This study aims to find a communication model of contingency plan for disaster risk management of Sinabung Volcano eruption, in North Sumatera. The object of the research is communication and coordination across the government, non-government organization, and community. This study used planning theory, the concept of communication planning, and types of disaster management plan as tools for analysing. Descriptive qualitative is used as the method. Data collection was obtained from the focus group discussion (FGD), in-depth interviews, observation, and study documentation. There are three stages in descriptive qualitative research that is data reduction, data presentation, and conclusion. An analysis was conducted qualitatively on the program and competence actors. The results found the communication model of disaster risk management through documents of contingency planning to overcome the threat of Mount Sinabung eruption. During the emergency response period a core model was used to reduce the impact of the Mount Sinabung eruption. The contingency plan becomes the Karo District Government’s document. This document were authorized by an authorized official and is ready to be applied to the Emergency Response Operation Plan. Plans for emergency response operations are carried out based on information regarding damage and the need to obtain results of a quick review. Contingency plans are submitted to the legislature for political commitment and support and budget allocation.

In mega cities such as Seoul in South Korea, it is very important to protect the city from the flooding even for the short time of period due to the enormous amount of economic damage. In impervious area of the city, stormwater pipe network is commonly applied to discharge rainfall to the outside of catchment. Therefore, the stormwater pipe network in urban catchment should be carefully designed to discharge the runoff quickly and efficiently. In this study, different types of structures in stormwater pipe network were evaluated using the relationship between the peaks rainfall and runoff in urban catchments in South Korea. More than 400 historical rainfall events were applied in five urban catchments to estimate peak runoff from different type of network structures. Linear regression analysis was implemented to estimate peak runoffs. The coefficient of determination of the regressions were higher than 0.9 which means the regression model represent very well the relationship between the two peaks. However, the variation of the prediction becomes large as the peak rainfall increases and the variation become even larger when the network structure is branched. Therefore, it depends on the structure of stormwater pipe network. When the water paths in the pipe network is unique (branched network), the increased amount of rainfall is congested around the rainwater inlets and the uncertainty of peak runoff prediction is increased. If there are many possible water paths depending on the amount of discharge (looped network), the increased rainfall is discharged more quickly through the many water paths. This can be a way to represent the reliability of the stormwater pipe network. The structures of stormwater pipe network is evaluated using drainage density which is the length of pipes over the unit catchment area and 95% confidence interval. As a result, the 95% confidence interval is increased as the drainage density is increased because the accuracy of peak runoff prediction is decreased. As mentioned earlier, because the looped networks have many alternative water flowing paths, elimination time of rainfall from the catchments become short, the 95% confidence interval become narrow, and the reliability of peak runoff prediction become high. Therefore, it is beneficial to install looped stormwater pipe network within the affordable budget. It is important factor to determine the amount of complexity in stormwater pipe network to decrease the risk of urban flooding.

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.

Background: In Malaysia, the mortality from melioidosis infection was reported to be higher than in other infectious diseases. The research on melioidosis is still limited in Malaysia but slightly increasing. Objective: To give an overview of the study designs, statistical methods and comparison of research in identifying the predictors of melioidosis mortality in Malaysia between January 2010 to December 2021. This review articles were divided into two sections; Section 1: Review of literature and Section 2: Findings on predictors of melioidosis mortality in Malaysia. Data sources: Pubmed/Medline. Study Eligibility Criteria: Original English-language articles were abstracted. The articles that identified the predictors of melioidosis from mortality in Malaysia only included. Letters to the editor, editorials, reviews, systematic reviews, meta-analysis, case reports and any other ineligible articles were excluded. Results: A total of 7 studies were identified related to predictors of melioidosis mortality in Malaysia. From the selected articles, all of the data were retrospectively collected. Six out of 7 articles (85.7%) used the logistic regression in identifying the predictors of melioidosis mortality. Only 1 (14.3%) used advanced survival analysis methods of Cox regression analysis. Conclusion: Logistic regression methods remain the most common methods of analysis in publications on predictors of melioidosis mortality in Malaysia while retrospective research designs are favoured. There is a limitation of research in predictors of melioidosis mortality and the use of advanced statistical techniques reported using the melioidosis data in Malaysia. More published research on melioidosis will provide input to the clinicians on a more detailed understanding of how to improve the diagnosis of melioidosis and the prognosis factors of this disease.

COVID-19 is an infectious disease spreading through human touch. This study explored the risk perception and knowledge towards COVID-19 infection among Bangladeshi adult participants. Two self-administered online surveys were administered at two different time points from 26-31 March 2020 (Early lockdown) and 11-16 May 2020 (Late lockdown) through social media on 1005 respondents (322 and 683 participants, respectively) during COVID-19 lockdown period in Bangladesh. Univariate and multiple linear regression models were used to examine factors associated with risk perception and knowledge towards COVID-19. The mean knowledge (8.4 vs. 8.1, P=0.022) and risk perception (11.2 vs. 10.6, P < 0.001) scores differ significantly between early and late lockdown. Compared to the early lockdown period, the scores for perceived risk of contracting COVID-19 decreased significantly while public knowledge about COVID-19 was lower but not statistically significant. Female participants who practiced high quarantine particularly those who did so at the public health order during the lockdown reported increased knowledge towards the spread of COVID-19 and perceived high risk of contracting COVID-19. Education intervention using awareness to increase public knowledge and perception towards COVID-19 in Bangladesh should target male participants who practiced low quarantine and are less worried about the spread of such novel coronavirus even as the physical distancing persists.

A recent survey that determined heavy metal concentrations in an abandoned Hg mine in Palawan, Philippines, found the occurrence of Hg with As, Ba, Cd, Co, Cr, Cu, Fe, Hg, Mn, Ni, Pb, Sb, Tl, V, and Zn. While the Hg originated from the mine waste calcines as supported by previous studies, the critical knowledge about the origin of the other heavy metals remains to be unknown. Our study investigated the sources of heavy metal pollution surrounding the abandoned Hg mine; and assessed the soil and sediment quality, ecological risks, and health risks associated with these toxic metals. Multivariate analyses, such as hierarchical cluster analysis (HCA), principal component analysis (PCA), and Pearson correlation analysis, were used to identify the heavy metal sources from the results of a previous paper. Our results showed that Fe, Ni, Cr, Co, and Mn are associated with the ultramafic geology of the study, whereas As, Ba, Cd, Cu, Pb, Sb, Tl, V, and Zn are likely due to historical mining and processing of cinnabar from 1953-1976. The mine waste calcines were used as construction material for the wharf and as land filler for the adjacent communities. The modified contamination factor (mCdeg) showed that the coast of Honda Bay is highly contaminated, while the inland areas, including the rivers, are very- to ultra-highly contaminated. There is a considerable ecological risk associated with the heavy metals, wherein Ni, Hg, Cr, and Mn contribute an average of 46.3 %, 26.3 %, 11.2 %, and 9.3 % to the potential ecological risk index (RI), respectively. The overall mean hazard index (HI) for both adults (1.4) and children (12.1) exceeded 1, implying the probability of non-carcinogenic adverse effects. The mean total cancer risk over a lifetime (LCR) for both adults (1.19×10-3) and children (2.89×10-3) exceeded the tolerable threshold of 10-4, suggesting a potentially high risk for developing cancer mainly by Ni, Co, and Cr exposure.

Purpose: Obstructive sleep apnoea (OSA) affects patients’ quality of life and health. Magnesium (Mg) is an essential mineral and a potent antioxidant. Mg deficiency can worsen oxidative stress caused by sleep deprivation or disorders. The impact of OSA on serum Mg levels and its health consequences remain unclear. Methods: This study systematically reviewed clinical studies investigating the serum Mg levels of OSA patients and the potential relationships with other biomarkers.Results: Six articles were included for qualitative synthesis; five were used in quantitative analysis. Two out of four studies that compared OSA patients to healthy controls found them to have significantly lower serum Mg levels. Our meta-analysis with three studies shows that patients with OSA had significantly lower serum Mg with an effect size of -1.22 (95% CI: -2.24, -0.21). However, the mean serum Mg level of OSA patients (n=251) pooled from five studies (1.90 mg/dL, 95% CI: 1.77, 2.04) does not differ significantly from the normal range. OSA severity appears to affect serum Mg negatively. Serum Mg levels generally improve after treatment, coincide with the improvement of OSA severity. Low serum Mg levels correlate with worsening of cardiovascular risk biomarkers of C-reactive protein, ischaemia-modified albumin, and carotid intima-media thickness. The serum Mg levels also potentially correlate with biomarkers for lipid profile, glucose metabolism, calcium and heavy metals. Conclusions: Sleep deprivation appears to deplete Mg levels of OSA patients, making them at risk of Mg deficiency, which potentially increases systemic inflammation and the risk of cardiovascular and metabolic diseases.

Cold brew coffee is a new trend in coffee industry. This paper presents pilot studies into several aspect of this beverage. Using an online survey, the current practices of cold brew coffee preparation were investigated identifying a rather large variability with a preference for extraction of medium roasted Arabica coffee using 50-100 g/l at 8°C for about 1 day. Sensory testing using ranking and triangle tests showed that cold brew may be preferred over iced coffee (cooled down hot extracted coffee). Extraction experiments at different conditions combined with nuclear magnetic resonance (NMR) analysis showed that the usual extraction time may be longer than necessary as most compounds are extracted within only a few hours, while increasing turbulence (e.g. using ultrasonication) and temperature may additional increase the speed of extraction. NMR analysis also revealed a possible chemical differentiation between cold brew and hot brew using multivariate data analysis. Decreased extraction time and reduced storage times could be beneficial for cold brew product quality as microbiological analysis of commercial samples detected samples with spoilage organisms and contamination with Bacillus cereus.

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.

We estimate general public’s willingness to pay (WTP) for agricultural soil quality protection and improvement in Spain (n=1000) and the UK (n=984) using data from a cross-sectional survey via Qualtrics panels in March-April 2021. We use a double bound dichotomous choice contingent valuation approach to elicit the individuals’ WTP. We investigate the effect of uncertainty on the success of policies aiming at achieving soil protection. In addition, to understand the heterogeneity in individuals’ WTP for agricultural soil quality protection and improvement we model individuals’ WTP through individual’s awareness and attitudes toward agricultural soil quality protection and the environment, trust in institutions; risk and time preferences; pro-social behavior and socio-demographics in Spain and the UK. We found that there is significant public support for agricultural soil quality protection and improvement in Spain and the UK. We also found that the support does not vary significantly under uncertainty of success of policies aiming at achieving soil protection. However the individual’s reasons for supporting agricultural soil quality protection and improvement are found to depend on the level of uncertainty and country. Hence, promoting public support for soil protection needs to be tailored according to the level of general public’s perceived uncertainty and geographic location.

