and with almost all monitored cardiometabolic factors, except for TC and systolic BP in females. The multivariate model selected variables such as low level of physical fitness, insufficient physical activity, breakfast skipping, a small number of daily meals, frequent consumption of sweetened beverages, and low educational level of fathers as the significant risk factors of IR in adolescents. Recognizing the main lifestyle risk factors and early IR identification is important in terms of the performance of preventive strategies. Weight reduction, regular physical activity, and healthy eating habits can improve insulin sensitivity and decrease the incidence of metabolic syndrome, type 2 diabetes, and CVD in adulthood.

At least one ultrasound is recommended to predict fetal growth restriction and low birthweight earlier in pregnancy. However, in low-income countries imaging equipment and trained manpower are scarce. Hence, we developed and validated a model and risk score to predict low birthweight using maternal characteristics during pregnancy, for use in resource limited settings. We conducted a prospective cohort study among 379 pregnant women in South Ethiopia. A step-wise multivariable analysis was done to develop the prediction model. To improve clinical utility, we developed a simplified risk score to classify pregnant women at high- or low-risk of low birthweight. The accuracy of the model was evaluated using the area under the receiver operating characteristics curve (AUC) and calibration plot. We evaluated the clinical impact of the model using a decision curve analysis across various threshold probabilities. Age at pregnancy, underweight, anemia, height, gravidity, and presence of comorbidity remained in the final multivariable prediction model. The area under the receiver operating characteristics curve (AUC) of the model was 0.83 (95% confidence interval: 0.78 to 0.88). The decision curve analysis shows the model provides a higher net benefit across ranges of threshold probabilities. In general, this study showed the possibility of predicting low birthweight using maternal characteristics during pregnancy. The model could help to identify those at higher risk of having a low birthweight baby. This feasible prediction model would offer an opportunity to reduce obstetric-related complications and thus improving the overall maternal and child healthcare in low- and middle-income countries.

Because of the widespread use of bisphenol analogues (BPs) as the alternatives to bisphenol A (BPA), they have attracted considerable attention for health risk in aquatic ecosystems. The occurrence and distribution of six BPs were researched in soluble phase (< 5 kDa), colloidal phase (5 kDa to 1 µm) and suspended particulate matter (SPM > 1 µm) in a water diversion project of Nanjing, China. Except for bisphenol Z, all BPs were detected in the two or three phases, the total concentrations of detected BPs were 161-613 ng/L, 5.19-77.2 ng/L and 47.5-353 ng/g for the soluble phase, colloidal phase and SPM, respectively. Among the detected compounds, BPA still the dominant BPs in the soluble and colloidal phases, followed by BPS, while BPAF was the major contaminant in SPM, followed by BPA. The mean contribution proportions of colloids were 1-2 orders of magnitude higher than SPM, suggesting that colloids have an obvious impact on regulating BPs’ environmental behaviors. In terms of spatial distribution, although the water diversion project could reduce the pollution levels of BPs, which might further affect the ecological security of the Yangtze River.

Owing to the widespread use of bisphenol analogues (BPs) as bisphenol A (BPA) alternatives, they have been recognized to constitute a health risk for aquatic ecosystems. The occurrence and distribution of six BPs were investigated in the truly dissolved phase (< 5 kDa), colloidal phase (5 kDa to 1 µm) and suspended particulate matter (SPM > 1 µm) in a water diversion project of Nanjing, China. With the exception of bisphenol Z, all BPs were detected in at least two phases, the total concentrations of detected BPs were 161-613 ng/L, 5.19-77.2 ng/L and 47.5-353 ng/g for the truly dissolved phase, colloidal phase and SPM, respectively. Among the detected compounds, BPA still the dominant BPs in the truly dissolved phase and colloidal phase, followed by BPS, while BPAF was the major contaminant in SPM, followed by BPA. The mean contribution proportions of colloids were 1-2 orders of magnitude greater than that of SPM, suggesting that colloids play an important role in regulating the environmental behaviors of BPs. In terms of spatial distribution, although the water diversion project could reduce the pollution levels of BPs, which might further affect the ecological security of the Yangtze River.

