Subjective and objective assessment of patients' compression therapy skills as a predicator of ulcer recurrence.

PubMed

Mościcka, Paulina; Szewczyk, Maria T; Jawień, Arkadiusz; Cierzniakowska, Katarzyna; Cwajda-Białasik, Justyna

2016-07-01

To verify whether the subjectively and objectively assessed patient's skills in applying compression therapy constitute a predicting factor of venous ulcer recurrence. Systematic implementation of compression therapy by the patient is a core of prophylaxis for recurrent ulcers. Therefore, patient education constitutes a significant element of care. However, controversies remain if all individuals benefit equally from education. A retrospective analysis. The study included medical records of patients with venous ulcers (n = 351) treated between 2001 and 2011 at the Clinic for Chronic Wounds at Bydgoszcz Clinical Hospital. We compared two groups of patients, (1) with at least one episode of recurrent ulcer during the five-year observation period, and (2) without recurrences throughout the analysed period in terms of their theoretical skills and knowledge on compression therapy recorded at baseline and after one month. Very good self-assessment of a patient's compression therapy skills and weak assessment of these skills by a nurse proved significant risk factors for recurrence of the ulcers on univariate analysis. The significance of these variables as independent risk factors for recurrent ulcers has been also confirmed on multivariate analysis, which also took into account other clinical parameters. Building up proper compression therapy skills among the patients should be the key element of a properly construed nurse-based prophylactic program, as it is the most significant modifiable risk factor for recurrent ulcers. Although the development of compression skills is undeniably important, also other factors should be considered, e.g. surgical correction of superficial reflux. Instruction on compression therapy should be conducted by properly trained nursing personnel - the nurses should have received both content and psychological training. The compression therapy training should contain practical instruction with guided exercises and in-depth objective assessment of the effects of the training. © 2016 John Wiley & Sons Ltd.

The importance of a proper against-medical-advice (AMA) discharge: how signing out AMA may create significant liability protection for providers.

PubMed

Levy, Frederick; Mareiniss, Darren P; Iacovelli, Corianne

2012-09-01

Every year, patients leave the Emergency Department against medical advice (AMA) and before an adequate evaluation can be performed. It is well known that many of these patients are at risk of subsequent complications. The goal of this article is to explain the potential legal protections that may be created from a proper AMA discharge. In this article, the authors review the steps that need to be taken when performing an AMA discharge, including an assessment of capacity, proper documentation, and adequate disclosure. The authors then review the potential legal protections that can result from a properly documented and performed discharge. Among these protections are: proof that the provider's duty to the patient ended with discharge and that the patient assumed the risk of a subsequent complication. The authors conclude that a properly executed discharge can provide significant legal protection from liability risks. Copyright © 2012 Elsevier Inc. All rights reserved.

The past, present and perhaps future of pharmacovigilance: homage to Folke Sjoqvist.

PubMed

Moore, Nicholas

2013-05-01

Over the years since 1961 and the identification of thalidomide as the common link in thousands of birth defects, daily pharmacovigilance activities and signal generation have evolved from the analysis of individual case reports and imputology, to case series and underreporting, to spontaneous report databases and disproportionality analyses, to data mining in population databases. Regulatory requirements have also changed from purely passive monitoring and reacting to alerts to a proactive approach that includes risk management plans and risk minimization, and from reporting only by healthcare professionals to patient reporting and exploration of social media. The emphasis only on risk assessment is changing towards assessment of the risk/benefit ratio and the exploration of real-life efficacy studies to complement the measure of real-life risk. The interactions between industry and regulators have been amplified and strengthened. However, most adverse reactions, including severe ones, are related to well-known and often pharmacological effects of the older drugs, possibly with genetic predispositions. Prevention is the next frontier for pharmacovigilance, beyond simply generating alerts, and it involves not only the removal of drugs from the market, but also promotion of proper drug prescribing by better trained physicians and the proper use of drugs by better informed patients.

Management system of health and safety work (SMK3) with job safety analysis (JSA) in PT. Nira Murni construction

NASA Astrophysics Data System (ADS)

Melliana, Armen, Yusrizal, Akmal, Syarifah

2017-11-01

PT Nira Murni construction is a contractor of PT Chevron Pacific Indonesia which engaged in contractor, fabrication, maintenance construction suppliers, and labor services. The high of accident rate in this company is caused the lack of awareness of workplace safety. Therefore, it requires an effort to reduce the accident rate on the company so that the financial losses can be minimized. In this study, Safe T-Score method is used to analyze the accident rate by measuring the level of frequency. Analysis is continued using risk management methods which identify hazards, risk measurement and risk management. The last analysis uses Job safety analysis (JSA) which will identify the effect of accidents. From the result of this study can be concluded that Job Safety Analysis (JSA) methods has not been implemented properly. Therefore, JSA method needs to follow-up in the next study, so that can be well applied as prevention of occupational accidents.

[The role of a specialised risk analysis group in the Veterinary Services of a developing country].

PubMed

Urbina-Amarís, M E

2003-08-01

Since the World Trade Organization (WTO) Agreement on the Application of Sanitary and Phytosanitary Measures was established, risk analysis in trade, and ultimately in Veterinary and Animal Health Services, has become strategically important. Irrespective of their concept (discipline, approach, method, process), all types of risk analysis in trade involve four periods or phases:--risk identification-- risk assessment--risk management--risk information or communication. All veterinarians involved in a risk analysis unit must have in-depth knowledge of statistics and the epidemiology of transmissible diseases, as well as a basic knowledge of veterinary science, economics, mathematics, data processing and social communication, to enable them to work with professionals in these disciplines. Many developing countries do not have enough well-qualified professionnals in these areas to support a risk analysis unit. This will need to be rectified by seeking strategic alliances with other public or private sectors that will provide the required support to run the unit properly. Due to the special nature of its risk analysis functions, its role in supporting decision-making, and the criteria of independence and transparency that are so crucial to its operations, the hierarchical position of the risk analysis unit should be close to the top management of the Veterinary Service. Due to the shortage of personnel in developing countries with the required training and scientific and technical qualifications, countries with organisations responsible for both animal and plant health protection would be advised to set up integrated plant and animal risk analysis units. In addition, these units could take charge of all activities relating to WTO agreements and regional agreements on animal and plant health management.

Toxicity risk assessment of mercury, DDT and arsenic legacy pollution in sediments: A triad approach under low concentration conditions.

PubMed

Marziali, L; Rosignoli, F; Drago, A; Pascariello, S; Valsecchi, L; Rossaro, B; Guzzella, L

2017-09-01

The determination of sediment toxicity is challenging due to site-specific factors affecting pollutants distribution and bioavailability, especially when contamination levels are close to expected non-effect concentrations. Different lines of evidence and sensitive tools are necessary for a proper toxicity risk assessment. We examined the case study of the Toce River (Northern Italy), where past industrial activities determined Hg, DDT and As enrichment in sediments. A triad approach comprising chemical, ecotoxicological and ecological analyses (benthic invertebrates) was carried out for risk assessment of residual contamination in river sediments. A "blank" site upstream from the industrial site was selected to compare the other sites downstream. Sediment, water and benthic invertebrate samplings were carried out following standard protocols. Results emphasized that despite the emissions of the industrial site ceased about 20years ago, sediments in the downstream section of the river remain contaminated by Hg, DDT and As with concentrations exceeding Threshold Effect Concentrations. A chronic whole-sediment test with Chironomus riparius showed decreased development rate and a lower number of eggs per mass in the contaminated sediments. Benthic community was analyzed with the calculation of integrated (STAR_ICMi) and stressor-specific metrics (SPEAR pesticide and mean sensitivity to Hg), but no significant differences were found between upstream and downstream sites. On the other hand, multivariate analysis (partial Redundancy Analysis and variation partitioning) emphasized a slight impact on invertebrate community, accounting for 5% variation in taxa composition. Results show that legacy contaminants in sediments, even at low concentrations, may be bioavailable and possibly toxic for benthic invertebrates. At low concentration levels, sensitive and site-specific tools need to be developed for a proper risk analysis. Copyright © 2017 Elsevier B.V. All rights reserved.

Insomnia and risk of dementia in older adults: Systematic review and meta-analysis.

PubMed

de Almondes, Katie Moraes; Costa, Mônica Vieira; Malloy-Diniz, Leandro Fernandes; Diniz, Breno Satler

2016-06-01

There are cross-sectional evidences of an association between sleep disorders and cognitive impairment on older adults. However, there are no consensus by means of longitudinal studies data on the increased risk of developing dementia related to insomnia. We conduct a systematic review and meta-analysis to evaluate the risk of incident all-cause dementia in individuals with insomnia in population-based prospective cohort studies. Five studies of 5.242 retrieved references were included in the meta-analysis. We used the generic inverse variance method with a random effects model to calculate the pooled risk of dementia in older adults with insomnia. We assessed heterogeneity in the meta-analysis by means of the Q-test and I2 index. Study quality was assessed with the Newcastle-Ottawa Scale The results showed that Insomnia was associated with a significant risk of all-cause dementia (RR = 1.53 CI95% (1.07-2.18), z = 2.36, p = 0.02). There was evidence for significant heterogeneity in the analysis (q-value = 2.4, p < 0.001 I2 = 82%). Insomnia is associated with an increased risk for dementia. This results provide evidences that future studies should investigate dementia prevention among elderly individuals through screening and proper management of insomnia. Copyright © 2016 Elsevier Ltd. All rights reserved.

Achieving the Proper Balance Between Crew and Public Safety

NASA Technical Reports Server (NTRS)

Gowan, John; Rosati, Paul; Silvestri, Ray; Stahl, Ben; Wilde, Paul

2011-01-01

A paramount objective of all human-rated launch and reentry vehicle developers is to ensure that the risks to both the crew onboard and the public are minimized within reasonable cost, schedule, and technical constraints. Past experience has shown that proper attention to range safety requirements necessary to ensure public safety must be given early in the design phase to avoid additional operational complexities or threats to the safety of people onboard. This paper will outline the policy considerations, technical issues, and operational impacts regarding launch and reentry vehicle failure scenarios where crew and public safety are intertwined and thus addressed optimally in an integrated manner. Historical examples and lessons learned from both the Space Shuttle and Constellation Programs will be presented. Using these examples as context, the paper will discuss some operational, design, and analysis approaches to mitigate and balance the risks to people onboard and in the public. Manned vehicle perspectives from the FAA and Air Force organizations that oversee public safety will also be summarized. Finally, the paper will emphasize the need to factor policy, operational, and analysis considerations into the early design trades of new vehicles to help ensure that both crew and public safety are maximized to the greatest extent possible.