This qualitative research explores the intricate relationship between cultural influences on supply chain practices and their implications for marketing strategies. Cultural dimensions such as individualism versus collectivism, uncertainty avoidance, and contextuality significantly shape decision-making processes, risk management strategies, and relationship dynamics within global supply chains. Through semi-structured interviews with supply chain managers, marketing executives, and cultural experts across diverse industries and regions, this study investigates how cultural values impact supply chain operations and consumer engagement strategies. Key findings highlight that collectivist cultures prioritize consensus-building and long-term relationships, fostering trust and collaboration among supply chain partners. In contrast, individualist cultures emphasize efficiency and accountability but may face challenges in relationship building. Risk management practices vary with cultural orientations towards uncertainty, influencing the adoption of structured versus flexible approaches to mitigate disruptions. In terms of marketing implications, the study underscores the importance of cultural sensitivity in crafting effective strategies. High-context cultures require marketing messages that resonate emotionally through implicit communication and cultural symbolism, while low-context cultures prefer clear, direct messaging focusing on product benefits. The study concludes by advocating for cultural competence as a strategic imperative for global businesses, enabling them to leverage cultural diversity for innovation and competitive advantage. It emphasizes the need for continuous adaptation to cultural nuances and market dynamics to foster inclusive collaboration and achieve sustainable growth in a globalized economy.

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.

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.

In areas with strongly seasonal climates, local people often use complex strategies to manage agricultural production shortages, including diverse activities such as hunting, selling and consuming non-agricultural products, and wage labor. We surveyed all the households in a village in northern Laos to evaluate how such livelihood activities varied during years with differing agricultural production conditions. We compared two years with normal rice production conditions (2010, 2012) and one year with a severe rice shortage (2011) due to a rodent outbreak. Earning wages inside and outside the village was the most important activity for mitigating rice shortages, followed by selling livestock and using/selling non-timber forest products. Villagers also borrowed rice from a village rice bank. Most cash income was earned from selling rice. We concluded that a balance of traditional risk management activities under the swidden system (e.g., raising livestock) with the more recent rice bank system and wages from the market economy will be critical for the sustainable development of mountain villages in northern Laos. Permanent crops and monocultures tend to make local livelihoods more dependent on a single crop, but maintaining the traditional swidden system will help local people to manage agricultural production shortages.

Hepatitis is the eighth highest cause of mortality globally and second-highest in Pakistan. The purpose of this study was to determine frequency of Hepatitis B and C and related lifestyle and socio-demographic risk factors among adults. The data were collected though questionnaire from Hepatitis B and C patients from Mayo and Jinnah hospital Lahore. The data was analyzed using SPSS version 18. There were 5095 patients with Hepatitis B and C out of which 146 patients (67 males and 79 females) filled questionnaire. The frequency of hepatitis C was higher than hepatitis B. The significant risk factors associated with hepatitis B and C were education, marital status, family history, household income, and type of food consumed. Therefore, socio-demographic and lifestyle risk factors related interventions are needed to reduce frequency of Hepatitis B and C.

Background: Urinary tract infection (UTI) is one of the commonest bacterial infections among reproductive age females. Untreated UTI in reproductive age female is associated with sexual dysfunction, cystitis, pyelonephritis and Pelvic inflammatory disease. At present, the antimicrobial resistance emergency has quadrupled worldwide and poses a serious threat to the treatment of patients. Thus, this study aimed to determine bacterial profile, antibiotic susceptibility pattern and associated risk factors of urinary tract infection among reproductive age females attending the Logbaba District Hospital Methods: A hospital-based cross-sectional study was conducted from January – July, 2023. Convenient sampling was employed to recruit 259 reproductive age females. Sociodemographic and risk factors information were obtained using a well-structured questionnaire. Mid-stream urine was collected and inoculated on cystine lactose electrolyte deficient media. Isolates were identified using API 20. Antibiotic sensitivity testing was performed using modified kirby-bauer susceptibility testing technique. Multivariate logistic regression model was used to assessed risk factors. A p-value < 0.05 was considered as statistically significant. Results: The overall prevalence of UTI among reproductive age females was 82/259 (31.66%). Symptomatic and asymptomatic patients reported a prevalence of 50/121(41.32%) and 32/138 (23.19%), respectively. Ages ranging from 21-30 years (AOR: 2.53 ,95% CI 1.32 – 4.43, p=0.006) and 31 – 40 years (AOR: 0.19 , 95% CI: 0.14- 0.54; p <0.0001), student (AOR: 1.8, 95% CI: 1.21 - 2.75; p = 0.010), history of UTI (5.34, 95% CI = 1.86 - 18.15; p = 0.03), symptomatic (AOR = 2.86, 95% CI1.78 - 4.67, p <0.0001) and secondary education (AOR: 0.13, 95% CI 0.08 - 0.32; p<0.0001) were predictors to UTI. Klebsiella Pneumoniae was the most frequent species 27 (32.9%), follow by E coli 22(26.8%), Staphylococcus aureus 16 (19.5%), CONS 8 (9.8%), Proteus mirabilis 6 (7.3 %) and Pseudomonas aeruginosa 3(3.7%). Majority of the isolates were sensitive to cefotaxime (87.80%), imipenem (85.7%), vancomycin (79.27%), Ofloxacillin (76.83%), Ceftriaxone (75.61%), Ciprofloxacin (74.39%), Gentamicin (71.95%) and Doxycycline (69.51%), and resistant to Amoxicillin (51.22%), cotrimoxazole (47.56%) and Azithromycin (31.71%) , All the isolates were multidrug drug resistant (100%) and Klebsiella Pneumoniae and E coli were the most multidrug drug resistant species Conclusion: In the present study, the prevalence of urinary tract infection among reproductive age females was high and considerably a high proportion of multidrug resistance was observed. This result will have a significant impact on the selection of appropriate antimicrobial agents for the treatment of urinary tract infection in the study area.

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.

Abstract: Objective: To assess both individual and interactive effects of prenatal medical conditions depression and Diabetes, and health behaviors including smoking during pregnancy on infant birth defects. Methods: The data for this research study were collected by the Pregnancy Risk Assessment Monitoring System (PRAMS) in 2018. Birth certificate records were used in each participating jurisdiction to select a sample representative of all women who delivered a live-born infant. Complex sampling weights were used to analyze the data with a weighted sample size of 4,536,867. Descriptive statistics were performed to explore frequencies of the independent and dependent variables. Bivariate and multivariable analyses were conducted to examine associations among the independent and dependent variables. Results: The results indicate and significant interaction between the variables smoking and Depression and Depression and Diabetes (OR= 3.17; p-value <0.001 and OR= 3.13; p-value <0.001 respectively). Depression during pregnancy was found to be strongly associated with delivering an infant with a birth defect (OR= 1.31, P-value < 0.001). Conclusion: Depression during pregnancy and its interaction with smoking and Diabetes are vital in determining birth defects in infants. The results indicate that birth defects in the United States can be lowering Depression in pregnant women.

The association between angiotensin-converting enzyme insertion/deletion (ACE I/D) polymorphisms and plasma ACE levels may allow for the optimization of a preventive intervention to reduce cardiovascular morbidity and mortality in the chronic kidney disease (CKD) population. In this study, we aimed to analyze the association between ACE I/D polymorphism and cardiovascular mortality risk among non-hemodialyzed chronic kidney disease patients. This cross-sectional study examined 70 patients of Javanese ethnic origin with stable CKD who did not receive hemodialysis. ACE I/D polymorphisms, plasma ACE levels, atherosclerotic cardiovascular disease (ASCVD) risk, and cardiovascular mortality risk were investigated. As per our findings, the I allele was found to be more frequent (78.6) than the D allele (21.4), and the DD genotype was less frequent than the II genotype (4.3 vs. 61.4). The ACE I/D polymorphism had a significant direct positive effect on plasma ACE levels (path coefficient = 0.302, p = 0.021). Similarly, plasma ACE levels had a direct and significant positive effect on the risk of atherosclerotic cardiovascular disease (path coefficient = 0.410, p = 0.000). Moreover, atherosclerotic cardiovascular disease risk had a significant positive effect on cardiovascular mortality risk (path coefficient = 0.918, p = 0.000). The ACE I/D polymorphism had no direct effect on ASCVD and cardiovascular mortality risk. However, our findings show that the indirect effects of high plasma ACE levels may be a factor in the increased risk of ASCVD and cardiovascular mortality in Javanese CKD patients.

Risk assessment of chemicals is usually conducted for individual chemicals whereas mixtures of chemical are occurring in the environment. Considering that neuroactive chemicals are a group of contaminants that dominate in the environment, it is then imperative to understand the combined effects from mixtures. The commonly used models to predict mixture effects, namely concentration addition (CA) and independent action (IA), are thought suitable for mixtures of similarly or dissimilarly acting components, respectively. For mixture toxicity prediction, one important challenge is to clarify whether to group neuroactive substances based on similar mechanisms of action, e.g. same molecular target or rather similar toxicological response, e.g. hyper- or hypoactivity (effect direction). We addressed this by using the spontaneous tail coiling (STC) of zebrafish embryos, which represents the earliest observable motor activity in the developing neural network, as a model to elucidate the link between mechanism of action and toxicological response. Two questions were asked: 1.) Can the mixture models CA or IA be used to predict combined effects for neuroactive chemical mixtures when the components share a similar mode of action (i.e. hyper- or hypoativity) but show different mechanism of action? 2.) Will a mixture of chemicals where the components show opposing effect directions result in an antagonistic combined effect? Results indicate that mixture toxicity of chemicals such as propafenone and abamectin as well as chlorpyrifos and hexaconazole that are known to show different mechanisms of action but similar effect directions were predictable using CA and IA models. This could be interpreted with the convergence of effects on the neural level leading to either a collective activation or inhibition of synapses. We also found antagonistic effects for mixtures containing substances with opposing effect direction. Finally, we discuss how the STC may be used to amend risk assessment.

Background: This study aimed to estimate the prevalence of sexualized drug use (SDU) in gay, bisexual, and other men who have sex with men living with HIV (HIV+GBMSM) in Madrid during 2019/2020 and compare it with data from 2016/2017. Methods: We analysed the frequency of SDU in a sample of HIV+GBMSM attending HIV clinics, who participated in an anonymous online survey regarding sexual behaviour and recreational drug use. The association between SDU, sexual risk behaviours, and STIs was evaluated. The methodology employed in the present study(U-SEX-2) in 2019/2020 was consistent with that of a previous study(U-SEX-1) in 2016/2017. Results: The study included 424 HIV+GBMSM, with a mean age of 40(10.43) years. Overall, 94% (396) reported being sexually active. Additionally, 33% (140) had been diagnosed with an STI within the previous year. Moreover, 54% (229) had used drugs in the last year, 25% (107) engaged in SDU, and 15% (17) reported engagement in slamsex. After adjusting for confounding factors, SDU was associated with STIs, fisting, unprotected anal intercourse, and having &gt; 24 sexual partners in the last year. According to the DUDIT test scores, 76% (81) probably had problematic drug use (≥6 points), and 5% (8) probable drug dependence (≥25 points). When comparing the U-SEX-1(2016/2017) data with the U-SEX-2(2019/2020) data, no significant differences were found in the proportion of participants practicing SDU or slamsex. Conclusion: The prevalence of SDU among HIV+GBMSM has remained high in recent years and without significant changes. We observed a clear association between SDU, high-risk sexual behaviors, STIs, and the risk of drug related problems.

