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

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

Abstract – Objective: Ovarian cancer, although not possessing a high incidence, is still the most common cancer-related deaths among women diagnosed with a gynecologic malignancy. The present study aims to highlight the epidemiology, risk factors of this disease and the significance of development of improved early detection strategies. Materials and Methods: This study was conducted using current published English studies by searching PubMed and Google Scholar. The search strategy included the keywords “ovarian cancer”, “diagnosis”, “risk factors”, “screening”, “epidemiology”. Studies on incidence and mortality were also considered. Case reports were excluded.Results: The highest incidence and mortality rates are observed in Central and Eastern Europe, while rates are relatively low in Asia and Africa. These rates are highest among the white population (14.3 per 100,000) and lowest among blacks (10 per 100,000) and Asians (9.7 per 100,000). The risk factors for this disease includes a family history, hormonal factors, nutrition and diet and physical activity, with some of them playing protective roles in reducing risk of ovarian cancers. There are no reliable screening methods for ovarian cancers. The most common diagnosis methods include a transvaginal ultrasound and a blood test to detect CA125 markers.Conclusions: The mortality rate of ovarian cancer is gradually increasing; thus, preventative measures are required to reduce lifetime risk of ovarian cancers and improve mortality rate.

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

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

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

This paper presents the results of quantitative research regarding the predictive model of citizens' attitudes about the risks of introducing the death penalty in the Republic of Serbia legal system. The research was conducted with the use of a questionnaire that was requested and then collected online from 427 people in June 2021. A multivariate regression analysis was used, identifying the extent to total scores of the main dependent variables (introducing the death penalty; trust in the legal system; advantages of introduction; disadvantages of introduction scores) were associated with five demographic and socio-economic variables: gender, marital, education, income, and age. We tested the central hypothesis of which gender is predicting variables citizens' attitudes about the risks of introducing the death penalty in the legal system of Serbia. The findings revealed that gender and educational level were the most effective predictors of the research variables under question. The majority of respondents support the introduction of the death penalty and the most important predictor of disadvantages of introducing the death penalty in the legal system is age. Based on the findings that there are major differences in the citizens' attitudes about the risks of introducing the death penalty in the legal system, policies, strategies, and regulations must take into account these very important findings.

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

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

The use of multi-gene panels for germline testing in breast cancer enables the estimation of cancer risk and guides risk-reducing management options for tested individuals and their family members. We performed an analysis in our clinical database to identify breast cancer patients undergoing genetic testing with positive reports. We reviewed positive results with respect to the different levels of information provided in the reports; risk estimation and management, cascade family testing, information from secondary findings and actionable information for treatment decision-making. A total of 415 positive test reports were identified with 57.1%, 18.1%, 10.8% and 13.5% of individuals having pathogenic/likely pathogenic variants in high (BRCA1, BRCA2, PALB2, PTEN, TP53), moderate (ATM, CHEK2, NBN), low (BARD1, BRIP1, CHEK2, MLH1, MSH2, MSH6, NF1, RAD51C) and with insufficient evidence for breast cancer risk genes (FANCA, FANCM, NBN, MRE11, PMS2, RAD50, RAD51B, XRCC2, MUTYH), respectively. 6.7% of individuals were double heterozygotes with two pathogenic variants. Germline findings in 92% of individuals are linked to evidence-based treatment information and receive risk estimates for predisposition to breast and/or other cancer types. The use of germline findings for treatment decision making expands the indication of genetic testing to include individuals that could benefit from targeted treatments.

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

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

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

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

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

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

Today, rupture of the anterior cruciate ligament is the most common heavy injury in athletes, but it can also occur in sedentary subjects. Its treatment, always adapted to the lifestyle, age and will of the patient, often remains surgical. However, despite its frequency and universality, there are still walking disorders following the operation. These disorders sometimes persist for several months, or even several years after surgery. The present study is therefore interested in determining the risk factors linked to walking disorders following reconstruction of the anterior cruciate ligament. The objective of this study is to determine what risk factors associated with walking disorders are after reconstruction of the anterior cruciate ligament by hamstring graft. This study focused on factors that may exist at 3 and 6 months postoperatively. Two populations participated in this study, a healthy population and a population having benefited from reconstruction of the anterior cruciate ligament. The operated test group is divided into two subgroups, one with a postoperative period of 3 months and the second at 6 months. All subjects were subjected to the same protocol, their gait on the treadmill was analyzed and evaluated with an Optogait® analysis system. A univariate analysis was carried out first. Then, a multivariate analysis by adjustment method was carried out in order to eliminate the potential confounding factors. The comparison of the results between the populations in the univariate analysis shows an absence of significant results however there are trends. The statistical results of the multivariate analysis showed interactions in the two subgroups of the operated population.In fact, it turns out that at 3 months there is a tendency to worse gait disorders in subjects with a high BMI reflecting overweight, when an associated surgical procedure has taken place on the meniscus, in subjects over 35 years of age and males. On the other hand, at 6 months, the tendency to worsening is visible only in the strata represented by subjects with a BMI corresponding to overweight, as well as in subjects having benefited from a meniscal suture associated with ACL reconstruction. .The results of the present study show that there are certain factors which tend to increase the risk of these walking disorders after reconstruction of the anterior cruciate ligament by hamstring graft, these factors are different depending on the time postoperative.

Frailty is defined as a state of increased vulnerability to stressors, and it predicts the disability and mortality in the older population. This study aimed to investigate standardized prevalence and multidimensional risk factors associated with frailty among the Korean community-dwelling older adults. We analyzed the baseline data of 2,907 adults aged 70–84 years (mean age 75.8±3.9 years, 57.8% women) in the Korean Frailty and Aging Cohort Study. The Fried frailty phenotype was used to define frailty. Analyzed data included sociodemographic, physical, physical function, biological, lifestyle, health condition, medical condition, psychological, and social domains. Data were standardized using the national standard population composition ratio based on the Korean Population and Housing Census. The standardized prevalence of frailty and pre-frailty was 7.9% (95% confidence interval [CI] 6.8–8.9%) and 57.2% (95% CI 45.1–48.8%), respectively. The following 14 risk factors had a significant association with frailty: at risk of malnutrition, sarcopenia, severe mobility limitation, poor social capital, rural dwellers, depressive, poor self-perceived health, polypharmacy, elevated high-sensitivity C-reactive protein, elevated glycosylated hemoglobin, low 25-hydroxy vitamin D level, longer timed up and go, and low short physical performance battery score (p<0.05). Physico-nutritional, psychological, sociodemographic, and medical factors are strongly associated with frailty.

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

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

Consumption of milk contaminated with antibiotic residues above the maximum residue limit (MRL) causes direct toxicity to humans and the development of superbugs that leads to the failure of antibiotic therapy and threatens human life. Besides, long-duration exposure might alter the nature of gut microflora results in the enhancement of many diseases. Therefore, we examined 300 raw and processed packet milk samples using thin layer chromatography (TLC) and ultra high performance liquid chromatography (UHPLC) method against five veterinary antibiotics and assessed the risk for consumers in Chattogram, Bangladesh. Risk analysis was calculated by using hazard quotient on the basis of 165 ml per capita milk consumption. We found a total of 7% prevalence of antibiotic residues in raw milk samples which were higher (8%) in individual samples than the pooled samples (4%). However, we did not find any processed packet milk samples as positive. The mean concentration of oxytetracycline residue was detected 61.29 µg/l and amoxicillin was 124 µg/l in individual milk samples. Risk analysis showed the hazard quotient values of 0.0056 for oxytetracycline and 0.0017 for amoxicillin residue which was confirmed that, no significant health risk associated with the consumption of milk produced and marketed in the study area. Our study might fill the gap of knowledge to measure the safety status of milk regarding public health issues.