Quantifying introgression risk with realistic population genetics.

PubMed

Ghosh, Atiyo; Meirmans, Patrick G; Haccou, Patsy

2012-12-07

Introgression is the permanent incorporation of genes from the genome of one population into another. This can have severe consequences, such as extinction of endemic species, or the spread of transgenes. Quantification of the risk of introgression is an important component of genetically modified crop regulation. Most theoretical introgression studies aimed at such quantification disregard one or more of the most important factors concerning introgression: realistic genetical mechanisms, repeated invasions and stochasticity. In addition, the use of linkage as a risk mitigation strategy has not been studied properly yet with genetic introgression models. Current genetic introgression studies fail to take repeated invasions and demographic stochasticity into account properly, and use incorrect measures of introgression risk that can be manipulated by arbitrary choices. In this study, we present proper methods for risk quantification that overcome these difficulties. We generalize a probabilistic risk measure, the so-called hazard rate of introgression, for application to introgression models with complex genetics and small natural population sizes. We illustrate the method by studying the effects of linkage and recombination on transgene introgression risk at different population sizes.

Quantifying introgression risk with realistic population genetics

PubMed Central

Ghosh, Atiyo; Meirmans, Patrick G.; Haccou, Patsy

2012-01-01

Introgression is the permanent incorporation of genes from the genome of one population into another. This can have severe consequences, such as extinction of endemic species, or the spread of transgenes. Quantification of the risk of introgression is an important component of genetically modified crop regulation. Most theoretical introgression studies aimed at such quantification disregard one or more of the most important factors concerning introgression: realistic genetical mechanisms, repeated invasions and stochasticity. In addition, the use of linkage as a risk mitigation strategy has not been studied properly yet with genetic introgression models. Current genetic introgression studies fail to take repeated invasions and demographic stochasticity into account properly, and use incorrect measures of introgression risk that can be manipulated by arbitrary choices. In this study, we present proper methods for risk quantification that overcome these difficulties. We generalize a probabilistic risk measure, the so-called hazard rate of introgression, for application to introgression models with complex genetics and small natural population sizes. We illustrate the method by studying the effects of linkage and recombination on transgene introgression risk at different population sizes. PMID:23055068

An Assessment of Oral Hygiene in 7-14-Year-Old Children undergoing Orthodontic Treatment.

PubMed

Krupińska-Nanys, Magdalena; Zarzecka, Joanna

2015-01-01

The study is focused on increased risk of dental plaque accumulation among the children undergoing orthodontic treatment in consideration of individual hygiene and dietary habits. The study was conducted among 91 children aged 7-14 including 47 girls and 44 boys. The main objectives of the study were: API index, plaque pH, DMF index, proper hygiene and dietary habits. Statistical analysis was provided in Microsoft Office Exel spreadsheet and STATISTICA statistical software. The average API index among the children wearing removable appliance was 9 (SD = 13), and among children without appliances was 16 (SD = 21). DMF index for patients using appliances was 5 (SD = 3) and for those without appliances was 4 (SD = 2). The average plaque pH was 6 for children with appliances (SD = 0.9) and 6.2 without ones (SD = 0.3). In patients in whom there is a higher risk of dental plaque accumulating, correct oral hygiene supported with regular visits to the dentist is one of the best ways to control dental caries. In the fight against caries the most effective and only approach is to promote awareness of the problem, foster proper hygiene and nutritional habits, as well as educate children from a very young age in how to maintain proper oral hygiene.

Analyses in support of risk-informed natural gas vehicle maintenance facility codes and standards :

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ekoto, Isaac W.; Blaylock, Myra L.; LaFleur, Angela Christine

2014-03-01

Safety standards development for maintenance facilities of liquid and compressed gas fueled large-scale vehicles is required to ensure proper facility design and operation envelopes. Standard development organizations are utilizing risk-informed concepts to develop natural gas vehicle (NGV) codes and standards so that maintenance facilities meet acceptable risk levels. The present report summarizes Phase I work for existing NGV repair facility code requirements and highlights inconsistencies that need quantitative analysis into their effectiveness. A Hazardous and Operability study was performed to identify key scenarios of interest. Finally, scenario analyses were performed using detailed simulations and modeling to estimate the overpressure hazardsmore » from HAZOP defined scenarios. The results from Phase I will be used to identify significant risk contributors at NGV maintenance facilities, and are expected to form the basis for follow-on quantitative risk analysis work to address specific code requirements and identify effective accident prevention and mitigation strategies.« less

Seawater intrusion risk analysis under climate change conditions for the Gaza Strip aquifer (Palestine)

NASA Astrophysics Data System (ADS)

Dentoni, Marta; Deidda, Roberto; Paniconi, Claudio; Marrocu, Marino; Lecca, Giuditta

2014-05-01

Seawater intrusion (SWI) has become a major threat to coastal freshwater resources, particularly in the Mediterranean basin, where this problem is exacerbated by the lack of appropriate groundwater resources management and with serious potential impacts from projected climate changes. A proper analysis and risk assessment that includes climate scenarios is essential for the design of water management measures to mitigate the environmental and socio-economic impacts of SWI. In this study a methodology for SWI risk analysis in coastal aquifers is developed and applied to the Gaza Strip coastal aquifer in Palestine. The method is based on the origin-pathway-target model, evaluating the final value of SWI risk by applying the overlay principle to the hazard map (representing the origin of SWI), the vulnerability map (representing the pathway of groundwater flow) and the elements map (representing the target of SWI). Results indicate the important role of groundwater simulation in SWI risk assessment and illustrate how mitigation measures can be developed according to predefined criteria to arrive at quantifiable expected benefits. Keywords: Climate change, coastal aquifer, seawater intrusion, risk analysis, simulation/optimization model. Acknowledgements. The study is partially funded by the project "Climate Induced Changes on the Hydrology of Mediterranean Basins (CLIMB)", FP7-ENV-2009-1, GA 244151.

Quantitative risk analysis of oil storage facilities in seismic areas.

PubMed

Fabbrocino, Giovanni; Iervolino, Iunio; Orlando, Francesca; Salzano, Ernesto

2005-08-31

Quantitative risk analysis (QRA) of industrial facilities has to take into account multiple hazards threatening critical equipment. Nevertheless, engineering procedures able to evaluate quantitatively the effect of seismic action are not well established. Indeed, relevant industrial accidents may be triggered by loss of containment following ground shaking or other relevant natural hazards, either directly or through cascade effects ('domino effects'). The issue of integrating structural seismic risk into quantitative probabilistic seismic risk analysis (QpsRA) is addressed in this paper by a representative study case regarding an oil storage plant with a number of atmospheric steel tanks containing flammable substances. Empirical seismic fragility curves and probit functions, properly defined both for building-like and non building-like industrial components, have been crossed with outcomes of probabilistic seismic hazard analysis (PSHA) for a test site located in south Italy. Once the seismic failure probabilities have been quantified, consequence analysis has been performed for those events which may be triggered by the loss of containment following seismic action. Results are combined by means of a specific developed code in terms of local risk contour plots, i.e. the contour line for the probability of fatal injures at any point (x, y) in the analysed area. Finally, a comparison with QRA obtained by considering only process-related top events is reported for reference.

Risk-accepting personality and personal protective equipment use within the Agricultural Health Study.

PubMed

DellaValle, Curt T; Hoppin, Jane A; Hines, Cynthia J; Andreotti, Gabriella; Alavanja, Michael C R

2012-01-01

Pesticide exposures can be reduced by use of personal protective equipment as well as proper mixing and application practices. The authors examined the effects of risk-accepting personality on personal protective equipment (PPE) use and mixing and application practices among private pesticide applicators and their spouses within the Agricultural Health Study (AHS) in Iowa and North Carolina and commercial applicators in Iowa. The AHS follow-up questionnaire included four questions designed to assess attitudes toward risk. Analysis was limited to those who were currently working on a farm or registered as a commercial applicator and indicated current pesticide use (n=25,166). Respondents who answered three or more questions in the affirmative (private applicators: n=4160 [21%]; commercial applicators: n=199 [14%]; spouses: n=829 [23%]) were classified as having a risk-accepting personality. Logistic regression was used to evaluate specific work practices associated with risk-accepting attitudes. Among private applicators, the likelihood of using any PPE when mixing or loading pesticides was lower among risk-acceptors compared to risk-averse individuals (odds ratio [OR] = 0.72, 95% confidence interval [CI]: 0.65-0.79). A similar relationship was observed among commercial applicators (OR = 0.77, 95% CI: 0.34-1.77) but not among spouses (OR = 1.09, 95% CI: 0.90-1.33). Among private applicators, risk-acceptors were more likely than the risk-averse to apply pesticides within 50 feet of the home (OR = 1.21, 95% CI: 1.01-1.44), compared to further than ¼ mile. These findings suggest that the decisions to use personal protective equipment and properly handle/apply pesticides may be driven by risk-accepting personality traits.

Risk-Accepting Personality and Personal Protective Equipment Use within the Agricultural Health Study

PubMed Central

DellaValle, Curt T.; Hoppin, Jane A.; Hines, Cynthia J.; Andreotti, Gabriella; Alavanja, Michael C.R.