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.

The assessment and prediction of drought risk under future climate change and land use land cover (LULC) scenarios is critically important for drought prevention and mitigation, as it enables a clearer understanding of potential shifts in drought patterns. The primary aim of this study is to evaluate sub-seasonal and seasonal meteorological and hydrological drought hazards across the Yellow River Basin (YRB) under projected future climate conditions and LULC patterns. The BCC-CSM1-1 climate model projections from the NASA Earth Exchange Global Daily Downscaled Projections (NEX-GDDP) dataset are utilized to represent future climate for 2025-2060 under RCP 4.5 and 8.5 scenarios. The CA-Markov model is employed to predict future LULC distributions. Meteorological and hydrological drought risks across different YRB zones are evaluated through a copula-based risk assessment approach, based on the joint probability distribution of drought duration and severity. The results indicate that sub-seasonal meteorological and hydrological droughts will likely be the primary concern moving forward. Specifically, the upper YRB (zones A, B, C) exhibits greater vulnerability to sub-seasonal meteorological drought, while the Loess Plateau (zones C, E) shows higher susceptibility to sub-seasonal hydrological drought. Moreover, zone F in the downstream region may experience increased seasonal hydrological drought risk due to projected urban expansion in the middle and lower portions of the YRB.

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

The purpose of this study is to analyze the causes of cost variation in natural disaster prevention projects (NDPP) in Gyeongsangbuk-do and to develop effective cost and risk management strategies. The study collected data by conducting an online survey of 244 stakeholders. Binary logistic regression was used to analyze the impact of various variables on cost deviation, in-cluding project management risk (PMR), project costing and execution risk (PCER), project exe-cution strategy risk (PESR), construction project risk (CPR), project cost and schedule risk (PCSR), project management challenges (PMC), and construction project subcontractor and safety man-agement (CPSSM). The results showed that PMR (OR=3.744, 95% C.I. [1.657, 8.457]), PCER (OR=5.068, 95% C.I. [2.236, 11.484]), PESR (OR=3.447, 95% C.I. [1. 853, 6.413]), CPR (OR=2.292, 95% C.I. [1.020, 5.151]), PCSR (OR=4.817, 95% C.I. [2.250, 10.317]), PMC (OR=2.954, 95% C.I. [1.452, 6. 013]), and CPSSM (OR=2.419, 95% C.I. [1.297, 4.515]) had statistically significant effects on cost deviation. In particular, PMR, PCER, and PESR were identified as the main causes, and the effects of additional factors such as CPSSM were also important. The developed predictive model plays an important role in helping stakeholders of NDPP to manage risks in advance and take appro-priate preventive measures to ensure the success of the project. This study empirically supports the theoretical hypotheses of previous studies and provides a clear understanding of the causes of cost deviation in NDPP, which provides important insights for strategic decision-making and provides a new perspective on risk management.

Stakeholder input into the decision-making process when developing public health programs and policies is crucial. This article presents an innovative approach, involving online participation with a wide group of stakeholders located in different geographic locations, for policy consensus by research methodology. The results of the project have been used to propose assumptions regarding a strategy for preventing blood-borne diseases in Poland. The research was conducted iteratively using a multi-stage qualitative methodology to explore risk assessment involving blood-borne infections. The final output of the entire project is a list of key problems/challenges and solutions associated with medical and nonmedical services that are connected to the breakage of tissue continuity. Qualitative research is rare in risk assessment as priority is usually given to statistical data and end-points (quantitative studies ). Statistical data on health risk allows to assess the health implications, while the methodology applied also allowed diagnosis of the processes leading to these effects. In addition to policy preparation for blood-borne illnesses, the methodology employed in the study can also be used to successfully explore other areas of public health policy decisions.

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.

There are evidences of shared biological mechanisms between obesity and hypertension during childhood in the adulthood, and loads of research literatures have proven that, it will cost the economies and health of nations profoundly if neglected. The Prevention and early diagnosis of cardiovascular risk factors such as overweight and hypertension is an essential strategy for control, effective treatment and prevention of its’ complications. The aim of the study is to assess the effect of school based Exercise and Life style Motivation Intervention (SEAL-MI) on adolescent's cardiovascular risk factors and academic performance. An experimental study was conducted among 1005 adolescents - 520 and 485 adolescents were randomly selected for control and study group, respectively. Demographic details and the data related to dietary habits, physical activity and sleep quality were collected by a structured interview questionnaire. The study group adolescents were given the SEAL-MI for six months which includes a school based rope exercise for 45 minutes per day for 5 days a week and a motivation intervention related to dietary habits, physical activity and sleep. Post-test 1 and 2 were done after 3 and 6 months of intervention. The prevalence of overweight among adolescents was 28.73% and prehypertension was 9.26%. Among overweight adolescents, the prevalence of prehypertension was found to be very high (32.25%). In post intervention, there was a significant reduction in weight, BP (p=0.000) and improvement in dietary habits, physical activity, sleep (p=0.000) and academic performance. A significant positive correlation was found between BMI and SBP (p=0.000) and BMI and academic performance (p=0.003). The linear regression analyses revealed that the gender (ß: 0.47, 95% CI: 0.39, 0.81), age (ß: 0.39, 95% CI: 0.17, 0.46), family income (ß: 0.2, 95% CI: 0.41, 0.5), residence (ß: 0.19, 95% CI: 0.01, 0.27) and type of family (ß: 0.25, 95% CI: 0.39, 0.02) had the strongest correlate with the BMI of the adolescents. Also, Mother’s education Mother’s education (ß: 0.35, 95% CI: 0.18, 0.59) had the strongest correlate with the SBP of the adolescents. In contrast, the DBP was negatively persuaded by age (ß: -0.36, 95% CI: 1.54, 0.29) and gender (ß: -0.26, 95% CI: 1.34, 0.12) of the adolescents. Regular practice of rope exercise and lifestyle modification such as diet, physical activity and sleep quality among adolescents prevent and control childhood CVD risk factors like overweight, hypertension. The SEAL-MI may lead to age appropriate development of adolescents and improves their academic performance and quality of life. Giving importance to the adolescents from urban habitat, from affluent nuclear family and catching them young will bring significant change in the disease burden.

Diabetic Foot Ulcer (DFU) is a severe complication of diabetes mellitus (DM), often leading to hospitalization and non-traumatic amputations in the United States. It is particularly prevalent among individuals of Hispanic descent, with a prevalence rate exceeding 10% [1, 2]. The target of this study is to identify markers of severity of DFU. This work follows a strategy that uses first Electronic Health Records and machine learning to identify risk factors reported as measurements of blood tests, such as cholesterol, blood sugar, and specific proteins in a cohort of thousands of patients. After this RNA risk factors are predicted using samples of bulk and single-cell gene expression across patients with different levels of DFU severity. We found the Albu-min/Creatinine Ratio (ACR) test as a key factor in severe DFUs. We also found a cluster of cells that harbor high expression of Apolipoprotein E protein (APOE) and it is significant in non-healing DFU cases. Overall, the study shows how the use of hundreds of thousands of EHR can reduce and inform the search space of molecules in a few samples of bulk-single cell transcriptomics and identify molecular markers of severity of DFU.

Background: Atypical teratoid/rhabdoid tumor (AT/RT) is an uncommon and aggressive pediatric central nervous system neoplasm. However, a universal clinical consensus or reliable prognostic evaluation system for this malignancy is lacking. Our study aimed to develop a risk model based on comprehensive clinical data to assist in clinical decision-making. Methods: We conducted a retrospective study by examining data from the Surveillance, Epidemiology, and End Results (SEER) repository, spanning 2000 to 2019. The external validation cohort was sourced from the Children's Hospital Affiliated to Chongqing Medical University, China. To discern independent factors affecting overall survival (OS) and cancer-specific survival (CSS), we applied Least Absolute Shrinkage and Selection Operator (LASSO) and Random Forest (RF) regression analyses. Based on these factors, we structured nomogram survival predictions and initiated a dynamic online risk-evaluation system. To contrast survival outcomes among diverse treatments, we used propensity score matching (PSM) methodology. Molecular data with the most common mutations in AT/RT were extracted from the Catalogue of Somatic Mutations in Cancer (COSMIC) database. Results: The annual incidence of AT/RT showed an increasing trend (APC, 2.86%; 95% CI:0.75-5.01). Our prognostic study included 316 SEER database participants and 27 external validation patients. The entire group had a median OS of 18 months (range 11.5 to 24 months) and median CSS of 21 months (range 11.7 to 29.2). Evaluations involving C-statistics, DCA, and ROC analysis underscored the distinctive capabilities of our prediction model. An analysis via PSM highlighted that individuals undergoing triple therapy (integrating surgery, radiotherapy, and chemotherapy) had discernibly enhanced OS and CSS. The most common mutations of AT/RT identified in the COSMIC database were SMARCB1, BRAF, SMARCA4, NF2, and NRAS. Conclusions: In this study, we devised a predictive model that effectively gauges the prognosis of AT/RT and briefly analyzed its genomic features, which might offer a valuable tool to address existing clinical challenges.

This paper explores the application of fisheries management theories to broader environmental issues, including climate change and biodiversity conservation. It underscores the inherent trade-off in fisheries between yield and resource conservation, identifying harvesting as a significant environmental burden. Early recognition of the sustainability concept aimed to address challenges like economic discounts and the tragedy of the commons, contributing to the issue of overfishing. These insights extend beyond fisries to other environmental concerns, particularly climate change. The development of adaptive management, initially tailored to address uncertainties and non-stationarity in fisheries, has found application in diverse environmental issues. Recognizing humans as integral parts of ecosystems highlights the impossibility of achieving zero environmental impact when utilizing natural resources. The paper advocates for passive restoration to prevent overfishing, leveraging nature's resilience. While goals like complete biodiversity restoration are inherent in fisheries, their relevance may not be immediately apparent to other environmentalists. Despite ongoing discussions on the sustainability of ecosystem services, legislation often tends to favor the long-term maximization of fisheries yield. The paper calls for mutual understanding of theories and experiences across various environmental fields, including fisheries, to enhance collaborative efforts in each field.