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

Background: Colorectal cancer (CRC) is one of the most prevalent diseases and the second leading cause of death worldwide. However, the relationship between CRC and cerebrovascular-specific mortality (CVSM) remains elusive and less is known about the influencing factors associated with CVSM in CRC. Here, we aimed to analyze the incidence as well as the risk factors of CVSM in CRC. Methods: Patients with a primary CRC diagnosed between 1973 and 2015 were identified from Surveillance Epidemiology and End Results database with follow-up data available until 31 December 2016. Conditional standardized mortality ratios were calculated to compare the incidence of CVSM between CRC patients and the general US population. Univariate and multivariate survival analyses with a competing risk model were used to interrogate the risk factors for CVSM. Results: A total of 563298 CRC individuals were included. The CVSM in CRC patients was significantly higher than the general population in all age subgroups. Among competing causes of death in patients, the cumulative mortality caused by cerebrovascular-specific diseases steadily increased during study period. While age and surgery positively influenced CVSM on both univariate and multivariate analyses, male patients and those who had radiotherapy, chemotherapy, more recent year (2001-2015) of diagnosis as well as multiple primary or distant tumors experienced a lower risk of CVSM. Interpretation: Our data suggest a potential role for CRC in the incidence of CVSM and also identify several significant predictors of CVSM, which may be helpful for risk stratification and therapeutic optimization of cerebrovascular-specific diseases in CRC patients.

Background/Purpose: Over the last two decades, malaria has remained a major worldwide public health concern, especially in the developing countries leading to high morbidity and mortality among children. Nigeria is the world most burdened malaria endemic nation, contributing more than a quarter of global malaria cases. This study determined the prevalence of malaria among children 6-59 months in Nigeria, and the effects of individual and contextual factors. Methods: The study utilized data from 2018 Nigeria Demographic and Health Survey (NDHS) involving a weighted sample size of 10,185 children who were tested for malaria using rapid diagnostic test (RDT). Given the hierarchical structure of the data set, such that children at level-1 are nested in community at level-2, and nested in states and Federal Capital Territory (FCT) at level-3, multilevel mixed effect logistic regression models were used for the analysis. Results: The proportion of children 6-59 months of age in Nigeria that had malaria fever positive as assessed by RDTs was 35.5% (3,418/10185), (CI: 33.9-37.1). Kebbi State had the highest proportion of children 6-59 months who were malaria positive, 77.6%, (CI: 70.2-83.5), followed by Katsina State, 55.5%, (CI: 47.7-63.1). The Federal Capital Territory (FCT), Abuja had the proportion of 29.6%, (CI: 21.6-39.0), malaria positive children of 6-59 months of age. Children between the age of 48 and 59 months were 2.68 times more likely to have malaria fever than children 6-11 months of age (AOR=2.68, 95% CI: 2.03-3.54). Also, children from the rural area (AOR= 2.12, 95% CI: 1.75-2.57), were more likely to suffer from malaria infection compare with children from urban area. Conclusion: The study identified some individual and contextual predictors of malaria among children in Nigeria. These factors are areas that need to be considered for policy designs and implementations toward control and total elimination of malaria-related morbidity and mortality among children in Nigeria.

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

INTRODUCTION There have been several advances in the treatment of hepatitis C virus (HCV) infection which have resulted in major reductions in the morbidity and mortality from liver-associated disease. These are not widely available in the Caribbean, due in part, to lack of knowledge of the epidemiology of infections with HCV. As efforts are made to eliminate HCV from the region, these and other existing barriers such as lack of an established database on HCV must be addressed. This review seeks to identify gaps in the knowledge of HCV in the Caribbean with respect to seroprevalence, genotype distribution and general epidemiologic characteristics. MATERIALS AND METHODS The literature for the period January 1, 2005, to October 2022, was reviewed to gather country specific data on HCV across the Caribbean. References were identified through indexed journals accessed through established databases. The usage pattern of HCV drugs was determined from data obtained from Pharmacists and Infectious Diseases Specialists across the region. RESULTS The prevalence of HCV in the Caribbean was 1.5%; the region should therefore be considered an area of moderate prevalence. Notably, data from specific countries were limited. The prevalence of HCV among intravenous drug users (21.9-58.8%); persons living with HIV/AIDS (0.8 to 58.5%); prisoners (32.8-64%) and men who have sex with men (MSM) (0.8-6.9%) was generally higher than in the general population (0.8-2.3%). Genotype 1 (83% was most prevalent followed by genotypes 2 (7.2%) and 3(2.1%), respectively. Drugs currently being used for treatment of HCV infections across the Caribbean include Epclusa (Sofosbuvir/velpatasvir), and Harvoni (Ledipasvir/sofosbuvir). Some of these drugs, are only available in the private sector and are sourced externally whenever needed. CONCLUSION There is a paucity of current data on the seroprevalence of HCV in the Caribbean and well-designed prospective studies are indicated to drive the implementation of treatment and control programs for HCV in the region. Barriers which need to be first overcome include unavailability and high cost of drugs used to treat HCV infections, injecting drug use and limited access to medical care and laboratory testing.