2012-01-01

Pesticide exposures can be reduced by use of personal protective equipment as well as proper mixing and application practices. We examined the effects of risk-accepting personality on personal protective equipment (PPE) use and mixing and application practices among private pesticide applicators and their spouses within the Agricultural Health Study (AHS) in Iowa and North Carolina and commercial applicators in Iowa. The AHS follow-up questionnaire included four questions designed to assess attitudes toward risk. Analysis was limited to those who were currently working on a farm or registered as a commercial applicator and indicated current pesticide use (n=25,166). Respondents who answered three or more questions in the affirmative (private applicators: n=4,160 (21%); commercial applicators: n=199 (14%); spouses: n=829 (23%)) were classified as having a risk-accepting personality. Logistic regression was used to evaluate specific work practices associated with risk-accepting attitudes. Among private applicators, the likelihood of using any PPE when mixing or loading pesticides was lower among risk-acceptors compared to risk-averse individuals (odds ratio (OR) = 0.72; 95% Confidence Interval (CI): 0.65 – 0.79). A similar relationship was observed among commercial applicators (OR = 0.77, 95% CI: 0.34 – 1.77) but not among spouses (OR = 1.09, 95% CI: 0.90 – 1.33). Among private applicators, risk-acceptors were more likely than the risk-averse to apply pesticides within 50 ft of the home (OR=1.21; 95% CI: 1.01 – 1.44), compared to further than ¼ mile. Our findings suggest that the decisions to use personal protective equipment and properly handle/apply pesticides may be driven by risk-accepting personality traits. PMID:22732067

Trends and correlates of child passenger restraint use in 6 Northwest tribes: the Native Children Always Ride Safe (Native CARS) project.

PubMed

Lapidus, Jodi A; Smith, Nicole Holdaway; Lutz, Tam; Ebel, Beth E

2013-02-01

We compared proportions of children properly restrained in vehicles in 6 Northwest American Indian tribes in 2003 and 2009, and evaluated risks for improper restraint. During spring 2009 we conducted a vehicle observation survey in Oregon, Washington, and Idaho tribal communities. We estimated the proportions of children riding properly restrained and evaluated correlates of improper restraint via log-binomial regression models for clustered data. We observed 1853 children aged 12 years and younger in 1207 vehicles; 49% rode properly restrained. More children aged 8 years and younger rode properly restrained in 2009 than 2003 (51% vs 29%; P < .001). Older booster seat-eligible children were least likely to ride properly restrained in 2009 (25%). American Indian children were more likely to ride improperly restrained than nonnative children in the same communities. Other risk factors included riding with an unrestrained or nonparent driver, riding where child passenger restraint laws were weaker than national guidelines, and taking a short trip. Although proper restraint has increased, it remains low. Tribe-initiated interventions to improve child passenger restraint use are under way.

Problem formulation in the environmental risk assessment for genetically modified plants

PubMed Central

Wolt, Jeffrey D.; Keese, Paul; Raybould, Alan; Burachik, Moisés; Gray, Alan; Olin, Stephen S.; Schiemann, Joachim; Sears, Mark; Wu, Felicia

2009-01-01

Problem formulation is the first step in environmental risk assessment (ERA) where policy goals, scope, assessment endpoints, and methodology are distilled to an explicitly stated problem and approach for analysis. The consistency and utility of ERAs for genetically modified (GM) plants can be improved through rigorous problem formulation (PF), producing an analysis plan that describes relevant exposure scenarios and the potential consequences of these scenarios. A properly executed PF assures the relevance of ERA outcomes for decision-making. Adopting a harmonized approach to problem formulation should bring about greater uniformity in the ERA process for GM plants among regulatory regimes globally. This paper is the product of an international expert group convened by the International Life Sciences Institute (ILSI) Research Foundation. PMID:19757133

Bayesian-network-based safety risk assessment for steel construction projects.

PubMed

Leu, Sou-Sen; Chang, Ching-Miao

2013-05-01

There are four primary accident types at steel building construction (SC) projects: falls (tumbles), object falls, object collapse, and electrocution. Several systematic safety risk assessment approaches, such as fault tree analysis (FTA) and failure mode and effect criticality analysis (FMECA), have been used to evaluate safety risks at SC projects. However, these traditional methods ineffectively address dependencies among safety factors at various levels that fail to provide early warnings to prevent occupational accidents. To overcome the limitations of traditional approaches, this study addresses the development of a safety risk-assessment model for SC projects by establishing the Bayesian networks (BN) based on fault tree (FT) transformation. The BN-based safety risk-assessment model was validated against the safety inspection records of six SC building projects and nine projects in which site accidents occurred. The ranks of posterior probabilities from the BN model were highly consistent with the accidents that occurred at each project site. The model accurately provides site safety-management abilities by calculating the probabilities of safety risks and further analyzing the causes of accidents based on their relationships in BNs. In practice, based on the analysis of accident risks and significant safety factors, proper preventive safety management strategies can be established to reduce the occurrence of accidents on SC sites. Copyright © 2013 Elsevier Ltd. All rights reserved.

An Extreme-Value Approach to Anomaly Vulnerability Identification

NASA Technical Reports Server (NTRS)

Everett, Chris; Maggio, Gaspare; Groen, Frank

2010-01-01

The objective of this paper is to present a method for importance analysis in parametric probabilistic modeling where the result of interest is the identification of potential engineering vulnerabilities associated with postulated anomalies in system behavior. In the context of Accident Precursor Analysis (APA), under which this method has been developed, these vulnerabilities, designated as anomaly vulnerabilities, are conditions that produce high risk in the presence of anomalous system behavior. The method defines a parameter-specific Parameter Vulnerability Importance measure (PVI), which identifies anomaly risk-model parameter values that indicate the potential presence of anomaly vulnerabilities, and allows them to be prioritized for further investigation. This entails analyzing each uncertain risk-model parameter over its credible range of values to determine where it produces the maximum risk. A parameter that produces high system risk for a particular range of values suggests that the system is vulnerable to the modeled anomalous conditions, if indeed the true parameter value lies in that range. Thus, PVI analysis provides a means of identifying and prioritizing anomaly-related engineering issues that at the very least warrant improved understanding to reduce uncertainty, such that true vulnerabilities may be identified and proper corrective actions taken.

Probabilistic cost-benefit analysis of disaster risk management in a development context.

PubMed

Kull, Daniel; Mechler, Reinhard; Hochrainer-Stigler, Stefan

2013-07-01

Limited studies have shown that disaster risk management (DRM) can be cost-efficient in a development context. Cost-benefit analysis (CBA) is an evaluation tool to analyse economic efficiency. This research introduces quantitative, stochastic CBA frameworks and applies them in case studies of flood and drought risk reduction in India and Pakistan, while also incorporating projected climate change impacts. DRM interventions are shown to be economically efficient, with integrated approaches more cost-effective and robust than singular interventions. The paper highlights that CBA can be a useful tool if certain issues are considered properly, including: complexities in estimating risk; data dependency of results; negative effects of interventions; and distributional aspects. The design and process of CBA must take into account specific objectives, available information, resources, and the perceptions and needs of stakeholders as transparently as possible. Intervention design and uncertainties should be qualified through dialogue, indicating that process is as important as numerical results. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.

Contract Source Selection: An Analysis of Lowest Price Technically Acceptable and Tradeoff Strategies

DTIC Science & Technology

2016-06-01

thorough market research, acquisition professionals must decide at an early stage which source selection strategy (lowest price technically...minimizing risk and ensuring best value for all stakeholders. On the basis of thorough market research, acquisition professionals must decide at an early...price-based, market -driven environment from requirements development through properly disposal. Source selection must be 8 made on a ‘best value

Infrasound array criteria for automatic detection and front velocity estimation of snow avalanches: towards a real-time early-warning system

NASA Astrophysics Data System (ADS)

Marchetti, E.; Ripepe, M.; Ulivieri, G.; Kogelnig, A.

2015-11-01

Avalanche risk management is strongly related to the ability to identify and timely report the occurrence of snow avalanches. Infrasound has been applied to avalanche research and monitoring for the last 20 years but it never turned into an operational tool to identify clear signals related to avalanches. We present here a method based on the analysis of infrasound signals recorded by a small aperture array in Ischgl (Austria), which provides a significant improvement to overcome this limit. The method is based on array-derived wave parameters, such as back azimuth and apparent velocity. The method defines threshold criteria for automatic avalanche identification by considering avalanches as a moving source of infrasound. We validate the efficiency of the automatic infrasound detection with continuous observations with Doppler radar and we show how the velocity of a snow avalanche in any given path around the array can be efficiently derived. Our results indicate that a proper infrasound array analysis allows a robust, real-time, remote detection of snow avalanches that is able to provide the number and the time of occurrence of snow avalanches occurring all around the array, which represent key information for a proper validation of avalanche forecast models and risk management in a given area.

The c-index is not proper for the evaluation of $t$-year predicted risks.

PubMed

Blanche, Paul; Kattan, Michael W; Gerds, Thomas A

2018-02-16

We show that the widely used concordance index for time to event outcome is not proper when interest is in predicting a $t$-year risk of an event, for example 10-year mortality. In the situation with a fixed prediction horizon, the concordance index can be higher for a misspecified model than for a correctly specified model. Impropriety happens because the concordance index assesses the order of the event times and not the order of the event status at the prediction horizon. The time-dependent area under the receiver operating characteristic curve does not have this problem and is proper in this context.

A Systematic Literature Mapping of Risk Analysis of Big Data in Cloud Computing Environment

NASA Astrophysics Data System (ADS)

Bee Yusof Ali, Hazirah; Marziana Abdullah, Lili; Kartiwi, Mira; Nordin, Azlin; Salleh, Norsaremah; Sham Awang Abu Bakar, Normi

2018-05-01

This paper investigates previous literature that focusses on the three elements: risk assessment, big data and cloud. We use a systematic literature mapping method to search for journals and proceedings. The systematic literature mapping process is utilized to get a properly screened and focused literature. With the help of inclusion and exclusion criteria, the search of literature is further narrowed. Classification helps us in grouping the literature into categories. At the end of the mapping, gaps can be seen. The gap is where our focus should be in analysing risk of big data in cloud computing environment. Thus, a framework of how to assess the risk of security, privacy and trust associated with big data and cloud computing environment is highly needed.

Trends and Correlates of Child Passenger Restraint Use in 6 Northwest Tribes: The Native Children Always Ride Safe (Native CARS) Project

PubMed Central

Smith, Nicole Holdaway; Lutz, Tam; Ebel, Beth E.

