Oral health surveys are essential to assess the dental caries experience and to influence national policies. This retrospective cross-sectional study aims to analysis dental caries experience who sought dental treatment in a reference university dental hospital at the Lisbon Metropolitan Area between January 2016 and March 2020. Full-mouth examination, sociodemographic, behaviors and medical information were included. Descriptive analyses and logistic regression analysis were applied to ascertain risk indicators associated with dental caries experience. A final sample of 9,349 participants (5,592 females/3,757 males) were included, aged 18 to 99 years old. In this population, caries experience was 91.1%, higher in female participants. Age (OR= 1.01, 95% CI [1.00-1.02], occupation (OR= 2.94, 95% CI [2.37-3.65], OR= 3.35, 95% CI [2.40-4.67], OR= 2.55, 95% CI [1.66-3.91], for employed, unemployed and retired, respectively), overweight (OR= 1.52, 95% CI [1.18-1.96]), reporting to never visited a dentist (OR= 0.38, 95% CI [0.23-0.64] and self-reported week teeth status (OR= 2.14, 95% CI [1.40-3.28]) were identified as risk indicators for the presence of dental caries, according to adjusted multivariable logistic analyses. These results highlight a substantial rate of dental experience in a Portuguese cohort and will pave the way for future tailored oral public health programs in Portugal.

Diabetes mellitus is a popular life-threatening disease and patients may gradually have started suffering from other diabetes-causing diseases such as heart attacks, stroke, hypertension, blurry vision, blindness, foot ulcer, amputation, kidney damage and other organ failures before diagnosis. Early detection can help reduce the fatality of this disease. Deep learning models have proven very useful in disease detection and computer-aided diagnosis. In this work, we proposed a deep unsupervised machine learning model for early detection of diabetes using voting ensemble feature selection and deep belief neural networks (DBN). Dataset was obtained from an online repository containing responses of prediagnosed patients to direct questionnaires administered in Sylhet Diabetes Hospital in Sylhet, Bangladesh. The dataset was preprocessed and preprocessed. Features were reduced using the ensemble feature selector. The DBN model was pretrained and tuned to obtain optimal performance. The model was also compared with other models with no multiple hidden layers. The DBN performed at its relative best with F1-measure, precision and recall of 1.00, 0.92 and 1.00 respectively. We conclude that DBN is a useful tool for an unsupervised early prediction of Type II diabetes mellitus.

The perception in pair trading is to recognize two stocks that move together, and their prices will converge to a mean value in future. However, finding the mean-reverted point at which the value of the pair will converge, and optimal boundaries of the trade is not easy. As uncertainty and model misspecifications may lead to losses. To cater for the problems, this study employs the novel entropic approach that utilizes entropy as penalty function for the misspecification of the model. The use of entropy as a measure of risk in pair trading is a nascent idea and this study utilizes daily data for 64 companies listed on PSX for the years 2017, 2018, and 2019, respectively to compute the returns based on the entropic approach. These companies cover the major sectors including Cement, Chemical, Automobile Assembler, Food and Personal Care Products, Oil and Gas Marketing Companies, Oil and Gas Exploration Companies Ltd, Power Generation and Distribution, Refinery and Pharmaceuticals. The returns to these stocks are then evaluated and compared with the Buy and Hold strategy. The results show positive and significant returns from pair trading using an entropic approach.

Antibiotic resistance is a pressing global and planetary health challenge. Links between climate change, antibiotic use and the emergence of antibiotic resistance have been well documented, but less attention has been given to the impact(s) of earth systems on specific bacterial livestock diseases at a more granular level. Understanding the precise impacts of climate change on livestock health – and in turn the use of antibiotics to address that ill-health – is important in providing an evidence base to tackle such impacts and to develop practical, implementable and locally acceptable solutions within and beyond current antibiotic stewardship programmes. In this paper, we set out the case for better integration of earth scientists and their specific disciplinary skill set (specifically, problem-solving with incomplete/fragmentary data; the ability to work across four dimensions and at the interface between the present and deep/geological time) into planetary health research. We then discuss a methodology that makes use of risk mapping, a common methodology in earth science but less frequently used in health science, to map disease risk against changing climatic conditions at a granular level. This will enable predictions of future disease risk and risk impacts based on predicted future climate conditions, and thus provide an evidence base for planetary health activists to influence policy and develop mitigations. Our case study – of climate conditions’ impact on livestock health in Karnataka, India – clearly evidences the benefit of integrating earth scientists into planetary health research.

Introduction: This study explores exposure to misinformation, COVID-19 risk perception, and confidence towards the government as predictors to negative attitudes toward the COVID-19 vaccine. Methods: A cross-sectional survey was carried out from 30 June to 30 August 2021 involving 775 respondents. The survey instrument for the questionnaire is an adaptation from various different studies consisting of five main variables: 1) misinformation about vaccination; 2) risk perception toward COVID-19; 3) attitudes toward the vaccination programme; 4) intention to get vaccinated; and 5) public confidence in the government in executing the vaccination programme. Results: The results of this study indicate that higher exposure to misinformation led to higher levels of negative attitudes toward the COVID-19 vaccine. When the perceived risk of COVID-19 infection was high, mistrust of vaccine benefits was low but there were also higher worries about the future effects of the vaccine. Confidence in government was associated with lower negative attitudes toward the COVID-19 vaccine. Conclusion: The results of this study may help develop an understanding of negative attitudes toward vaccinations in Malaysia and its contributing factors.

Gestational diabetes mellitus (GDM) is a common complication of pregnancy that adversely affects maternal and offspring health. A variety of risk factors, such as BMI and age, have been associated with increased risks of gestational diabetes. However, in many cases gestational diabetes occurs in healthy nulliparous women with no obvious risk factors. Emerging data suggest that the tendency to develop gestational diabetes has genetic and environmental components. Here we develop a polygenic risk score for gestational diabetes. We further investigate relationships between the genetic architecture of GDM and genetically constructed risk factors and biomarkers. Our results show that genetics can be used as an early screening tool that identifies at-risk at higher risk of GDM before its onset to propose comprehensive monitoring and preventative programs to mitigate the risks.

In this study, we described the most critical risk factors for different malignancies including: breast, prostate, lung, and colorectal carcinoma among others, with an emphasis on modifiable risk factors. We revised the literature review about risk factors involved in the genesis of cancer in various databases, including articles indexed in PUBMED, SCOPUS, PMC, and Google Scholar. Awareness of risk factors enables conscious decisions to be made in an effort to combat malignancies. Knowing risk factors is a mode of fighting malignancy. Diet, lifestyle, practises, and laboratory/clinical interventions were among risk factors of diverse malignancy. Diet, lifestyle, laboratory/clinical interventions all contribute to the genesis and prognosis in a variety of malignancies. We concluded that abstaining from risk factors can prevent the development of many malignancies in a century where this conundrum is raising disproportionately. By informing the public about modifiable risk factors cancer mortality rates can be reduced. It is treated here is to make the public aware of the modifiable risks of cancers.

Objectives: A wealth of literature has established risk factors for social isolation among older people, however much of this research has focused on community-dwelling populations. Relatively little is known about how risk of social isolation is experienced among those living in long-term care (LTC) homes. We conducted a scoping review to identify possible risk factors for social isolation among older adults living in LTC homes. Methods: A systematic search of five online databases retrieved 1535 unique articles. Eight studies met the inclusion criteria. Results: Thematic analyses revealed that possible risk factors exist at three levels: individual (e.g., communication barriers), systems (e.g., location of LTC facility), and structural factors (e.g., discrimination). Discussion: Our review identified several risk factors for social isolation that have been previously documented in literature, in addition to several risks that may be unique to those living in LTC homes. Results highlight several scholarly and practical implications.

Coronavirus disease 2019 (COVID-19) is caused by infection with the 2019 novel coronavirus 2 (2019-nCoV, now referred to as SARS-CoV-2). COVID-19 has become a global pandemic since its outbreak at the end of Dec 2019. COVID-19 could lead to severe acute respiratory disease, especially to those who have reduced immunity. Binding of the viral Spike protein (S) to its receptor ACE2 (Angiotensin Converting Enzyme 2) on the surface of target cells has been proven to be key for virus entry and infection. Although ACE2 expression in the respiratory system is necessary for pneumonia infection by SARS-CoV-2, the regulation of ACE2 gene expression remains poorly investigated, especially for patients that are in pre-pathological conditions. Here, by analyzing The Gene Expression Omnibus (GEO) database, we investigated the expression regulation of ACE2 in various kinds of primary epithelial cells from the respiratory system after varies of respiratory viruses infection such as influenza A virus (IFV), respiratory syncytial virus (RSV) and human rhinovirus (hRV). Our analyses reveal that infection of multiple kinds of respiratory viruses or influenza vaccines greatly increased ACE2 expression, suggesting that respiratory viruses infection could represent a high risk factor for developing COVID-19. We also found that the regulatory effect of influenza A virus on ACE2 expression is associated with activation of the interferon beta-induced pathway and viral RNA-activated host response. Together, our data provide a theoretical framework for clinical classification for SARS-CoV-2 infection susceptibility and could be used for future prevention and therapy treatment for COVID-19.

Adversarial Classification (AC) is a major subfield within the increasingly important domain of adversarial machine learning (AML). Most approaches to AC so far have followed a classical game-theoretic framework. This requires unrealistic common knowledge conditions untenable in the security settings typical of the AML realm. After reviewing such approaches, we present alternative perspectives on AC based on Adversarial Risk Analysis.

Nowadays tourism is growing as a gigantic, global business accounting for 10.4 % of Global GDP and 10% of global employment (Joppe, 2020). This review paper aims to explore the risks borne for tourism sector by the outbreak of corona-virus in 2020. Tourism sector is a highly vulnerable sector and the costs that will be borne from corona-virus pandemic will be devastating, particularly for the countries relying on this sector as a basic source of income. The paper suggests possible solutions and adaptation routes, while at the same time reviews lessons of the past from other pandemics and crisis. This paper is very useful for tourism policy makers and governments in countries where tourism contributes a significant part of their GDP, but also for other economic sectors closely but indirectly connected in the tourism value chain.

Diarrhoea contributes significantly in the under-five childhood morality and mortality worldwide. This cross-sectional study was carried out in a tertiary care hospital in Ujjain, India from July 2015 to June 2016. Consecutive children aged 1 month to 12 years having “some dehydration” and “dehydration” according to World Health Organization classification were eligible to be included in the study. Other signs and symptoms used to assess severe dehydration were capillary refill time, urine output, and abnormal respiratory pattern. A questionnaire was administered to identify risk factors for severe dehydration, which was the primary outcome. Multivariate logistic regression modeling was used to detect independent risk factors for severe dehydration. The study included 332 children, with mean ± standard deviation age of 25.62 ± 31.85 months; out of which, 70%(95% confidence interval [CI] 65 to 75) were diagnosed to have severe dehydration. The independent risk factors for severe dehydration were: child not exclusive breast fed in the first six months of life (AOR 5.67, 95%CI 2.51 to 12.78; p<0.001), history of not receiving oral rehydration solution before hospitalization (AOR 1.34, 95%CI 1.01 to 1.78; p=0.038), history of not receiving oral zinc before hospitalization (AOR 2.66, 95%CI 1.68 to 4.21; p<0.001) and living in overcrowded conditions (AOR 5.52, 95%CI 2.19 to 13.93; p<0.001). The study identified many risk factors associated with severe childhood dehydration; many of them are modifiable though known and effective public health interventions.

This review aimed to update the main aspects of aflatoxin production, occurrence and incidence in selected countries, and associated aflatoxicosis outbreaks. Means to reduce aflatoxin incidence in crops were also presented with an emphasis on the environment-friendly technology using atoxigenic strains of Aspergillus flavus. Aflatoxins are unavoidable widespread natural contaminants of foods and feeds with serious impact on health, agricultural and livestock productivity, and food safety. They are secondary metabolites produced by Aspergillus species distributed on three main sections of the genus (section Flavi, section Ochraceorosei, and section Nidulantes). Poor economic status of a country exacerbates the risk and the extent of crop contamination due to faulty storage conditions that are usually suitable for mold growth and mycotoxin production: temperature of 22 to 29°C and water activity of 0.90 to 0.99. This situation paralleled the prevalence of high liver cancer and the occasional acute aflatoxicosis episodes that have been associated with these regions. Risk assessment studies revealed that Southeast Asian and Sub-Saharan African countries remain at high risk and that, apart from the regulatory standards revision to be more restrictive, other actions to prevent or decontaminate crops are to be taken for adequate public health protection. Indeed, a review of publications on the incidence of aflatoxins in selected foods and feeds from countries whose crops are classically known for their highest contamination with aflatoxins, reveals that despite the intensive efforts made to reduce such an incidence, there has been no clear tendency, with the possible exception of South Africa, towards sustained improvements. Nonetheless, a global risk assessment of the new situation regarding crop contamination with aflatoxins by international organizations with the required expertise is suggested to appraise where we stand presently.

Microplastics (of size < 5mm) pollution in our environment is of current concern by researchers, public media and non-governmental organizations. Implications by their presence in aquatic and soil ecosystems have been well studied and documented, but less attention has been paid on airborne microplastics (MPs). Studies concerning airborne microplastics started from 2016 and only a few (n=7) have been published till date. Although, studies may increase in the following years, since air is very important for human survival. Microplastics have been observed in atmospheric fallouts in indoor and outdoor environments using a sampling or vacuum pump, rain sampler and/or particulate fallout collector. Identification and quantification have been carried out by visual, spectroscopic and spectrometric techniques. Factors such as meterological, climatic and anthropogenic influence the distribution and movement of airborne MP. Human exposure may be through inhalation or dermal route with their potential biopersistence and translocation. Ingestion may cause localized inflammation and cancer due to responses by the immune cells, especially in individuals with compromised metabolism and poor clearance mechanisms. Ecological risks involve possible contamination of the ecosystem through a dynamic relationship of MPs in soil, water and air forming a MP contamination cycle. The present review aimed at providing a comprehensive overview of current knowledge or information regarding microplastics in air, identifies gap in knowledge and give suggestions for future research.