Objectives: The aim of the present study was to evaluate the association between psoriasis and osteoporosis using two different studies. Methods: Data from the Korean National Health Insurance Service-Health Screening Cohort of participants who were ≥ 40 years old were collected from 2002 to 2013. Psoriasis and osteoporosis were included using ICD-10 codes. In study I (a follow-up study), a total of 25,306 psoriasis participants were matched to 101,224 controls with respect to age group, sex, income group, and region of residence, and the occurrence of osteoporosis was analyzed. Crude (simple) and adjusted hazard ratios (HRs) were analyzed using a stratified Cox proportional hazard model. In study II (a nested case–control study), a total of 79,212 osteoporosis patients were matched to 79,212 controls, and a previous history of psoriasis was analyzed. Crude and adjusted odds ratios (ORs) were analyzed using a conditional logistic regression analysis. Subgroup analyses were conducted according to age group and sex. Results: The adjusted HR of osteoporosis was 1.11 (95% confidence interval [CI] = 1.07-1.15, P < 0.001) in study I. In the subgroup analysis according to age and sex, the results were consistent except for the ≥ 60-year-old women. The adjusted OR of psoriasis was 1.22 (95% CI = 1.16-1.28, P < 0.001) in study II. All subgroups demonstrated high adjusted ORs of osteoporosis for psoriasis. Conclusions: Psoriasis increased the risk of osteoporosis in the population of participants aged ≥ 40 years in Korea.

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

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

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

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

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

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

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

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

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

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

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

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

This paper relies on accounting-based measures of country risk to investigate U.S. global banks' exposure to foreign country risk over the 2017 fiscal year as measured by the sum of cross-border risk, foreign office risk, and derivative risk claims. We achieve this using panel linear modeling methods with country level heterogeneity and time fixed effects, along with a constructed panel data of 284 observations on 71 countries distributed across 6 world regional blocks, and observed over 4 consecutive quarters starting from 4th quarter 2016 and ending with 3rd quarter 2017. The results show that on average, over the four quarters, a 1% increase in foreign banking sector's claims significantly increases U.S. global banks cross border risk exposure by 0.34%, while reducing derivative risk exposure by 0.22%, but have no significant impact on foreign office risk exposure. Similar results are observed with public sector claims which significantly increase banks' exposure to cross border risk by 0.21%, while reducing derivative risk exposure by 0.19%. Conversely however, non-bank financial sector claims are found to have no significant affect on cross-border risk exposure, but significantly reduce foreign office risk exposure by 0.09%, while increasing derivative risk exposure by 0.06%. These results indicate the presence of sectoral heterogeneities in U.S. banks' exposure to foreign counterparties' risk, and also that overall, over the course of 2017 the level of U.S. global banks' cross-border risk exposure increased, while their level of derivative risk exposure decreased, and the level of foreign office risk exposure remained relatively unchanged.

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.

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

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.

Perimenopause, the transitional phase leading up to menopause, affects millions of women worldwide, yet remains poorly understood and under-addressed in healthcare. This report investigates the significant impact of perimenopause symptoms on women's lives, emphasizing the often debilitating effects such as anxiety, depression, weight gain, and hot flashes, which collectively cost an estimated $1.8 billion annually in lost work time. Despite the availability of treatment options like Hormone Replacement Therapy (HRT) and non-hormonal alternatives, awareness and utilization of these options vary significantly among women. The report highlights the historical neglect of women's health issues and the need for improved communication between patients and healthcare providers. A cross-sectional survey conducted with 1,000 adults from the United States and Canada reveals widespread dissatisfaction with the quality of healthcare communication, underscoring the importance of personalized and comprehensive insights for women's health. The findings advocate for more at-home solutions and resources to empower women in managing perimenopause and menopause, promoting informed decision-making and reducing stigma. This study aims to enhance awareness and support for women during this critical life stage.

This study examines the differential impact of proactive and reactive job crafting behaviors on job well-being, drawing from the perspective of boundary theory. The increasing popularity of work connectivity behavior after-hours (WCBA) after work has attracted widespread attention from scholars on the relationship between WCBA and employee well-being. One view suggests that the impact of WCBA is negative, while another view suggests it is positive. Obviously, the impact of (WCBA) on well-being at work is still contradictory. To clarify the complexity of the impact of WCBA on well-being at work, based on boundary theory, we divided WCBA into proactive WCBA (PC) and reactive WCBA (RC), and examined the double-edged sword effect of WCBA on well-being at work, as well as the mediating mechanisms of job control and work-to-home conflict, and the moderated effects of boundary segmentation preferences. This study uses empirical sampling method to collect data from 125 employees for a period of five days for quantitative research. The results show that, first, PC has an inverted U-shaped effect on job control, and job control is negatively related to well-being at work. Thus the mediating effect of job control is significant. Second, RC has a negative impact on job control, and there is also a negative relationship between job control and well-being at work. Therefore, the mediating effect of job control is significant. Third, PC and RC are positively correlated with work-to-home conflict, and work-to-home conflict has a significant positive impact on well-being at work. Therefore, the mediating effect of work-family conflict is significant. Fourth, the study also found that integration preference moderates the relationship between work-to-home conflict and PC on well-being at work, that is, the mediating effect of work-to-home conflict is stronger for employees with low integration preference. This study enriches our understanding of WCBA, PC and RC from the perspective of proactive and passive employee behaviors. The study also provides a new interpretation of the impact of WCBA on well-being at work and offers valuable insights for the sustainable development in digital social transformation and the application of boundary theory and the theory of empowerment-subjugation in achieving the United Nations Sustainable Development Goals. In addition, the study deepens our understanding of the heterogeneous regulatory role played by work-family integration preferences in influencing well-being at work under different types of WCBA.

In view of the limitations of the existing optimization method of suspender cable force, in order to improve the stress of suspender under completion state and avoid frequent adjustment of cable force and grid beam elevation during construction, a new method of cable force optimization is proposed. The article takes the longest large span arch bridge in the world, Pingnan Third Bridge, a Concrete-filled steel tube (CFST) arch bridge with a span of 575m as the engineering background combined with the finite element analysis and multi-objective optimization method. One cable force optimization method that suspender “Real-time correction during construction, in the process variable optimal and results reliable” during panel girder lifting of long span CFST arch bridges is clarified. Taking the panel girder weight and displacement during the construction as parameter variables, the displacement and unevenness of the panel girder under completion state as constraint conditions, the displacement and cable force during the hoisting construction as the objective equation, through the optimization of the objective equation, the suspender cable force and dis-placement of each hoisting section are calculated. The results show that it is feasible to introduce the optimization theory into the cable force optimization when lifting the panel girder. the segment displacement variation is minimized to meet the destination. The cable force distributed evenly under completion state of the bridge that further making sure the completion state satisfies the requirements. No repeating iteration is needed, thus avoiding cumberso me calculation, getting cable force once. With higher optimization efficiency and better effects, the method provides high value for the cable force calculation of same type bridge suspender construction and for guiding construction.

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

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

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.

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

We propose a new approach to extending the notion of commutator and Lie algebra to algebras with ternary multiplication laws. Our approach is based on ternary associativity of the first and second kind. We propose a ternary commutator, which is a linear combination of six (all permutations of three elements) triple products. The coefficients of this linear combination are the cube roots of unity. We find an identity for the ternary commutator that holds due to ternary associativity of the first or second kind. The form of the found identity is determined by the permutations of the general affine group GA(1,5)⊂S5. We consider the found identity as an analogue of the Jacobi identity in the ternary case. We introduce the concept of a ternary Lie algebra at the cubic root of unity and give examples of such an algebra constructed using ternary multiplications of rectangular and three-dimensional matrices. We point out the connection between the structure constants of a ternary Lie algebra with three generators and an irreducible representation of the rotation group.