In this paper, we introduce the application of Type-I fuzzy inference systems (FIS) as an alternative to improve the prioritization in the FMECA analysis applied in cyber-power grids. Classical FMECA assesses the risk level through the Risk Priority Number (RPN). The multiplication between three integer numbers computes this, called risk factors, representing the severity, occurrence, and detectability of each failure mode and are defined by a team of experts. The RPN does not consider any relative importance between the risk factors and may not necessarily represent the real risk perception of the FMECA team members, usually expressed by natural language; this is the main FMECA shortcoming criticized in the literature. Our approach considers fuzzy variables defined by FMECA experts to represent the uncertainty associated with the human language and a rule base consisting of 125 fuzzy rules to represent the risk perception of the experts. To test our approach, we select a cyber-power grid previously analyzed by the authors using the classical FMECA. The results reveal our proposed fuzzy approach as promissory to represent the uncertainty associated with expert knowledge and to perform an accurate prioritization of failure modes in the context of electrical power systems.

In 2014, the International Union for Conservation of Nature adopted the Red List of Ecosystems (IUCN RLE) criteria as the global standard for assessing risks to terrestrial, marine, and freshwater ecosystems. Identifying and quantifying the impacts of biodiversity assessments on the status of nature is key to justifying continued investment in assessments and enabling strategic planning to maximize future impact. In this policy perspective, we use an established impact evaluation framework to identify the impacts of the IUCN RLE since its inception. To date, 1,397 ecosystem units in 100 countries have been assessed following the IUCN RLE protocol. Systematic assessments are complete or underway in more than 25 countries and two continental regions (the Americas and Europe). Countries with established ecosystem red lists have already used them to inform legislation, land-use planning, protected area expansion, monitoring and reporting, and ecosystem management. IUCN RLE indices based on systematic assessments have high potential to inform global biodiversity reporting for the Aichi Targets and the United Nations Sustainable Development Goals. Expanding the coverage of IUCN RLE assessments, building capacity to undertake them, and establishing stronger policy instruments to manage red-listed ecosystems will be key to maximizing conservation impacts over the coming decades.

Background: This study, conducted in October 2017 at two Canadian universities, aimed to explore the relationships between gender expression, protective coping strategies, alcohol saliency, and high-risk alcohol use. Methods: Validated scales were employed to assess these variables using survey data. Multivariate analyses were conducted to investigate the associations between these factors and high-risk drinking. Results: The study revealed significant associations between high-risk drinking and androgynous gender roles (OR=1.58, 95% CI: 1.19-2.10) as well as among self-reported males (OR=2.21; 95% CI: 1.77-2.75). Additionally, protective behavioral strategies were inversely related to high-risk drinking (OR=0.95; 95% CI: 0.94-0.96), while higher alcohol saliency exhibited a positive correlation with high-risk drinking (OR=1.12; 95% CI: 1.11-1.14). Conclusions: These findings underscore the importance of considering gender, alcohol saliency beliefs, and protective behavioral strategies in the development and refinement of interventions aimed at reducing high-risk alcohol use on Canadian campuses.

Risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are not well-defined in resident physicians and fellows (trainees). We aimed to identify sociodemographic, occupational and community factors associated with SARS-CoV-2 infection among trainees during the first wave of the coronavirus disease 2019 (COVID-19) pandemic in New York City (NYC). In this retrospective cohort study, we administered an electronic survey between June 26 and August 31, 2020 to trainees at the Mount Sinai Health System in NYC to assess risk factors for SARS-CoV-2 infection between February 1 and June 30, 2020. We used Bayesian generalized linear mixed effect regression and structural equation models to examine associations. SAR-CoV-2 infection was determined by self-reported IgG antibody and reverse transcriptase-polymerase chain reaction results and confirmed with laboratory results. Among 2354 trainees invited to participate, 328 (14%) completed the survey and reported test results. The cumulative incidence of SARS-CoV-2 infection was 20.1%. Assignment to medical-surgical units (odds ratio [OR], 2.51; 95% CI, 1.18-5.34), and training in emergency medicine, critical care and anesthesiology (OR, 2.93; 95% CI, 1.24-6.92) were independently associated with infection. Deployment to care for unfamiliar patient populations was protective against infection (OR, 0.16; 95% CI, 0.03-0.73). Community factors were not significantly associated with infection after adjustment for occupational factors. Our findings may inform tailored infection prevention strategies for trainees responding to the COVID-19 pandemic.