This study is aimed to explore the environmental risk posed by the unsustainable mining activities in Mulawarman village, East Kalimantan, and articulate the disproportionate impact from the perspective of environmental justice on how mining regulations affect the lives of a vulnerable community. A qualitative comparative analysis based on the legislation and administrative rules on coal mining, and a case study of Mulawarman village were adopted. The information was framed based (participatory) observation, and in-depth interview, and purposively conducted to six selected respondents. The result shows how the laws and regulations disadvantage the community and expose them to unequal treatment. The adverse effects of mining activities change the socio-environmental dynamics in this village. Being the breadbasket in 1997, Mulawarman villagers experience the loss of food self-sufficiency, and turn to the government and mining company for social welfare, and clean water. Also, inconsistent and incomplete regulations pertaining to mining, favor to serve the business interests before the environment and the local community. This results in severe encroachment upon community rights and leads to long-term conflicts between mining companies and local communities, and has weakened the capacity of local authorities to help the affected community to recover their rights.

Downpours are increasing in frequency and severity due to climate change. Cities are particularly susceptible to downpours because of their large share of impervious surfaces. Minimising pluvial flood risk requires all involved stakeholders to collaborate and overcome probable barriers. Simultaneously, an increase in citizen engagement in climate adaptation is preferred, whereas experiences with inclusive decision-making are still limited. The aim of this paper is to obtain a deeper understanding of how the capacity to govern pluvial flood risk can be developed through citizen engagement. We scrutinised the capacity of local actors to govern pluvial flood risk in the city of Utrecht, the Netherlands. For the analysis of Utrecht’s problem-solving capacity, the Governance Capacity Framework provided a consistent assessment of governance components. The results indicate that Utrecht’s capacity to govern pluvial flooding is relatively well-developed. Collaboration between public authorities is advanced, sufficient financial resources are available and smart monitoring enables high levels of evaluation and learning. However, citizen awareness and engagement in policy making is rather low. Accordingly, citizens’ willingness to pay for flood adaptation is limited. Stimulating flood risk awareness by combining financial incentives with more advanced arrangements for active citizen engagement is key for Utrecht and other cities.

Improving the efficiency of the supply process in prefabricated components is challenging and requires accounting for a variety of risks involved in the management of the suppliers. The purpose of this study is to present a method to account for the systematic trade-offs between several supplier alternatives. A novel framework is presented for the whole assessment of supplier alternatives by taking advantage of the information extracted from customized building information modeling (BIM) and a database required for assessment of impacts. A data library related to assessment criteria for supply alternatives is built to facilitate the storage and sharing of information. Analytic hierarchy process (AHP) is used to select the optimal supplier that is able to provide the most satisfaction for the determined criteria. The proposed framework was also illustrated by the implementation in a mega project. The study implication is that BIM-enabled supplier selection can indeed lead to more benefits and higher values for all stakeholders.

Abdominal aortic aneurysm (AAA) represents an important public health problem with a prevalence between 1.3% and 12.5%. Several population-based randomized trials have evaluated ultrasound screening for AAA providing evidence of a reduction in aneurysm-related mortality in the screened population. The aim of our study was to perform a systematic review and meta-analysis of the risk factors for AAA. We conducted a systematic review of observational studies and we performed a meta-analysis that evaluated the following risk factors: gender, smoking habits, hypertension, diabetes mellitus, Coronary Artery Disease and family history of AAA. Abdominal aortic aneurysm prevalence is higher in smokers and in males. It is important to underline that all countries, where AAA screening was set up, had high income level and the majority belong to Western Europe (United Kingdom, Sweden, Italy, Poland, Spain and Belgium). Abdominal aortic aneurysm screening is fundamental for public health. It would avoid deaths, ruptures, and emergency surgical interventions if abdominal aortic aneurysm was diagnosed early in the population target for screening.

In current diagnostic systems, schizophrenia and bipolar disorder are still conceptualized as distinct categorical entities. Recently, both clinical and genetic evidence have challenged this Kraepelinian dichotomy. There are only few longitudinal studies addressing the potential overlaps between these conditions. Here, we present design and first results of the PsyCourse study, an ongoing transdiagnostic study of the affective-to-psychotic continuum that combines longitudinal deep phenotyping and dimensional assessment of psychopathology with an extensive collection of biomaterial. Within the DSM-IV framework, we compare two broad diagnostic groups: one consisting of predominantly affective and one of predominantly psychotic disorders. Depressive, manic, and psychotic symptoms as well as global functioning over time were analyzed. Furthermore, we explore the effects of polygenic risk scores for schizophrenia on diagnostic group membership and address their effects on non-participation in follow-up visits. While phenotypic results show differences in both current psychotic and manic symptoms, depressive symptoms did not vary between both groups. Polygenic risk scores for schizophrenia significantly explained part of the variability of the diagnostic group. Furthermore, there was a trend that a higher polygenic loading for schizophrenia was associated with attrition. Because of its unique properties, the PsyCourse study presents a prime resource for the interrogation of complex genotype-phenotype relationships.

Regulators require financial institutions to estimate counterparty default risks from liquid CDS quotes for the valuation and risk management of OTC derivatives. However, the vast majority of counterparties do not have liquid CDS quotes and need proxy CDS rates. Existing methods cannot account for counterparty-specific default risks; we propose to construct proxy CDS rates by associating to illiquid counterparty liquid CDS Proxy based on Machine Learning Techniques. After testing 156 classifiers from 8 most popular classifier families, we found that some classifiers achieve highly satisfactory accuracy rates. Furthermore, we have rank-ordered the performances and investigated performance variations amongst and within the 8 classifier families. This paper is, to the best of our knowledge, the first systematic study of CDS Proxy construction by Machine Learning techniques, and the first systematic classifier comparison study based entirely on financial market data. Its findings both confirm and contrast existing classifier performance literature. Given the typically highly correlated nature of financial data, we investigated the impact of correlation on classifier performance. The techniques used in this paper should be of interest for financial institutions seeking a CDS Proxy method, and can serve for proxy construction for other financial variables. Some directions for future research are indicated.

Comorbidities can have a cumulative effect on hospital outcomes of care, such as the length of stay (LOS), and hospital mortality. This study examines patients hospitalized with Congestive Heart Failure (CHF), a life-threatening condition, which, when it coexists with a burdened disease profile, the risk for negative hospital outcomes increases. Since coexisting conditions co-interact, with a variable effect on outcomes, clinicians should be able to recognize these joint effects. In order to study CHF comorbidities, we used medical claims data from CMS. After extracting the most frequent cluster of CHF comorbidities, we: (i) Calculated, step-by-step, the conditional probabilities for each disease combination inside this cluster (ii) Estimated the cumulative effect of each comorbidity combination on the LOS and hospital mortality (iii) Constructed (a) Bayesian, scenario-based graphs and (b) Bayes-networks to visualize results. Results show that, for CHF patients, different comorbidity constructs have variable effect on the LOS and hospital mortality. Therefore, dynamic comorbidity risk assessment methods should be implemented for informed clinical decision making in any ongoing effort for quality of care improvements.

Preoperative assessment is crucial in surgical care, traditionally relying on physical examinations and paper-based questionnaires. The emergence of digital tools like Pathpoint® ePOA represents a significant advancement, aiming to enhance the efficiency, accuracy, and standardisation of preoperative evaluations. Pathpoint® ePOA is a cloud-based platform designed to integrate seamlessly with Electronic Health Records (EHRs), providing a comprehensive, data-driven approach to preoperative assessments. It supports improved risk stratification, optimised resource allocation, and enhanced patient engagement through features such as customisable templates and real-time data integration.Current research highlights that digital preoperative tools like ePOA offer notable advantages, including increased clinical capacity, better complexity stratification, and improved patient follow-up. Despite these benefits, gaps remain in comparative studies, detailed clinical outcomes, and patient engagement strategies, indicating areas for further exploration. Pathpoint® ePOA adheres to rigorous safety standards and risk management protocols, ensuring reliability and data security while contributing to improved surgical outcomes. The benefit-risk ratio for ePOA is favourable, underscoring its potential to advance preoperative care by optimising clinical workflows and enhancing patient safety.

Background: Pathologic complete response (pCR) of breast cancer after neoadjuvant chemotherapy (NAC) is highly related to molecular subtypes. Patients who achieved tumor pCR after NAC have a better prognosis. However, despite of better prognosis, pCR patients have a potential for recurrence. There is little evidence of risk factors of recurrence in patients with pCR. We aim to analyze factors associated with tumor recurrence in patients who achieved pCR. Methods: This study retrospectively reviewed the data of patients diagnosed with breast cancer who achieved pCR after receiving NAC between January 2009 and December 2018 in Samsung Medical Center. pCR was defined as no residual invasive cancer in the breast and axillary nodes even if there is residual ductal carcinoma in situ (ypT0 or ypTis with ypN0). Breast cancers are classified into 4 subtypes based on hormone receptors (HR) and human epithelial growth factor receptor 2 (HER2) status. Patients who had bilateral breast cancer, inflammatory breast cancer, distant metastasis, unknown subtype, and histologically unique case were excluded from the study. Results: In total 483 patients were included in this study except for patients who corresponded to the exclusion criteria. The median follow-up duration was 59.0 months (range, 0.5-153.3 months). Breast cancer recurred in 4.1% of patients (20 of 483). There was a significant difference in clinical T (p = .004) and clinical N (p = .034) stage in the Kaplan-Meier curve for disease-free survival. Molecular subtypes (p = .573), Ki67 (p = 1.000), and breast surgery type (p = .574) were not associated with tumor recurrence in patients who achieved pCR after NAC. In the clinical T stage and clinical N stage, there was a significant difference between recurrence and no-recurrence groups (clinical T stage; p = .045, clinical N stage; p = .002). Univariable Cox regression revealed statistical significance in the clinical T stage (p = .049) and clinical N stage (p = .010), while multivariable Cox regression demonstrated non-significance in the clinical T stage (p = .320) and clinical N stage (p = .073). Conclusion: Results in this study showed that clinical T, clinical N stage, and molecular subtypes were not statistically significant predictors of recurrence in patients who achieved pCR after NAC. It is hypothesized that a multicenter-based study would lead to the identification of factors as predictors of recurrence after achieving pCR.

This study aimed to quantify the extent of heavy metal, non-metal and metalloid level of Campomanesia adamantium pulp obtained from area crossed by road of the high large vehicle traffic and intensive agriculture modern farm, and for monitoring the health risks associated with pulp human consumption. For this purpose, three spots located between this area, ripe fruits were collected in roadside, bush and margin-farm. Pulp samples were digested by microwave-assisted equipment, and mineral elements were quantified by ICP OES. The mineral elements average demonstrated no statistical difference observed between this pulp (p > 0.05). The heavy metals and metalloid concentrations that exceeded FAO/WHO standards are ordered Pb > As > Mo > Co > Ni > Mn > Cr. Therefore, among these metalloid and heavy metals, As, Pb and Cr were found higher in farm-margin > roadside > bush (1.5 × 10^-3, 1.1 × 10^-3 and 6.2 × 10^-4) respectively. Therefore, As is the most important metalloid with higher levels in farm-margin, roadside and bush (1.5 × 10^-3, 1.1 × 10^-3 and 6.2 × 10^-4 > 10^-6–10^-4 and 3.33, 2.30 and 1.34 > 1) respectively, to total cancer risk and hazard quotient, if 100 g daily of pulp are consumed.

Background and Objectives: Previous studies revealed anti-angiogenic, antiproliferative and anti-inflammatory effects of Vitamin D on cancer cells. Although this body of evidence supported the correlation of high Vitamin D levels with reduced incidence rates for various malignancies, contradictory results were reported regarding non-melanoma skin cancer (NMSC). Aim of this overview was to summarize the available evidence from the existing pool of systematic reviews and meta-analyses, focusing on Vitamin D serum status, dietary intake, and Vitamin D receptor (VDR) polymorphisms in correlation to NMSC incidence. Materials and Methods: A literature search in electronic databases was conducted from inception to January 2023. Inclusion criteria were systematic reviews and meta-analyses published in peer-reviewed journals, evaluating Vitamin D serum levels, dietary and/or supplementary intake, or VDR gene polymorphisms, and reporting data on NMSC. Results: A total of 10 studies were included in the data analysis models. A positive association between Vitamin D serum levels and NMSC is highlighted. However, dietary/supplementation of Vitamin D doesn’t exhibit a likewise strong linkage to NMSC. Despite the contradictory findings, VDR polymorphisms may play a crucial role in the intricate NMSC pathogenesis. Conclusions: This umbrella review showed that high Vitamin D levels are associated with increased NMSC incidence, potentially due to its direct correlation with increased sun exposure. Further research on VDR polymorphisms is suggested to explore their true effect size on NMSC risk.

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

Multi-stakeholder based construction projects are subject to various risk factors due to dynamic business environments. These risks affect project activities which indirectly impact construction costs, resulting in delays and poor building quality. So, managing these project risks requires suitable risk mitigation strategies to evaluate and analyse their severity. Hence, risk evaluation and assessment of construction projects is a multi-criteria decision making (MCDM) problem. In present real-life problems, evaluation of project risks is often uncertain and even incomplete, and the prevailing methodologies fail to handle such situations. To address the problem, this paper extends the analytical network process (ANP) methodology in the D number domain to handle three types of ambiguous evaluations, viz. complete, uncertain, and incomplete, and assesses the weight of risk criteria. The D number based approach overcomes the deficiencies of the exclusiveness hypothesis and completeness constraint of Dempster-Shafer (D-S) theory. Here, preference ratings of the decision matrix for each decision-maker are determined using a D number extended consistent fuzzy preference relation (D-CFPR). An extended multi-attributive border approximation area comparison (MABAC) method in D number is then developed to rank and select the best alternative risk response strategy. Finally, an illustrative example from construction sector is presented to check the feasibility of the proposed approach. For checking the reliability of alternative ranking, a comparative analysis is performed with different MCDM approaches (D-COPRAS, D-ARAS, D-MABAC, and D-TOPSIS). Based on different criteria weights, a sensitivity analysis of obtained ranking of the hybrid D-ANP-MABAC model is performed for verify the robustness of the proposed method.