In South Western Indian ocean (IO), Extended-Spectrum β-Lactamase producing Enterobacteriaceae (ESBL) are a main public health issue. In livestock, ESBL burden was unknown. The aim of this study was estimating the prevalence of ESBL on commercial farms in Reunion, Mayotte and Madagascar and genes involved. Secondly, risk factors of ESBL occurrence in broiler, beef cattle and pig farms were explored. In 2016-2017, commercial farms were sampled using boot swabs and samples stored at 4°C before microbiological analysis for phenotypical ESBL and gene characterization. A semi-directive questionnaire was performed. Prevalences observed in all production types and territories were elevated, except for beef cattle in Reunion which differed significantly. The most common ESBL gene was the CTX-M-1 subtype. Generalized linear models explaining ESBL occurrence varied between livestock production sectors and allowed identifying main protective (e.g., water quality control and detergent use for cleaning) and risk factors (e.g., recent antibiotic use, other farmers visiting the exploitation, pet presence). This study is the first to explore tools for antibiotic resistance management in IO farms. It provides interesting hypothesis to explore about antibiotic use in IO and ESBL transmission between pig, beef cattle and humans in Madagascar.

Smoking is a major risk factor for non-communicable diseases and remains a significant public health challenge in many lower- and middle-income countries (LMIC) including Namibia. The purpose of the study was to estimate the prevalence of smoking and its associated risk factors among HCWs and non-HCWs in Zambezi region. An exploratory cross-sectional survey was conducted between March and October 2020 among residents of the eight (8) constituencies of Zambezi region. Four hundred and sixty-one (461) respondents who had been residents of the selected constituencies for over five years and aged between 17-60 years were selected for the study. The main outcome measure was current cigarette smoking status. Descriptive statistics were used to summarize the socio-demographic characteristics of the respondents. We stratified data analysis by individual being health workers or non-health workers. A bivariate Pearson Chi-square test was used to determine the association between socio-demographic characteristics and the smoking status. Statistically significant variables in the bivariate analysis were used as predictors in the univariate and multivariate models. The response rate of potential participants was 95% (n=434). The mean (±SD) age of participant’s was 32.5 (± 11.34 years). Significant relationships were observed between smoking status and area of residency (constituency), gender, age category, level of education, age of onset of smoking and the daily smoking frequency. The majority of smokers (n=108) were none-HCWs with males being the majority (n=62). Age (p=0.001), education levels (p=0.001) and area of residency (p=0.022) were highly associated with smoking among none-HCW while marital status was associated with smoking among HCWs (p=0.013). In the final multivariate model, the odds of smoking among female non-HCWs were significantly lower (OR: 0.386; 95% CI: 0.228 – 0.655). Furthermore, the odds of smoking among this same group were lower among those who had secondary level education (OR: 0.178; 95% CI: 0.0659 – 0.483), post-secondary (OR: 0.117, 95% CI: 0.0412 – 0.330) and first stage tertiary (OR: 0.306: 95% CI: 0.106 – 0.881) compared to those who had primary school education. In conclusion, smoking prevalence among none HCWs and HCWs working in Zambezi included in the study was similar to that of the general Namibian population but higher than other neighboring countries within SADC. The results showed a need for the establishment of specific smoking related strategies that target HCWs to address smoking use parallel to the running of none HCWs which would ultimately decrease the smoking prevalence and improve health.

The study is dedicated to analyzing the complex interaction between Artificial Intelligence (AI) and the Internet of Things (IoT) with institutional structures in the context of sustainable development. This work examines the impact of these technologies on economic and social development, identifying their potential advantages and risks. Methodologically, the research relies on information gathering and case study analysis, assessing the impact of technology in various domains, from smart cities to the manufacturing sector. The findings emphasize the necessity of integrating technological innovations into broader social and environmental initiatives, highlighting the importance of institutional transformations for achieving environmental sustainability.

Uncontrolled chronic inflammation results in cardiovascular disease and early death. In this review, we studied the impact of rheumatoid arthritis on the cardiovascular system, including the early and accelerated development of atherosclerosis, and its clinical manifestations, focusing on the inflammatory mechanisms leading to arterial wall damage, rapid atherosclerotic plaque formation, and thrombosis. Furthermore, the influence of medications used to treat rheumatoid arthritis on the cardiovascular system. The influence of chronic inflammation and medicaments on traditional cardiovascular risk factors is not the main subject of this review. We found that uncontrolled chronic inflammation and some medications directly impact all stages of atherosclerosis. In conclusion, reducing inflammation and maintaining long-term remission in rheumatoid arthritis may pre-vent early atherosclerosis. We believe that this review will encourage a better interdisciplinary approach for these patients and further research in this field.

Chronic obstructive pulmonary disease (COPD) is increasingly being recognized as a systemic disease rather than a mere disorder of the lungs. Central (respiratory) and peripheral (limb) muscle weakness are among the main pronounced systemic effects of COPD. While the disease primarily affects the lower limb muscles and contributes to gait impairment, COPD is also associated with an increasing risk of falls in patients (COPDp). Previous studies have reported higher rates of falls among COPDp (1.17 to 1.20 falls/person-year), amounting to four times higher than an age-matched healthy group. Potential fall risk factors include muscle weakness, impaired daily activities, cognitive dysfunction, and gait and balance impairment. Although COPDp often manifest many of these risk factors, there remains a gap in literature regarding falls during walking in this population. This study aimed to 1. analyze the literature to identify the risk factors of falling in COPDp, and 2. investigate the underlying mechanisms by which these risk factors can lead to increased prevalence of falling. The results suggest that in addition to the known risk factors of falling, low back pain and mental fatigue should also be considered as relevant risk factors in the treatment process of these patients. Moreover, respiratory problems, which are common in this population, have demonstrated pronounced effects on energy expenditure, gait, and other types of activities of daily living (ADLs), leading to reduced intensity, disrupted coordination of the trunk-pelvic structure with the lower limbs during gait, and altered motor control performance due to activation of muscles in an inefficient synergic manner. These problems potentially lead to the increased vulnerability of these patients to external disturbances and higher incidence risk of falls and injuries. Cognitive problems, which are typically due to reduced oxygen received by the brain, as well as general inflammation caused by COPD, also play a significant role in gait disruption and balance. Future research is warranted to determine the prevalence of falls in COPDp by examining the response of these patients to Medio-Lateral (ML) and Anterior-Posterior (AP) disturbances during gait in association with traditional and recommended fall risk factors.

The aim of this study was to develop and validate a predictive early tooth loss multivariable model for periodontitis patients before periodontal treatment. A total of 544 patients seeking periodontal care at a university dental hospital were enrolled in the study. Teeth extracted after periodontal diagnosis and due to periodontal reasons were recorded. Clinical and sociodemographic variables were analyzed, considering the risk of short-term tooth loss. This study followed the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) guidelines for development and validation, with two cohorts considered as follows: 455 patients in the development phase and 99 in the validation phase. As a result, it was possible to compute a predictive model based on tooth type and clinical attachment loss. The model explained 25.3% of the total variability and correctly ranked 98.9% of the cases. The final reduced model area under the curve (AUC) was 0.809 (95% Confidence Interval (95% CI): 0.629 - 0.989) for the validation sample and 0.920 (95% CI: 0.891 - 0.950) for the development cohort. The established model presented adequate prediction potential of early tooth loss due to periodontitis. This model may have clinical and epidemiologic relevance towards the prediction of tooth loss burden.

Multiple governmental agencies and private organisations have made commitments for the colonisation of Mars. Such colonisation requires complex systems and infrastructure that could be very costly to repair or replace in cases of cyber-attacks. This paper surveys deep learning algorithms, IoT cyber security and risk models, and established mathematical formulas to identify the best approach for developing a dynamic and self-adapting system for predictive cyber risk analytics supported with Artificial Intelligence and Machine Learning and real-time intelligence in edge computing. The paper presents a new mathematical approach for integrating concepts for cognition engine design, edge computing and Artificial Intelligence and Machine Learning to automate anomaly detection. This engine instigates a step change by applying Artificial Intelligence and Machine Learning embedded at the edge of IoT networks, to deliver safe and functional real- time intelligence for predictive cyber risk analytics. This will enhance capacities for risk analytics and assists in the creation of a comprehensive and systematic understanding of the opportunities and threats that arise when edge computing nodes are deployed, and when Artificial Intelligence and Machine Learning technologies are migrated to the periphery of the internet and into local IoT networks.

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.

Aims: Heart failure (HF) is frequently accompanied by atrial fibrillation (AF), a combination that worsens the outcomes of both diseases. Despite advances in the treatment of AF, it remains a serious and unsolved problem for clinicians and researchers. The aim of this study was to examine risk factors for incidents of paroxysmal and persistent AF in patients having heart failure with mid-range ejection fraction (HFmrEF). Methods. Overall, 71 patients with HFmrEF and non-valvular AF, including paroxysmal and persistent types, were enrolled in this study. As a control group, 42 HFmrEF patients without AF were also enrolled. All patients underwent detailed physical examination, including resting electrocardiography, echocardiography, and 24-hour ambulatory Holter monitoring. Levels of the inflammation markers high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α) and the fibrotic marker transforming growth factor-β1 (TGF-β1) were measured by ELISA and expressed as odds ratios. Results: We show that paroxysmal AF was associated with higher diastolic blood pressure, whereas both paroxysmal and persistent forms of AF were associated with more frequent occurrence of hypertensive crisis episodes and greater body mass index. Progression from paroxysmal to persistent AF was associated with significant ventricular remodeling. Persistent and paroxysmal AF were associated with higher levels of inflammatory markers when compared to HFmrEF patients having no AF. In addition, TGF-1 was significantly increased in HFmrEF patients having persistent but not paroxysmal AF. Conclusions: Occurrence of AF, first paroxysmal and then persistent, in HFmrEF patients is associated with left ventricular remodeling and the appearance of systemic inflammatory and fibrotic markers. Changes in those parameters may be indicators by which to identify patients at increased risk of atrial fibrillation. Further studies are needed to determine the prognostic validity of these markers.

The frequent incidents of oil spills and other forms of pollution arising from crude oil exploration and exploitation (OEE) in the Niger Delta have caused several investigations on Polycyclic Aromatic Hydrocarbons (PAHs) pollution. This study aimed at developing a comprehensive report on PAH pollution and its human health risks recorded in the Niger Delta. Studies were extracted from Google Scholar, PubMed, and ResearchGate using a defined selection criterion. The quality of each study was assessed using the Newcastle – Ottawa Scale. Thirty-eight studies were selected with the majority reporting on PAH pollution in aquatic environments. Across all the selected studies, the total number of PAHs recorded ranged from 7 to 28 PAH congeners. Also, PAH potential sources reported in the studies were of pyrogenic and petrogenic sources. PAH concentrations recorded in water, sediment, aquatic organisms (fish and shrimp), soil, dust, and crop samples ranged from below detection limit (BDL) to 450 ± 117.9 mg/L, BDL to 1821.5 mg/kg, 0.005 to 1.098 mg/kg, ND to 4154 ± 3461 mg/kg, 165.1 to 1012 mg/kg, and 0.020 to 3.37 mg/kg, respectively. Majority of the selected studies reported PAH levels which were higher than the permissible limits. Incremental Lifetime Cancer Risk (ILCR) assessment of PAHs in samples ranged from low to high via ingestion and dermal routes of exposure to humans. It is recommended that the Federal Government of Nigeria promotes environmentally friendly operations of OEE. Future studies should focus on PAH pollution in farmlands, ambient air and the associated human and ecological health risks.