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

Introdução: Os fatores de risco vasculares são decisivos na evolução da doença aterosclerótica e a ecografia Doppler carotídea e vertebral permite acompanhar o seu aparecimento e evolução. A medida do espessamento da parede arterial permite o diagnóstico precoce da doença potencializando seu tratamento e controle dos fatores de risco vasculares. Objetivo: Analisar a presença de doença ateromatosa em indivíduos com idade > 65 anos e compreender sua transformação com fatores de risco vascular. Materiais e Métodos: Estudo observacional transversal, em indivíduos com idade > 65 anos manifestados ao ecoDoppler carotídeo entre 1º de janeiro de 2012 e 31 de dezembro de 2021. Foi calculado o índice médio-intimal, a presença de placas ateromatosas, sua repercussão hemodinâmica e fatores de risco vascular foram registrados. Resultados: Obteve-se uma amostra de 5885 indivíduos, sendo 41,8% do sexo feminino e 58,2% do sexo masculino. A média de idade foi de 76,59 anos, variando entre 65 e 98 anos (+6,69). A hipertensão arterial foi a mais prevalente 81,3%. Houve relação positiva significativa entre índice médio-intimal, idade e história pessoal de doenças cardiovasculares e cerebrovasculares (p=0,001). Na presença de placas, sexo masculino, hipertensão arterial, diabetes, dislipidemia, tabagismo e história pessoal de doenças cardiovasculares e cerebrovasculares apresentadas de forma positiva. Conclusões: Nesta amostra, fatores de risco vascular não modificáveis ​​parecem ser determinantes na presença de aumento da espessura da parede arterial. Na presença de sinais de um estágio mais avançado da doença aterosclerótica, os fatores de risco vascular modificáveis ​​​​são decisivos,

The ability to identify and rank risk is essential for efficient and effective supervision of financial service firms, such as banks and insurers. Risk ranking ensures limited resources are allocated where they are most needed. Today, automatic risk identification within insurance supervision primarily relies on quantitative metrics based on numerical data (e.g. returns). The purpose of this work is to assess whether Natural Language Processing (NLP) and cognitive networks can achieve similar automated risk ranking and identification by analysing textual data, i.e. NIDT=829 investor transcripts from Bloomberg. To this aim, this work explores and tunes 3 NLP techniques: (1) keyword extraction enhanced by cognitive network analysis; (2) valence/sentiment analysis; and (3) topic modelling. Results highlight that keyword analysis, enriched by term frequency-inverse document frequency scores and semantic framing through cognitive networks, could detect events of relevance for the insurance system like cyber-attacks or the COVID-19 pandemic. Cognitive networks were found to highlight events that related to specific financial transitions: The semantic frame of "climate" grew in size by +538% between 2018 and 2020 and outlined an increased awareness that agents and insurers expressed towards climate change. A lexicon-based sentiment analysis achieved a Pearson’s correlation of ρ=0.16 (p&lt;0.001,N=829) between sentiment levels and daily share prices. Although relatively weak, this finding indicates that insurance jargon is insightful to support risk supervision. Topic modelling is considered less amenable to support supervision, because of a lack of results’ stability and an intrinsic difficulty to interpret risk patterns. We discuss how these automatic methods could complement existing supervisory tools in automated risk ranking.

This study explores how the covid-19 pandemic affected some psychological factors in people who got tattoos during or after the lockdown, the psychological factors assessed were self-esteem, risk taking behaviour, body image and locus of control. The study used a quantitative, between-subjects design to investigate the experiences of participants who acquired tattoos during the pandemic compared to those who did not. The results showed that participants who got a tattoo during the pandemic reported higher levels of self-esteem and body image satisfaction compared to those who did not get a tattoo. Furthermore, the findings suggest that individuals with tattoos may have a more external locus of control. Participants with tattoos exhibited higher levels of risk-taking behaviour compared to those without tattoos, furthermore sex affected risk-taking behaviour in tattooed individuals, and females with tattoos displayed a higher risk taking tendency than their tattooed male counterparts. Further research needs to be done while acknowledging the limitations of this study. Overall, this study is pivotal in establishing how the pandemic may have affected the aforementioned psychological factors in people with tattoos. It also adds to the growing body of literature in body modification and psychology.