Life is supported by metabolism, a vital physiological activity. It guarantees enough energy available to power every cellular activity. The primary cellular substrate, glucose, is where the majority of the energy needed by the cell to support all other life activities and the growth of living creatures is derived. The quality of life is greatly impacted by any disease or flaw that alters the metabolism of glucose. There is no known cure for the metabolic illness known as diabetes. As diabetes is so varied, the only effective treatments would be based on precision medicine and a molecular strategy. This review covers a wide range of topics, including the ability to recognize the various forms of diabetes, the anthropogenic and genetic influence of the cause of diabetes, the severity of the various forms of diabetes, its potential existential risk, the disease burden, and clinical methods for diagnosing them. The most recent research goes on to recommend ways to ameliorate the disease, including diet-based management, biotherapies, and other individual lifestyle choices. Futuristic therapy using molecular biology approach was suggested. Recent research found a direct correlation between an individual's lifestyle and the rate of gene mutation in diabetes. There is an existential risk associated with the sickness as the rate of the spread of the disease among population globally is faster than the world's population growth rate. It is possible to think of diabetes as a silent pandemic.

Background: School meals represent a significant supply of nutrients for children in Brazil, especially those in conditions of social vulnerability. Objectives: This study aimed to assess the levels of arsenic (As), cadmium (Cd), and lead (Pb) in meals served in public elementary schools in four municipalities in the state of Bahia, Brazil, and assess the risk posed to children's health. Methods: Ninety-six samples were collected from 16 schools, freeze-dried, and subjected to microwave-assisted digestion. The As, Cd, and Pb levels were determined by graphite furnace atomic absorption spectrometry. The risk assessment was based on calculating each element's hazard quotient (HQ). Results: None of the samples reached or exceeded the tolerable levels for the elements analyzed. Pb was the metal that obtained the most significant result, reaching maximum levels of 39-157 µg.kg-¹. Conclusions: No element exceeded the PTWI proposed by JECFA; thus, the toxic metal content in school meals poses a negligible risk to children´s health.

Objectives: COVID-19, a respiratory disease caused by SARS-COV2 and transmitted from person-to-person through viral droplets remains a global pandemic. There is a need to understand the transmission modes, populations at risk, and how to mitigate the spread and case fatality in the United States (US) and globally. The current study aimed to assess the global COVID-19 transmission and case fatality, examine similar parameters by countries and determine evidence-based practice in extreme epidemiology response in epidemic curve flattening and case fatality reduction. Methods: A cross-sectional ecologic design was used to assess the preexisting data on confirmed COVID-19 cases and mortality in March 2020 from the CDC, WHO, Worldodomter, and STATISTA. A rapid assessment between March 23^rd and 31^st, 2020, was utilized for the extreme epidemiology response. The case fatality, termed fatality proportion, was examined using mortality in relation to confirmed cases involving the world, United States of America (USA), United Kingdom (UK), Italy, France, Spain, China, Germany, India and South Korea. Results: The COVID-19 is a global pandemic, with the US as the epicenter for transmission, representing 20.9% of all confirmed cases worldwide, while Italy is the epicenter for case fatality, 30.6% of mortality as at 03/31/ 2020. The fatality proportion (FP) in Italy was 11.4%, Spain (8.8%), France (6.8%) and UK (6.4%). Despite the increased number of confirmed cases, the lowest FP was observed in Germany (0.96%) and South Korea (1.66%). There is increasing linear tends in transmission in the US, R²=0.97 as well as positive daily percentage change, ranging from 1.27% to 20.5%. Conclusions: The USA remains the epicenter for COVID-19 transmission, while Italy is the epicenter for case fatality. The observed relatively low case fatality in Germany and South Korea is due to an “extreme epidemiology” response through the application of Wuhan, China’s early data on COVID-19 transmission control measures and optimized patient care. These data are suggestive of relaxing the clinical guidelines in the United States in COVID-19 testing, application of contact tracing and testing, case isolation and most importantly enhancing resources for case management and social and physical distancing globally, hence epidemic curve flattening and case fatality reduction.

Background and objectives: Induction of labor (IOL) is an event that occurs in up to one-quarter of pregnancies; less is known about the outcomes and safety of IOL in obese pregnant woman; no data is available on misoprostol vaginal insert (MVI) IOL in high-risk pregnancy obese women. Objectives: (1) to evaluate the rate of successful IOL with 200 μg MVI in obese (Body Mass Index - BMI over 30 kg/m2) high-risk pregnant women: late-term pregnancy, hypertension or diabetes, compared to obese non-high-risk ones; (2) to evaluate the safety profile of MVI in high-risk pregnancy obese patients. Study design: We conducted a cross-sectional study in "Filantropia" Clinical Hospital, Bucharest, Romania, from June 2017 to September 2019 (28 months). From a total of 11,096 registered live births, IOL was performed in 206 obese patients; 74 obese high-risk pregnant patients matched the inclusion criteria; of these, 33.8% pregnancies (n=25) were late-term (41 – 41+6 weeks), 43.2% (n=32) had associated pathologies (hypertension and diabetes); labor induction was guided using a standardized protocol. We evaluated the maternal and gestational age, parity, fetal tachysystole, hyper-stimulation, initial cervical status, time from induction to delivery, drug side effects, mode of delivery, and neonatal outcomes. Results: (a) The overall successful labor induction rate, evaluated by the vaginal delivery rate, was 71.6% (n=53), spontaneously or instrumentally assisted; 28.4% (n=21) births were unsuccessful MVI IOL, converted into caesareans. (b) No significant differences were found regarding the maternal outcomes; in terms of perinatal outcomes of safety, four cases of high-risk pregnancies vaginally delivered were associated with neonatal intensive care unit (NICU) admissions and a one-minute Apgar score under seven (5.4%). Most cases with adverse effects of misoprostol have been managed conservatively, except for three emergency C-section cases. Conclusions: Misoprostol vaginal insert is a safe choice in IOL in obese high-risk pregnancies with good maternal and perinatal outcomes.

Persistent cervical infection with high-risk Human papillomaviruses (hrHPVs) is a necessary, but not sufficient, condition for the development of cervical cancer. Therefore, there are other co-factors facilitating the hrHPV carcinogenic process, one of which is smoking. In order to assess the effect of smoking on high-risk (hr) HPV DNA positivity and on the expression of HPV E7 oncoprotein, as a surrogate of persistent hrHPV infection, we used data from women recruited for the PIPAVIR project, which examined the role of E7 protein detection in cervical cancer screening. Women were tested for hrHPV DNA, using Multiplex Genotyping and E7 protein, using a novel sandwich ELISA method, and gave information on their smoking habits. Among 1473 women, hrHPV prevalence was 19.1%. The odds ratio (OR) for hrHPV positivity of smokers compared to non-smokers was 1.785 (95%CI: 1.365-2.332, p<0.001). The ORs for E7 positivity, concerning hrHPV positive women, ranged from 0.720 to 1.360 depending on the E7 detection assay used, but this was not statistically significant. Smoking increases the probability of hrHPV infection, and smoking intensity is positively associated to this increase. Smoking is not related to an increased probability of E7 protein positivity for hrHPV positive women.

Understanding the vulnerability of areas and the likelihood of specific disasters, particularly earthquakes, is one of the most important issues in Iran. One of the major concerns in Iran is the resilience of rural communities. The present study is devoted to spatial analysis of risk in rural areas and the evaluation of preparedness in the rural districts of the city of Abhar. In particular, this study evaluates the resilience to earthquakes. The research was conducted in two parts in which the first part has used the VIKOR Multiple criteria decision making model as well as the employment of this model in the ArcGis. The second part of the study used field studies, in the form of questionnaires, to evaluate the readiness of the local population against the risks of earthquakes. Four indicators, individual, physical, economic abilities and access, were assessed. The population included rural districts, where statistical samples were villagers. Results of the spatial analysis indicated that 15 villages are in the high-risk areas, 24 villages were in the medium-risk areas and all other villages were in low-risk areas. In terms of readiness of the locals, the results indicated a lack of planning with regards to the four mentioned indicators.

Cardiovascular disease (CVD) is considered to be one of the leading health issues in Thailand. CVD not only contributes to an increase in the number of hospital admissions year on year but also impacts on the rising health care expenditure for the treatment and long-term care of CVD patients. Therefore, this study is aimed at examining the impacts of risk reduction strategies on the number of CVD hospital admissions, Disability-Adjusted Life Years (DALYs) and the costs of hospitalisation. To estimate such impacts a CVD cost-offset model wasapplied using a Microsoft Excel spreadsheet. The number of the mid-year population was classified by age, gender and the CVD risk factor profiles from the recent Thai National Health Examination Survey (NHES) IV. This survey was chosen as the baseline population. The CVD risk factor profiles included age, gender, systolic blood pressure, total cholesterol, and smoking status. The Asia-Pacific Collaborative Cohort Study (APCCS) equation was applied to predict the probability of developing CVD over the next eight-year period. Estimates on the following were obtained from the model: (1.) the CVD events both fatal and non-fatal; (2.) the difference between the projected number of deaths and the actual number of deaths in that population; (3.) the number of patients who are expected to live with CVD; (4.) the DALYs from the estimated number of fatal and non-fatal events; (5.) the cost of hospital admissions. Four CVD risk strategy scenarios were investigated as follows: (1.) the do nothing scenario; (2.) the optimistic scenario; (3.) achieve the UN millennium development goal; and (4.) the worst-case scenario. The findings showed that over the next eight years there are likely to be 3,297,428 recorded cases of CVD; 5,870,049 cases of DALYs; and, approximately ฿57,000 million, ($1.9 billion), is projected as the total cost of hospital admissions. However, if the current health policy can reduce the levels of risk factors as defined in the optimistic scenario or such policy meets the specifications of the UN millennium development goal,there would be a significant reduction in the number of hospital admissions. These are estimated to be a reduction of 522,179 male and 515,416 female cases. With these results it is expected that health care costs would save approximately ฿9,000 million, ($298.3 million), for CVD and 900,000 million of DALYs over the next eight years. However, if there is an upward trend in the risk factors as predicted in the worst-case scenario, then there will be an increase of 428,220 CVD cases; consequently, DALYs cases may rise by 766,029 while the hospitalisation costs may increase by approximately ฿7,000 million, ($232.1 million). Based on our findings, reducing the levels of CVD risk factors in the population will drastically reduce: (1.) the number of CVD cases; (2.) DALYs cases; and (3.) health care costs. Therefore it is recommended that the health policy should enhance the primary prevention programs which would be targeted at reducing the CVD risk factors in the population.

Bisphenol A (BPA) has been identified as one of endocrine disrupting chemicals (EDCs). Due to its massive production (over 700,000 tons per year) and the extensive use of BPA-based plastics (i.e., polycarbonate and epoxy resin) in Taiwan, it was thus included into a toxic substance by the Ministry of Environment. This work surveyed the updated information about the production of BPA and its environmental distributions in Taiwan over the past decade. Furthermore, the regulatory strategies and countermeasures for managing the environmental risks of BPA by the Taiwan government were summarized to show the cross-ministerial efforts under the relevant acts, including the Toxic and Concerned Chemical Substances Control Act (TCCSCA), the Food Sanitation Management Act (FSMA) and the Commodity Inspection Act (CIA). The findings showed that most of the monitoring data showed far below the acceptable risks. However, the people may pose an adverse threat to the aquatic environment and human health via ecological and food chains. In addition, some countermeasures were further recommended to echo the international actions on environmental endocrine disruptors in recent years.

Flash flood is one of the most significant natural disasters in China, particularly in mountainous area, causing heavy economic damage and casualties of life. Accurate risk assessment is critical to an efficient flash flood management. There are more than 530,000 small watersheds in 2058 counties in China where flash flood should be prevented. In practice, with limited fund and different risk levels, the priorities of each small watershed for flash flood prevention and control are also needed for an efficient flash flood management. This paper, take Licheng county in China as an example, aims to give out these priorities for management. First, sensitive indexes are identified among index system, which includes 9 indexes based on underlying surface characteristics of small watershed in hilly region. Second, the range of each index and the rank division of each index for evaluation are determined. Based on the rank divisions for evaluation, the flash flood risk grade eigenvalue (H) is calculated by Variable Fuzzy Method (VFM ) using 1000 samplings generated by Latin hypercube sampling method. Third, the key sensitivity factors that affect flash flood risk grade eigenvalue (H) are assessed by two different global sensitivity analysis methods -- stepwise regression analysis and mutual entropy. Both results indicate that watershed slope (S) is the most sensitive factor; the second is antecedent precipitation index (CN); while other factors are slightly different sensitive in sequence. This study shows that stepwise regression analysis and mutual information analysis are appropriate for the sensitivity analysis of mountain flash flood risk. Finally, based on watershed slope (S), the priorities of flash flood prevention and control of 119 small watersheds in Licheng county are given out.

As in many parts of the world, rural-urban, forest-urban interface areas surrounding urban regions expose the natural areas they interact with to a threat of fire risk that can reach various sizes. This risk has been assessed for various regions of the world using many different methods and numerical models so far. Among these, it is seen that machine learning models have successful applications in risk assessment and risk prediction studies. For the fire risk prediction of Istanbul's yet unurbanized regions, but where the city is anticipated to potentially shift, data was collected using the opportunities provided by Geographic Information Systems and Remote Sensing technologies based on fires that occurred between 2000-2021, and the region was examined. Machine learning methods' Random Forest (RF), Extreme Gradient Boosting (XGB), and Light Gradient Boosting (LGB) models were applied for the classification of factors effective in fire. The best result was given by the RF model with 0.93 accuracy, 0.062 F1 score, and 0.753 Area Under Curve (AUC) value. In the classification of factors in the RF model, the grouping between fire-initiating factors and factors effective in spreading is evident, while this distinction is partially noticeable in the other two models.