This study explores the intricacies of supplier relationships and inventory optimization within high-technology industries, offering a comprehensive analysis of the strategic imperatives and operational challenges faced by firms in these sectors. By adopting a qualitative research methodology involving semi-structured interviews with supply chain professionals and documentary analysis, the study provides in-depth insights into the evolving dynamics of supply chain management. Findings reveal a marked shift towards collaborative and strategic supplier relationships, characterized by trust, transparency, and joint innovation initiatives. These partnerships are essential for enhancing operational efficiency, driving product development, and navigating market uncertainties. Additionally, the research underscores the critical role of advanced technologies, such as artificial intelligence and the Internet of Things, in optimizing inventory levels and improving supply chain visibility. The integration of these technologies facilitates precise demand forecasting and proactive inventory management, thereby reducing costs and enhancing service levels. However, the study also highlights significant challenges, including geopolitical uncertainties, supply chain disruptions, and cultural barriers, which necessitate robust risk management strategies and adaptive supply chain practices. Strategic implications for organizational leaders and policymakers include the need to invest in supplier development, embrace digital transformation, and enhance risk management frameworks to build resilient and agile supply chains. This study contributes valuable insights into the complex interplay between supplier relationships, inventory optimization, and technological integration in high-technology industries, offering actionable recommendations for practitioners and researchers seeking to drive innovation and maintain competitiveness in a dynamic global marketplace.

A total of 281 guano samples were collected from caves (N = 181) in 8 European countries (Bulgaria, Czech Republic, France, Hungary, Italy, Romania, Slovakia and Slovenia) and attics in the Czech R. (N = 100). The correlation of detection of mycobacteria between Ziehl-Neelsen (ZN) microscopy and culture examination and qPCR was strong. ZN microscopy was positive in guano from caves (58.6%) more than double than positivity in guano from attics (21.0%; P &lt;0.01). From 89 mycobacterial isolates (73 isolates from cave guano and 16 isolates from attics’ guano) 68 (76.4%) isolates of 19 sp., ssp. and complex were identified as members of 3 Groups (M. fortuitum, M. chelonae, and M. mucogenicum), and 4 Complexes (M. avium, M. terrae, M. vaccae, and M. smegmatis). A total of 20 isolates (22,5%) belonged to risk group 1 (environmental saprophytes), 48 isolates (53.9%) belonged to risk group 2 (potential pathogens), and none of isolates belonged to risk group 3 (obligatory pathogens). When comparing bat guano collected from caves and attics, differences (P&lt;0.01; Mann-Whitney test) were observed for the electrical conductivity, total carbon, total organic and total inorganic carbon. None difference (P&gt; 0.05; Mann-Whitney test) was found for pH and oxidation-reduction potential parameters.

(1) Aims: To analyse the relationship between demographic and clinical characteristics and particular kinds of suicidal behaviour and its relationship with a nurse-led suicide prevention program. (2) Methods: A 5-year cross-sectional study design. Study performed in the region of Osona (Catalonia) during 2013-2017. Suicidal behaviour was classified as suicidal ideation, interrupted self-directed violence, suicide attempt and completed suicide. (3) Results: The sample included 753 patients ─ of whom 53 died by suicide─ and encompassed 931 suicidal behaviour episodes. Men represented 38.4% of the sample but 81.1% of deaths by suicide. Mental disorders were associated with suicidal behaviour in 75.4% of the sample. 66.4% of the individuals were engaged in the nurse-led Suicidal Behaviour Case Management Program, of which 0.8% (n=4) died by suicide. (4) Conclusion: The main risk factors were female sex for suicidal behaviour, and male sex and older age for suicide. Mental disorders, widowhood and retirement were also associated with suicide. A high proportion of patients was engaged to the nurse-led suicide prevention program with a low proportion of suicides.

A key step in providing management/treatment options to men with suspected prostate cancer (PCa) is categorizing the risk for the presence of benign, low risk, intermediate risk, or high-risk disease. Our novel modality brings new evidence, based on the long-known hallmark characteristic of PCa – decreased Zinc (Zn), which is the most direct metabolic sign of malignancy and its aggressiveness. To date, this approach has not been adopted for clinical use for a number of reasons that are described in this article and which have been addressed by our approach: Zn has to be measured on fresh samples, prior to fixating in formalin, therefore samples have to be scanned during the biopsy session; as Zn depletion occurs in the glands, where the tumors develop, estimation of the glands’ levels in the scanned tissue along with their compactness, are essential for accurate diagnosis. Combined with the Zn depletion, this facilitates a reliable assessment of the disease aggressiveness. Data gathered in the clinical study described here indicate that in addition to improving the biopsy quality by real-time interactive guidance, a malignancy score can now be established for the entire prostate, allowing higher granularity personalized risk stratification and more decisive treatment decisions for all PCa patients.

Reliability assessment in traditional power distribution systems has played a key role in power system planning, design, and operation. Recently, new information and communication technologies have been introduced in power systems automation and asset management, making the distribution network even more complex. In order to achieve efficient energy management, the distribution grid has to adopt a new configuration and operational conditions that are changing the paradigm of the actual electrical system. Therefore, the emergence of the cyber-physical systems concept to face future energetic needs requires alternative approaches for evaluating the reliability of modern distribution systems, especially in the smart grids environment. In this paper, a reliability approach that makes use of failure modes of power and cyber network main components is proposed to evaluate risk analysis in smart electrical distribution systems. We introduce the application of Failure Modes and Effects Analysis (FMEA) method in future smart grid systems in order to establish the impact of different failure modes on their performance. A smart grid test system is defined and failure modes and their effects for both power and the cyber components are presented. Preventive maintenance tasks are proposed and systematized to minimize the impact of high-risk failures and increase reliability.

The complexity of plastic polymers and even more so of additives has increased enormously in recent years. This makes the high-quality recycling of mixed plastic waste considerably more difficult. Some additives have now been strictly regulated or even completely banned for good reasons ('legacy additives'). Material or mechanical recycling generally utilises old plastics that still contain these substances. Consequently, products that are manufactured using such recyclates are contaminated with these harmful substances. We therefore recommend avoiding the use of these recyclates for products with intensive contact with consumers until further notice. We also show that the climate policy challenges for the plastics (and chemical) industry necessitate a defossilisation ('feedstock change'). This turnaround can only succeed if solely high-quality recycling takes place in future; recyclates should primarily replace virgin plastics. This can only work if used plastics with a high degree of homogeneity and known formulation are collected separately, as is already the case today with PET bottles. In this context, we would like to point out inconsistencies in the current legislation on the European emissions trading system.

Background and aims: Only one cohort study exists on the incidence of the risk of malnutrition (RM) in older adults, though numerous cross-sectional –and that cohort research– have reported several risk factors associated with the prevalence and incidence of this condition. However, alterations of body composition and impaired physical performance as exposition variables of RM have not been explored. This study assessed the incidence of RM and determined its association with excess fat mass, low total lean tissue, gait speed, and handgrip strength as exposition variables for RM in community-dwelling older adults. Methods: This is a secondary analysis in older adults (≥60 years old) derived from the study “Frailty, dynapenia, and sarcopenia in Mexican adults (FraDySMex)” a prospective cohort project conducted from 2014 to 2019 in Mexico City. At baseline, volunteers underwent body composition analysis and physical performance tests. Several covariates were identified through comprehensive geriatric assessment. At baseline and follow-up, RM was assessed using the long form of the mini nutritional assessment (MNA-LF) scale. Associations between the exposition variables and RM were assessed by multiple logistic regression. Results: The cohort included 241 subjects. Average age was 75.6±7.8 years; 83.4% were women. The mean follow-up period was 4.1 years, during which 28.6% of subjects developed RM. This condition was less likely to occur in subjects with excess fat mass index, even after adjusting for several covariates. RM was also more likely to occur in subjects with low total lean tissue index, according to both an unadjusted model and after adjusting for the corresponding variables. Regarding the association between RM and gait speed, RM was also more likely to occur in subjects with low gait speed according to both the unadjusted and adjusted models. Similar results were found for RM in relation to low handgrip strength; however, after adjusting for the associated covariates, models 1 and 2 no longer reached the level of significance. Conclusion: The risk of malnutrition diagnosed by MNA-LF was significantly less likely to occur among subjects with excess fat mass, but possibility was significantly higher in those with low total lean tissue and low gait speed after 4.1 years of follow-up in community-dwelling older adults. These results highlight that excess fat mass, low total lean tissue, and low gait speed are first than risk of malnutrition and not vice versa.

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

This transdisciplinary review of research about international cooperation on social and environmental change builds the case for replacing Sustainable Development as the dominant framework for an era of increasing crises and disasters. The review is the output of an intentional exploration of recent studies in multiple subject areas, based on the authors’ decades of work in related fields since the Rio Earth Summit 30 years ago (rather than a keyword search of databases). It summarizes the research which documents failure to progress towards the Sustainable Development Goals (SDGs). Consequently, the extensive scholarship critiquing the conceptual framework behind those ‘Global Goals’, and the economic ideology they arose from and support, is used to explain that failure. Although the pandemic set back the SDGs, it further revealed the inappropriate strategy behind those goals. This suggests the Global Goals constitute an ‘own-goal’ scored against people and nature. From this conclusion, alternative frameworks for organizing action on social and environmental issues become more important and are therefore briefly reviewed. It is argued that such a future framework must relate a new eco-social contract between citizen and state, and engage existing organizations and capabilities that are relevant to an increasingly disrupted world. Therefore, the case is made for considering an upgraded form of Disaster Risk Management (DRM) as an overarching framework. The proposed upgrades include detaching from economic ideologies, and recognizing that a wider metadisaster from climate chaos may reduce the future availability of external support. Therefore, self-reliant resilience and locally-led adaptation are identified as important to the future of DRM. Some options for professionals continuing to use the term sustainability, such as this journal, are discussed.