2013-01-01

Objectives. We compared proportions of children properly restrained in vehicles in 6 Northwest American Indian tribes in 2003 and 2009, and evaluated risks for improper restraint. Methods. During spring 2009 we conducted a vehicle observation survey in Oregon, Washington, and Idaho tribal communities. We estimated the proportions of children riding properly restrained and evaluated correlates of improper restraint via log-binomial regression models for clustered data. Results. We observed 1853 children aged 12 years and younger in 1207 vehicles; 49% rode properly restrained. More children aged 8 years and younger rode properly restrained in 2009 than 2003 (51% vs 29%; P < .001). Older booster seat–eligible children were least likely to ride properly restrained in 2009 (25%). American Indian children were more likely to ride improperly restrained than nonnative children in the same communities. Other risk factors included riding with an unrestrained or nonparent driver, riding where child passenger restraint laws were weaker than national guidelines, and taking a short trip. Conclusions. Although proper restraint has increased, it remains low. Tribe-initiated interventions to improve child passenger restraint use are under way. PMID:23237177

External model validation of binary clinical risk prediction models in cardiovascular and thoracic surgery.

PubMed

Hickey, Graeme L; Blackstone, Eugene H

2016-08-01

Clinical risk-prediction models serve an important role in healthcare. They are used for clinical decision-making and measuring the performance of healthcare providers. To establish confidence in a model, external model validation is imperative. When designing such an external model validation study, thought must be given to patient selection, risk factor and outcome definitions, missing data, and the transparent reporting of the analysis. In addition, there are a number of statistical methods available for external model validation. Execution of a rigorous external validation study rests in proper study design, application of suitable statistical methods, and transparent reporting. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Risk, Politics, and Money: The Need for a Value-Based Model for Financing Public Health Preparedness and Response

DTIC Science & Technology

2014-12-01

determine the proper investment in public health preparedness to assure value for money spent? A. PROBLEM STATEMENT Our federal, state, and local...in the survey. It assured the respondent that their identity would be protected and their responses remain anonymous and confidential. Questions two...preparedness level. D. DATA ANALYSIS The Pearson Chi-square test was used to examine the significance of the association (contingency) between

The use of debt.

PubMed

Hood, W L; Loughery, C V

1990-05-01

Stewards of Catholic healthcare organizations must proceed cautiously before embarking on new construction or renovation projects. Many important issues are involved in financing such projects, including business risk, financial philosophy, financial structure, and forms of debt. The proper foundation for any financing structure must begin with financial philosophy. Some healthcare facilities have traditionally used no external financing; others have employed significant levels of debt. To determine a proper level of debt for the project(s) being financed, it is important to look at business risk. If a modest decline in revenues (or a similar increase in costs) would threaten the project's viability, the business risk would be high; therefore prudence would dictate that the level of debt undertaken be relatively small. A separate analysis is required to determine the appropriate mix of floating-rate and fixed-rate long-term debt. As a rule of thumb, fixed-rate debt would typically form two thirds of the debt structure; floating-rate debt, no more than one third. For healthcare, debt can take two forms: tax exempt and taxable. Tax-exempt financing has many constraints, including use of proceeds by a tax-exempt entity, arbitrage rules, tax legislation, and financial disclosure laws. Taxable debt can be issued by private placement or on a publicly traded basis.

Leakage Currents and Gas Generation in Advanced Wet Tantalum Capacitors

NASA Technical Reports Server (NTRS)

Teverovsky, Alexander

2015-01-01

Currently, military grade, established reliability wet tantalum capacitors are among the most reliable parts used for space applications. This has been achieved over the years by extensive testing and improvements in design and materials. However, a rapid insertion of new types of advanced, high volumetric efficiency capacitors in space systems without proper testing and analysis of degradation mechanisms might increase risks of failures. The specifics of leakage currents in wet electrolytic capacitors is that the conduction process is associated with electrolysis of electrolyte and gas generation resulting in building up of internal gas pressure in the parts. The risk associated with excessive leakage currents and increased pressure is greater for high value advanced wet tantalum capacitors, but it has not been properly evaluated yet. In this work, in Part I, leakages currents in various types of tantalum capacitors have been analyzed in a wide range of voltages, temperatures, and time under bias. Gas generation and the level of internal pressure have been calculated in Part II for different case sizes and different hermeticity leak rates to assess maximal allowable leakage currents. Effects related to electrolyte penetration to the glass seal area have been studied and the possibility of failures analyzed in Part III. Recommendations for screening and qualification to reduce risks of failures have been suggested.

Incorporating linguistic, probabilistic, and possibilistic information in a risk-based approach for ranking contaminated sites.

PubMed

Zhang, Kejiang; Achari, Gopal; Pei, Yuansheng

2010-10-01

Different types of uncertain information-linguistic, probabilistic, and possibilistic-exist in site characterization. Their representation and propagation significantly influence the management of contaminated sites. In the absence of a framework with which to properly represent and integrate these quantitative and qualitative inputs together, decision makers cannot fully take advantage of the available and necessary information to identify all the plausible alternatives. A systematic methodology was developed in the present work to incorporate linguistic, probabilistic, and possibilistic information into the Preference Ranking Organization METHod for Enrichment Evaluation (PROMETHEE), a subgroup of Multi-Criteria Decision Analysis (MCDA) methods for ranking contaminated sites. The identification of criteria based on the paradigm of comparative risk assessment provides a rationale for risk-based prioritization. Uncertain linguistic, probabilistic, and possibilistic information identified in characterizing contaminated sites can be properly represented as numerical values, intervals, probability distributions, and fuzzy sets or possibility distributions, and linguistic variables according to their nature. These different kinds of representation are first transformed into a 2-tuple linguistic representation domain. The propagation of hybrid uncertainties is then carried out in the same domain. This methodology can use the original site information directly as much as possible. The case study shows that this systematic methodology provides more reasonable results. © 2010 SETAC.

Risk-Based Prioritization Method for the Classification of Groundwater Pollution from Hazardous Waste Landfills.

PubMed

Yang, Yu; Jiang, Yong-Hai; Lian, Xin-Ying; Xi, Bei-Dou; Ma, Zhi-Fei; Xu, Xiang-Jian; An, Da

2016-12-01

Hazardous waste landfill sites are a significant source of groundwater pollution. To ensure that these landfills with a significantly high risk of groundwater contamination are properly managed, a risk-based ranking method related to groundwater contamination is needed. In this research, a risk-based prioritization method for the classification of groundwater pollution from hazardous waste landfills was established. The method encompasses five phases, including risk pre-screening, indicator selection, characterization, classification and, lastly, validation. In the risk ranking index system employed here, 14 indicators involving hazardous waste landfills and migration in the vadose zone as well as aquifer were selected. The boundary of each indicator was determined by K-means cluster analysis and the weight of each indicator was calculated by principal component analysis. These methods were applied to 37 hazardous waste landfills in China. The result showed that the risk for groundwater contamination from hazardous waste landfills could be ranked into three classes from low to high risk. In all, 62.2 % of the hazardous waste landfill sites were classified in the low and medium risk classes. The process simulation method and standardized anomalies were used to validate the result of risk ranking; the results were consistent with the simulated results related to the characteristics of contamination. The risk ranking method was feasible, valid and can provide reference data related to risk management for groundwater contamination at hazardous waste landfill sites.

The benefits of integrating cost-benefit analysis and risk assessment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fisher, K.; Clarke-Whistler, K.

1995-12-31

It has increasingly been recognized that knowledge of risks in the absence of benefits and costs cannot dictate appropriate public policy choices. Recent evidence of this recognition includes the proposed EPA Risk Assessment and Cost-Benefit Analysis Act of 1995, a number of legislative changes in Canada and the US, and the increasing demand for field studies combining measures of impacts, risks, costs and benefits. Failure to consider relative environmental and human health risks, benefits, and costs in making public policy decisions has resulted in allocating scarce resources away from areas offering the highest levels of risk reduction and improvements inmore » health and safety. The authors discuss the implications of not taking costs and benefits into account in addressing environmental risks, drawing on examples from both Canada and the US. The authors also present the results of their recent field work demonstrating the advantages of considering costs and benefits in making public policy and site remediation decisions, including a study on the benefits and costs of prevention, remediation and monitoring techniques applied to groundwater contamination; the benefits and costs of banning the use of chlorine; and the benefits and costs of Canada`s concept of disposing of high-level nuclear waste. The authors conclude that a properly conducted Cost-Benefit Analysis can provide critical input to a Risk Assessment and can ensure that risk management decisions are efficient, cost-effective and maximize improvement to environmental and human health.« less

Risk management for food and beverage industry using Australia/New Zealand 4360 Standard

NASA Astrophysics Data System (ADS)

Kristina, S.; Wijaya, B. M.

2017-12-01

This research aims to identifying, measuring and establishing risk in food and beverage industry. The risk management is implemented by referring to Australia/New Zealand 4360 Standard which has four phases such as problem formulation, risk analysis, risk characterization, and risk management. The implementation of risk management is done by case study at Back Alley Café. Based on the risk identification result, there are 59 risks were found in Back Alley Café. The risk identification is conducted based on observation and interview with the café manager who understand the condition of Back Alley Café properly. Based on the assessment of impact and probability, the risk mapping produced four risks at extreme level, 16 risks at high level, 24 risks at medium level, and 18 risks at low level. The strategy was designed as the risk mitigation after the risk mapping for the extreme and high level. The strategy which is given as the prevention or treatment of risk in Back Alley Café is divided into three. There are reducing the risk, sharing the risk and accepting the risk. The strategy is then implemented for each relevant activities.

45 CFR 153.350 - Risk adjustment data validation standards.

Code of Federal Regulations, 2012 CFR

2012-10-01

... implementation of any risk adjustment software and ensure proper validation of a statistically valid sample of... respect to implementation of risk adjustment software or as a result of data validation conducted pursuant... implementation of risk adjustment software or data validation. ...

Analysis of CSIRT/SOC Incidents and Continuous Monitoring of Threats

NASA Technical Reports Server (NTRS)

Wang, John; Ishisoko, Katsutoshi C.

2012-01-01

Security Operations Centers (SOC) contain a wealth of data which, if properly classified and tagged upfront, can yield a wealth of real-time information about your organizations IT Security posture, risks, and threats. These include answers to relevant and actionable questions such as: What are our biggest threats? Who is attacking us and what do they want? What controls are working or not working? How effective was the new technology we just implemented? What is our ROI?