Purpose - This study investigates the solution of a boundary value problem using two numerical methods: the Rayleigh-Ritz method and the finite element method (FEM). The aim is to compare the performance of these methods and assess the reliability of FEM as an generalization of the Rayleigh-Ritz approach for more complex problems. Design/Methodology/Approach - The Rayleigh-Ritz method and the linear element formulation of the finite element method were employed to solve the boundary value problem. A detailed comparison of the results obtained from both methods was performed. Graphical illustrations were used to present the solutions, and potential sources of error were analyzed, including element and domain approximation errors, round-off errors, and the impact of using linear rather than quadratic elements in FEM. Findings - The solutions generated by both methods were found to be in close agreement, demonstrating that FEM is a viable alternative to the Rayleigh-Ritz method for solving boundary value problems. The minor discrepancies observed can be attributed to approximation errors and the choice of linear elements in the finite element analysis. Originality/Value - This work highlights the applicability and effectiveness of both the Rayleigh-Ritz method and FEM in solving boundary value problems. It underscores the finite element method’s flexibility, especially in handling more complex boundary conditions and geometries, and contributes to the understanding of the factors influencing the accuracy of numerical methods in structural analysis.

Lotions with or without 28% ascorbyl glucoside arginine complex (AGAC) were applied twice daily for 24 weeks in a double‐blind half‐face study of 27 Japanese females with solar lentigos (SLs). Pigmentation scores were evaluated using a photo‐scale and skin colors were assessed using a color difference meter and a Mexameter. Treatment with the test lotion elicited a significant decrease in pigment scores at 24 weeks compared to week 0; with a significant decrease in pigment scores at 24 weeks compared to the placebo lotion‐treated SLs. In the test lotion‐treated SLs; the L values and melanin index (MI) significantly (p<0.0001) increased and decreased; respectively; at 12 and 24 weeks of treatment compared to week 0. Comparisons of increased L (△L) values or decreased MI (△MI) values between test and placebo lotion‐treated SLs demonstrated that the test lotion‐treated SLs had significantly higher △L or △MI values than the placebo lotion‐treated SLs both at 12 and 24 weeks of treatment. The sum of our results strongly indicates that AGAC is distinctly effective in ameliorating the hyperpigmentation levels of SLs at a visibly recognizable level by the subjects without any hypo‐pigmenting effects or skin irritation.

The Midwestern region of the United States has been experiencing periodic forage shortages due to frequent droughts, a growing livestock population, and reliance on traditional farming practices. This study evaluated the dry matter yield (DMY), forage nutritive value, water use efficiency (WUE), and economic viability of forage soybean [Glycine max (L.) Merr.] in a no-till winter wheat-based rainfed cropping system in the Midwest, USA. The research aimed to identify alternative summer forage crops that are drought-resilient, require lower inputs, mitigate seasonal gaps, and provide higher DMY and forage nutritive value compared to traditional forages. A four-year field experiment in a randomized complete block design with four replications assessed these parameters at various growth stages and planting dates. Results showed that forage soybean had a high DMY (~13 Mg ha-1), especially when optimally planted and harvested at the R3 stage. Forage nutritive value, including crude protein (CP), in vitro dry matter digestibility (IVDMD), and relative feed value (RFV), was highest at early vegetative stages (V2-V3), meeting livestock nutritional requirements. Forage soybean also demonstrated good WUE (21 kg ha-1 mm-1), making it suitable for water-limited regions. Economic analysis indicated substantial net profits ($322 per hectare), confirming its economic viability. The study concludes that forage soybean is a promising summer forage option for Midwest growers, offering high-quality forage, efficient water use, and economic benefits. Further research, particularly animal feeding trials, is recommended to validate its potential for widespread adoption in cropping systems.

Waste glycerol can be subjected to various processing operations, including purification and re-fining, to obtain glycerol of appropriate purity. In addition, alternative methods of utilising waste glycerol are also being sought, e.g. by converting it into other valuable chemical products or biofuels. Therefore, various technologies are being developed to utilise this type of waste effectively and sustainably. The production of value-added products from waste glycerol is an important issue that determines the improvement of the economic viability of biofuel production and corresponds to the model of a waste-free and emission-free circular economy. This paper characterised the mechanisms and evaluated the efficiency of existing methods of microbiological utilisation of waste glycerol into liquid biofuels, including biodiesel, bioethanol and biobutanol, and identified further directions for the production of value-added products. In addition, a bibliographical analysis of publications re-lated to the production of liquid fuels and economically valuable products from glycerol was carried out, the progress of research and application work was assessed and directions for future research were identified.

The design of thin-walled structures is commonly based on the solutions of linear boundary-valued problems, formulated within well-developed theories for elastic plates and shells. However, in modern appliances, especially in MEMS design, it is necessary to take into account non-linear mechanical effects that become decisive for flexible elements. Among substantial non-linear effects, that significantly change the deformation properties of thin plates, are the effects of residual stresses caused by incompatibility of deformations, which inevitably arise during the manufacture of ultra-thin elements. The development of new methods of mathematical modeling of residual stresses and incompatible finite deformations in plates is the subject of the paper. To this end the local unloading hypothesis is used. It makes possible to define smooth fields of local deformations (inverse implant field) for the mathematical formalization of incompatibility. The main outcomes are field equations, natural boundary conditions and conservation laws, derived from least action principle and variational symmetries with account of implant field. The derivations were carried out in the framework of elasticity theory for simple materials and, over and above, within the Cosserat’s theory of a two-dimensional continuum. As illustrative examples the distributions of incompatible deformations in a circular plate are considered.

We performed urine cytology analysis of a pharmacologically induced diuresis for diagnostics of upper tract urothelial carcinoma. To evaluate the diagnostic value of cytology of pharmacologically forced diuresis, a first cohort of 77 consecutive patients with primary upper tract urothelial carcinoma treated with radical surgery was enrolled. To evaluate pharmacologically forced diuresis cytology as follow-up procedure, a second cohort of 1250 patients who underwent radical cystectomy for bladder cancer was selected. In the first cohort, sensitivity of cytology of pharmacologically forced diuresis in patients with invasive, high-grade, low-grade, and concomitant carcinoma in situ was 8%, 9%, 0% and 14%, respectively. In the second cohort, cytology of pharmacologically forced diuresis was positive in 30/689 (4.3%) of patients, in whom upper urinary tract recurrence was present in 21/30 (70%) and urethral recurrence in 8/30 (26%) of cases. As a follow-up tool, cytology of pharmacologically forced diuresis showed a sensitivity, specificity, and positive and negative predictive value of 60%, 99%, 70% and 98%, respectively. Summarized, as diagnostic tool, sensitivity of cytology of pharmacologically forced diuresis is slightly better in patients with invasive upper tract urothelial carcinoma and concomitant carcinoma in situ. As follow-up method, positive cytology of pharmacologically forced diuresis is strongly related to cancer recurrence and can reveal urethral recurrence. cytology of pharmacologically forced diuresis might be useful in patients with contraindications for imaging or with difficult endoscopic access to the upper urinary tract.

Active front-end (AFE) rectifiers have been becoming widely employed in power systems to achieve unity power factor and harmonic mitigations. The typical modeling approaches applied for AFE rectifiers in the literature mostly relied on two baselines named the detailed model and the time average model. The former approach deals with the switching element model (SEM) leads to significant harmonics in currents with distorted waveforms. The latter approach uses the average-value model (AVM) to overcome the currents’ harmonics as well as provide fast responses. However, even the AVM baseline has contained problems during the starting stage (lack of control signals) and over the dead-time periods which causes serious issues in the implementation process. This paper presents an improved dynamic AVM for AFE rectifiers by precisely considering the issues mentioned above along with the practical starting procedure and desirable initialization. The studied AFE rectifier is developed using the voltage-oriented control (VOC) technique based on the different modeling methodologies including SEM, Conventional AVM, and the proposed AVM. The performance of all models is analyzed and compared using simulation results with MATLAB/Simulink R2023a Function blocks for all the algorithm parts and SimScape elements for the electrical circuit model. The simulation results illustrate that the performance of the proposed AVM approach can closely resemble the behavior of the SEM baseline with low harmonic distortion.