.Background: Clostridioides difficile infections (CDI) vary in severity from mild diarrhea to life-threatening conditions like pseudomembranous colitis or toxic megacolon, often leading to sepsis and death. The COVID-19 pandemic prompted changes in healthcare practices, potentially affecting CDI incidence, though reported data are inconclusive. We studied factors influencing CDI incidence and outcomes at a university hospital throughout the COVID-19 pandemic years. Methods: We conducted a retrospective study on all adult hospitalized CDI cases from January 1, 2020, to December 31, 2022. We collected demographic information, comorbid conditions, and concurrent infections. Results: While overall CDI and COVID-19 rates decreased in 2022, a nota-ble increase in CDI infections was observed among oncological patients and those undergoing some aggressive treatments, such as colon or gastroscopies. The prevalence of comorbidities remained unmodified, and there were declines in prior gastrointestinal surgeries and proton pump inhibitor prescriptions. Factors associated with patient fatality or prolonged hospitaliza-tion included older age, cancer, chronic kidney disease, higher Charlson and McCabe indices, elevated C-reactive protein, and low albumin concentrations. Conclusion: Our study shows the evolving landscape of CDI during the COVID-19 pandemic and emphasizes the impact of de-layed diagnoses and treatments exacerbated by telemedicine adoption. Identified risk factors for CDI-related mortality or prolonged hospital stays underscore the importance of targeted inter-ventions in high-risk populations.

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.

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

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.

This study utilizes the Random Forest technique to investigate risk management practices and concerns in Islamic banks using survey data from 2016 to 2021. Findings reveal that larger banks provide more consistent survey responses, driven by their confidence and larger survey budgets. Moreover, a positive link is established between a country's development, characterized by high GDPs and low inflation and interest rates, and the precision of Islamic banks' survey responses. Analyzing risk-related concerns, the study notes a significant reduction in credit portfolio risk, attributed to improved risk management practices, global economic growth, stricter regulations, and diversified asset portfolios. Concerns related to terrorism financing and cybersecurity risks have also decreased due to better enforcement of anti-money laundering regulations and investments in cybersecurity infrastructure and education. This research enhances our understanding of risk management in Islamic banks, highlighting the impact of bank size and country development. Additionally, it emphasizes the need for ongoing analysis beyond 2021 to account for potential COVID-19 effects and evolving risk management and regulatory practices in Islamic banking.

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.

Static and dynamic analysis of website security risks is generally used for website security meas-urements. The website security measurements method recently proposed includes similarity hash-based website security risk analysis and machine learning-based website security risk anal-ysis. In this study, a method that can be performed through information disclosed on the Internet was proposed to measure the risk of a website. DNS information, IP information, and website history information are required to measure the risk of a website. In addition, global traffic rank-ing, malicious code distribution history, and HTTP access status can be checked in the website history information. In this study, information related to the security risk of websites in a total of 2,000 domains was collected and analyzed in 1,000 normal and malicious domains. Through the experiment results, 11 open information collection items were selected to measure the security risk of the website. This study presented the possibility of using public information collection to measure website security risk.

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.

Background: The prevalence of physical inactivity has been rising in many countries in recent years, adding to the burden of non-communicable diseases and affecting overall health worldwide. The aim of this study is to determine the impact of physical activity on mortality from ischemic heart disease (IHD) separately for those respondents who were diagnosed with IHD and for those who were not diagnosed with IHD in their baseline health survey. Methods: In the baseline survey (2006–2008), 7100 men and women ages 45–72 were examined within the framework of the international study Health, Alcohol, and Psychosocial Factors in Eastern Europe (HAPIEE). 6770 participants were available for statistical analysis (after excluding 330 respondents due to missing information on study variables). Physical activity was determined by leisure-time physical activities (hours/week). All participants in the baseline survey were followed up for IHD mortality events until December 31, 2018. Results: Using multivariate Cox regression analysis, it was found that moderate and higher levels of physical activity significantly reduced the risk of IHD mortality (HR=0.54 and HR=0.60 respectively) in men who were not diagnosed with IHD at baseline compared with physically inactive subjects. It was found that among men and women who were diagnosed with IHD at baseline, physical activity reduced the risk of mortality from IHD compared with those who were physically inactive (HR=0.54 and HR=0.41 respectively). Using mediation analysis, was found that physical activity directly predicted statistically lower IHD mortality (P&lt;0.05) in men and women. Conclusion: Physical activity was a significant factor that directly predicted statistically lower IHD mortality, regardless of whether subjects had IHD at baseline or not.

: 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.

Since 2012, the northeast of Tunisia has been experiencing an emergence of dog rabies. Published data revealed that the disease is widespread in the north of Tunisia. Even with studies on rabies, lacking knowledge on the associated risk factors was highlighted. Therefore, we conducted a case-control study on dog rabies in northeast Tunisia to identify potential risk factors for dog rabies occurrence. The cases group (n=77) included positive dog rabies confirmed at the referral laboratory using Fluorescent Antibody Test (FAT) in 2014 and 2018. The controls group (n=77) involved all negative cases received at the laboratory and 15-days quarantine dogs that received a certificate of absence of rabies after the observation period. Univariate and multivariate logistic regression was conducted to explore the risk factors (age, sex, breed, confinement, vaccination status, presence of bites, owned or not and origin of dogs, sector, presence of rabies cases, and slaughterhouses, etc.…) related to the occurrence of rabies. The final logistic regression model revealed that unconfined dogs were almost twice as likely to be affected as confined dogs (OR=1.9; 95% CI: 1.17 to 3.27). The odds of rabies occurrence were 25 times higher in areas where rabies cases have been reported between 3 months and 1 year compared to the uninfected areas (25.7; 95% CI: 3.02-219.14). Similarly, the risk of rabies is significantly higher in dogs born in the home to the owner bitch (OR=2.41; 95% CI: 1.14-5.13). Living in areas with rabies cases in the last three months increases by 2.8 times the risk of getting rabies (2.8; 95% CI: 1.16-6.77). However, vaccination reduces by 1.6 times the risk of contracting rabies (0.6; 95% CI: 0.38-0.97). Our findings provide reliable data on dog rabies that will be very useful for decision-makers and could contribute to improving the ongoing national control program of rabies.

The research objects are the tax and budgetary policies of the Russian Federation. In this research, financial (budgetary) risks are understood as a decrease in the balance of the state (national) budget resulting from a reduction in revenues or an increase in expenditures. This research considers production in the main sectors of the economy as a key factor of financial risk in the COVID-19 pandemic. The research aims to analyze the main directions of the budgetary and tax policy of the Russian Federation aiming at supporting the economy and the population during the spread of COVID-19, which is especially relevant in connection with the expected recession in a number of sectors of the economy and a decrease in the level of employment and, accordingly, the well-being of citizens. In these conditions, it is necessary to adjust the budgetary and tax policy to preserve the state’s social obligations and expand social and economic support for businesses and citizens to smooth out the negative consequences of the impact of restrictive measures. The authors applied systemic and institutional approaches and statistical methods. The main results of the research reflect the need to (1) implement support measures (tax and budgetary incentives) for small and medium-sized enterprises, on which the crisis provoked by the COVID-19 pandemic has had the most destructive impact, and (2) to expand the volume of budgetary financing of social programs for financial risk management of the Russian economy during the COVID-19 pandemics.

The COVID-19 pandemics has had an unprecedented global impact, and the COVID-19 mass vaccination campaign has been commonly regarded as crucial to overcome the pandemics. Since all-cause mortality is the best way to measure the consequences of a health intervention, the present study was devised to analyze the all-cause mortality data of the United Kingdom (UK), which are made publicly available broken down by vaccination status. Data from January to May 2022 were retrospectively collected and analyzed according to age groups and vaccination status and the relative risk (RR) for all-cause mortality was calculated in comparison to the corresponding unvaccinated groups. All-cause mortality RR was also calculated from January to May 2021 for vaccinated people. Results show that the all-cause mortality RR was higher in people who received one or two doses of COVID-19 vaccines throughout the whole period and in any of the age groups considered. People vaccinated with three doses more than 21 days earlier had RRs lower than unvaccinated people, which however linearly increased over time. RR in vaccinated people of all ages in comparison to unvaccinated people were lower in January-May 2021, however they steadily grew over time. The finding that all-cause mortality RR in vaccinated in comparison to unvaccinated people increases over time requires careful examination to understand the underlying factors. Meanwhile, all the other major countries should undertake a systematic collection of all-causes mortality broken down by vaccination status, and mass vaccination campaigns should be suspended.

Healthcare workers (HCWs) are regarded as role models regarding health-related issues including vaccination. Therefore, it is essential to identify the predictors for COVID-19 vaccine acceptance among them. A cross-sectional study to assess the risk perception, attitudes and knowledge of HCWs toward COVID-19 vaccination was carried out. A total of 710 responses were received between September 2021 to March 2022, from HCWs in the Northern, Western and Eastern regions of Nigeria. Cross tabulations were performed to determine statistical relations between sociodemographic variables, knowledge, attitudes and risk perceptions concerning COVID-19 vaccine acceptance. Multinomial Logistic Regression analysis was performed to determine the predictive variables for COVID-19 vaccine acceptance. Statistical analyses were performed and P-values less than 0.05 were considered statistically significant at a CI of 95%. Results showed that 59.3% of the participants were amenable to COVID-19 vaccines. Multinomial regression analysis identified 14 variables at α <0.05 as predictors for vaccine acceptance. Male HCWs were 2.8 times more likely to accept the vaccine than their female counterparts. HCWs that were knowledgeable of the different kinds of vaccines, willing to recommend the vaccines to their patients, believe that the timing of COVID-19 vaccination was appropriate and had recent vaccination history within three years were 1.6, 24.9, 4.4 and 3.1 times more likely to take COVID-19 vaccine than those not sure. The study found a relatively high trust (51.3%) in the Nigerian Center for Disease Control (NCDC) for information regarding COVID-19 vaccines. Therefore, the NDCD should disseminate more robust insights regarding the safety profiles of various COVID-19 vaccines.

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.

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.

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

The COVID-19 pandemic affected the whole world, but not all countries were impacted equally. This opens the question of what factors can explain the initial faster spread in some countries compared to others. Many such factors are overshadowed by the effect of the countermeasures, so we studied the early phases of the infection when countermeasures have not yet taken place. We collected the most diverse dataset of potentially relevant factors and infection metrics to date for this task. Using it, we show the importance of different factors and factor categories as determined by both statistical methods and machine learning (ML) feature selection (FS) approaches. Factors related to culture (e.g., individualism, openness), development, and travel proved the most important. A more thorough factor analysis was then made using a novel rule discovery algorithm. We also show how interconnected these factors are and caution against relying on ML analysis in isolation. Importantly, we explore potential pitfalls found in the methodology of similar work and demonstrate their impact on COVID-19 data analysis. Our best models using the decision tree classifier can predict the infection class with roughly 80% accuracy.

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.

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.