Information and communication on risks related to medications and proper use of medications for healthcare professionals and the general public: precautionary principle, risk management, communication during and in the absence of crisis situations.

PubMed

Molimard, Mathieu; Bernaud, Corine; Lechat, Philippe; Bejan-Angoulvant, Theodora; Benattia, Cherif; Benkritly, Amel; Braunstein, David; Cabut, Sandrine; David, Nadine; Fourrier-Réglat, Annie; Gallet, Benoit; Gersberg, Marta; Goni, Sylvia; Jolliet, Pascale; Lamarque-Garnier, Véronique; Le Jeunne, Claire; Leurs, Irina; Liard, François; Malbezin, Muriel; Micallef, Joelle; Nguon, Marina

2014-01-01

Recent drug crises have highlighted the complexity, benefits and risks of medication communication. The difficulty of this communication is due to the diversity of the sources of information and the target audience, the credibility of spokespersons, the difficulty to communicate on scientific uncertainties and the precautionary principle, which is influenced by variable perceptions and tolerances of the risk. Globally, there is a lack of training in risk management with a tendency of modern society to refuse even the slightest risk. Communication on medications is subject to regulatory or legal requirements, often uses tools and messages that are not adapted to the target audience and is often based on a poor knowledge of communication techniques. In order to improve this situation, the available information must be coordinated by reinforcing the unique medication information website and by coordinating communication between authorities by means of a single spokesperson. A particular effort must be made in the field of training in the proper use and risk of medications for both the general population and patients but also for healthcare professionals, by setting up a unified academic on-line teaching platform for continuing medical education on medications and their proper use. © 2014 Société Française de Pharmacologie et de Thérapeutique.

Malaria Prevention, Mefloquine Neurotoxicity, Neuropsychiatric Illness, and Risk-Benefit Analysis in the Australian Defence Force.

PubMed

McCarthy, Stuart

2015-01-01

The Australian Defence Force (ADF) has used mefloquine for malaria chemoprophylaxis since 1990. Mefloquine has been found to be a plausible cause of a chronic central nervous system toxicity syndrome and a confounding factor in the diagnosis of existing neuropsychiatric illnesses prevalent in the ADF such as posttraumatic stress disorder and traumatic brain injury. Overall health risks appear to have been mitigated by restricting the drug's use; however serious risks were realised when significant numbers of ADF personnel were subjected to clinical trials involving the drug. The full extent of the exposure, health impacts for affected individuals, and consequences for ADF health management including mental health are not yet known, but mefloquine may have caused or aggravated neuropsychiatric illness in large numbers of patients who were subsequently misdiagnosed and mistreated or otherwise failed to receive proper care. Findings in relation to chronic mefloquine neurotoxicity were foreseeable, but this eventuality appears not to have been considered during risk-benefit analyses. Thorough analysis by the ADF would have identified this long-term risk as well as other qualitative risk factors. Historical exposure of ADF personnel to mefloquine neurotoxicity now also necessitates ongoing risk monitoring and management in the overall context of broader health policies.

Malaria Prevention, Mefloquine Neurotoxicity, Neuropsychiatric Illness, and Risk-Benefit Analysis in the Australian Defence Force

PubMed Central

McCarthy, Stuart

2015-01-01

The Australian Defence Force (ADF) has used mefloquine for malaria chemoprophylaxis since 1990. Mefloquine has been found to be a plausible cause of a chronic central nervous system toxicity syndrome and a confounding factor in the diagnosis of existing neuropsychiatric illnesses prevalent in the ADF such as posttraumatic stress disorder and traumatic brain injury. Overall health risks appear to have been mitigated by restricting the drug's use; however serious risks were realised when significant numbers of ADF personnel were subjected to clinical trials involving the drug. The full extent of the exposure, health impacts for affected individuals, and consequences for ADF health management including mental health are not yet known, but mefloquine may have caused or aggravated neuropsychiatric illness in large numbers of patients who were subsequently misdiagnosed and mistreated or otherwise failed to receive proper care. Findings in relation to chronic mefloquine neurotoxicity were foreseeable, but this eventuality appears not to have been considered during risk-benefit analyses. Thorough analysis by the ADF would have identified this long-term risk as well as other qualitative risk factors. Historical exposure of ADF personnel to mefloquine neurotoxicity now also necessitates ongoing risk monitoring and management in the overall context of broader health policies. PMID:26793391

Risk-Informed Decision Making: Application to Technology Development Alternative Selection

NASA Technical Reports Server (NTRS)

Dezfuli, Homayoon; Maggio, Gaspare; Everett, Christopher

2010-01-01

NASA NPR 8000.4A, Agency Risk Management Procedural Requirements, defines risk management in terms of two complementary processes: Risk-informed Decision Making (RIDM) and Continuous Risk Management (CRM). The RIDM process is used to inform decision making by emphasizing proper use of risk analysis to make decisions that impact all mission execution domains (e.g., safety, technical, cost, and schedule) for program/projects and mission support organizations. The RIDM process supports the selection of an alternative prior to program commitment. The CRM process is used to manage risk associated with the implementation of the selected alternative. The two processes work together to foster proactive risk management at NASA. The Office of Safety and Mission Assurance at NASA Headquarters has developed a technical handbook to provide guidance for implementing the RIDM process in the context of NASA risk management and systems engineering. This paper summarizes the key concepts and procedures of the RIDM process as presented in the handbook, and also illustrates how the RIDM process can be applied to the selection of technology investments as NASA's new technology development programs are initiated.

How To Investigate a Sexual Harassment Complaint.

ERIC Educational Resources Information Center

Shoop, Robert J.

1997-01-01

Addresses how administrators should investigate sexual harassment complaints. When conducted properly, the investigation process will resolve the claim fairly and reduce the likelihood of further harassment and the risk of litigation. Administrators should keep a file of all complaints, investigate thoroughly, conduct interviews properly, make…

Chemical Risk Assessment: Traditional vs Public Health Perspectives

EPA Science Inventory

Preventing adverse health impacts from exposures to environmental chemicals is fundamental to protecting individual and public health. When done efficiently and properly, chemical risk assessment enables risk management actions that minimize the incidence and impacts of environme...

Risk Assessment in the UK Health and Safety System: Theory and Practice.

PubMed

Russ, Karen

2010-09-01

In the UK, a person or organisation that creates risk is required to manage and control that risk so that it is reduced 'So Far As Is Reasonably Practicable' (SFAIRP). How the risk is managed is to be determined by those who create the risk. They have a duty to demonstrate that they have taken action to ensure all risk is reduced SFAIRP and must have documentary evidence, for example a risk assessment or safety case, to prove that they manage the risks their activities create. The UK Health and Safety Executive (HSE) does not tell organisations how to manage the risks they create but does inspect the quality of risk identification and management. This paper gives a brief overview of where responsibility for occupational health and safety lies in the UK, and how risk should be managed through risk assessment. The focus of the paper is three recent major UK incidents, all involving fatalities, and all of which were wholly avoidable if risks had been properly assessed and managed. The paper concludes with an analysis of the common failings of risk assessments and key actions for improvement.

MIXED-STATUS FAMILIES AND WIC UPTAKE: THE EFFECTS OF RISK OF DEPORTATION ON PROGRAM USE

PubMed Central

Vargas, Edward D.; Pirog, Maureen A.

2016-01-01

Objective Develop and test measures of risk of deportation and mixed-status families on WIC uptake. Mixed-status is a situation in which some family members are U.S. citizens and other family members are in the U.S. without proper authorization. Methods Estimate a series of logistic regressions to estimate WIC uptake by merging data from Fragile Families and Child Well-being Survey with deportation data from U.S.-Immigration Customs and Enforcement. Results The findings of this study suggest that risk of deportation is negatively associated with WIC uptake and among mixed-status families; Mexican origin families are the most sensitive when it comes to deportations and program use. Conclusion Our analysis provides a typology and framework to study mixed-status families and evaluate their usage of social services by including an innovative measure of risk of deportation. PMID:27642194

Report of geomagnetic pulsation indices for space weather applications

USGS Publications Warehouse

Xu, Z.; Gannon, Jennifer L.; Rigler, Erin J.

2013-01-01

The phenomenon of ultra-low frequency geomagnetic pulsations was first observed in the ground-based measurements of the 1859 Carrington Event and has been studied for over 100 years. Pulsation frequency is considered to be “ultra” low when it is lower than the natural frequencies of the plasma, such as the ion gyrofrequency. Ultra-low frequency pulsations are considered a source of noise in some geophysical analysis techniques, such as aeromagnetic surveys and transient electromagnetics, so it is critical to develop near real-time space weather products to monitor these geomagnetic pulsations. The proper spectral analysis of magnetometer data, such as using wavelet analysis techniques, can also be important to Geomagnetically Induced Current risk assessment.

Using real options analysis to support strategic management decisions

NASA Astrophysics Data System (ADS)

Kabaivanov, Stanimir; Markovska, Veneta; Milev, Mariyan

2013-12-01

Decision making is a complex process that requires taking into consideration multiple heterogeneous sources of uncertainty. Standard valuation and financial analysis techniques often fail to properly account for all these sources of risk as well as for all sources of additional flexibility. In this paper we explore applications of a modified binomial tree method for real options analysis (ROA) in an effort to improve decision making process. Usual cases of use of real options are analyzed with elaborate study on the applications and advantages that company management can derive from their application. A numeric results based on extending simple binomial tree approach for multiple sources of uncertainty are provided to demonstrate the improvement effects on management decisions.

Unwanted pregnancy and induced abortion among young women 16-22 years old in Greece: a retrospective study of the risk factors.

PubMed

Salakos, N; Koumousidis, A; Bakalianou, K; Paltoglou, G; Kalampokas, T; Iavazzo, C

2010-01-01

Unwanted pregnancies and the subsequent induced abortions are common problems of our youths in modern Greece. The aim of this study was to recognize the risk factors of the problem in an effort to find the best possible solution out of this social dead end. We interviewed 1,320 young female individuals and analyzed their answers using statistical analysis. Several useful conclusions were reached concerning the forces that are involved in unwanted pregnancy/induced abortions. We have tried to underline the strategy to combat the problem. Sexual education and the proper use of contraception remain the essential tools in this effort.