Land use and land cover change (LULCC) is a critical factor for enhancing the soil erosion risk and land degradation process in the Wabi Shebelle Basin. Up-to-date spatial and statistical data on basin-wide erosion rates can provide an important basis for planning and conservation of soil and water ecosystems. The objectives of this study were to examine the magnitude of LULCC and consequent changes in the spatial extent of soil erosion risk, and identify priority areas for Soil and Water Conservation (SWC) in the Erer Sub-Basin, Wabi Shebelle Basin, Ethiopia. The soil loss rates were estimated using an empirical prediction model of the Revised Universal Soil Loss Equation (RUSLE) outlined in the ArcGIS environment. The estimated total annual actual soil loss at the sub-basin level was 1.01 million tons in 2000 and 1.52 million tons in 2018 with a mean erosion rate of 75.85 t ha^–1 y^–1 and 107.07 t ha^–1 y^–1, respectively. The most extensive soil loss rates were estimated in croplands and bare land cover, with a mean soil loss rate of 37.60 t ha^–1 y^–1 and 15.78 t ha⁻¹ y⁻¹, respectively. The soil erosion risk has increased by 18.28% of the total area, and decreased by 15.93%, showing that the overall soil erosion situation is worsening in the study area. We determined SWC priority areas using the Multi-Criteria Decision Rule (MCDR) approach, indicates that the top three levels identified for intense SWC account for about 2.50%, 2.38%, and 2.14%, respectively. These priority levels are typically situated along the steep slopes in Babile, Fedis, Fik, Gursum, Gola Oda, Haramaya, Jarso, and Kombolcha districts that need emergency SWC measures.

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.

This purpose was to compare the ability of body shape index (ABSI) and body roundness index (BRI) with waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and body adiposity index (BAI) to predict metabolic risk. The cross-sectional study was conducted in 17,360 Chinese subjects (were aged 18-95 years old) who escaped cardiovascular disease (CVD) or diabetes. Biochemical and anthropometric variables were measured by trained staff. Receiver operating characteristic curve (ROC) and optimal cutoff values of obesity indices were recruited to compare the predictive ability for metabolic risk factors. The mean age of subjects was 53.7(13.1) years, 41.6 % were males. Within young group (<60 years), the areas under the curve (AUC) demonstrated that WC, BMI, WHR, WHtR and BRI were able to similarly predict high metabolic risk in males (0.74 vs. 0.74 vs. 0.73 vs. 0.73 vs. 0.73) and in females (0.73 vs. 0.73 vs. 0.71 vs. 0.73 vs. 0.73), while the approximate predictive ability were only acquired in males (0.73 vs. 0.73 vs. 0.70 vs. 0.73 vs. 0.73) within elder group (≥60 years). The optimal cut-off values of BRI for high metabolic risk were calculated in males (<60 y: 3.49 vs. ≥60 y: 3.46) and females (<60 y: 3.47 vs. ≥60 y: 3.60). Meanwhile, BRI displayed a strong prediction to elevated BP and elevated TG in males (AUC = 0.64; AUC = 0.70) and to elevated BP, elevated TG and elevated SUA in females (AUC = 0.67; AUC = 0.69; AUC =0.70). BRI was able to similarly predict high metabolic risk compared to WC, BMI, WHR, WHtR and BAI, while ABSI was not. Moreover, BRI revealed specific predictive ability for elevated BP, elevated TG and elevated SUA.

LoRa and its upper layers definition LoRaWAN is one of the most promising LPWAN technologies for implementing the Internet of Things (IoT). Although being a popular technology, several works in the literature have revealed various weaknesses regarding the security of LoRaWAN v1.0 (the official 1st draft). By using all these recommendations from the academia and industry, the LoRa-Alliance has worked on the v1.0 to develop an enhanced version and provide more secure and trustable architecture. The result of these efforts ended-up with LoRaWAN v1.1, which was released on Oct 11, 2017. This manuscript aims at demystifying the security aspects and provide a comprehensive Security Risk Analysis related to latest version of LoRaWAN. Besides, it provides several remedies to the recognized vulnerabilities. To the best of authors’ knowledge, this work is one of its first kind by providing a detailed security analysis related to latest version of LoRaWAN. According to our analysis, end-device physical capture, rogue gateway and replay attacks are found to be threating for safety operation of the network. Eventually, v1.1 of LoRaWAN is found to be less vulnerable to attacks compared to v1.0, yet possesses several security implications that need to be addressed and fixed for the upcoming releases.

Radiological risk affect the quality of the environment in buildings since population and workers can be potentially exposed to high level of dose. Radon gas emanated from both subsoil and building materials represents the most important source of radiation exposure for people. This study investigates the sustainability concept of a small rural village of Ischia Island, named Ciglio, in relation to the radiological risk. Radon activity concentration was measured in typical green tuff dwellings and in water samples collected from a local spring using E-Perm devices. Moreover, for green-tuff as building material, the radon emanation coefficient was calculated by gamma spectroscopy. The results highlight the importance to perform environmental radon monitoring and to investigate the radon content of building materials, especially in geographical areas characterized by traditional use of typical stones for constructions. In conclusion, the sustainability development of rural buildings is possible if the radiological risk for inhabitants and workers was assessed.

Background/Purpose: In recent times, Sub-Sahara Africa (SSA) had been rated by the World Health Organization, (WHO), as the most malaria endemic region in the world. Evidence synthesis of the risk factors associated with malaria among children aged under-five in SSA is urgently needed. This would help to inform decisions that policy makers and executors in the region need to make for the effective distribution of scare palliative resources to curb the spread of the illness. This scoping review is aimed to identify studies that have used multivariate classical regression analysis to determine risk factors associated with malaria among children under-five years old in SSA. Methods/Design: The search terms followed PICOTS, (Population, Intervention, Comparator, Outcome, Timing, Setting), and were used in searching through the following databases: PubMed, MEDLINE, Web of Science, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Scopus, and MeasureDHS. The databases were searched for published articles from January 1990 to December 2020. Results: Among the 1154 studies identified, only thirteen (13) studies met the study’s inclusion/exclusion criteria. Narrative syntheses were performed on the selected papers to synchronise the various risk factors identified. Factors ranging from child-related, (age, birth order and use of bed net), parental/household-related, (maternal age and education status, household wealth index) and community-related variables, (community wealth status, free bed net distribution), were some of the identified significant risk factors. Conclusion: It is timely to have a synthesis of risk factors that influence the malaria status of children under-five in SSA. The outcome of the review will increase the knowledge of the epidemiology of morbidity that will form the basis for designing efficient and cost-effective distribution of palliatives and controls of malaria in SSA.

Rice cultivation is the main agricultural activity in Asia, and it results in an enormous amount of agricultural waste, that are usually disposed-off by burning, causing serious environmental health and climate problems. Pakistan is the tenth largest producer in the world and the fourth exporter of rice in the world. To date, there are no studies targeting Pakistan’s profile monitoring its contribution in open burning emissions from rice straw waste. This study presents the characterization of PCDD/Fs, PCBs and PAHs emissions from three samples of rice straw collected from the main rice cultivation regions of Pakistan (Punjab, Sindh and Azad Jammu and Kashmir) in relation to the role of metal-based agricultural additives. PCDD/Fs, PCBs and PAHs emissions were quantified using a fixed grid system biomass plant and measuring the macro-pollutants online and sampling the organic micro-pollutants and metals in isokinetic mode, followed by ISO and CEN standards methods. In addition, role of agrochemicals was monitored in terms of metal catalysis resulted in POPs emissions. This study provides the characterization of most relevant group of pollutants (metals, PCDD/Fs, PCBs and PAHs) as a result of agricultural waste combustion. The rice straw samples from AJK showed high values of organochlorine micro-pollutants compared to the values followed by samples from Punjab and Sindh, i.e., respectively, ∑PCDD/F (2594>1493>856 pg/Nm³) and ∑PCB (41>38>30 pg/Nm³). Whereas the organic micro-pollutants ∑PAH, indicators of incomplete combustion (PICs), were recorded high in the samples from Sindh followed by Punjab and AJK. This study supports the idea that the phenomena that lead to the formation of PCDD/F and PCB are influenced not only by poor combustion but also by the presence of metal catalysts or precursors in the burned fuel.

Background: Two years after the first cases, critical gaps remain in identifying prognostic factors in multisystem inflammatory syndrome in children (MIS-C). Methods: This retrospective study included 99 patients with MIS-C hospitalized between August 2020 and March 2022 in a pediatric tertiary center. The patients were divided into two groups according to clinical severity (low and high-risk). Prognostic values of baseline clinical and laboratory characteristics were evaluated with advanced statistical analysis, including machine learning. Results: Sixty-three patients were male, and the median age was 83 (3–205) months. Fifty-nine patients (%59.6) were low-risk cases. Patients aged six years and over tended to be at higher risk. Involvement of aortic or tricuspid valve or &gt;1 valve was more frequent in the high-risk group. Mortality in previously healthy children was 3.2%. Intensive care unit admission and mortality rate in the high-risk group were 37.5% and 7.5%, respectively. At admission, high-risk patients were more likely to have reduced lymphocyte count and total protein level and increased brain natriuretic peptide (BNP), ferritin, D-dimer, and troponin concentrations. The multiple logistic regression model showed that BNP, total protein, and troponin were associated with higher risk. When the laboratory parameters were used together, BNP, total protein, ferritin, and D-dimer provided the highest contribution to the discrimination of the risk groups (100%, 89.6%, 85.6%, and 55.8%, respectively). Conclusions: Our study widely evaluates and points to some clinical and laboratory parameters that, at admission, may indicate a more severe course. Modeling studies with larger sample groups are strongly needed.

The water quality index (WQI) and irrigational index for groundwater were studied in the northeastern section of the Manipur Valley in northeast India. Water samples were collected in 2022 during the pre-monsoon season. To compute the water quality index for drinking water, the basic chemical parameters of total hardness, pH, electrical conductivity, total dissolved solids, Ca2+, Na+, Fe, Mg2+, Mn, Cl-, and HCO3, were used. The assessment of bacteriological quality is also done, which is crucial for overall water quality evaluation, alongside physical and chemical analyze. For determining irrigation suitability, irrigational indices such as sodium absorption ratio, sodium percentage, and magnesium hazard were calculated. WQI, %Na+, SAR, magnesium hazard, permeability Index and total hardness indicate that most water samples are harmless for irrigation and drinking purpose. They have affirmative relationships indicating that these characteristics are interdependent. Approximately 25% of the Piedmont zone groundwater is found to be unfit for agricultural and drinking usage. The encrustation of gypsum, halite, and evaporation into the Disang shares accelerate the dissolution of ions in Piedmont water, resulting in quality degradation. According to Gibbs plots, Durov Scatter Plot, and Hill Piper Trilinear Diagram of water dominated the rock-weathering process, while hydro chemical facies progressed from the beginning to the intermediate stage of Chadha's graphical representation illustrates the progression of hydro chemical processes in surface water. Therefore, proper integrated water resource management and development are required for effective water resource utilization, particularly around the Piedmont zone. To prevent a water crisis, groundwater resources must be managed sustainably. The current study also concentrated on a bibliometric examination of groundwater management and access to gauge the state of the field.

Frass generated during the production of black soldier fly larvae is taking the interest of scientists and horticultural producers because it is a material from the biotransformation of organic waste, it has several nutrients that can be used by plants, and its recent focus on its biostimulant capacity. The thermal-composting process is a stabilization that improves physical and chemical properties of treated wastes, allowing better performance in plants compared to its fresh state. In this research, thermocomposted frass was evaluated as a germination substrate for kale seeds (Brassica olerasea). To achieve this, it was evaluated the phytotoxicity in different concentrations on the seeds, and seedlings were grown in a germination substrates mixed with 20, 40, 60, 80 and 100% of frass. The treatment with 20% frass showed the highest values of seedling height, stem diameter, number of leaves, length, and width of first true leaf and length and width of cotyledons, reduced the content of phenols and tannins antioxidants but the content of flavonoids increased compared to the control and the rest of mixtures.

Lifestyle physical activity (PA) and nutrition are known to be effective interventions in preventing and managing obesity related comorbidities is adult populations, but less so in children and adolescents. We examined the effectiveness of lifestyle interventions in children from minority ethnic populations in western high-income countries. Our systematic review included 53 studies involving 26045 children from minority ethnic populations within western countries, who followed lifestyle intervention programs lasting between 8 weeks and 5 years with an aim to prevent and/or manage childhood obesity and associated comorbidities, including adiposity and cardiometabolic risks. Studies were heterogenous in terms of lifestyle intervention components (nutrition, PA, behavioural counselling) and settings (community vs. schools and after schools). Our meta-analysis included 31 eligible studies and showed no significant effects of lifestyle interventions when they focused on body weight and body mass index (BMI) outcomes [pooled BMI mean change = -0.09 (95% CI -0.19, 0.01), p=0.09]. This was irrespective of the intervention program duration (< 6 months vs. ≥ 6 months), type (PA vs nutrition/combined intervention) and weight status (overweight or obese vs no normal weight), all showed no significant effects in the sensitivity analysis. Nonetheless, 19 of the 53 studies reported reduction in BMI, BMI z scores and body fat percentage. However, majority of lifestyle interventions adopting a quasi-design with a combined primary and secondary obesity measures (11 out of 15 studies), were effective in reducing obesity comorbidities of cardiometabolic risks including metabolic syndrome, insulin sensitivity, and blood pressure in children with overweight and obesity. Preventing childhood obesity and associated comorbidities in children from high-risk ethnic minority groups is best achieved using a combined PA and nutrition intervention approach, which jointly target preventing obesity and cardiometabolic disease primary and secondary outcomes, especially measures of diabetes, hypertension, and cardiovascular disease.

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

Introduction: Desmoid tumor (DT) is a rare benign neoplasm rising from muscle aponeurosis, having been associated mostly with trauma or pregnancy. DT has an infiltrative and locally aggressive growth pattern and usually does not metastasize. However, it has a high recurrence and complication rate. When they occur in pregnancy, are all pregnancies and deliveries taken as individual case for optimal management by the physicians and midwifes, who need to be cautious in finding the optimal delivery mode for patients, which depends on tumor size, location, behavior and past history. Study Objectives: We present a case report of a large desmoid tumor of the anterior abdominal wall in a 29-year-old woman in pregnancy, presenting a delivery problem, which resolved in surgical management. Moreover, we are bringing a systematic review of the literature to provide an overview on pathomechanism, symptoms, diagnostics and treatment management of the pregnant women affected by DT. Results: The authors report a case of pregnant women who underwent systemic oncological treatment for abdominal wall desmoid tumor and have been pregnant afterwards. The observational conservative management was chosen with an elective cesarean section at the 38+4 pregnancy week with uncomplicated postpartum follow-up. Conclusion: Pregnancy-associated desmoid tumors are very rare and optimal management of this tumor is not well established, despite some guidelines for non-pregnant patients. The authors reviewed the literature focusing on the actual modern management of desmoid tumors at all, including patients during the pregnancy, as well.