In this review we collect some recent achievements in the accurate and efficient solution of the Nonlinear Schrödinger Equation (NLSE), with the preservation of its Hamiltonian structure. This is achieved by using the energy-conserving Runge-Kutta methods named Hamiltonian Boundary Value Methods (HBVMs) after a proper space semi-discretization. The main facts about HBVMs, along with their application for solving the given problem, are here recalled and explained in detail. In particular, their use as spectral methods in time, which allows efficiently solving the problems with spectral space-time accuracy.

Long-term storage may reduce the nutritional quality of brown rice, so the present study was aimed to evaluate the nutritive values and application in pig diets. In Exp.1, 18 Landrace × Yorkshire (L × Y) barrows with initial body weight (IBW) of 25.48 ± 3.21 kg were randomly assigned to three treatments, which included corn diet, one-year stored brown rice (BR1) diet and six-year stored brown rice (BR6) diet, to determine the digestible energy (DE) and metabolisable energy (ME) value of stored brown rice. In Exp. 2, 24 barrows (L × Y; IBW: 22.16 ± 2.42 kg) fixed with ileal T-cannula were randomly allotted to four dietary treatments, including corn diet, two stored brown rice diets and nitrogen-free diet, to evaluate the amino acid (AA) digestibility of stored brown rice. In Exp. 3 and 4, 108 crossbred weaned piglets (L × Y; IBW: 9.16 ± 0.89 kg) and 90 crossbred growing pigs (L × Y; IBW: 48.28 ± 3.51 kg) were allotted to 3 treatment diets, including control diet and two stored brown rice diets, respectively, to investigate the application of stored brown rice in weaned piglet and growing-finishing pig diets. Results showed that: 1) The DE and ME of corn and stored brown rice showed no significant differences (P > 0.05), while the apparent ileal digestibility (AID) of arginine, histidine, aspartic acid, and the standardized ileal digestibility (SID) of arginine and histidine were higher in stored brown rice compared to corn (P < 0.05). 2) Compared with the control diet, the stored brown rice diets showed no significant effects on growth performance, nutrient apparent total tract digestibility (ATTD) and serum biochemical indices (P > 0.05), but decreased digestive enzymes activities in duodenum, jejunum and ileum of piglets (P < 0.05). 3) Compared with the control diet, the stored brown rice diets showed no significant effects on growth performance, carcass traits, meat quality, fatty acids profiles in the longissimus dorsi muscle of growing-finishing pigs (P > 0.05). In conclusion, the brown rice stored for 6 years under good conditions has no obvious changes in available energy and nutrient values. Although it may reduce digestive enzyme activity in small intestine of the piglets, the stored brown rice showed no obvious adverse effect on growth performance and meat quality, and can be effectively used in pig diet.

Suppose for n∈ ℕ, set A⊆ℝⁿ and function f∶A→ℝⁿ. If set A, using the Hausdorff outer measure, is measurable in the sense of Carathèodory; we want to find an extension of the expected value, w.r.t the Hausdorff measure, that's unique, finite and "natural" (defined on §2.3 & §2.4) for all f in a prevalent subset of ℝᴬ. The issue is current extensions of the expected value are finite for all functions in only a shy subset of ℝᴬ. The reason this issue wasn't resolved is mathematicians have not thought of the problem, focusing on application rather than generalization. Despite the lack of potential use, we'll attempt to solve the problem by defining a choice function---this shall choose a unique set of equivalent sequences of sets (Fₖ***) , where the set-theoretic limit of Fₖ*** is the graph of f; the measure Hʰ is the ℎ-Hausdorff measure, such for each k∈ℕ, 0 < Hʰ(Fₖ***) < +∞; and (fₖ*) is a sequence of functions where {(x,fₖ*(x))∶x∈ dom(Fₖ***)}=Fₖ***. Thus, the extended expected value of or E**[f,Fₖ***] is: ∀(ε>0)∃(N∈ℕ)∀(k∈N)(k≥N⇒1/Hʰ(dom(Fₖ***))∫dom(Fₖ*** )fₖ* dHʰ - E**[f,Fₖ***]<ε ) which should be unique, finite, and "natural" (defined on §2.3 & §2.4) for all f in a prevalent subset of ℝᴬ. Note we guessed the choice function using computer programming but we don’t use mathematical proofs due to the lack of expertise in the subject matter. Despite this, the biggest use of this research is the extension of the expected value is finite for "almost all" functions: this is easier to use in application when finding the "average" of functions covering an infinite expanse of space.

The implementation of grey and green infrastructure is an effective mean to address urban flooding and nonpoint source pollution, but due to the complexity of the process and the diver-sity of benefits, there is a lack of measurement for their comprehensive benefits. Adopting a typ-ical university in Beijing as an example, this paper simulated the multidimensional benefits of the water quantity, water quality, and ecology of grey and green facility renovation by coupling the storm water management model (SWMM) and InfoWorks Integrated Catchment Manage-ment (ICM). Monetization methods and economical means were employed to characterize the comprehensive benefits. The results showed that grey and green infrastructure retrofitting re-duces the number of severe overflow nodes in the study area by 54.35%, the total overflow vol-ume by 22.17%, and the nonpoint source pollution level by approximately 80% under the heavy rain scenario and 60% under the rainstorm scenario. The annual benefits of grey and green infra-structure renovation reached ¥765,600/year, of this amount, ¥83,100/year is from hydrological regulation, ¥454,100/year is from nonpoint source pollution reduction, and ¥228,300/year is from ecological improvement. The benefits of green facilities were higher than those of grey facilities, and the combined benefits were negatively correlated with the rainfall level, with a total bene-fit–cost ratio of 1.19. The results provide methodological and data support for grey and green in-frastructure retrofitting within the context of sponge cities.

In this study, the partial least squares regression (PLSR) models were developed using no pre-processing, traditional preprocessing, multi-preprocessing 5 range, multi-preprocessing 3 range, genetic algorithm (GA), and successive projection algorithm (SPA) to assess the higher heating value (HHV) and ultimate analysis of grounded biomass for energy usage employing near-infrared (NIR) spectroscopy. A novel approach was utilized based on the assumption that using multiple pretreatment methods across different sections in the entire NIR wavenumber range would enhance the performance of the model. The performance of the model obtained from 200 biomass samples for HHV and 120 samples for ultimate analysis was compared, and the best model was selected based on the coefficient of determination of validation set, root mean square error of prediction, and the ratio of prediction to deviation values. Based on model performance results, the proposed HHV model from GA-PLSR, and the N and O models from the mul-ti-preprocessing PLSR 5 range method could be used for most applications, including research, whereas the C and H models from GA-PLSR performance is fair and applicable only for rough screening. The overall findings highlight that the multi-preprocessing 5-range method, which was attempted as a novel approach in this study to develop the PLSR model, demonstrated better accuracy for HHV, C, N, and O, improving by 4.1839%, 8.1842%, 3.7587%, and 35.9404%, respec-tively. Therefore, it can be considered a reliable and non-destructive alternative method for rap-idly assessing biomass properties for energy usage and can also be used effectively in biomass trading. However, due to the smaller number of samples used in the model development, more samples are needed to update the model for a robust application.