Risk Assessment and Prediction of Flyrock Distance by Combined Multiple Regression Analysis and Monte Carlo Simulation of Quarry Blasting

NASA Astrophysics Data System (ADS)

Armaghani, Danial Jahed; Mahdiyar, Amir; Hasanipanah, Mahdi; Faradonbeh, Roohollah Shirani; Khandelwal, Manoj; Amnieh, Hassan Bakhshandeh

2016-09-01

Flyrock is considered as one of the main causes of human injury, fatalities, and structural damage among all undesirable environmental impacts of blasting. Therefore, it seems that the proper prediction/simulation of flyrock is essential, especially in order to determine blast safety area. If proper control measures are taken, then the flyrock distance can be controlled, and, in return, the risk of damage can be reduced or eliminated. The first objective of this study was to develop a predictive model for flyrock estimation based on multiple regression (MR) analyses, and after that, using the developed MR model, flyrock phenomenon was simulated by the Monte Carlo (MC) approach. In order to achieve objectives of this study, 62 blasting operations were investigated in Ulu Tiram quarry, Malaysia, and some controllable and uncontrollable factors were carefully recorded/calculated. The obtained results of MC modeling indicated that this approach is capable of simulating flyrock ranges with a good level of accuracy. The mean of simulated flyrock by MC was obtained as 236.3 m, while this value was achieved as 238.6 m for the measured one. Furthermore, a sensitivity analysis was also conducted to investigate the effects of model inputs on the output of the system. The analysis demonstrated that powder factor is the most influential parameter on fly rock among all model inputs. It is noticeable that the proposed MR and MC models should be utilized only in the studied area and the direct use of them in the other conditions is not recommended.

Safety in the Weightroom.

ERIC Educational Resources Information Center

Fernandez-Balboa, Juan-Miguel

1993-01-01

Secondary level physical educators must be sure to instruct their weight lifters in proper spotting and lifting procedures, because weight training carries a high risk of injury. The article explains how to check the equipment, spot properly for specific exercises, and take general safety precautions in the weight room. (SM)

Assessing social and economic effects of perceived risk: Workshop summary: Draft: BWIP Repository Project. [Basalt Waste Isolation Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nealey, S.M.; Liebow, E.B.

1988-03-01

The US Department of Energy sponsored a one-day workshop to discuss the complex dimensions of risk judgment formation and the assessment of social and economic effects of risk perceptions related to the permanent underground storage of highly radioactive waste from commercial nuclear power plants. Affected parties have publicly expressed concerns about potentially significant risk-related effects of this approach to waste management. A selective review of relevant literature in psychology, decision analysis, economics, sociology, and anthropology was completed, along with an examination of decision analysis techniques that might assist in developing suitable responses to public risk-related concerns. The workshop was organizedmore » as a forum in which a set of distinguished experts could exchange ideas and observations about the problems of characterizing the effects of risk judgments. Out of the exchange emerged the issues or themes of problems with probabilistic risk assessment techniques are evident; differences exist in the way experts and laypersons view risk, and this leads to higher levels of public concern than experts feel are justified; experts, risk managers, and decision-makers sometimes err in assessing risk and in dealing with the public; credibility and trust are important contributing factors in the formation of risk judgments; social and economic consequences of perceived risk should be properly anticipated; improvements can be made in informing the public about risk; the role of the public in risk assessment, risk management and decisions about risk should be reconsidered; and mitigation and compensation are central to resolving conflicts arising from divergent risk judgments. 1 tab.« less

Assessment of economic factors affecting the satellite power system. Volume 1: System cost factors

NASA Technical Reports Server (NTRS)

Hazelrigg, G. A., Jr.

1978-01-01

The factors relevant to SPS costing and selection of preferred SPS satellite configurations were studied. The issues discussed are: (1) consideration of economic factors in the SPS system that relate to selection of SPS satellite configuration; (2) analysis of the proper rate of interest for use in SPS system definition studies; and (3) the impacts of differential inflation on SPS system definition costing procedures. A cost-risk comparison of the SPS satellite configurations showed a significant difference in the levelized cost of power from them. It is concluded, that this difference is the result more of differences in the procedures for assessing costs rather than in the satellite technologies required or of any advantages of one satellite configuration over the other. Analysis of the proper rate of interest for use in SPS system is 4 percent. The major item of differential inflation to be expected over this period of time is the real cost of labor. This cost is likely to double between today and the period of SPS construction.

Authentication techniques for smart cards

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nelson, R.A.

1994-02-01

Smart card systems are most cost efficient when implemented as a distributed system, which is a system without central host interaction or a local database of card numbers for verifying transaction approval. A distributed system, as such, presents special card and user authentication problems. Fortunately, smart cards offer processing capabilities that provide solutions to authentication problems, provided the system is designed with proper data integrity measures. Smart card systems maintain data integrity through a security design that controls data sources and limits data changes. A good security design is usually a result of a system analysis that provides a thoroughmore » understanding of the application needs. Once designers understand the application, they may specify authentication techniques that mitigate the risk of system compromise or failure. Current authentication techniques include cryptography, passwords, challenge/response protocols, and biometrics. The security design includes these techniques to help prevent counterfeit cards, unauthorized use, or information compromise. This paper discusses card authentication and user identity techniques that enhance security for microprocessor card systems. It also describes the analysis process used for determining proper authentication techniques for a system.« less

7 CFR 407.16 - Group risk plan for soybean.

Code of Federal Regulations, 2012 CFR

2012-01-01

... calculate indemnities. Planted acreage. Land in which the soybean seed has been placed by a machine... properly prepared for the planting method and production practice. Land on which seed is initially spread... accepted application; (b) Properly planted and reported by the acreage reporting date; (c) Planted with the...

7 CFR 407.17 - Group risk plan for wheat.

Code of Federal Regulations, 2011 CFR

2011-01-01

... calculate indemnities. Planted acreage. Land in which the wheat seed has been planted by a machine... properly prepared for the planting method and production practice. Land on which seed is initially spread... accepted application; (b) Properly planted and reported by the acreage reporting date; (c) Planted with the...

7 CFR 407.16 - Group risk plan for soybean.

Code of Federal Regulations, 2011 CFR

2011-01-01

... calculate indemnities. Planted acreage. Land in which the soybean seed has been placed by a machine... properly prepared for the planting method and production practice. Land on which seed is initially spread... accepted application; (b) Properly planted and reported by the acreage reporting date; (c) Planted with the...

7 CFR 407.17 - Group risk plan for wheat.

Code of Federal Regulations, 2012 CFR

2012-01-01

... calculate indemnities. Planted acreage. Land in which the wheat seed has been planted by a machine... properly prepared for the planting method and production practice. Land on which seed is initially spread... accepted application; (b) Properly planted and reported by the acreage reporting date; (c) Planted with the...

Nanotoxicity prediction using computational modelling - review and future directions

NASA Astrophysics Data System (ADS)

Saini, Bhavna; Srivastava, Sumit

2018-04-01

Nanomaterials has stimulated various outlooks for future in a number of industries and scientific ventures. A number of applications such as cosmetics, medicines, and electronics are employing nanomaterials due to their various compelling properties. The unending growth of nanomaterials usage in our daily life has escalated the health and environmental risks. Early nanotoxicity recognition is a big challenge. Various researches are going on in the field of nanotoxicity, which comprised of several problems such as inadequacy of proper datasets, lack of appropriate rules and characterization of nanomaterials. Computational modelling would be beneficial asset for nanomaterials researchers because it can foresee the toxicity, rest on previous experimental data. In this study, we have reviewed sufficient work demonstrating a proper pathway to proceed with QSAR analysis of Nanomaterials for toxicity modelling. The paper aims at providing comprehensive insight of Nano QSAR, various theories, tools and approaches used, along with an outline for future research directions to work on.

Making the Right Treatment Decision Requires Consideration of Utility and Reconsideration of Value.

PubMed

Rossi, Michael J; Lubowitz, James H; Brand, Jefferson C; Provencher, Matthew T

2017-02-01

To achieve a good clinical outcome, arthroscopic and related surgeons must choose the proper treatment, and the basis of this choice is accurate diagnosis. Generally, our clinical focus is on outcome, but outcome is achieved after the fact. While this seems obvious, arthroscopic and related surgeons-and our patients who participate in shared decision making-evaluate the utility, or usefulness, of potential treatments based on desired and expected benefits versus potential risks. Today, cost is frequently considered as a determinant of value in medicine and may be applied to the decision analysis, but if an individual patient perceives health to be priceless, cost becomes irrelevant. In the end, an individual patient's satisfaction is determined on a case-by-case basis. Proper choice of treatment cannot be formulaic. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Pros and cons of practice-owned and office-based ambulatory surgery centers.

PubMed

Bert, J M

2000-01-01

A detailed feasibility analysis is imperative to ensure the success of a practice-owned ASC. Analysis of the payer mix and the market relating to surgical volume that can be performed at the ASC is imperative. If overbuilding, overequipping, and overstaffing are avoided and the group has adequate volume that can be managed at the ASC, the facility should be a success. Building a practice-owned ASC without an accurate and detailed financial feasibility and payer study can place the endeavor at risk. A well-planned, economically constructed and properly managed ASC will result in an efficient and successful ancillary service for the orthopedic group practice.

An All-Sky Search for Wide Binaries in the SUPERBLINK Proper Motion Catalog

NASA Astrophysics Data System (ADS)

Hartman, Zachary; Lepine, Sebastien

2017-01-01

We present initial results from an all-sky search for Common Proper Motion (CPM) binaries in the SUPERBLINK all-sky proper motion catalog of 2.8 million stars with proper motions greater than 40 mas/yr, which has been recently enhanced with data from the GAIA mission. We initially search the SUPERBLINK catalog for pairs of stars with angular separations up to 1 degree and proper motion difference less than 40 mas/yr. In order to determine which of these pairs are real binaries, we develop a Bayesian analysis to calculate probabilities of true companionship based on a combination of proper motion magnitude, angular separation, and proper motion differences. The analysis reveals that the SUPERBLINK catalog most likely contains ~40,000 genuine common proper motion binaries. We provide initial estimates of the distances and projected physical separations of these wide binaries.