Purpose: During the COVID-19 pandemic, the health care workers (HCWs) at the frontline have been largely exposed to infected patients, running an high risk of being infected by the SARS-CoV-2 virus. This study investigates the epidemiological, clinical and lifestyles characteristics that might play roles in the susceptibility of HCWs to COVID-19 in a hit Italian hospital. Methods:Demographic, lifestyle, work-related and comorbidities data of 1447 HCWs which underwent a nasopharyngeal swab for SARS-CoV-2 were retrospectively collected. For the 164 HCWs positive for SARS-CoV-2, data about safety in the workplace, symptoms and clinical course of COVID-19 were also collected. Cumulative incidence of SARS-CoV-2 infection was estimated. Risk factors for SARS-CoV-2 infection were assessed using a multivariable Poisson regression. Results: The cumulative incidence of SARS-CoV-2 infection among the screened HCWs was 11.33 (9.72-13.21). Working in a COVID-19 ward, being a former smoker (vs being a person who never smoked) and BMI were positively associated with SARS-CoV-2 infection, whereas being a current smoker was negatively associated with this variable. Conclusions: Assuming an equal accessibility and proper use of PPE of all the HCWs of our Hospital, the great and more prolonged contact with COVID-19 patients remains the crucial risk factor for SARS-CoV-2. Therefore, increased and particular care needs to be focused specifically on the most exposed HCWs groups, which should be safeguarded. Furthermore, in order to limit the risk of asymptomatic spread of SARS-CoV-2 infection, the HCWs mild symptoms of COVID-19 should be considered when evaluating the potential benefits of universal staff testing

Different toll collection types of vehicles and different distribution of tollbooths lead to the toll plaza diverging area becoming a typical vehicle weaving area with frequent crossing behaviors and conflicts on highways. This study aims to identify contributing factors to conflict risks of four vehicle-following patterns in a toll plaza diverging area by developing random parameters ordered logit models with heterogeneity in means and variances. The model can flexibly capture the unobserved heterogeneity of the contributing factors in different vehicle-following patterns. Real-world vehicle trajectory data obtained from the toll plaza diverging area in Nanjing, China, are used for model estimation. The results show that vehicle-following patterns with the same toll collection types have higher percentage of severe conflict risks. The average acceleration of the following vehicles, lane marking indicator, the initial lanes and lane-changes of vehicles are significantly associated with the collision risk levels. The standard deviation of surrogate safety measures of all vehicles in sub-segments are found differ significantly between vehicle-following patterns. Furthermore, a series of likelihood ratio tests are adopted to test the spatial dependence in sub-segments of the diverging area. The findings of this study could provide valuable information for safety improvement in toll plazas.

Objectives: To evaluate the relationship between the type of conization, the volume and dimensions of the cone, with the persistence/recurrence of CIN 2-3, presence of affected margins and post-cone HR-HPV positivity. Methods: 227 women treated with LLETZ and histologically confirmed CIN2-3 were evaluated between 1996 and 2006 and followed up until June 2016. Age, type of resection according to IFCPC 2011, volume, cone dimensions, margins were studied. of resection, post-cone high-risk human papillomavirus (HR-HPV) status and viral load. Determinants of HR-HPV positivity were estimated using unconditional logistic regression and time to recurrence was assessed using Kaplan-Meier curves. Results: Persistent/recurrent CIN2-3 was found in 12 cases (5.2%), type 1 conization was performed in 81 patients, with 5 recurrences (6.1%), type 2 in 101 patients, with 6 recurrences (5 .9%) and type 3 resection in 45 women, with 1 recurrence (2.2%). Volume and dimensions were not associated with recurrence. The Log-Rank Test did not show a significant difference between the 3 treatments (p= 0.18). The free margins in type 1 were 37%, in type 2 resection 61% and in type 3 71% (p=0.001). Resection type 1 had 15% HR-HPV post positive cone, type 2 reached 16% and type 3 had 9%, this difference being non-significant (p=0.58). The incidence of recurrence at 36 months in type 1 resection was 0.08%, in type 2 treatment it was 0.04% and in type 3 resection it was 0.0%. Conclusions : Type 3 resection had a higher proportion of free margins and lower post-cone HR-HPV positivity, with a lower incidence of persistence/recurrence.

The present study aims to develop a risk-based approach to find optimal solutions for life extension management for offshore wind farms based on Markowitz’s modern portfolio theory, adapted from finance. The developed risk-based approach assumes that the offshore wind turbines (OWT) can be considered as cash-producing tangible assets providing positive return from the initial investment (capital) with a given risk attaining the targeted (expected) return. In this regard, the present study performs a techno-economic life extension analysis within the scope of the multi-objective optimisation problem. The first objective is to maximise the return from the overall wind assets, while the latter aims to minimise the risk associated with obtaining the return. In formulating the multi-dimensional optimisation problem, the life-extension assessment considers the results of a detailed structural integrity analysis, free-cash-flow analysis, and probability of project failure, local and global economic constraints. Further, the risk is identified as the variance from the expected mean of return on investment. The risk-return diagram is utilised to classify the OWTs of different classes using an unsupervised machine learning algorithm. The optimal portfolios for the various required rate of return are recommended for different stages of life extension.

Cold brew coffee has emerged as a new trend during the last decade. However, “cold brew” is an extraction style of ground roasted coffee with water at less than body temperature (typically 8°C or room temperature) rather than a beverage per se. Cold brew extraction poses several challenges including the need of specific optimization depending on the multivariate influences of coffee variety and processing, roast degree, grinding, dosage, water composition, turbulence, brew system (drip, immersion etc.), time and temperature. While cold brew is typically characterized by a floral sweetness, over-extraction may lead to abundant acidity and bitterness. To avoid this, an extraction degree of 70% was suggested using rather shorter times (i.e. 2 h at 15°C with 80 g/L coffee with optimized medium roast profiles). Due to the lack of sterilizing temperatures during preparation, cold brew is special in the coffee sector because hygiene and food safety aspects pose specific challenges for food industry. To avoid microbiological contamination and spoilage, cold brew should be as freshly prepared as possible and shelf-life should be minimized.

Disposable absorbent hygiene products have evolved for superior performance, enhancing the convenience of daily lives. Yet the use of disposable hygiene pads has brought safety concerns on chemical exposure, and significant efforts have been made to assess the potential risks associated with use of hygiene pads. This article intends to overview the safety assessment framework of diapers and feminine pads, which includes hazard identification, hazard characterization, exposure assessment, risk characterization, and postmarket risk management. Risk assessment of various constituents are reviewed for quantification methods and conservative estimation of exposure parameters. By reviewing the up-to-date considerations in risk assessment, we aim to provide insightful discussion on safety evaluation of current versions of disposable absorbent products. More clinical testing and postmarket surveillance are needed for continuous monitoring of potential health impacts of advanced products and constituents.

We investigate the effect of geopolitical risk on the returns of the Information Technology, Communication Services, and Consumer Staples sector firms within the S&P 500 index. We use the event study methodology and perform more than 17,000 regressions to provide empirical evidence at the sector level that geopolitical risk leads to different responses across these 3 sectors. The response of the Information Technology sector is negative for all event windows under study, except the one spanning 10 days prior to the geopolitical event and 10 days after. The Communication Services sector has positive returns as a result of geopolitical events for all event windows, except the one from the geopolitical event date and 5 days after. The Consumer Staples sector shows a negative impact on geopolitical risk for all event windows except the one from the geopolitical event date and 5 days after, demonstrating a negative correlation to the Communication Services sector.

In these times, consumers mistakenly believe that the terms “expiration date” and “best before” found on packages only convey information about food safety. Consequently, a misunderstanding of these terms contributes to food waste. In this sense, the understanding and behavior of the con-sumer with respect to the two terms were evaluated; in addition, the consumer's perception of the health risks of consuming expired food was analyzed. The research was carried out with the population of the sector of Lurigancho-Chosica, Lima – Peru; sample size was 555 participants. An online survey was sent to consumers over 18 years of age, from different sociodemographic and socioeconomic conditions. In general terms, it was found that 45% (p <0.01) consider that both terms mean the same thing, this result is a problem for food safety. The 67% (p <0.05) and 45% (p <0.05) correctly defined the first and second terms, respectively; however, the behavior is not coherent with the understanding of the terms. In addition, irrational and dangerous behavior toward expired food was evidenced, i.e., they consume expired food - "expiration date", and discard expired food - "best before". Finally, the health risks they perceived from consuming expired foods of both terms were: upset stomach, vomiting, gas, intoxi-cation, and malnutrition; these perceptions are erroneous and unfounded. Sociodemographic and socioeconomic conditions influence the under-standing, behavior, and perception of health risks. Therefore, in general lines, the level of understanding of the terms was low (p<0.01), the be-havior was inappropriate toward expired food (p<0.01), and the percep-tion of the health risk of consuming expired food was incorrect (p<0.01).

Aims: Chronic coronary syndrome is associated with several risk factors, such as dyslipidemia and hypertension. AIP has been demonstrated to be a biochemical risk factor for coronary artery disease (CAD). This study aimed to determine whether AIP is an effective parameter for estimating obstructive CAD. Methods and Results: A total of 345 patients (mean age 62,2±10,3; 63% male) who underwent coronary angiography were included in this study. Obstructive CAD is defined as having one or more vessels with a stenosis of≥50%. Depending on the presence of obstructive CAD, all patients were divided into two groups. The AIP was significantly higher in the obstructive coronary artery group (AIP; 0,49±0,26 vs. 0,58±0,27, p=0,002). In univariate analysis, AIP was significantly associated with obstructive coronary artery disease [OD:3,74 (CI95% 1,62-8,64), P=0,020]. The AIP was further adjusted for confounding risk factors in three multivariate analysis models. Therefore, all three models showed a significant association. According to ROC analysis, 0.49 is the cut-off value for AIP, and a value above 0.49 indicates 50% coronary artery stenosis Conclusions: AIP may be used in the assessment of cardiovascular risk in patients with stable angina pectoris, and it may also be used to estimate obstructive CAD.

Bonfire night is a worldwide phenomenon given to numerous annual celebrations characterised by bonfires and fireworks. Since Thailand has no national ambient air quality standards for metal particulates, it is important to investigate the impacts of particulate injections on elevations of air pollutants and ecological health impacts resulting from firework displays. In this investigation, Pb and Ba were considered potential firework tracers because their concentrations were significantly higher during the episode and lower than/comparable with minimum detection limits during other periods, indicating that their elevated concentrations were principally due to pyrotechnic displays. Pb/Ca, Pb/Al, Pb/Mg, and Pb/Cu can be used to pin-point emissions from firework displays. Air mass backward trajectories (72 h) from the Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) model indicated that areas east and north-east of the study site were the main sources for the air transportation. Although the combined risk associated with levels of Pb, Cr, Co, Ni, Zn, As, Cd, V, and Mn was far below the standards mentioned in international guidelines, the lifetime cancer risks associated with As and Cr levels exceeded US-EPA guidelines, and may expose inhabitants of surrounding areas of Bangkok to elevated cancer risk.

The failure to acknowledge and account for environmental externalities or spillovers in climate change adaptation policy, advocacy and programming spaces exercabates the risk of ecological degradation, more so, degradation of land. In particular use of unsuitable water sources for irrigation may increase salinisation risks. However, little if any policy assessments and research effort has been directed at investigating how farmer perceptions mediate spillovers from the ubiquitous irrigation adaptation strategy. In this study cognitive failure and/or bias construct is examined and proposed as an analytical lens in research, policy and learning and the convergence of disaster risk reduction and climate change adaptation discourses. The findings from small-scale farmers, Machakos and Kakamega counties, Kenya, suggest multifaceted biases and failures about the existence and importance of externalities in adaptation planning discourses. Among other dimensions, cognitive failure which encompasses fragmented approaches among institutions for use and management of resources, inadequate policy and information support, as well as, poor integration of actors in adaptation planning accounts for adaptation failure. The failures in such Human-Environment system interactions have the potential to exercabate existing vulnerability of farmer production systems in the long run. The findings further suggest that in absence of risk message information dissemination, education level, farming experience and information accumulation, as integral elements to human capital, do not seem to have significant effect on behaviour about mitigation of environmental spillovers. Implicitly, reversing the inherent adaptation failures calls for system approaches that enhance coordinated adaptation planning, prioritises proactive mitigation of slow onset disaster risks and broadens decision support systems, such as, risk information dissemination integration into the existing adaptation policy discourses and practice.

Outcomes of repeated decision--making processes may be affected by adversarial actors, without being noticed. Adversaries may try to gain knowledge about a particular decision--making process, identify its decision--makers, and guess which underlying decision support model is used. Then they can simulate the process, and craft different scenarios to affect its decision outcomes. Therefore, designers of decision support systems need to incorporate this in the decision modeling phase. The purpose of this study is to demonstrate this for the repeated decision--making in a patent application process. In this process, two sequential decision outcomes can be affected by adversarial actors: a company's decision to which type of patent office to send a patent request to, and the decision of a specialized patent officer to grant an application, or not. It is motivated that the company's decision--maker is \emph{bounded} rational. A theory for information--theoretic bounded rational decision--making under uncertainty proposed by Ortega et al.\ is adopted to model this type of decision--maker. A framework is provided to simulate a number of scenarios that adversaries may deploy to affect decision outcomes of a repeated patent application decision--making process. The framework is also utilized for statistically testing the presence of the scenarios, and to demonstrate how to discourage adversaries from deploying them.