Life evolved in an euxinic world with subsequent oxic 'invasion' leading to two parallel but interconnected biospheres, hydrogen sulphide (H₂S) and hydrogen peroxide (H₂O₂) exemplify these worlds respectively. Their concentration gradients have informational value in meromictic lakes. Similarly, it is posited, there exists a whole body chemocline in humans in which the two molecules form an inversely coupled oxic/sulphidic oscillator (OSO). The OSO is hormetic and characterised by a range of amplitudes and frequencies in health. Deviations from its baseline profile heralds the onset of SIRS before the appearance of clinical signs. Loss of oscillator status and transition to a steady state causes widespread intercellular and inter-organ communication failure presaging multi-organ dysfunction. The salient clinico-pathophysiological features of SIRS of any aetiology are emergent phenomena related to the OSO profile. Extent of recovery of organ function will mirror the recovery of the OSO profile thereby providing a tool to predict outcomes in SIRS.

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

We examine the profitability of the momentum and contrarian strategies in three South Asian markets i.e. Bangladesh, India and Pakistan. We also analyze, whether credit risk influences momentum and contrarian return for these markets from 2008 to 2014. We use Distance-to-default (DD) of Kealhofer, McQuown and Vasicek (KMV) model as a measure of credit risk. We calculate the credit risk and form the momentum and contrarian strategies of the firms on the basis of high, medium and low risk. We find that in all three markets, the momentum and contrarian returns are significant for medium and high credit risk portfolios and no momentum and contrarian returns for low credit risk portfolios.

Microorganisms belonging to the Lactobacillus genus are naturally associated or deliberately added to fermented food products and are widely used in probiotic food additives and supplements. Moreover these bacteria normally colonize mouth, gastrointestinal (GI) tract and female genitourinary tract of humans. They exert multiple beneficial effects and are regarded as safe microorganisms. However, infections caused by lactobacilli, mainly endocarditis, bacteremia and pleuropneumonia occasionally occur. The relevance of Lactobacillus spp. as opportunistic pathogens in humans and related risk factors and predisposing conditions are illustrated in this review article with more emphasis on the species L. rhamnosus, that has been more often involved in infection cases. The methods used to identify this species in clinical samples, to distinguish strains and to evaluate traits that can be associated to pathogenicity, as well as future perspectives for improving the identification of potentially pathogenic strains are outlined.

OBJETIVE: This study analyses the views of four groups of healthcare professionals who may play a role in the management of suicidal behaviour. The goal was to identify key factors for suicide prevention in different areas of the healthcare system. METHODOLOGY: Qualitative research was conducted using focus groups made up of different healthcare professionals who participated in the identification, management and prevention of suicidal behaviour. Professionals included were primary care physicians, psychologists, psychiatrists and emergency physicians. RESULTS: ‘Suicide’ was amongst the most relevant terms that came up in discussions most of the times it appeared associated with words such as ‘risk’, ‘danger’ or ‘harm’. In the analysis by categories, the four groups of professionals agreed that interventions in at-risk behaviours are first in importance. Prevention was the second main concern with greater significance among psychiatrists. DISCUSSION: Primary care professionals claim for more time to address patients at risk for suicide and an easier access to and communication with the mental health network. Emergency care professionals have a lack of awareness of their role in the detection of risk for suicide in patients who seek attention at emergency care facilities for reasons of general somatic issues. Mental health care professionals are in high demand in case of self-harm but they would like to receive specific training in dealing with g suicidal behaviour.

The purpose of this paper is to evaluate the timing of innovative investment in technology product life cycles using a compound binomial option with management flexibility. Considering the business cycles changes in the macroeconomic will affect consumer purchasing power. The focus is how to evaluate the optimal investment strategy and the project value. It was applied to different product stages (three stages including production innovation, manufacture innovation, and operation innovation) and factored to different risks to build a technology innovation strategy model. An aim of this study is the options premium of the best strategy timing for each innovation stage. Its application of the compound binomial options for the manufacture innovation will only be considered after the execution of the production innovation. The same condition is applied to the operation innovation, which will only be considered after the execution of the manufacture innovation. Then, this paper constructs the dynamic investment sequential decision model, assesses the feasibility of an investment strategy, and makes a decision on the appropriate project value and options premium for each stage under the possible change of Gross Domestic Product (GDP). This paper investigates the product life cycle innovation investment topic by using the compound binomial options method and will provide a more flexible strategy decision compared with other trend forecast criteria.

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

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

Proximal Junctional Kyphosis (PJK) as one of the most discussed problems after corrective surgery in adolescent idiopathic scoliosis (AIS), is still not fully clarified and seems to be multifactorial. Biome-chanical and few clinical studies have shown the influence of destruction of posterior ligaments by re-section of spinous processes and some parameters concerning rod contouring as risk factors for PJK. To verify these results 192 patients with AIS and corrective surgery via posterior approach between 2009 and 2017 were included. Radiographic parameters were analyzed preoperatively (preOP), postoperatively (postOP), and with a mean follow up (FU) of 27 months. The participants were divided into two groups (PJK group and non-PJK group). The incidence of PJK was 15.6%. Contrary to the results of biomechanical studies, we could not find any significant influence of the spinous process resection. However, the PJK group had significantly larger preOP T4-T12 kyphosis (31.1°±13.93° vs. 23.3°±14.93°, p=.016). Furthermore, the PJK group showed a significantly larger rod contour angle (RCA) (8.0°±4.44° vs. 5.9°±3.28°, p=.003) and mismatch of postOP proximal junctional angle (PJA) and RCA (3.5°±5.72° vs. 0.9°±4.86°, p=.010) compared to the non-PJK group. An increase of the mismatch of postOP PJA and RCA (OR=1.14, p=.008) and a high RCA are risk factors for PJK and need to be focused on by surgeons.

The development of small scale hydroelectric power plants in Norway is determined by natural conditions, policies, attitudes and property rights. The owner of the river is the central decision maker. It is he who decides whether he will develop the power plant himself, Whether he wants to enter into a contract with an external investor and let him develop the power plant, whether he will sell his property rights or postpone the decisions. All available choices will involve risk. In order for him to make the best choice he must find the certainty equivalent to each of the choices and choose the one with the highest certainty equivalent. This is the first time the utility theory of John von Neumann and Oskar Morgenstern has been applied to decision makers in the hydro power industry in Norway.

Lymphadenopathy is a common manifestation of both reactive and malignant diseases, and fine needle aspiration (FNA) is an effective and inexpensive screening method. It can prevent unnecessary invasive surgery and excisional biopsy, especially in benign cases. Unfortunately, the lack of universally accepted terminology for reporting results has hindered its widespread support. The Sydney system proposal for lymph node cytopathology categorization and reporting introduced five diagnostic categories to address the lack of universally accepted terminology for reporting results in lymphadenopathy. Our study analyzed 188 lymph node FNC samples from King Abdulaziz University Hospital, Saudi Arabia, examining clinical follow-up data, pathology records, patient information, and final diagnosis from January 2019 to December 2022. Most specimens were from axillary LNs, with 99.5% tissue correlation. The Sydney System Category classification identified 56.9% of cases as malignant, while 26.1% were benign. The final surgical specimen diagnosis revealed a higher percentage of malignant diagnoses, with the highest ROM in malignant/Category V. In conclusion, our study demonstrates that LN-FNAC offers high diagnostic accuracy for LN aspirates, with the Sydney approach potentially aiding risk stratification and achieving consistency in cytologic diagnosis, but further multi-centric research is needed.

Ulleung County, one of the most medically vulnerable areas in South Korea, requires public attention because of the high incidence of liver cancer. This study was conducted as a part of the Ulleung Liver Cancer Prevention and Management Project. The purpose of this study was to estimate the community prevalence of hepatitis B and C viruses and to identify the associated risk factors. The Project’s interagency workgroup established a procedure for conducting blood sampling and health behavior surveys at the Ulleung Public Community Health Center. A total of 1,792 residents aged 40 years and older voluntarily participated in the study between 2019 and 2022. The hepatitis B surface antigen (HBs Ag) and hepatitis C virus antibody (anti-HCV) positive rates in Ulleung were 7.19% and 1.37%, respectively. Low education level and lifetime smoking were associated with HBsAg positivity, whereas cupping therapy at non-medical institutions was associated with anti-HCV positivity. The odds of HBs Ag positivity were lower among those with tattoos than among those without. There was a difference in the risk factors associated with hepatitis B and C viral infection. While a high HBs Ag positivity rate alone may not fully explain the high incidence of liver cancer in Ulleung, it may be a contributing factor.

Background: During the COVID-19 pandemic, hygiene behaviors such as keeping distance, avoid-ing masses, wearing face masks and adhering to hand hygiene recommendations became impera-tive. The current study aims to determine factors interrelating with hygiene behaviors. Methods: 4,049 individuals (1,305 male, 2,709 female, aged 18-80 years) were recruited from rehabilitation clinics or freely on the internet and surveyed via online questionnaire between May 2020 and August 2021. Socio-demographics, hygiene behaviors, emotions (fear), life-satisfaction, risk factors and disability as well as communication were assessed. Results: Prevalence for hygiene behaviors was: keeping the distance 84.9%, avoiding mass gatherings 84.6%, wearing face masks 96.5% and hand hygiene 80.7%. Hygiene behaviors were significantly related to fear with linear and quad-ratic associations. Conclusion: Individuals with disabilities, risk factors and psychological symp-toms are more compliant. Especially hand hygiene should be targeted to achieve higher compli-ance rates. A medium level of fear is more functional than too elevated fear. Behavioral interven-tions and targeted communication aiming at improving different behaviors in orchestration can help individuals to remain healthy and maintain a high life-satisfaction. Thereby, communication in the healthcare setting is imperative and all involved individuals should become more aware of this to ensure high hygiene standards and patient safety.

Traditional flood hazard analyses often rely on univariate probability distributions; however, in many coastal catchments, flooding is the result of complex hydrodynamic interactions between multiple drivers. For example, synoptic meteorological conditions can produce considerable rainfall-runoff, while also generating wind-driven elevated sea levels. When these drivers interact in space and time, they can exacerbate flood impacts; this phenomenon is known as compound flooding. In this paper, we build a Bayesian Network based on Gaussian copulas to generate the equivalent of 500 years of daily stochastic boundary conditions for a coastal watershed in Southeast Texas. In doing so, we overcome many of the limitations of conventional univariate approaches and are able to probabilistically represent compound floods caused by riverine and coastal interactions. We calculate the resulting water levels using a 1D steady-state hydraulic model and find that flood stages in the catchment are strongly affected by backwater effects from tributary inflows and downstream water levels. By comparing with a bathtub modeling approach, we show that simplifying the multivariate dependence between flood drivers can lead to an underestimation of flood impacts, highlighting that accounting for multivariate dependence is critical for the accurate representation of flood risk in coastal catchments prone to compound events.