Understanding Suicide Risk: Identification of High Risk Groups during High Risk Times

PubMed Central

Overholser, James C.; Braden, Abby; Dieter, Lesa

2012-01-01

Background The assessment of suicide risk is a complex task for mental health professionals. Certain demographic groups are associated with completed suicide including males, divorced adults, and Caucasians. However, demographic variables alone provide a crude assessment of suicide risk. Psychiatric diagnosis and recent life events may improve the identification of high risk individuals. Method The current study evaluated 148 individuals who died by suicide compared to 257 adults who died suddenly from accidents or medical problems. Psychological autopsy was used to assess Axis I psychiatric diagnosis and recent stressful life events. Results Suicide completers were significantly more likely than comparison subjects to have a depressive disorder, a substance abuse disorder, and to have experienced interpersonal conflict in the months leading up to their death. A discriminant function analysis revealed that the combination of demographic variables, recent stressful life events, and psychiatric diagnoses best discriminated between suicide completers and comparison subjects. Conclusions Proper assessment of suicide risk should include a comprehensive evaluation of demographic characteristics, recent life stressors, and psychiatric diagnosis. PMID:22140004

Risk of Potential Exposure Incident in Non-healthcare Workers in Contact with Infectious and Municipal Waste

PubMed Central

Kanisek, Sanja; Gmajnić, Rudika; Barać, Ivana

2018-01-01

Abstract Introduction The proper classification of sharp and infectious waste in situ by the healthcare workers is an important measure of prevention of sharps and other exposure incidents in non-healthcare workers, who handle such waste. The aim was to examine the practice of classifying sharp and infectious waste in family and dental practices. Methods An analysis of 50 bags of infectious and 50 bags of municipal waste from five family and five dental practices for five days in October 2016 at the Health centre Osijek. Results Healthcare workers in 70% of the practices deposited sharps in infectious waste. In 56% of infectious waste bags, sharp object were found. More risky bags of infectious waste were produced by family practices (64%), but with no significant differences in relation to dental practices (48%), (P=0.143). Disposing of infectious into municipal waste was the case in 90% of the practitioners, where in 60% of municipal waste bags, infectious waste was disposed. Dental practices produced more risky bags of municipal waste (76%) in relation to family practices (44%), but with no significant difference (P=0.714). Conclusions The results of this research point to importance of performing audits of proper disposal of sharps and infectious waste to reduce the risks of injury to non-healthcare workers who come into contact with the said waste. Given results could be used for framing written protocols of proper disposal of sharps and infectious waste that should be visibly available in family and dental practices and for education of healthcare workers. PMID:29651317

Risk Assessment Strategies and Techniques for Combined Exposures

EPA Science Inventory

Author: Cynthia V. Rider, Ph.D., and Jane Ellen Simmons, Ph.D.Abstract: Consideration of cumulative risk is necessary to evaluate properly the safety of, and the risks associated with, combined exposures. These combined exposures ("mixtures") commonly occur from exposure to: envi...

The physical vulnerability of elements at risk: a methodology based on fluid and classical mechanics

NASA Astrophysics Data System (ADS)

Mazzorana, B.; Fuchs, S.; Levaggi, L.

2012-04-01

The impacts of the flood events occurred in autumn 2011 in the Italian regions Liguria and Tuscany revived the engagement of the public decision makers to enhance in synergy flood control and land use planning. In this context, the design of efficient flood risk mitigation strategies and their subsequent implementation critically relies on a careful vulnerability analysis of both, the immobile and mobile elements at risk potentially exposed to flood hazards. Based on fluid and classical mechanics notions we developed computation schemes enabling for a dynamic vulnerability and risk analysis facing a broad typological variety of elements at risk. The methodological skeleton consists of (1) hydrodynamic computation of the time-varying flood intensities resulting for each element at risk in a succession of loading configurations; (2) modelling the mechanical response of the impacted elements through static, elasto-static and dynamic analyses; (3) characterising the mechanical response through proper structural damage variables and (4) economic valuation of the expected losses as a function of the quantified damage variables. From a computational perspective we coupled the description of the hydrodynamic flow behaviour and the induced structural modifications of the elements at risk exposed. Valuation methods, suitable to support a correct mapping from the value domains of the physical damage variables to the economic loss values are discussed. In such a way we target to complement from a methodological perspective the existing, mainly empirical, vulnerability and risk assessment approaches to refine the conceptual framework of the cost-benefit analysis. Moreover, we aim to support the design of effective flood risk mitigation strategies by diminishing the main criticalities within the systems prone to flood risk.

A review on risk assessment techniques for hydraulic fracturing water and produced water management implemented in onshore unconventional oil and gas production.

PubMed

Torres, Luisa; Yadav, Om Prakash; Khan, Eakalak

2016-01-01

The objective of this paper is to review different risk assessment techniques applicable to onshore unconventional oil and gas production to determine the risks to water quantity and quality associated with hydraulic fracturing and produced water management. Water resources could be at risk without proper management of water, chemicals, and produced water. Previous risk assessments in the oil and gas industry were performed from an engineering perspective leaving aside important social factors. Different risk assessment methods and techniques are reviewed and summarized to select the most appropriate one to perform a holistic and integrated analysis of risks at every stage of the water life cycle. Constraints to performing risk assessment are identified including gaps in databases, which require more advanced techniques such as modeling. Discussions on each risk associated with water and produced water management, mitigation strategies, and future research direction are presented. Further research on risks in onshore unconventional oil and gas will benefit not only the U.S. but also other countries with shale oil and gas resources. Copyright © 2015 Elsevier B.V. All rights reserved.

Subtypes of Benign Breast Disease as a Risk Factor for Breast Cancer: A Systematic Review and Meta-Analysis Protocol

PubMed Central

Zendehdel, Manoosh; Niakan, Babak; Keshtkar, Abbasali; Rafiei, Elahe; Salamat, Fatemeh

2018-01-01

Breast cancer is a multifactorial disease. Benign breast disease (BBD) is one of the most important risk factors for breast cancer. The etiology of BBD is unknown. It is divided into nonproliferative and proliferative diseases. The selection of studies will be based on titles, abstract screening, inclusion and exclusion criteria, and quality assessment. Previous studies have shown that all types of BBD increase the risk of breast cancer, but the risk degree is different for each one. Accurate risk estimation of breast cancer in each category can be very important for proper clinical management. This systematic review and meta-analysis will be conducted on observational studies (traditional case control, nested case control, case cohort, and cohort) published in the Web of Science (ISI), PubMed (MEDLINE), Scopus, Google Scholar, and the key journals of this field such as Breast Cancer Research and Treatment and Cancer Research from January 2000 to June 2015. Reference lists and gray literature will be reviewed too. All the initial retrievals will be performed by 2 researchers independently. The data extraction form will consist of general information concerning the studies, study eligibility, method, risk of bias assessment, and results—including odds ratios, risk ratios, rate ratios, and hazard ratios. The PRISMA and MOOSE guidelines will be used to report our findings. Registration Details: PROSPERO-42016035243 PMID:29398746

Subtypes of Benign Breast Disease as a Risk Factor for Breast Cancer: A Systematic Review and Meta-Analysis Protocol.

PubMed

Zendehdel, Manoosh; Niakan, Babak; Keshtkar, Abbasali; Rafiei, Elahe; Salamat, Fatemeh

2018-01-01

Breast cancer is a multifactorial disease. Benign breast disease (BBD) is one of the most important risk factors for breast cancer. The etiology of BBD is unknown. It is divided into nonproliferative and proliferative diseases. The selection of studies will be based on titles, abstract screening, inclusion and exclusion criteria, and quality assessment. Previous studies have shown that all types of BBD increase the risk of breast cancer, but the risk degree is different for each one. Accurate risk estimation of breast cancer in each category can be very important for proper clinical management. This systematic review and meta-analysis will be conducted on observational studies (traditional case control, nested case control, case cohort, and cohort) published in the Web of Science (ISI), PubMed (MEDLINE), Scopus, Google Scholar, and the key journals of this field such as Breast Cancer Research and Treatment and Cancer Research from January 2000 to June 2015. Reference lists and gray literature will be reviewed too. All the initial retrievals will be performed by 2 researchers independently. The data extraction form will consist of general information concerning the studies, study eligibility, method, risk of bias assessment, and results-including odds ratios, risk ratios, rate ratios, and hazard ratios. The PRISMA and MOOSE guidelines will be used to report our findings. Registration Details: PROSPERO-42016035243.

Multivariate hydrological frequency analysis for extreme events using Archimedean copula. Case study: Lower Tunjuelo River basin (Colombia)

NASA Astrophysics Data System (ADS)

Gómez, Wilmar

2017-04-01

By analyzing the spatial and temporal variability of extreme precipitation events we can prevent or reduce the threat and risk. Many water resources projects require joint probability distributions of random variables such as precipitation intensity and duration, which can not be independent with each other. The problem of defining a probability model for observations of several dependent variables is greatly simplified by the joint distribution in terms of their marginal by taking copulas. This document presents a general framework set frequency analysis bivariate and multivariate using Archimedean copulas for extreme events of hydroclimatological nature such as severe storms. This analysis was conducted in the lower Tunjuelo River basin in Colombia for precipitation events. The results obtained show that for a joint study of the intensity-duration-frequency, IDF curves can be obtained through copulas and thus establish more accurate and reliable information from design storms and associated risks. It shows how the use of copulas greatly simplifies the study of multivariate distributions that introduce the concept of joint return period used to represent the needs of hydrological designs properly in frequency analysis.

Oral cancer associated with chronic mechanical irritation of the oral mucosa.

PubMed

Piemonte, E; Lazos, J; Belardinelli, P; Secchi, D; Brunotto, M; Lanfranchi-Tizeira, H

2018-03-01

Most of the studies dealing with Chronic Mechanical Irritation (CMI) and Oral Cancer (OC) only considered prosthetic and dental variables separately, and CMI functional factors are not registered. Thus, the aim of this study was to assess OC risk in individuals with dental, prosthetic and functional CMI. Also, we examined CMI presence in relation to tumor size. A case-control study was carried out from 2009 to 2013. Study group were squamous cell carcinoma cases; control group was patients seeking dental treatment in the same institution. 153 patients were studied (Study group n=53, Control group n=100). CMI reproducibility displayed a correlation coefficient of 1 (p<0.0001). Bivariate analysis showed statistically significant associations for all variables (age, gender, tobacco and alcohol consumption and CMI). Multivariate analysis exhibited statistical significance for age, alcohol, and CMI, but not for gender or tobacco. Relationship of CMI with tumor size showed no statistically significant differences. CMI could be regarded as a risk factor for oral cancer. In individuals with other OC risk factors, proper treatment of the mechanical injuring factors (dental, prosthetic and functional) could be an important measure to reduce the risk of oral cancer.