In Taiwan, colorectal cancer is ranked second and third in terms of mortality and cancer incidence, respectively. In addition, medical expenditures related to colorectal cancer are considered to be the third highest. While advances in treatment strategies have provided cancer patients with longer survival, potentially harmful second primary cancers can occur. Therefore, second primary colorectal cancer analysis is an important issue with regard to clinical management. In this study, a novel predictive scheme was developed for predicting the risk factors associated with second colorectal cancer in patients with colorectal cancer by integrating five data mining classification techniques, including support vector machine, random forest, multivariate adaptive regression splines, extreme learning machine, and extreme gradient boosting. In total, 4,287 patients in the datasets provided by three hospital tumor registries were used. Our empirical results revealed that this proposed predictive scheme provided promising classification results and the identification of important risk factors for predicting second colorectal cancer based on accuracy, sensitivity, specificity, and area under the curve metrics. Collectively, our clinical findings suggested that the most important risk factors were the combined stage, age at diagnosis, BMI, surgical margins of the primary site, tumor size, sex, regional lymph nodes positive, grade/differentiation, primary site, and drinking behavior. Accordingly, these risk factors should be monitored for the early detection of second primary tumors in order to improve treatment and intervention strategies.

Background: Permanent Daylight Savings Time (DST) may improve road safety by providing more daylight in the evening but could merely shift risk to morning commutes or increase risk due to fatigue and circadian misalignment. Methods: To identify how potential daylight exposure and fatigue risk could differ between permanent DST versus permanent Standard Time (ST) or current time arrangements (CTA), generic work and school schedules in five United States cities were modeled in SAFTE-FAST biomathematical modeling software. Commute data were categorized by morning (0700-0900) and evening (1600-1800) rush hours. Results: Percent darkness was greater under DST compared to ST for the total waking day (t=2.59, p=0.03) and sleep periods (t=2.46, p=0.045). Waketimes occurred before sunrise 63%±41% percent of the time under DST compared to CTA (42%±37%) or ST (33%±38%; F(2, 74)=76.37; p<0.001). Percent darkness was greater during morning (16%±31%) and lower during evening rush hour (0%±0%) in DST compare to either CTA (morning:7%±23%; evening:7%±14%) or ST (morning:7%±23%; evening:7%±15%). Discussion: Morning rush hour overlapped with students’ commutes and shift worker reverse commutes, which may increase traffic congestion and risk compared to evening rush hour. Switching to permanent DST may be more disruptive than either switching to ST or keeping CTA without noticeable benefit to fatigue or potential daylight exposure.

Prostate cancer (PCa) is most commonly observed in male patients. Although PCa progresses relatively slowly, high-risk PCa is associated with an increased risk of lymph nodes, distant metastases, and PCa-related death. Several guidelines recommend radiation therapy (RT) of the prostate combined with long-term androgen deprivation therapy for high-risk PCa. A comparison of clinical outcomes between radical prostatectomy (RP) and RT for high-risk PCa by propensity score-matched analysis showed that RP had a significantly higher risk of biochemical recurrence than RT. However, the combination of neoadjuvant chemohormonal therapy followed by RP may be more likely to achieve a cure when overall survival is considered the primary endpoint. In this review, we aimed to confirm the oncological outcomes of RP and RT for high-risk PCa and highlight the importance of neoadjuvant therapy followed by RP for high-risk PCa.

In recent years, there is a growing concern about the alarming spread of antimicrobial resistance (AMR) in different environments. Increasingly, many species of bacteria, fungi and viruses are becoming immune to the most commonly used pharmaceuticals. One of the causes of the development of the resistance is the persistence of these drugs, excreted by humans, in municipal and hospital wastewater (WW). Consequently, wastewater treatment plants (WWTPs) are a primary source of antimicrobial resistance genes as novel pollutants. This systematic review sought to examine the relevant literature on pharmaceutical residues (PRs) responsible for AMR in municipal and hospital WW in order to propose a classification of the PRs of greatest concern and provide an updated source for AMR management in WWTPs. Among 546 studies collected from four databases, 18 were included in the present review. The internal and external validity of each study was assessed, and the risk of bias was evaluated on a 20-parameter basis. Results were combined in a narrative synthesis discussing influents and effluents PR concentrations at 88 WWTPs, seasonal variations, differences between hospital and municipal WW, environmental risk assessment values of antimicrobial substances and treatment facilities removal efficiencies. Among the 45 PRs responsible for AMR evaluated in this study, the antibiotics ciprofloxacin, clarithromycin, erythromycin, metronidazole, ofloxacin, sulfamethoxazole and trimethoprim constitute a considerable risk in terms of ubiquitous distribution, worrying concentrations, risk quotients values, and resistance to removal treatments. Gaps in knowledge, data and information reported in this review provide a valuable source for managing AMR in WWTPs.

Objectives: The aim of our current study was to analyze whether the use of important measures of methodological quality and reporting of randomized clinical trials published in the field of cardiovascular disease research have changed over time. Further aim was to investigate whether there was an improvement over time in the ability of these trials to provide a good estimate of the true intervention effect. Methods We conducted two searches in the Cochrane Central Register of Controlled Trials (CENTAL) database to identify cardiovascular clinical research trials published in either 2012 or 2017. Randomized clinical trials (RCTs) trials in cardiovascular disease research with adult participants were eligible to be included. We randomly selected 250 RCTs for both publication year 2012 and 2017. Trial characteristics, data on measures of methodological quality and reporting were extracted and risk of bias for each trial was assessed. Results As compared to 2012 in 2017 there were significant improvements in the reporting of the presence of a data monitoring committee (42.0% in 2017 compared to 34.4% in 2012), and a positive tendency of registering cardiovascular disease research RCTs in clinical trial registries (83.6% in 2017 compared to 72.0% in 2012). On the other hand, we also observed that significantly fewer RCTs reported sample size calculation (60.4% in 2017 compared to 98.4% in 2012) in 2017 as compared to 2012. RCTs in 2017 were more likely to have low overall risk of bias ( RoB ) than in 2012 (29.2% in 2017compared to 21.2% in 2012). Conclusion: As compared to 2012 in 2017 there were significant improvement in some, but not all the important measures of methodological quality. Although more trials in the field of cardiovascular disease research had a lower overall RoB in 2017, the improvement over time was not consistently perceived in all RoB domains.

The functions of annexin A1 (ANXA1) that is expressed on membranes and in cytoplasmic granules have been fully described. Nonetheless, the role of this protein in protecting against DNA damage in the nucleus is still emerging and requires further investigation. Here, we investigated the involvement of ANXA1 in DNA damage response in placental cells. Placenta was collected from ANXA1 knockout mice (AnxA1-/-) and pregnant women with gestational diabetes mellitus (GDM). The placental morphology and ANXA1 expression, which are related to the modulation of cellular response markers in the presence of DNA damage, were analyzed. Total area of AnxA1-/- placenta was smaller because of reduced labyrinth zone, enhanced DNA damage, and impaired base excision repair (BER) enzymes, which resulted in the induction of apoptosis in the labyrinthine and junctional layers. The placentas from pregnant women with GDM showed reduced expression of AnxA1 in the villous compartment, increased DNA damage, apoptosis, and reduction of enzymes involved in the BER pathway. Our translational data provide valuable insights into the possible involvement of ANXA1 in the response of placental cells to oxidative DNA damage and represent advancement in investigations on the mechanisms involved in placental biology.

The global coronavirus (COVID-19) pandemic has created a whole new set of risks in construction industries generating unprecedented delays, disruptions, and uncertainty on construction projects, and has forced the industries in adopting more sophisticated technologies while combating the reduced workforce on job sites. Further, the post-pandemic era of construction is expected to be a lot different as the industries will embrace the technology as the augmentation and collaboration strategy. Thus, it will be extremely hard to sustain for construction industries in the absence of effective risk management. The existing risk plans need to be inspected for their capability of handling new risks arising from COVID-19 and the project managers will need to make the necessary revisions as needed. This paper discusses on past (NORM), present (NEW NORM), and future (Post COVID-19 NORM) of the construction industry and highlights key strategies for managing projects and construction risks during and post COVID-19 pandemic.

This study analyses the short-run hydro generation scheduling for the wind power differences from the contracted schedule. The approach for construction of the joint short-run marginal cost curve for the hydro-wind coordinated generation is proposed and applied on the real example. This joint short-run marginal cost (SRMC) curve is important for its participation in the energy markets and for economic feasibility assessment of such coordination. The approach credibly describes the short-run marginal costs which this coordination bears in “real life”. The approach is based on the duality framework of a convex programming and as a novelty combines the shadow price of risk mitigation capability and the water shadow price. The proposed approach is formulated as a stochastic linear program and tested on the case of the Vinodol hydropower system and the wind farm Vrataruša in Croatia. The result of the case study is a family of 24 joint short-run marginal cost curves.

The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread rapidly to most parts of the world, causing high numbers of deaths and significant social and economic impacts. SARS-CoV-2 is a novel coronavirus with a suggested zoonotic origin and with the potential for cross-species transmission among animals. Antarctica can be considered the only continent free of SARS-CoV-2 although at the end of the 2019-2020 tourist season, at least one SARS-CoV-2 positive tourist visited the Antarctic Peninsula. Therefore, concerns have been expressed regarding the potential human introduction of this virus to the continent through the activities of research or tourism with potential effects including those related to human health, but also the potential for virus transmission to Antarctic wildlife. This reverse-zoonotic transmission risk to Antarctic wildlife is assessed considering the available information on host susceptibility, dynamics of the infection in humans, and contact interactions between humans and Antarctic wildlife. Measures to reduce the risk are proposed as well as the identification of knowledge gaps related to this issue.

Introduction: Due to the spread of SARS CoV-2 virus responsible for COVID-19 disease, there is an urgent need to analyse COVID-19 epidemic perception in Poland. This study aims to investigate social perception of coronavirus in the Internet media during the epidemic. It is a signal report highlighting the main issues in public perception and medical commutation in real time. Methods: We study the perception of COVID-19 epidemic in Polish society using quantitative analysis of its digital footprints on the Internet on platforms: Google, Twitter, YouTube, Wikipedia and electronic media represented by Event Registry, from January 2020 to 29.04.2020 (before and after official introduction to Poland on 04.03.20). We present trend analysis with a support of natural language processing techniques. Results: We identified seven temporal major clusters of interest on the topic COVID-19: 1) Chinese, 2) Italian, 3) Waiting, 4) Mitigations, 5) Social distancing and Lockdown, 6) Anti-crisis shield, 7) Restrictions releasing. There was an exponential increase of interest when the Polish government “declared war against disease” around 11/12.03.20 with a massive mitigation program. Later on, there was a decay in interest with additional phases related to social distancing and an anti-crisis legislation act with local peaks. We have found that declarations of mitigation strategies by the Polish prime minister or the minister of health gathered the highest attention of Internet users. So enacted or in force events do not affect interest to such extent. Traditional news agencies were ahead of social media (mainly Twitter) in dissemination of information. We have observed very weak or even negative correlations between a colloquial searching term 'antiviral mask' in Google, encyclopaedic definition in Wikipedia “SARS-CoV-2” as well official incidence series, implying different mechanisms governing the search for knowledge, panic related behaviour and actual risk of acquiring infection. Conclusions: Traditional and social media do not only reflect reality, but also create it. Risk perception in Poland is unrelated to actual physical risk of acquiring COVID-19. As traditional media are ahead of social media in time, we advise to choose traditional news media for a quick dissemination of information, however for a greater impact, social media should be used. Otherwise public information campaigns might have less impact on society than expected.

We found out main regularities of surface waters pollution by diesters of о-phthalic acid (PAEs) at the background level of concentrations. Lake Baikal was selected as a model for our studies. The composition of PAEs in Baicalins waters is represented by dimethyl phthalate (DMP), diethyl phthalate (DEP), di-n-butyl phthalate (DnBP), and di-(2-ethylhexyl) phthalate (DEHP). Their concentrations are assessed in statistically valuable average values and ranges: 0.02 (0.01 – 0.02), 0.07 (0.06 – 0.09), 0.55 (0.47 – 0.66), 0.30 (0.26 – 0.34), µg/L, respectively. Main factors determining PAEs concentration are found out: year and season of sampling. The distribution of PAEs in the water body meets their hydrophobicity and is characterized by: i) even distribution of minor hydrophilic congeners DMP and DEP in the whole water area; ii) maximal concentrations of hydrophobic congeners DnBP and DEHP in the upper and near-bottom layers of the water column; iii) decrease of concentration of hydrophobic congeners in the near-shore zone. The contribution of near-shore sources of PAEs into the pelagic site is minimal, the main pollutants source is atmospheric transfer. A valuable contribution of DEHP from biogenic sources into the background level of PAEs is shown. Within RQ coefficients, we assessed the environmental risk for Baicalins biota.

In the European Union, Occupational Safety and Health legislation generally refers to European Regulation (CE) n. 1272/2008 to define and classify carcinogens of concern for occupational risk assessment and exposure assessment. In Europe, the current reference is Directive (UE) 2022/431, regarding carcinogen, mutagen and reprotoxic agents (CMRs) exposure. However, at worldwide level, different classification approaches are used to establish carcinogenicity of substances and it is often difficult to compare the classifications of carcinogenicity (CoCs) proposed by different international bodies. This study aims to investigate a list of carcinogens of concern in occupational settings based on the CLP (Classification Labelling Packaging) CoC, and to create a tool that allows a rapid translation-comparison of some international CoCs with the reference one. CoCs proposed by various sources were consulted and used to apply a translation method, to favor an alignment of different CoCs according to a reference. Results outlined that considering diverse sources, CoCs can result in different classifications of the same chemicals. Overall, this may have implications for the hazard assessment process, which is the base of risk assessment. The proposed tool is expected to help risk assessors in the occupational field when it is needed to have a comparison with different CoC systems.

Pressure ulcers carry a significant risk in clinical practice and require effective preventive measures. This paper proposes a practical and interpretable approach to estimate the risk levels of pressure ulcers using decision tree models. In order to address the common problem of imbalanced learning in nursing classification datasets, various oversampling configurations are analyzed to improve data quality prior to modeling. The decision trees built are based on three easily identifiable and clinically relevant pressure ulcer risk indicators: mobility, activity and skin moisture. Their analysis allows nursing professionals to predict the risk levels of pressure ulcer and make informed decisions about patient care. Additionally, this research introduces a novel tabular visualization method to enhance the usability of the decision trees in clinical practice. The approach proposed aims to support nursing professionals in making timely decisions regarding the appropriate preventive interventions according to the risk levels of pressure ulcers, thus improving patient outcomes and healthcare costs. The usefulness and effectiveness of the models presented make them a valuable resource for nursing care in the prevention of pressure ulcers.