Geometrical assessments of human skull have been done based on the anatomical landmarks. Automatic detection of the landmarks, if developed, will be a great help not only medically, but also anthropologically. An automated system with multi-phased deep learning networks to predict three-dimensional coordinate values of cranio-facial landmarks, was developed. From a publicly available database, computed tomography images of craniofacial area were obtained. They were digitally reconstructed into three-dimensional models. Sixteen anatomical landmarks were plotted on each of the models and coordinate values of them were recorded. Three-phased regression deep learning networks were trained respectively with 90 training datasets. For evaluation, 30 testing datasets were employed. Three-dimensional error for the first phase, testing 30 data, was 11.60 pixels in average. (1 pixel = 500 / 512 mm) For the second phase, it was significantly improved to 4.66 pixels. For the third phase, it was significantly progressed to 2.88. This was comparable to the gaps between the landmarks, plotted by two experienced practitioners. Our proposing method of multi-phased prediction, coarse detection first and narrowing down the detection area, may be a possible solution, within the physical limitation of memory and computation.

Deep learning has been applied in many areas that have had a significant impact on applications that improves real-life challenges. The success of deep learning in a wide range of areas is due in part to the use of activation functions, which are particularly effective at solving non-linear problems. Activation functions are a key focus for researchers in artificial intelligence who aim to improve the performance of neural networks. This article provides a comprehensive explanation and comparison of different activation functions, with a focus on the arc tangent and its variations specifically. The paper presents experimental results that show that variations of the arc tangent using irrational numbers such as pi, the golden ratio, and Euler’s number, as well as a self-arctan function, produce promising results. Since we experimented with promising activation functions on two different problems, and datasets, we reached a result that different irrationals work well for different problems. In other words, arctan ϕ gives the best results mostly for multiclass classification and arctan e gives the best results for time series prediction problems. The paper focuses on a multi-class classification problem applied to the Reuters Newswire dataset and a time-series prediction problem on Türkiye energy trade value to show the impacts of activation functions.

Cashew nut shells (CNS) are the primary waste produced during the processing of cashew nuts; and needs constant attention to handle or valorize these wastes effectively. As a result, these CNS wastes are processed into solid briquettes citing their significant calorific content, thus making them as a promising renewable biofuel for combustion based applications. In most cases, these wastes are pre-treated either through de-oiling or carbonizing prior to compaction, thus removing the harmful hydrocarbons present in them in form of CNS liquids. Presently, this chapter focus on summarising various data related to these CNS wastes and their briquettes in terms of their availability, chemical characteristics, pre-treatment and processing technique, fuel and combustion properties as reported in various literatures. Here, availability depicts the current trend in global consumption of these snack nuts and the proportionate amount of waste shells produced; while, chemical characteristics focused on discussing their anatomy, proximate, lignocellulosic and elemental compositions. Following this, pre-treatment and processing techniques list out the various practises followed to remove CNSL, process de-oiled CNS cakes into bio-char through carbonization, and briquetting of pre-treated CNS wastes along with their compacting techniques prescribed by various researchers. Lastly, fuel and combustion properties brief out about the fuel traits of developed CNS briquettes along with their burning characteristics; and include parameters like proximate and elemental compositions, density and compressive strength, and results related to their combustion and water boiling tests. Moreover, all the reported results and data in this study were in accordance with the international testing standards; and ranged in between their permissible range.

This review article aims at improving understanding of the theoretical discussion on technonationalism. Reviewing conventional works of the literature proposes protectionist, innovationist, and strategic industrial approaches toward high-tech industries. The findings show that technonationalism is a concept linking technology and national security, seeking geoeconomic interests in the integrated global market to exert state power for economic statecraft. The nature of industry highly relies on the global value chain, and technological innovation in the high-tech sectors occurs mainly in the private sector; thus, this article points out the issue of embracing business interests into the state’s strategic addenda as a critical criterion of technonationalism. Also, technonationalism is a narrowly defined concept with state actors involved in national security affairs and high-tech business actors.

The task of determining the distance from one object to another is one of the important tasks solved in robotics systems. Conventional algorithms rely on an iterative process of predicting distance estimates, which results in an increased computational burden. Algorithms used in robotic systems should require minimal time costs, as well as be resistant to the presence of noise. To solve these problems, the paper proposes an algorithm for Kalman combination filtering with a Goldschmidt divisor and a median filter. Software simulation showed an increase in the accuracy of predicting the estimate of the developed algorithm in comparison with the traditional filtering algorithm, as well as an increase in the speed of the algorithm. The results obtained can be effectively applied in various computer vision systems.

This paper aims at computing feasible control strategies and the corresponding feasible state trajectories to drive an autonomous rear-axle bicycle robot from a given initial state to a final state such that the total running cost is minimized. Pontryagin’s Minimum Principle is applied and derives the optimality conditions from which the feasible control functions, expressed as functions of state and costate variables, are substituted into the combined state-costate system to obtain a new free-control state-costate nonlinear system of ordinary differential equations. A computer program was written in Scilab to solve the combined state-costate system and obtain the feasible state functions, the feasible costate functions and the feasible control functions. Associated Computational Simulations were provided to show the effectiveness and the reliability of the approach.

AbstractLocal estimates of coastal flood risk are required for coastal planning and development, including the location and design of sea-defences and coastal buildings, such as harbours and associated infrastructure. This paper discusses the use of three parameters associated with estimating such risks; the flood return period, the instantaneous flood probability and the flood design risk, and it describes the mathematical background for their derivation. The discussion is extended to include the effects of sea level rise and how it can be incorporated into the calculations. Flood height can vary quite rapidly with distance along the coast, being affected by coastal topology, which may magnify or diminish the tidal and surge effects. Similarly land heave influences the local effects of sea level rise and can be influenced by water extraction, tectonic movements and melting ice. Tide gauge measurements provide a local historical record from which the various parameters can be retrieved. This paper discusses the algorithms used to derive these measures from tide-gauge records. The figures have been derived for four tide gauges located on the UK east coast.

Burning woody biomass for energy is gaining attention due to environmental issues associated with fossil fuels and carbon emission. The carbon released from burning wood is absorbed by plants and is carbon neutral. The purpose of this study was to investigate the combustion characteristics (heat calorific values and ash contents) of three timbers: Araucaria cunninghamii, Instia bijuga and Pometia pinnata and recommend for fuelwood. The test samples were sawdust particles (treatment) and solid woods (control) extracted from the heartwoods. The sawdust particles were oven-dried, sieved and pelletized into pellets using a hand-held pelletizing device, thus, forming cylindrical dimension (volume 1178.57 mm3, oven dry density 0.0008 g/mm3). While the solid woods were cubed and oven-dried (volume 1000.00 mm3, oven dry density 0.001 g/mm3). Prior to combustion in a semi-automatic bomb calorimeter, 90 test specimens (15 replicates per treatment and control per species) were conditioned to 14 % moisture content (at temperature 105 ºC) and weighed to a constant (unit) mass (1.0 g). The heat energy outputs and ash residues (of treatments) were analyzed statistically. The results indicated variability in heat energy outputs and ash residues between test specimens of the three species. Comparatively, the treatment specimens of A. cunninghamii produced higher calorific value (18.546 kJ/g) than the control (18.376 kJ/g) whilst the treatment specimens of I. bijuga and P. pinnata generated lower heat calorific values (17.124 kJ/g and 18.822 kJ/g) than the control (18.415 kJ/g and 20.659 kJ/g), respectively. According to ash content analysis, A. cunninghamii generated higher residues (6.3%) followed by P. pinnata (4.5%) and I. bijuga (2.8%). The treatment specimens of the three species could not meet the standard heat energy requirement (20.0 kJ/g) and thus, were unsuitable for fuelwood. However, the control specimens of P. pinnata generated equivalent heat energy (20.659 kJ/g) and could be a potential fuelwood.