This systematic review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement to synthesizes the existing literature with a goal to review current conceptual frameworks of mental health of forced migrants for further practice research priorities in social work. The search was done between January 2015 to January 2021. As a result, 29 studies met inclusion criteria. Medicalizing mental health issues by relying solely on the effectiveness of medicine was a controversial risk factor that negatively affected the daily life activities of refugees and reduced their willingness for seeking professional mental health services. Empowering vulnerable minorities by giving them back their power and agency to be able to speak for themselves and raise voices of trauma and recovery was the missing protective factor for sustainable mental health practice. The benefits of group-based interventions are highlighted in which communities and individuals address mental health issues as well as isolation through building collective identities and support networks. Information and communication technologies (ICTs) can add more strength to any kind of mental health intervention. Finally, the benefits of applying ecological perspective for the mental health of refugees, and its implications for a sustainable intercultural practice are discussed. Social workers in this model are the representatives of at-risk groups, thus need more agency and creativity in reflecting client’s concrete needs.

In the last decades, climate and environmental changes have highlighted the fragility and vulnerability of the landscape, especially in mountain areas where the effects are most severe. The strategy for hazard mitigation must deploy synergistic actions based on a thorough knowledge of the territory and its phenomena to enable integrated and effective land planning and management through suitable communication tools. This study promotes the methodological setup of a Landscape Digital Twin to establish a multi-disciplinary and multi-scalar hazards overview according to a matrix framework implementable over time and space. The original contribution to the research addresses a holistic vision that combines meaningfully qualitative with quantitative approaches to generate risk maps by integrating various indicators within a multi-hazard framework from the socio-economic perspective. This contribution presents road network risk analysis by exploiting flooding and landslide scenarios. The critical road segments or nodes most vulnerable or impacted by network performance and accessibility can be identified with minimal preprocessing from credible open-source sources. The method's applicability is tested in a Piedmont Region, northern Italy case study. The integration proposed will help generate comprehensive risk analysis maps that effectively portray the interconnectedness among natural hazards, infrastructure, and socio-economic factors fostering more resilient decision-making processes.

While the foundations of climate science and ethics are well established, fine-grained climate predictions, as well as policy-decisions, are beset with uncertainties. This chapter maps climate uncertainties and classifies them as to their ground, extent and location. A typology of uncertainty is presented, centered along the axes of scientific and moral uncertainty. This typology is illustrated with paradigmatic examples of uncertainty in climate science, climate ethics and climate economics. Subsequently, the chapter discusses the IPCC’s preferred way of representing uncertainties and evaluates its strengths and weaknesses from a risk management perspective. Three general strategies for decision-makers to cope with climate uncertainty are outlined, the usefulness of which largely depends on whether or not decision-makers find themselves in a context of deep uncertainty. The chapter concludes by offering two recommendations to ease the work of policymakers, faced with the various uncertainties engrained in climate discourse.

One of the main problems for managing global crises is to clarify and reduces drivers of systemic weaknesses to face complex emergencies. This study here analyzes the relation between public debt, healthcare expenditures and fatality rates in the presence of pandemic crises, such as COVID-19. Statistical evidence, based on a sample of European countries, here shows that high public debt over time reduces health expenditures and increases the vulnerability of countries to face emergencies, such as COVID-19 pandemic crisis. Regression analysis with a log-log model suggests that when European countries experience a 1% increase in healthcare expenditure per capita, in general they have a 1.2% reduction in the COVID-19 fatality rate. Main implications of this study to reduce the systemic risk and vulnerability to environmental threats are that countries must reduce public debt with good governance and institutions without reducing the allocation of economic resources to the healthcare sector in order to improve the preparedness to unforeseen emergencies and crises, such as pandemics, natural disasters, conflicts, and other environmental threats.

Despite significant prevention efforts, the numbers of physically inactive individuals, chronic illnesses, exhaustion syndromes and sick leaves are increasing. A still unresolved problem with exercise promotion is the low participation of sedentary persons. This collective term covers heterogeneous subgroups. Their engagement with movement campaigns and resistance to change are influenced by numerous factors. Our aim was to analyse survey data on health, performance, lifestyle habits and the approachability to physical activity campaigns obtained from the Germany-wide ActIv survey. From 2,888 study participants aged 50-60 years, 668 persons were categorised into the subgroups "never-athletes", "sports-dropouts", "always-athletes" and "sports-beginners". Large and significant group differences were found for BMI, assessment of quality of life, health and fitness, risk factors and health problems. 42.5% of "never-athletes" and 32.5% of "sports-dropouts" did not state any barriers to sport. There are substantial disparities between the non-athlete groups in terms of their motivation to exercise. In contrast, there are comparatively minor differences in motivation between "sports-dropouts" and "sports-beginners", whose health and fitness are the primary motivators for sport. Our analyses suggest that (i) negative health and performance trends cannot be compensated by appeals for voluntary participation in exercise programmes and (ii) powerful incentive systems are required.