The use of artificial intelligence technologies may help companies obtain the optimal use of resources and accomplish more activities with an increase in productivity by 40%. With access to real-time data and the ability to learn from patterns and behaviors, AI can perform these routine tasks more efficiently. Ambient intelligence, Ami, is one of the applications of artificial intelligence, which is called artificial environmental intelligence, which is a concept that focuses on using technology to create an environment that is intelligent and responsive to the needs of its users. This technology has the potential to revolutionize disaster response and management, which in turn facilitates access to necessary information and resources. necessary vitality in the event of a crisis. It may use ambient intelligence to create a network of sensors that can detect and respond to changes in the environment. So that this network can be used to monitor the environment for potential disasters, such as floods, fires and earthquakes. Sensors can also be used to detect changes in temperature, humidity, and other environmental factors that may indicate a potential disaster. This information can then be used to alert emergency responders and provide them with the information needed to respond quickly and effectively. Ambient intelligence can also be used to create a comprehensive database of resources and information that can be accessed in times of crisis. This database may include information about the location of shelters, medical facilities, and other resources that can be used to assist those affected by a disaster. It may also provide information about the condition of roads, bridges, and other infrastructure that may be affected by a disaster. This information can be used to inform response and management decisions, helping to ensure that resources are used in the most efficient way possible. Ambient intelligence can be used to create a communication platform between emergency responders and those affected by a disaster. This platform can also be used to provide updates on the emergency situation, in addition to providing information about available resources to those affected. This can help ensure that those affected by a disaster can access the resources they need in a timely manner.

This literature review was aimed to identifying the opportunistic bacterial pathogens that can be transmitted by contaminated food and represent a current threat for patients particularly suscep-tible to infections because of underlying conditions or predisposing factors. The analysis was focused on recent case or outbreak reports, and systematic reviews published in years 2019 - 2023 and resulted in sorting 24 bacterial groups comprising genera or species able to cause a variety of systemic or invasive infections if ingested with food or drinking water. These included both bacteria known to cause mild infections in immunocompetent persons and bacteria considered innocuous that are used in food fermentation or as probiotics. No recent cases from dietary routes were reported for bacteria of critical importance as nosocomial pathogens and widely occurring in food products, primarily, Acinetobacter baumanii and Klebsiella pneumoniae. However, the very first sources of their introduction in the clinical environment still need to be estab-lished. In many instances, risky dietary habits such as eating raw fish, seafood, raw meat, unpasteurized milk and derived products or the lack of control on fermentation processes led to the reported illnesses, pointing out to the necessity to improve the hygiene of production and consumer’s awareness of risks.

Modelling and presenting mathematical relationships for human behaviour is one of the most complex issues that researchers have always dealt with. In this article, a bottom-up framework for calculating agricultural needs is presented using the socioeconomic characteristics of farmers (such as education level, age, and dependence on income on agriculture) and how their lands are located concerning each other (interactions between neighbours). The objective function of this framework is to maximize the profit of individual farmers based on the amount of water received. Two scenarios, ABM1 (not considering neighbourhood effects) and ABM2 (all cases of farmers' placement and feeling neighbourhood effects), were investigated. In the first scenario (ABM1), there was a noteworthy reduction in water deficit volumes by approximately 35%, accompanied by a 20% increment in farmers' profits. Interestingly, higher risk-taking tendencies correlated with reduced profit margins. The second scenario (ABM2) underscored the significant role of neighborhood dynamics in cultivating diverse behavioral patterns among farmers, subsequently affecting their profitability. A granular examination revealed that farmers with a higher propensity for risk-taking generally accrued lower profits. Additionally, the study facilitated the calculation of total annual profits and average water consumption for each farmer, offering valuable insights for optimizing water resource management and allocation strategies. These findings are instrumental for planners and water resource managers aiming to promote sustainable agricultural practices and efficient water use.

Socially Responsible Investments, also referred to as ethical or sustainable investments, have experienced rapid global growth in recent years. They represent an investment approach that incorporates social, environmental, and ethical considerations into decision-making processes. Consequently, the significance of SRIs has captured the attention of academics, prompting inquiries into the impact of integrating social criteria on portfolio performance. The primary objective of this work was to conduct a comparative study of the performance between socially responsible and non-socially responsible investment funds, using funds domiciled in Portugal and Spain. Various multi-factor models, including the three-factor model of Fama and French (1992), the four-factor model of Carhart (1997), and the five-factor model of Fama and French (2015), were employed to assess performance. The sample comprised 125 investment funds, with 43 identified as socially responsible and 82 as non-socially responsible. The study's findings indicate that there are no significant differences between socially responsible funds and their conventional counterparts. The majority of funds experience performance alterations during periods of crisis compared to crisis-free periods. Additionally, when comparing non-conditional models with conditional models, an improvement in the explanatory power of the latter is observed. This suggests that the inclusion of the dummy variable enhances the quality of fit for the models.

The present work fronts the human pose estimation problem, developing a method that enables automated ergonomic risk assessment. A research methodology is developed to calculate joint angles from digital snapshots or videos by using computer vision and machine learning techniques to get a more accurate ergonomic risk assessment. Starting from an ergonomic analysis, the study explores the use of a semi-supervised training method to detect the skeletons of workers. The research methodology developed aims to infer the positions and angles of the joints, to calculate the criticality index based on the RULA scores and fuzzy rules. Then, to prevent work-related musculoskeletal disorders (WMSD), improve production capacity and decrease the ergonomic risk, the system uses joint with a collaborative robot to support the worker in carrying out the most critical operations. The method has been tested on a real industrial case in which manual assembly activities of electrical components are conducted. The approach developed can overcome the limitations of recent developments based on computer vision or wearable measurement, sensors by performing an assessment with an objective and flexible ap-proach to postural analysis development.

The global SARS-Cov-2 which caused the coronavirus disease 2019 (COVID-19) pandemic has had a significant impact over the last 3.5 years, especially among healthcare workers (HCWs) who were constantly in the forefront of the pandemic. Due to the nature of their work, HCWs faced a potential risk of exposure. Therefore, this study investigated the individual-level factors associated with perceived COVID-19 risk among South African HCWs. We used an analytical cross-sectional study design to analyse data from the South African Health Care workers’ response to the Coronavirus (COVID-19) pandemic online survey conducted by the Human Sciences Research Council across the nine provinces in South Africa, from 11th April to 7th May 2020. In this study, only data (n= 5 579) with non-missing values for COVID-19 risk and individual-level factors (age, gender, educational level, occupational category, and race) was analysed. Univariate and Multivariate binomial logistic regression analyses were conducted. The crude and adjusted odds ratio and p-value ≤ 0.05, were used to describe the association between the individual-level factors and perceived COVID-19 risk, from low-medium to high. The binomial logistic regression was used to assess the factors associated with high perceived risk. Perceived COVID-19 risk among HCWs in South Africa was significantly associated with age, race, educational level and occupational category. Being 60 years and older, being “White”, having a Master’s and Doctorate degrees and being a healthcare worker other than a nurse practitioner and medical practitioner, all had higher odds of having high perceived COVID-19 risk. The findings may be used to guide policies and programs aimed at mitigating the impacts of COVID-19 and other similar pandemics.

The spatial and temporal changes in social vulnerability to natural hazards in Mexico are analyzed. To this end, using census data from 2000, 2010, and 2020 and a statistical method, different indices were computed, and with a GIS-based approach, patterns of social vulnerability are examined. In addition, a risk assessment test for severe weather (thunderstorms, hailstorms, and tornadoes) is made out. The results show different common social vulnerability driving factors in the three analyzed years, with root causes that have not been addressed since the beginning of the century. Likewise, a wider gap between Mexico's most and least vulnerable populations is identified. The changes in spatial patterns respond to different historical situations, such as migration, urbanization, and increased population. Also, poverty, ethnicity, and marginalization factors located in very particular regions in Mexico have remained relatively the same in the last few years. These situations have strongly influenced the spatial-temporal distribution of vulnerability in the country. The role of social vulnerability in the disaster risk to extreme events such as thunderstorms, hailstorms, and tornadoes in Mexico is fundamental to understanding changes in disaster distribution at the national level, and it is the first step to generating improvements in integrated risk management.

Background: Patients with chronic obstructive pulmonary disease (COPD) often suffer from acute exacerbations. Our objective was to describe recurrent exacerbations in a GP based Swiss COPD cohort, and develop a statistical model for predicting exacerbation. Methods: In a questionnaire-based COPD cohort, demographic and medical data were recorded for 24 months. Data set was split into training (75%) and validation (25%) datasets. A negative binomial regression model was developed using the training dataset to predict the exacerbation rate within 1 year. An exacerbation prediction model was developed, and the overall performance was validated. A nomogram was created to facilitate the clinical use of the model. Results: Of the 229 COPD patients analyzed, 77% of patients had no exacerbation during the follow-up. The best subset in the training dataset found that lower forced expiratory volume, high scores on the MRC dyspnoea scale, exacerbation history, being on combination therapy of LABA+ICS or LAMA+LABA at baseline were associated with a higher rate of exacerbation. When validated, the area-under-curve (AUC) was 0.75 for one or more exacerbations. Calibration was accurate (predicted 0.34 exacerbations vs observed 0.28 exacerbations). Conclusion: Nomograms built from these models can assist clinicians in the decision-making process of their COPD care.

Aim: To improve risk stratification in early-stage endometrial cancer (EC), we performed mo-lecular classification, and L1CAM immunohistochemistry (IHC) for additional risk assessment. Method: We analyzed archival tumor tissue from 247 early-stage EC patients. POLE mutations were detected using a Droplet digital polymerase chain reaction assay and Sanger sequencing, while the mismatch repair (MMR) status was determined by MMR protein IHC and MSI test. Additionally, we conducted IHC of p53 and L1CAM. Results: The 247 ECs were categorized into four subgroups: POLE-mutated (13.0%), MMR-deficient (27.9%), p53-abnormal (8.5%), and non-specific molecular profile (NSMP, 50.6%). We further subcategorized NSMP subgroup into NSMP-L1CAMneg (44.9%) and NSMP-L1CAMpos (5.7%), which we refer to as the molecu-lar-L1CAM classification. The molecular-L1CAM classification was an independent prognostic factor for recurrence-free survival (RFS) and overall survival (OS) (p <0.001, each). Similarly, the simplified L1CAM-p53 categorization, for practical use, remained an independent prognostic factor for RFS and OS (p <0.001, p =0.003, respectively). Conclusion: Integrating the molecu-lar-L1CAM classification or the simplified L1CAM/p53 categorization can enhance risk stratifi-cation in early-stage EC, providing valuable prognostic information to guide treatment deci-sions and improve patient outcomes.

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.

Cervical cancer is the most common female reproductive tract tumor and is currently the only cancer that can be prevented by vaccination. Early detection and treatment of cervical cancer can be achieved through regular screening for human papillomavirus (HPV). Therefore, in this paper, an electrochemical sensor was designed to detect HPV 16 using a dual signal amplification technique. APTES modified glassy carbon electrode to improve stability. Combining gold nanoparticles and chain amplification reactions for signal amplification purposes. The limit of detection (LOD) was 1.731×10-16 mol/L, and the detection range of this electrochemical sensor was increased in comparison to previous research, with a linear response range from 1.0×10-13 mol/L to 1.0×10-5 mol/L (R2 = 0.99232) for the target detector.In addition, the sensor showed equally good recovery in sophisticated human serum samples. It shows that it has good interference resistance and the designed biosensor can be a powerful and reliable tool for clinical disease diagnosis.

Arsenic (As) contamination of groundwater is a common problem in BDP. The alkaline pH of the groundwater provides favourable condition for geomicrobiochemical processes, where organic matter also plays an important role in mobilization of As. The total arsenic content (AsT) of the groundwater is in the range of 69-178 µgL-1 with mean value of 118.58 µgL-1. The groundwater quality of monitored drinking water wells are related to local land–use pattern and rural sanitation installation and practices (which can have a strong influence on microbial contamination). The study indicates that As heterogeneity, probably a consequence of microbial heterogeneity is a feature of the study area. The excessive total and fecal coliform (TC and FC) count of the ponds possibly suggest uncontrolled surface run offs and sewage leakage, notably from nearby pit-latrine, which increased the microbial contamination in these water sources. The tube wells located in close proximity (~ 2-3 m) of the surveyed ponds are also contaminated with high TC and FC values, due to faulty water supply system, pond water infiltration and cracked tube well platforms. Coliforms may influence geomicrobiological processes in groundwater and thereby, contribute in As release and mobilization. The TC and FC values of monitored tube wells and ponds show seasonal variation, with high TC and FC values during wet season. Attempt has been made to focus on sanitation risk of the monitored wells (based on sanitation and fecal coliform scores) which is usually less explored. The sanitary risk score reveal the need of immediate attention to all the sites, as 25.0 %, 58.3 %, 11.1 % and 5 % of tube wells of the six sites fell under very high risk (sanitary risk score ≥ 9), high risk (sanitary risk score 6-8), intermediate risk (sanitary risk score 3-5) and low risk category (sanitary risk score 0-2), respectively. Fecal coliform score classified all the sites under intermediate risk category (FC count 10-100 per 100 ml of water). The predominance of As heterogeneity particularly in areas under high risk category (showing high TC and FC contamination) is observed along with the similar sinusoidal pattern of TC, FC and AsT content. Finally, this study shed light on the factors responsible for unsafe nature of monitored tube wells and the influence of anthropogenic activities on the microenvironment of the groundwater, which could be a probable reason behind the As heterogeneity in the groundwater of the study area.