Green innovation has become an important combination of high-quality economic growth and sustainable development of ecological environment. In this paper, the super-efficiency network SBM model is used to measure the two-stage green innovation efficiency of industrial science and technology R&amp;D and achievement transformation in 30 provinces and cities from 2009 to 2019, and exploratory Data Analysis (ESDA) and spatial econometric model are used to investigate the spatial-temporal evolution characteristics and influencing factors of green innovation efficiency. The results show that: firstly, the overall efficiency of industrial green innovation is low, and the efficiency of scientific research and development and achievement transformation has experienced three stages of "upward-declining-revitalized period". The low efficiency of achievement transformation is an important factor hiding the improvement of the efficiency of industrial green innovation. Secondly, The industrial green innovation efficiency gradually increases from northwest to southeast, forming a centralized "line" and "block" distribution. The high efficiency area is still concentrated in the eastern coastal region, and the balanced development trend is obvious in the central and western regions. Finally, openness has a positive impact on the two-stage green innovation efficiency; Industrial structure and government investment in science and technology have a positive impact on the efficiency of science and technology research and development, but have no significant effect on the efficiency of achievement transformation. Enterprise size has a positive effect on achievement transformation efficiency, but has no significant effect on R&amp;D efficiency. Environmental regulation has a positive impact on R&amp;D efficiency and a negative impact on achievement transformation efficiency.

In this work, we studied the Green’s functions of the second order differential operators with involution. Uniform equiconvergence of spectral expansions related to the second-order differential operators with involution is obtained. Basicity of eigenfunctions of the second-order differential operator operator with complex-valued coefficient is established.

The bivalve mollusk, Anadara tuberculosa (Black Shell, in Spanish Concha prieta, "CP"), is found on America's Pacific coast, where it is harvested for subsistence and commercial markets. This paper aims to diagnose the performance of the black shell's value chain. We also identify several challenges that must be addressed to improve the sustainability of the black shell fishery in Ecuador. The descriptive methodology was quantitative, with a non-experimental, field, cross-sectional, and ex post facto design. Similar questionnaires were designed, validated, and applied to each link in the production chain to collect information. The performance of the value chain was diagnosed in the dimensions of productivity, competitiveness, and quality of life, reaching a 75.1% index, a result that indicates that the value chain has a moderate to good performance level. However, the value chain can be improved if the following challenges are met: 1) Restoration of the mangrove ecosystem, 2) Promotion of low-intensity shellfish aquaculture, 3) Good sanitary management and purification, 4) Promotion of value-focused ventures, 5) Strengthening of organizations and agreements for the use and custody of mangroves, and 6) Strengthening of institutions that contribute to the advancement of these challenges.

This work is concerned with the existence and uniqueness of boundary value problems defined on semi-infinite intervals. These kinds of problems seldom admit exactly known solutions and, therefore, the theoretical information on their well-posedness is essential before attempting to derive an approximate solution by analytical or numerical means. Our utmost contribution in this context is the definition of a numerical test for investigating the existence and uniqueness of solutions of boundary problems defined on semi-infinite intervals. The main result is given by a theorem relating the existence and uniqueness question to the number of real zeros of a function implicitly defined within the formulation of the iterative transformation method. As a consequence, we can investigate the existence and uniqueness of solutions by studying the behaviour of that function. Within such a context the numerical test is illustrated by two examples where we find meaningful numerical results.

Recently the use of food by products as natural sources of biologically active substances has been extensively investigated especially for the development of functional foods fortified with natural antioxidants. Due to their content of bioactive compounds, such as carotenoids, flavonoids and limonoids, Citrus peels could be suitable to formulate enriched olive oils able to boost a healthy nutrition. The aim of this study was: (i) to determine the compositional and sensory profiles of the Citrus olive oil and (ii) to evaluate its nutraceutical properties in rats with high fat diet-induced-metabolic syndrome and oxidative stress. The results obtained show the potential of using the Citrus peels as a source of bioactive compounds to improve the sensory profile as well as the phytochemical composition of olive oil. We demonstrated that the production system of C. aurantium olive oil and C. limon olive oil improves their organoleptic properties without altering their beneficial effects, which, like control extra virgin olive oil, showed protective effects on glucose and serum lipid levels, metabolic activity of adipocytes, myocardial tissue functionality, oxidative stress markers and endothelial function at blood vessel level.

The complete-lattice approach to optimization problems with a vector- or even set-valued objective already produced a variety of new concepts and results and was successfully applied in finance, statistics and game theory. For example, the duality issue for multi-criteria and vector optimization problems could be solved using the complete-lattice approach, compare [11]. So far, it has been applied to set-valued dynamic risk measures (in the stochastic case), as discussed in Feinstein, Rudloff etc. (see [11], for example), but it has not been applied to deterministic calculus of variations and optimal control problems. In this paper, the following problem of set-valued optimization is considered: minimize the functional $$ \overline J_t[y]=\int_0^t \overline L(s,y(s),\dot y(s))\ ds + U_0(y(0)) $$ over all admissible arcs $y$, where $\overline L$ is the associated multifunction to a vector-valued Lagrangian $L$, the integral is in the Aumann sense and $U_0$ is the initial cost. A new concept of \emph{value function}, for which a Bellman's optimality principle holds, is introduced. Also the classical result of the Hopf-Lax formula holds for the generalized value function. Finally, a derivative with respect to the time $t$ and a directional derivative with respect to $x$ of the value function are defined, based on ideas close to the concepts in [12]. The value function is proved to be solution of a suitable Hamilton-Jacobi equation.

We examine how external triggers, including the digital imperative and the need for more sustainable resource and stakeholder employment, spark the development of transformative sustainable business models. Drawing on the resource-based view and the shared value approach we conceptualize a multifaceted framework that helps to identify key determinants and coherent layers of transformative sustainable businesses models. Our theoretical arguments integrate recent research findings on external dynamics, such as digital technological advances and rising global competitive dynamics, with internal capabilities on both the organizational and the individual level, allowing for a more complete understanding of transformative potentials on the firm level. We propose that key determinants of sustainable transformative business models adhere to both, innovative value-creating reconstructionist and sustainable shared-value logic, and include elements such as co-creation with customers, usage-based pricing, agile and adaptive behavior, closed-loop resource employment, asset-sharing, and collaborative business ecosystems. At the same time, organizational, economic, and environmental layers encompassing sustainable business models need to be both horizontally and vertically coherent to unfold their full potential.

The role of vitamin D in the prevention and treatment of non-skeletal health issues has received significant media and research attention in recent years. Costs associated with clinical management of low vitamin D (LVD) have increased exponentially. However, no clear evidence supports vitamin D screening to improve health outcomes. Authoritative bodies and professional societies recommend against population-wide vitamin D screening in community-dwelling adults who are asymptomatic or at low risk of LVD. In order to assess patterns of physician management of LVD in this conflicting environment, we conducted a scoping review of three electronic databases and gray literature. Thirty-eight records met inclusion criteria and were summarized in an evidence table. Results from seven countries showed a consistent increase in vitamin D lab tests and related costs. Many vitamin D testing patterns reflected screening rather than targeted testing for individuals at high risk of vitamin D deficiency or insufficiency. Interventions aimed at managing inappropriate clinical practices related to LVD were effective in the short term. Variability and controversy were pervasive in many aspects of vitamin D management, shining light on physician practices in the face of uncertainty. Future research is needed is needed to inform better clinical guidelines and to assess implementation practices that encourage evidence-based management of LVD in adult populations.