INTRODUCTION: This study focusses on diagnosis of stages of AD (Alzheimer’s disease) including MCI (Mild Cognitive Impairment) from two data modalities - gene expression and clinical data of ADNI (Alzheimer’s Disease Neuroimaging Initiative ) participants using multiclassification. The gene expression dataset is highly imbalanced and of HDLSS (high-dimensional and low-sample-size) characteristics. This is the only study where multiclassification based AD stage diagnosis is done to identify multiple stages of Alzheimer. We are able to achieve the best multiclassification result in both the modalities and identify new genetic biomarkers. METHODS: Combination of XGBoost and SFBS (“Sequential Floating Backward Selection”) methods is used to select features. We are able to select the most effective 95 gene probsets out of 49,386. For clinical study data, 8 most effective biomarkers could be selected using SFBS. For both genomic and clinical data, DL (‘Deep Learning’) classifier is used to identify stages - CN (Cognitive Normal), MCI (Mild Cognitive Impairment), AD (Alzheimer’s Disease / Dementia). Because of high data imbalance in genomic data, border line oversampling is used for model training and original data for validation. RESULT & DISCUSSION: With clinical data, we achieved ‘ROC AUC’ scores 0.97, 0.95, 0.94 for CN, MCI, Dementia stage respectively . We achieve ‘ROC AUC’ scores 0.75, 0.74, 0.70 for CN, MCI, Dementia stage respectively and 0.67 for both micro average F1 scores and micro weighted F1 score. This is the best result so far for AD stage diagnosis from gene expression profile data through multiclassification with ADNI data. Results reflect that our multiclassification model can efficiently handle the imbalanced data of HDLSS nature to identify samples of minority class. MAPK14, ZNF835, MID1, HLA-DQA1, TEP1 are some of the new genes found to be associated with AD risk. DRAXIN, HSPA12B, USP47 etc. are found to be AD preventive or suppressor.

Abstract Cholesterol has ruled the history of atherosclerotic cardiovascular diseases (CVD) for decades, and the transport of cholesterol by lipoproteins has become a cornerstone of our view of etiology of the disease. Discovery of the lipoprotein-specific transport of lipid oxidation products (LOP) has opened a new and exciting area in research of CVD by revealing strong connections between atherogenic LOP, lipoprotein transport functions and CVD. This review goes through the evidence in support of the lipoprotein-specific LOP transport and speculates of possible consequences of the proposed role of lipoprotein LOP transport as a risk factor. Association of lipoprotein LOP with known risk factors of CVD are largely parallel with those of cholesterol, and due to the common transport and cellular intake mechanisms the elucidation of independent effects of either cholesterol or LOP is difficult. Yet, unlike cholesterol, LOP can directly initiate and boost atherogenic processes. It therefore appears inevitable that increasing knowledge of the lipoprotein-specific LOP transport will affect the present view of the role of cholesterol in aetiology and as a risk factor of CVD.

The Canadian Prairies are associated with high natural hydroclimatic variability including the frequent periodic occurrence of droughts and pluvials. These extremes carry various risks in-cluding significant damage to the economy, environment and society. The well-documented level of damage necessitates further risk assessment and planned reductions to vulnerability, particu-larly in light of a warming climate. A logical starting point involves awareness and information about the changing characteristics of such climate extremes. We focus on the compound occurrence of droughts and pluvials as the risks from this type of event are magnified compared to the hy-droclimatic extremes in isolation. Also, research on compound droughts and pluvials is limited. Therefore, the purpose of this paper is to synthesize recent literature concerning the risks of com-pound droughts and pluvials, including examples of past occurrences, with a focus on the Cana-dian Prairies. Since literature from the Prairies is limited, global work is also reviewed. Rela-tionships between drought and pluvials are characterized using the SPEI Global Monitor for the Prairies, emphasizing the recent past, and through synthesis from the Prairie literature. That re-search mostly considers drought and pluvials as separate events, but is integrated here to charac-terize the relationships of these extremes. Examples of periods of compound droughts and exces-sive rainfall provide insights into the regional hydroclimatic variability. Furthermore, most lit-erature on future projections strongly suggests that this variability is likely to increase, mainly driven by anthropogenic climate change. These findings suggest means of decreasing vulnerabil-ity and associated damages. Although the study area is the Canadian Prairies, the work is rele-vant to other regions that are becoming more vulnerable to increasing risks of and vulnerabilities to such compound extremes.

This qualitative research explores the influence of supply chain disruption management on brand resilience and consumer perception. Amidst increasingly complex global dynamics, effective strategies are crucial for organizations to mitigate risks, maintain operational continuity, and preserve consumer trust. The study employs semi-structured interviews with stakeholders across diverse industries, focusing on strategies employed, outcomes observed, and challenges faced in managing disruptions. Key findings underscore the significance of proactive measures such as risk assessment, contingency planning, diversification, technology integration, and collaboration in enhancing organizational resilience. These strategies not only enable businesses to navigate disruptions effectively but also contribute to sustaining competitive advantage and stakeholder confidence. Consumer perception during disruptions emerges as pivotal, shaped by brands' transparency, responsiveness, and ethical considerations in managing supply chain challenges. Transparent communication and reliable service delivery during disruptions enhance brand reputation and foster consumer loyalty. However, challenges including information gaps, resource constraints, coordination issues, and regulatory compliance complexities highlight the need for adaptive strategies and robust partnerships across the supply chain. Overall, the study provides insights into the interconnectedness of disruption management, brand resilience, and consumer perception, offering practical implications for organizations seeking to strengthen their resilience strategies and consumer relationships in dynamic market environments.

Retinoids are vitamin A derivatives and include trans-retinoic acid, isotretinoin, tamibarotene, and bexarotene, all of which are currently available for clinical use. The clinical development of retinoid therapy for neuroblastoma has a history spanning more than four decades. The most promising agent is isotretinoin, which can contribute to improving event-free survival in patients with high-risk neuroblastoma by approximately 10 % when administered over six months as maintenance therapy. Although isotretinoin is regarded as an essential component in the standard clinical management of high-risk neuroblastoma, its use for this purpose in the US and EU is off-label. To promote isotretinoin use in Japan as a treatment for neuroblastoma, our clinical research team is planning to launch an investigator-initiated, registration-directed clinical trial. The present review article discusses the basic science behind retinoid therapy, pre-clinical / clinical evidence on neuroblastoma, the concept of the proposed clinical trial, and prospects for this therapy.

Background: In March 2020, a COVID-19 outbreak associated with the Falles Festival in Borriana, Spain, led to significant infections. Methods: In June 2022, we conducted a cross-sectional follow-up study of 473 socially engaged adults aged 18 to 64, examining the cumulative experience after SARS-CoV-2 infection and vaccination responses. Data included demographic details, lifestyle habits, medical history, infection records, and vaccinations from a population-based vaccine registry. Blood samples were analyzed for SARS-CoV-2 antibodies and cellular immunity. We employed a doubly robust inverse weighted probability analysis to estimate the booster vaccine dose's impact on long COVID prevalence and symptom count. Results: 28.1% of participants met the WHO criteria for long COVID, with older individuals showing higher rates. Not complying with long COVID criteria associated with factors including O blood group, higher occupational status, physical activity, three vaccine doses, strong SARS-CoV-2-S-reactive IFNγ‐producing‐CD8+ response, and infection during the Omicron period. Conversely, increased age, high or low social activity, underlying health conditions, a severe initial COVID episode, and reinfection associated with higher long COVID likelihood. A booster dose, compared to one or two doses, reduced long COVID risk by 74% (95% CI: 56.4% to 91.7%) and symptom count by 55.2% (95% CI: 31.6% to 78.7%). Conclusion: Long COVID was prevalent in a significant portion of those who contracted COVID-19, underscoring the need for sustained follow-up and therapeutic strategies. Vaccinations, notably the booster dose, had a substantial beneficial effect on long-term infection outcomes, affirming the vaccination’s role in mitigating SARS-CoV-2 infection consequences.

Insulin resistance/hyperinsulinemia as an independent risk factor for the development and worsening of HFpEF. Serafino Fazio MD¹, Valentina Mercurio MD, PhD2, Valeria Fazio MD3, Antonio Ruvolo MD⁴, Flora Affuso MD, PhD⁵. Authors’ Affiliation: ¹ Department of Internal Medicine (retired Professor). Federico II University, Via Sergio Pansini 5. 80135 Naples, Italy. 2 Department of Translational Medical Sciences. Federico II University. Via Sergio Pasini 5. 80135 Naples, Italy. ³ UOC Medicina Interna, Azienda Ospedaliera di Caserta, 81100 Caserta, Italy, ⁴ UOC Cardiologia AORN dei colli PO CTO, Viale Colli Aminei 21, 80100 Naples, Italy. ⁵ Independent researcher, Viale Raffaello 74, 80129 Naples, Italy. Abstract Heart failure (HF) has become a subject of continuous interest since it has been declared new pandemic in 1997 because of the exponential increase in hospitalizations for HF in the latest years. HF is the final state to which all heart diseases of different etiologies lead if not adequately treated, therefore it is highly prevalent worldwide, with a progressive increase with age, reaching a prevalence of 10% in subjects over the age of 65 years. It should also be underlined that lately, while the prevalence of HF with left ventricular reduced ejection fraction (HFrEF) is slowly decreasing, the incidence of HF with left ventricular preserved ejection fraction (HFpEF) is progressively increasing. In deed, among patients consecutively hospitalized for HF between 1987 and 2001 in a study from the Mayo Clinic Hospitals in Olmsted County, Minnesota, prevalence of HFpEF increased from 38% to 54%. HFpEF is typically characterized by concentric remodeling of the left ventricle (LV) with impaired diastolic function and increased filling pressures. Over the years, also the prevalence of insulin resistance/hyperinsulinemia in the general adult population has progressively increased, primarily due to lifestyle changes, particularly in developed and developing countries, with a range that globally ranges between 15.5% and 46.5%. Notably, insulin resistance (IR)/hyperinsulinemia (Hyperins) is present in up to 60% of patients with HF and is significantly higher in subjects with HfpEF. In the scientific literature it has been well highlighted that the increased circulating levels of insulin are associated with conditions of insulin resistance are responsible for progressive cardiovascular alterations over the years. In the setting of HFpEF, insulin stimulates the concentric remodeling of the left ventricle with associated diastolic dysfunction, which, coincidentally. Unfortunately, IR/Hyperins, despite being a well-known cardiovascular risk factor, is still not screened in the general population and is not treated as promptly as it should be, and this could at least in part concur in the progressive increase in prevalence of HFpEF in the general adult population. The aim of this manuscript was to review scientific literature that support a pathophysiologic connection between IR/Hyperins and HFpEF to stimulate the scientific community towards the identification of hyperinsulinemia associated with insulin resistance as an independent cardiovascular risk factor in development and worsening of HF, believing that its adequate screening in the general population and appropriate treatment could reduce the prevalence of HFpEF and improve its progression.