Strengthening the analysis and risk assessment of the pig epidemic will help to better prevent and mitigate epidemic risks and promote high-quality development of the pig industry. Based on the systematic grasp of the situation of live pig epidemics, a risk assessment index system was constructed, and the spatial and temporal variation characteristics of the risk of pig epidemics in China were explored by the entropy method. In recent years, the overall trend in pig epidemics in time first increased and then decreased, and in space, the trend in the acceleration of the spread across the country continued to weaken. China still faces challenges, such as many types and a wide range of diseases, large total livestock breeding and weak epidemic prevention and control capacity, and a large risk of introduction of foreign animal epidemics. The spatial and temporal variation in the pig epidemic risk was obvious; there was one high-risk area, two higher-risk areas and 10 medium-risk areas in recent years, and the epidemic risk was highest in Beijing, Hainan, Liaoning, Tibet and Zhejiang. However, there were significant differences in the regional distribution of the risk of pig epidemics in different years. To further build a secure “defense system” for the high-quality development of the pig industry, it is recommended to improve the monitoring and early warning system of pig epidemic risk, perfect the pig epidemic prevention and control system, and strengthen the regional collaboration mechanism of epidemic prevention and control.

: Border management serves as a crucial control checkpoint for governments to regulate the quality and safety of imported food. In 2020, the ensemble learning prediction model EL V.1 was introduced to Taiwan's border food management. This model primarily assesses the risk of imported food by combining five algorithms to determine whether quality sampling should be performed on imported food at the border. In this study, a second-generation ensemble learning prediction model, EL V.2, was developed based on seven algorithms to enhance the "detection rate of unqualified cases" and improve the robustness of the model. The chi-square test was employed to compare the efficacy of "pre-launch (2019) random sampling inspection" and "post-launch (2020–2022) model prediction sampling inspection". For cases recommended for inspection by the ensemble learning model and subsequently inspected, the unqualified rates were 5.10%, 6.36%, and 4.39% in 2020, 2021, and 2022, respectively, which were significantly higher (p=0.000***) compared with the random sampling rate of 2.09% in 2019. The prediction indices established by the confusion matrix were used to further evaluate the prediction effects of EL V.1 and EL V.2, and the EL V.2 model exhibited superior predictive performance compared with EL V.1, and both models outperformed random sampling.

Practitioners who assess the risk associated with urban trees often factor in the presence or absence of visual tree defects when determining whether a tree may fail. While these defects are a main fixture in many tree risk assessment systems and best management practices, the research supporting their usefulness in predicting tree failure during storms is limited. When looking at past research involving populations of storm-damaged trees, there are several defects that have never predicted failure (or have been associated with reduced rates of failure). In this study, we took a closer look at four such defects: codominant branches; branch unions with included bark; multiple stems originating from the same point; and overextended branches. After Hurricane Ian, we revisited 1519 risk assessed trees where one of these four defects was identified as the primary condition of concern. Fourteen of these trees experienced branch failure during the storm (which hit the study area as a downgraded tropical storm). Upon closer inspection, none of these failures occurred at the defect of concern. Our findings indicate that none of the defects assessed appeared to increase the likelihood of tree failure in the species tested. Our results are in line with past research on these defects derived from post-storm assessments and analysis.

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.

A thermal load dispatch problem minimizes the number of objectives viz operating cost and emission of gaseous pollutants together while allocating the power demand among the committed generating units subject to physical and technological system constraints. A stochastic thermal load dispatch problem is undertaken while taking into consideration, the uncertainties, errors in data measurements and nature of load demand which is random. Owing to uncertain load demand, variance due to mismatch of power demand termed as risk, is considered as another conflicting objective to be minimized. Generally multiobjective problems generate a set of non-inferior solutions are generated and supplied to a decision maker to select the best solution from the set of non-inferior solutions. This paper proposes opposition-based greedy heuristic search (OGHS) method to generate a set of non-inferior solutions. Opposition-based learning is applied to generate initial population to select good candidates. Migration to maintain diversity in the set of feasible solutions is also based on opposition-based learning. Mutation strategy is implemented by perturbing the genes heuristically in parallel and better one solution is sought for each member. Feasible solutions are achieved heuristically by modifying the generation-schedules in such a manner that violation of operating generation limits are avoided. The OGHS method is simple to implement and provides global solutions derived from the randomness of the population generated without tuning of parameters. Decision maker exploits fuzzy membership functions to decide the final decision. Validity of the method has been demonstrated by analysing systems in different scenarios consisting of six generators and forty generators.

Human Adenovirus (HAdV) infection occurs in 14-16% of patients in the early months after pediatric hematopoietic cell transplantation (HCT) and this correlates with a higher risk to develop HAdV disease and overall 6-month mortality. The main risk factors for HAdV infection are T-cell depletion of the graft by ex vivo CD34+ selection or in vivo use of alemtuzumab or anti-thymocyte serum, the development of grade III-IV graft versus host disease (GVHD), the type of donor (unrelated donor, cord blood, haploidentical or HLA mismatched parent) and severe lymphopenia (< 0.2 x 109/L). The prevention of HAdV disease is based on early intervention with antivirals in the asymptomatic patient when the permitted viral load threshold on blood (> 102-3 copies/ml) and/or on the stool (109 copies/g stool) is exceeded. Cidofovir, a monophosphate nucleotide analog of cytosine, is the primary drug for preemptive therapy, used at 5 mg/kg/week for 2 weeks followed by 3-5 mg/kg every 2 weeks. The alternative schedule is 1 mg/kg every other day (three times/week). Enhancing virus-specific T-cell immunity in the first months post-HCT by donor-derived or third-party-derived virus-specific T cells represents an innovative and promising way of intervention applicable both in prevention and therapeutic setting.

In West Africa, research on the hepatitis E virus (HEV) is barely covered despite the recorded outbreaks. The still low level of access to safe water and adequate sanitation is one of the main factors of HEV spread in developing countries. HEV infection induces acute or sub-clinical liver diseases with a mortality rate ranging from 0.5 to 4%. The mortality rate is more alarming (15 to 25%) among pregnant women, especially in the last trimester of pregnancy. Here, we conducted a multicentric socio-demographic and seroepidemiological survey of HEV in Senegal among pregnant women. A total of 1,227 consenting participants attending antenatal clinics responded to our questionnaire. Plasma samples were collected and tested for anti-HEV IgM and IgG by using the WANTAI HEV-IgM and IgG ELISA assay. HEV global seroprevalence was 7.9% with 0.5% and 7.4% for HEV IgM and HEV IgG, respectively. One participant's sample was IgM/IgG positive, while four were declared indeterminate to anti-HEV IgM as per the manufacturer's instructions. From one locality to another, the seroprevalence of HEV antibodies varied from 0 to 1% for HEV IgM and from 1.5 to 10.5% for HEV IgG. The data also showed that seroprevalence varied significantly by marital status (p&lt;0.0001), by the regularity of income (p=0.0043) and by access to sanitation services (p=0.0006). These data could serve as a basis to setup national prevention strategies focused on socio-cultural, environmental and behavioral aspects for a better management of HEV infection in Senegal.

There are two contrary opinions regarding the risk if mainland China (MC) moves away from its zero-COVID policy. Some experts think the risk shall be much lower than influenza as per MC’s own COVID-19 case fatality rate (CFR), while some other experts think the risk shall be much higher than influenza as per the COVID-19 CFRs of other regions. We elucidate here that this and multiple other striking differences in the CFR between various scenarios all support and substantially resulted from the view that good IDM is highly powerful to mitigate COVID-19, where IDM (isolation-disinfection-maintenance) means isolation of COVID-19 cases from other people, disinfection of their living environments, and health maintenance (e.g., rest, nutrition, breathing). The high effect of good IDM is also supported by the theoretic functions of IDM in minimizing co-infections and maintaining body functions, and the fact that all the 505 COVID-19 deaths reported in MC in 2022 before May 5 died directly of severe underlying diseases with COVID-19. Although it is tough for people in poverty to obtain good IDM, good IDM can be feasible at home for the most mild cases and in hospitals for the most severe cases. Therefore, good IDM can be crucial to mitigating COVID-19 worldwide. It also suggests that the risk for China to end its zero-COVID policy depends on China’s control policies or measures. Based on the effect of IDM, the cautious co-existence policy was proposed for COVID-19 control. This policy could reduce the whole death toll in MC because good IDM is non-specific and can reduce deaths of various other diseases. The cautious co-existence policy (non-specific) and the vaccination policy (specific) aid each other to mitigate COVID-19, and they cannot replace each other. Those who are qualified in health for vaccination should be vaccinated against COVID-19 timely.

In many countries, governments have implemented non-pharmaceutical techniques to limit COVID-19 transmission. Restricting human mobility is one of the most common interventions, including lockdown, travel restrictions, working from home, etc. However, due to the strong transmission ability of the virus variants, further rounds of interventions, including a strict lockdown, are not considered as effective as expected. The paper aims to understand how the lockdown policy and pandemics changed human mobility in the real scenario. Here we focus on understanding the mobility changes caused by compliance with restrictions and risk perceptions, using the mobility index from the Google report during three strict lockdown periods in Leeds, the largest city in the county of West Yorkshire, England from March 2020 to March 2021. The research proposed the time-varying z-scores and Principal Component Analysis (PCA) to simulate how local people dynamically process and perceive health risk based on multi-dimensional daily COVID-19 reports first. Further modelling highlights exponentially increasing policy non-compliance through the duration of lockdown, probably attributable to factors such as mental anxiety and economic pressures. Finally, the proposed nonlinear regression model examines the mobility changes caused by the population's dynamic risk perceptions and lockdown duration. The case study at Leeds fits data well and shows that the third lockdown policy took effect much slower than the first. At the same time, the negative impact of the epidemic on population mobility decayed 40% in the third lockdown period in contrast with the first lockdown. The risk perception estimation methods could reflect that the local population became increasingly accustomed to the COVID-19 situation, and local people rationally evaluated the risks of COVID in the third lockdown period. The results prove that simulated risk perceptions and policy decay could explain urban mobility behaviour during the mobility well during lockdown periods, which could be a reference for future decision-making processes.

Fogo (Fogo island, Cape Verde Republic) is the youngest and most active volcano of the archipelago. The last eruption occurred in 2014–2015. Aiming at studying dust emissions and transport during the eruption period and assessing their impact on air quality and human health, a mineralogical and chemical characterization was undertaken in outdoor dust from all over the island, as well as in the lava resulting from this event. Air quality monitors were used to obtain concentrations of atmospheric particulate matter (PM) and gaseous pollutants. The mineralogical constitution of the samples was analysed by X-ray diffraction and Electron Microprobe, while the chemical characterization was performed through X-ray Fluorescence Spectrometry and ICP-MS. The volcanic rock was found to be tephritic to basanitic, with high potassium content. Several minerals were identified, such as titanian augite with ilmenite, basaltic hornblendes, pyrrhotites, apatites, pyroxenes, basaltic hornblendes and hematites. Concentrations of the particulate matter inhalable fraction (PM10) exceeded the 24-hour mean of 50 µg/m3 recommended by the World Health Organization. Nevertheless, total volatile organic compounds (TVOCs) showed levels lower than the worrying range. The highest levels of CO2 were recorded in more populated villages and farthest from the volcano. The Pollution Load Index (PLI) for outdoor dust collected on rooftops was always above 1, suggesting enrichment, with higher values in the dust size fraction < 63 µm. In the same way, the Contamination Factor pointed to high enrichment of As, Ni and Pb, and very high enrichment of Cd in the same size fraction. The Non-carcinogenic Hazard Quotient and Hazard Index estimated for Children suggest that health problems may arise. The Carcinogenic Risk, for all size fractions, was above the target risk. The element that most contributed to the global risk was As, followed by Pb and Co. Ingestion was the main exposure route for all size fractions. The dust size fraction that represented the highest risk was < 63 µm, mostly due to the As concentration.

The cause and prevention of recurrent aphthous stomatitis (also called aphthous ulcers or canker sores) are still unknown. This may be due in part to ignorance of the risk factors present in susceptible people. In this systematic review (PROSPERO record #CRD42019122214), we show that most of the risk factors for the disease are single nucleotide genetic polymorphisms in genes related to the functioning of immune system (TLR4, MMP9, E-selectin, IL-1 beta and TNF-alpha). Single nucleotide genetic polymorphisms do not constitute a modifiable risk. This indicates that, at least in part, susceptibility to recurrent aphthous stomatitis is hereditary, and that these factors cannot be modified.

People living in areas of significant seismic risk seldom undertake sufficient preparations to safeguard their family. This is most problematic in remote communities such as those along the Dead Sea Fault, Israel, where self-reliance is a key factor in coping with disasters. To facilitate individual and familial involvement in earthquake preparedness in remote areas, we designed a tool for self-assessment of risk and preparedness. The personalized risk assessment is based on national hazard and building standards, and on personal input regarding structure characteristics. The risk and preparedness evaluations enhance awareness and provide immediate feedback to help users improve familial preparedness. Spatial analysis of the data collected is used to form high-resolution maps that expose specific challenges for emergency response. A study conducted in the town of Mitzpe Ramon exposed neighborhoods with relatively high risk of damage and low preparedness. Integrating these results with seasonal stress-factors such as peak tourism and extreme weather, provides new and important insights on the ability of the local community and emergency forces to cope with multi-hazard situations. Analysis of the heterogeneous distribution of expected hardship within a community should be implemented world-wide to improve risk mitigation.

In this study, a dynamic mixture copula is used to estimate the marginal expected shortfall in the South African insurance sector. While other studies assumed nonlinear dependence to be static over time, our model capture time-varying nonlinear dependence between institutions and the market. In order to capture time-varying nonlinear dependence, the generalized autoregressive score (GAS) is used to model the dynamic copula parameters. Furthermore, our study implements a ranking that expresses to what degree individual insurers are systemically important in South Africa. We use daily stock return of five South African insurers listed in the Johannesburg Stock Exchange (JSE) from November 13, 2007 to June 15, 2020. We find that Sanlam and Discovery contribute the most to systemic risk, while Santam is found to be the least contributor to the overall systemic risk in the South African insurance sector. Our findings would be of paramount importance for the South African regulators as they would be informed that not only banks are systemically important, but some insurers also are systemically important financial institutions. Hence, stricter regulation of these institutions in the form of higher capital and loss absorbency requirements could be required based on the individual business activities undertaken by the company.