Many clinical research datasets have a large percentage of missing values that directly impacts their usefulness in yielding high accuracy classifiers when used for training in supervised machine learning. While missing value imputation methods have been shown to work well with smaller percentages of missing values, their ability to impute sparse clinical research data can be problem specific. We previously attempted to learn quantitative guidelines for ordering cardiac magnetic resonance imaging during the evaluation for pediatric cardiomyopathy, but missing data significantly reduced our usable sample size. In this work, we sought to determine if increasing the usable sample size through imputation would allow us to learn better guidelines. We first review several machine learning methods for estimating missing data. Then, we apply four popular methods (mean imputation, decision tree, k-nearest neighbors, and self-organizing maps) to a clinical research dataset of pediatric patients undergoing evaluation for cardiomyopathy. Using Bayesian Rule Learning (BRL) to learn ruleset models, we compared the performance of imputation-augmented models versus unaugmented models. We found that all four imputation-augmented models performed similarly to unaugmented models. While imputation did not improve performance, it did provide evidence for the robustness of our learned models.

A tailored model for the assessment of environmental benefits achievable by “light-weighting” in the automotive field is presented. The model is based on the Fuel Reduction Value (FRV) coefficient, which expresses the Fuel Consumption (FC) saving involved by a 100 kg mass reduction. The work is composed of two main sections: simulation and environmental modelling. Simulation modelling performs an in-depth calculation of weight-induced FC whose outcome is the FRV evaluated for a wide range of Diesel Turbocharged (DT) vehicle case studies. Environmental modelling converts fuel saving to impact reduction basing on the FRVs obtained by simulations. Results show that for the considered case studies, FRV is within the range 0.115–0.143 and 0.142–0.388 L/100 km × 100 kg, respectively, for mass reduction only and powertrain adaptation (secondary effects). The implementation of FRVs within the environmental modelling represents the added value of the research and makes the model a valuable tool for application to real case studies of automotive lightweight LCA.

Our work is regarding the analysis of land use changes, in the light of “saving soil” against the expansion due to unearned plus value of land: The loss of natural and agricultural surface in front of the expanding urban environment is a critical aspect of unsustainability of urban development, especially in the way it was carried out in the past decades. The measure of the physical transition of land use and characters from a more natural condition of land surface to a new artificial one, joint with a parallel analysis of the increase of land value due to such change is nowadays a major land-policy tool. The interplay of urban economics regulation with planning, reveals new key issues in urban governance and environmental preservation. In this paper it will be shown some experiment about the impact assessment of soil take, related with the seek of valorization of property inside the planning process. Our paper reports as well about the experimental activity carried out inside the MITO Lab of the Polytechnic of Bari, where reports about property values and environmental values have been produced, specially looking at the reality of the Apulia, a southern Italian Region, that is rich of farmlands and coastlines, often invaded by constructions with a severe loss of nature, landscape and ecosystems services.

Background/Objectives: Body surface area is one of the most important anthropometric parameters in medicine. The study's primary objective is to compare the consistency of the BSA estimation results through applying available formulas. Other objectives include determining the ability of these formulas to discriminate between the deaths and living patients, comparing the formulas’ diagnostic features as well as investigating whether the risk associated with a low BSA is independent of BMI. Methods: The study included 1029 patients (median age: 54 years, female: 13.7%, NYHA I/II/III/IV: 6.3% / 36.5% / 47.7% / 9.5%) diagnosed with heart failure. For each patient, BSA was calculated using the 25 formulas. Over the 3-year observation period, 31.2% of the patients died. Results: The average BSA value of the optimal discrimination thresholds was 1.79 m2 ± 0.084 m2 and the BSA difference between the estimators with the lowest (BSAMeeh1879) and the highest (BSANwoye1989) optimal discrimination thresholds was 0.42 m2. The lowest mortality rate was 35.2% and occurred in the subgroup of individuals with BSA values below the optimal discrimination threshold using the BSASchlich2010 estimator. The highest mortality was observed when estimators BSAMeeh1879 or BSALivingston&Lee2001 were used. Conclusions: Our study has shown a relatively good concordance of 25 BSA estimators in BSA assessment in patients, without extremes of weight or height known to disrupt it. All BSA estimators presented a significant, although weak, ability to discriminate death from alive in 3-year follow-up. The higher risk of death in smaller patients as shown by BSA was independent of BMI in all but 2 BSA estimators.

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

In the rapidly evolving field of insurance, accurate risk measurement is crucial for effective claims management and financial stability. Therefore, this research presented a systematic literature review (SLR) on insurance claims risk measurement using Hidden Markov Model (HMM). Bibliometric analysis was conducted using VOSviewer and ResearchRabbit software to map research trends and collaboration networks in this topic. The review explored the implementation of HMM in predicting the frequency and magnitude of insurance claims, with a focus on the statistical distribution methods used. In addition, the research emphasized the influence of the number of hidden states in HMM on claims behavior, both in terms of frequency and magnitude, and provided interpretations of these hidden dynamics. Data sources for the review comprised three databases, namely Scopus, ScienceDirect, and Dimensions. The article selection process followed PRISMA guidelines, resulting in five key articles relevant to the topic. The results offered insights into the application of HMM for forecasting the frequency and severity of insurance claims and opened avenues for further investigation on distribution models and hidden state modeling.

This study aimed to investigate the prevalence of cardiovascular disease (CVD) risk factors among Algerian aircrew, a population exposed to unique environmental and occupational stressors. By comparing these rates to the general population, we sought to identify specific health challenges faced by aircrew. Methods: A cross-sectional study was conducted on 154 Algerian aircrew participants. Prevalence rates for current smoking, hypertension, diabetes, and dyslipidemia were compared between the aircrew and a general population control group. Results: Our findings revealed significantly higher rates of current smoking among aircrew compared to the general population. Additionally, smoking, dyslipidemia, hypertension, and diabetes emerged as the most prevalent risk factors within the aircrew population. Conclusions: Despite the rigorous selection process for aircrew recruitment, our study confirms findings from previous literature, highlighting the high rate of normal qualifying examinations. The substantial sample size and homogeneous nature of the aircrew population enhance the reliability and generalizability of our conclusions. These findings underscore the importance of targeted interventions to mitigate CVD risk factors within this specific population, given the unique environmental and occupational factors associated with aircrew.

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

(1) Background: Hepatoblastoma is the most common primary liver cancer in children. Nowadays, poor outcome occurs essentially for patients with distant metastases; (2) Methods: Starting from Mammalian Metabolic Enzyme Database over expression of metabolic enzymes was searched in hepatoblastoma tumors as compared to noncancerous liver tissue in transcriptome dataset GSE131329. With overexpressed enzymes, Elasticnet machine learning tuning was performed according to metastasis status outcome. With significant enzymes a metabolic expression score was computed and integrated in multivariate clinical-biological logistic model; (3) Results: Forty-one overexpressed enzymes discriminate hepatoblastoma tumors and noncancerous liver tissues. Eighteen of them predict metastasis status (AUC 0.90) with 85.7% of sensibility and 92.3% of specificity. Elasticnet machine learning model tuning highlighted major importance of DNMT3B and PFKFB4 expression to predict metastasis. Role of these two enzymes was confirmed by univariate analyses with respective p-values: 0.0058 and 0.0091. Metabolic score computed with combined expression of DNMT3B and PFKFB4 discriminates metastasis status and high-risk CHIC score by univariate analysis (p-value=0.005). Meta.score was found more sensitive than C1/C2 classifier to predict metastasis status (accuracy: 0.72 versus 0.55). Integration of meta.score (DNMT3B, PFKFB4) with epidemiological parameters: gender, age at diagnosis, histological types, and clinical PRETEXT stages in a multivariate model confirmed independent adverse role of meta.score to predict metastasis status (multivariate p-value=0.003, odds ratio: 2.12); (4) Conclusions: Based on metabolic enzyme expression program of hepatoblastoma, we characterized a dual overexpression of PFKFB4 and DNMT3B in samples of patients at risk of metastasis (High risk CHIC stratification). With combined tumor expression of DNMT3B and PFKFB4 a meta.score was computed and this parameter was confirmed as an independent adverse score to predict metastatic status during hepatoblastoma.

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

It is vital to analyze ship collision risk for preventing collisions and improving safety at sea. This paper takes Ningbo-Zhoushan Port, a typical complex navigable water, as the research object, propose a probabilistic conflict detection method to estimate the potential collision risk by using a dynamic domain model driven by AIS data. Combined with the algorithm of fast modularity optimization and spectral clustering, a ship group extraction method from the perspective of water navigation management was proposed. Aiming at ship traffic characteristics in complex navigable waters, conduct dynamic calculation of ship collision risk from individual, regional and local multi-scale perspectives. The results show that the proposed method can detect the collision risk in a timely, reliable and effective manner under complex dynamic conditions. As such, they provide valuable insights for ship collision risk prediction and the development of risk mitigation measures.

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

Credit business is a vital part of the bank's core business, which has an extremely important impact on the bank's income and development. In the operation of credit business, credit risk assessment is particularly crucial, and accurate risk assessment can minimize risks while maximizing the bank's returns. We propose a method to optimize credit risk assessment using machine learning techniques. In this work, we employ a random forest machine learning model to process and analyze large amounts of loan application data. By using correlation analysis, information enrichment, etc., the characteristics that have the most impact on credit risk assessment are screened. Subsequently, the model was constructed using a random forest algorithm. Random forests improve the generalization ability and accuracy of the model by building multiple decision trees and introducing randomness between these trees. In the experimental analysis part, we compare the performance of various models on the German credit dataset, and the results show that the deep learning model outperforms the traditional machine learning model in most indicators, verifying the effectiveness of our method.

This study aimed to develop a state-of-the-art method for assessing chemical risks. The method combined desk research findings and the authors' practical knowledge to identify the major shortcomings in performing risk assessments at the workplace. Data were collected from nine SMEs across three sectors: agriculture, laboratory research, and conservation and restoration laboratories. The results of the discussions with the workers and on-site observations were used to develop the method to assess chemical risks. The method uses numerical factors to account for the level of conformity and the duration of exposure to support an estimation of the probability of an incident. The developed method was designed to enhance risk assessment practices and tackle common issues encountered by enterprises, including SMEs.

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

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

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

Background: Long COVID, characterized by a persistent symptom spectrum following SARS-CoV-2 infection, poses significant health, social, and economic challenges. This review aims to consolidate knowledge on its epidemiology, clinical features, and underlying mechanisms to guide global responses; Methods: We conducted a systematic literature review, analyzing peer-reviewed articles and reports to gather comprehensive data on long COVID’s epidemiology, symptomatology, and management approaches; Results: Our analysis revealed a wide array of long COVID symptoms and risk factors, with notable demographic variability. The current understanding of its pathophysiology suggests a multifactorial origin yet remains partially understood. Emerging diagnostic criteria and potential therapeutic strategies were identified, highlighting advancements in long COVID management.; Conclusion: This review highlights the multifaceted nature of long COVID, revealing a broad spectrum of symptoms, diverse risk factors, and the complex interplay of physiological mechanisms underpinning the condition. Long COVID symptoms and disorders will continue to weigh on healthcare systems in years to come. Ad-dressing long COVID requires a holistic management strategy that integrates clinical care, social support, and policy initiatives. The findings underscore the need for increased international cooperation in research and health planning to address the complex challenges of long COVID. There is a call for continued refinement of diagnostic and treatment modalities, emphasizing a multidisciplinary approach to manage the ongoing and evolving impacts of the condition.

.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.

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

Lyme disease, the leading vector-borne ailment in the U.S., annually affects an estimated 476,000 individuals, predominantly in the Northeast and Upper Midwest. Despite its increasing incidence, the evaluation of risk within U.S. cities, including natural public lands, remains inadequate. This study focuses on blacklegged tick occurrences and Borrelia burgdorferi infection prevalence in 24 Staten Island parks, aiming to assess Lyme disease exposure risk. Monthly acarological risk index (ARI) calculations from 2019 to 2022 revealed elevated values (0.16-0.53) in specific parks, notably Wolfe’s Pond Park, High Rock Park, Clay Pit Pond Park, Clove Lake Park, and Fair View Park. June (0.36) and November (0.21) consistently exhibited heightened ARIs, aligning with peak tick collection months. Despite stable yearly infection rates at 28.97%, tick densities varied significantly between parks and years. Identifying a high transmission risk in specific parks in Staten Island, a highly urbanized part of New York City, emphasizes the continuous necessity for Lyme disease risk management, even within the greenspaces of large cities.

Attention to the work-related musculoskeletal disorders (WMSDs) involve also statistical surveys showing an increasing trend in the incidence of WMSDs. Technological development retrieves new tools and methods for the assessment of physical load at work. In addition to the conventional questionnaires and scaling assessment systems, these methods are mostly based on the direct sensing of appropriate parameters, which allows more precise quantification. The aim of this paper is to compare the assessment of ergonomic risk through current legislative regulations. A Captiv wireless sensor system was used at a car headlight quality control assembly workplace for sensing, data acquisition and data processing. During the evaluation of the postures and movements at work, we discovered differences in the applicable standards: Decree 542/2007 Coll. (Slovak legislation), STN EN 1005-4+A1, French standards default in the Captiv system. Standards define the thresholds for hazardous postures with significant differences in several evaluated body segments, which also affects the final evaluation of the measurements. Based on the results of our research, we found that respondents were in an acceptable position for approximately 63% of the total duration of the work activity in terms of the Legislative method, 44% with Captiv and 27% with Standards method.

Nowadays the dynamism induced by the constant change of strategic decisions on the markets produces an extra difficulty in the management of an organization. The strategic decisions made by managers can become obsolete in a short period of time. One of the major difficulties in managing a commercial organization is to predict, with some precision degree, the impact some strategic decisions have on the financial results. Business Intelligence (BI) is an area widely used to help managers to make strategic decisions. But the methods used, behind the scenes, to achieve the conclusions are kept secret by BI company-based services. Modelling the environment can be a good option to study the impact of an action, provided by a strategic decision, in a real environment. A good model should give an approximate result of an action applied to a previous state of the environment. Artificial Neural Networks (ANNs) are proven to be excellent in modeling environments with some level of data noise. The same strategic action can have different results in different organizations. A tool that allows an evaluation of a strategic action applied to an environment should have a major importance in the management scope. Modeling the environment should save time and money for the organization to improve the performance of the strategic plan. If one evaluates the state of the environment after a strategic action being applied, it can be possible to mitigate the risk of failure of the strategic plan. As we will be able to verify, it is possible to use ANNs to model strategic environments that should allow the prediction of sales and operating results by the used strategies with some precision, although the level of success will be directly related with the user’s necessity.

In the context of sustainable development, integrating the work aspect into health promotion systems is essential, ensuring that employees maintain a healthy balance between their professional and personal lives, which respects and amplifies the potential of every individual. Lately, there has been a noticeable shift of medical professionals from the public to the private sector. This trend paints a bleak picture, highlighting the vulnerabilities of a system teetering on the brink of failure, with significant impacts on patient care. Among the myriad reasons behind this shift, burnout stands out prominently. Medical professionals face increasing pressures due to understaffing, limited organizational support, and insufficient resources, leading to feelings of cynicism, exhaustion, and detachment from their roles. Utilizing the Maslach et al. questionnaire, we assessed the risk of burnout among physicians in public hospitals to identify and underscore preventive measures and improvements, correlating our findings with key aspects of organizational empowerment. Our research indicates that enhancing interpersonal relationships and resources—both within teams and between the organization and its physicians—is crucial for the revival of the healthcare system. This approach aims at improving the delivery of healthcare services and offering appropriate recognition to healthcare professionals, aligning with the principles of sustainable employment.