Novel Implications in Molecular Diagnosis of Lynch Syndrome

PubMed Central

Liccardo, Raffaella; Izzo, Paola

2017-01-01

About 10% of total colorectal cancers are associated with known Mendelian inheritance, as Familial Adenomatous Polyposis (FAP) and Lynch syndrome (LS). In these cancer types the clinical manifestations of disease are due to mutations in high-risk alleles, with a penetrance at least of 70%. The LS is associated with germline mutations in the DNA mismatch repair (MMR) genes. However, the mutation detection analysis of these genes does not always provide informative results for genetic counseling of LS patients. Very often, the molecular analysis reveals the presence of variants of unknown significance (VUSs) whose interpretation is not easy and requires the combination of different analytical strategies to get a proper assessment of their pathogenicity. In some cases, these VUSs may make a more substantial overall contribution to cancer risk than the well-assessed severe Mendelian variants. Moreover, it could also be possible that the simultaneous presence of these genetic variants in several MMR genes that behave as low risk alleles might contribute in a cooperative manner to increase the risk of hereditary cancer. In this paper, through a review of the recent literature, we have speculated a novel inheritance model in the Lynch syndrome; this could pave the way toward new diagnostic perspectives. PMID:28250766

Existential risks: exploring a robust risk reduction strategy.

PubMed

Jebari, Karim

2015-06-01

A small but growing number of studies have aimed to understand, assess and reduce existential risks, or risks that threaten the continued existence of mankind. However, most attention has been focused on known and tangible risks. This paper proposes a heuristic for reducing the risk of black swan extinction events. These events are, as the name suggests, stochastic and unforeseen when they happen. Decision theory based on a fixed model of possible outcomes cannot properly deal with this kind of event. Neither can probabilistic risk analysis. This paper will argue that the approach that is referred to as engineering safety could be applied to reducing the risk from black swan extinction events. It will also propose a conceptual sketch of how such a strategy may be implemented: isolated, self-sufficient, and continuously manned underground refuges. Some characteristics of such refuges are also described, in particular the psychosocial aspects. Furthermore, it is argued that this implementation of the engineering safety strategy safety barriers would be effective and plausible and could reduce the risk of an extinction event in a wide range of possible (known and unknown) scenarios. Considering the staggering opportunity cost of an existential catastrophe, such strategies ought to be explored more vigorously.

The Risk of Sexually Transmitted Infection and Its Influence on Condom Use among Pregnant Women in the Kintampo North Municipality of Ghana

PubMed Central

Afari-Asiedu, Samuel; Gyabaa-Febir, Lawrence; Adjei, Kwame Kesse; Mahama, Emmanuel; Tawiah-Agyemang, Charlotte; Newton, Sam K.; Asante, Kwaku Poku; Owusu-Agyei, Seth

2017-01-01

Sexually transmitted infection (STI) affects the reproductive health of both men and women worldwide. Condoms are important part of the available preventive strategies for STI control. The lack of proper risk-perception continues to impede women's ability to negotiate condom use with their partners. This paper is the outcome of secondary analysis of data collected in a cross-sectional survey that explored the perception of risk of STI and its influence on condom use among 504 pregnant women attending antenatal clinic at two health facilities in the Kintampo North Municipality. Consecutively, three Focus Group Discussions were conducted among 22 pregnant women which was analyzed using thematic analysis technique. Multivariate logistic regression analysis was used to identify possible predictors of condom use and risk of STI. Respondents mean age was 26.0 ± 5.9 years. 47% of respondents self-identified themselves as high risk for contracting STI, 50% of whom were married. High risk status (OR = 2.1, 95% CI: 1.1–4.4), ability to ask for condoms during sex (OR = 0.3, 95% CI: 0.1–0.73), and partner's approval of condom use (OR = 0.2, 95% CI: 0.01–0.05) were independent predictors of condom use. Condom use (OR 2.9 (1.5–5.7); p = 0.001) and marital status (engaged, OR 2.6 (1.5–4.5); p = 0.001) were independent predictors of risk of STI. Women who self-identified themselves as high risk for STI successfully negotiated condom use with their partners. This is however influenced by partner's approval and ability to convince partner to use condoms. Self-assessment of STI risk by women and the cooperation of male partners remain critical. PMID:28246570

People and Horses: The Risks of Riding.

ERIC Educational Resources Information Center

DeBenedette, Valerie

1989-01-01

The article looks at risks and benefits of horseback riding. Several risks can be minimized if riders take lessons, check riding equipment before each ride, wear proper headgear and footgear, and respect the horse's size and will. Medical guidelines for equestrian sports could help reduce injuries. (SM)

Particle Swarm Optimization Approach in a Consignment Inventory System

NASA Astrophysics Data System (ADS)

Sharifyazdi, Mehdi; Jafari, Azizollah; Molamohamadi, Zohreh; Rezaeiahari, Mandana; Arshizadeh, Rahman

2009-09-01

Consignment Inventory (CI) is a kind of inventory which is in the possession of the customer, but is still owned by the supplier. This creates a condition of shared risk whereby the supplier risks the capital investment associated with the inventory while the customer risks dedicating retail space to the product. This paper considers both the vendor's and the retailers' costs in an integrated model. The vendor here is a warehouse which stores one type of product and supplies it at the same wholesale price to multiple retailers who then sell the product in independent markets at retail prices. Our main aim is to design a CI system which generates minimum costs for the two parties. Here a Particle Swarm Optimization (PSO) algorithm is developed to calculate the proper values. Finally a sensitivity analysis is performed to examine the effects of each parameter on decision variables. Also PSO performance is compared with genetic algorithm.

When informed consent goes poorly: a descriptive study of medical negligence claims and patient complaints.

PubMed

Gogos, Andrew J; Clark, Richard B; Bismark, Marie M; Gruen, Russell L; Studdert, David M

2011-09-19

To describe the frequency, characteristics, and outcomes of medicolegal disputes over informed consent. Retrospective review and analysis of negligence claims against doctors insured by Avant Mutual Group Limited and complaints lodged with the Office of the Health Services Commissioner of Victoria that alleged failures in the informed consent process and were adjudicated between 1 January 2002 and 31 December 2008. Case frequency (by medical specialty), type of allegation, type of treatment. A total of 481 cases alleged deficiencies in the informed consent process (218 of 1898 conciliated complaints [11.5%]; 263 of 7846 negligence claims [3.4%]). 57% of these cases were against surgeons. Plastic surgeons experienced dispute rates that were more than twice those of any other specialty or subspecialty group. 92% of cases (442/481) involved surgical procedures and 16% (77/481) involved cosmetic procedures. The primary allegation in 71% of cases was that the clinician failed to mention or properly explain risks of complications. Five treatment types - procedures on reproductive organs (12% of cases), procedures on facial features excluding eyes (12%), prescription medications (8%), eye surgery (7%) and breast surgery (7%) - accounted for 46% of all cases. The typical dispute over informed consent involves an operation, often cosmetic, and allegations that a particular complication was not properly disclosed. With Australian courts now looking to patient preferences in setting legal standards of care for risk disclosure, medicolegal disputes provide valuable insights for targeting both quality improvement efforts and risk management activities.

[Assessment of health risk in view of changes in labor code and methods used for protecting the environment].

PubMed

Indulski, J A; Rolecki, R

1994-01-01

In view of the present and proposed amendments to the Labor Code as well as bearing in mind anticipated harmonization of regulations in this area with those of EEC, the authors emphasize the need for well developed methodology for assessing chemical safety in an occupational environment with special reference to health effects in people exposed to chemicals. Methods for assessing health risk induced by work under conditions of exposure to chemicals were divided into: methods for assessing technological/processing risk, and methods for assessing health risk related to the toxic effect of chemicals. The need for developing means of risk communication in order to secure proper risk perception among people exposed to chemicals and risk managers responsible for prevention against chemical hazards was also stressed. It is suggested to establish a centre for chemical substances in order to settle down all issues pertaining to human exposure to chemicals. The centre would be responsible, under the provisions of the Chemical Substances Act, for the qualitative and quantitative analysis of the present situation and for the development of guidelines on assessment of health risk among persons exposed to chemicals.

They're Suing Us? Liability and Risk Management.

ERIC Educational Resources Information Center

Hollander, Patricia A.

1982-01-01

Legal issues in liability for and prevention of injuries through negligence are discussed: proving negligence, who is owed a duty of care, who may be sued, remedies, risk management (shifting risk, insurance, indemnification, waivers and releases), and preventing claims (warning of known danger, proper supervision, school maintenance, security,…

Change of exposure response over time and long-term risk of silicosis among a cohort of Chinese pottery workers.

PubMed

Sun, Yi; Bochmann, Frank; Morfeld, Peter; Ulm, Kurt; Liu, Yuewei; Wang, Heijiao; Yang, Lei; Chen, Weihong

2011-07-01

An analysis was conducted on a cohort of Chinese pottery workers to estimate the exposure-response relationship between respirable crystalline silica dust exposure and the incidence of radiographically diagnosed silicosis, and to estimate the long-term risk of developing silicosis until the age of 65. The cohort comprised 3,250 employees with a median follow-up duration of around 37 years. Incident cases of silicosis were identified via silicosis registries (Chinese X-ray stage I, similar to International Labor Organisation classification scheme profusion category 1/1). Individual exposure to respirable crystalline silica dust was estimated based on over 100,000 historical dust measurements. The association between dust exposure, incidence and long-time risk of silicosis was quantified by Poisson regression analysis adjusted for age and smoking. The risk of silicosis depended not only on the cumulative respirable crystalline silica dust exposures, but also on the time-dependent respirable crystalline silica dust exposure pattern (long-term average concentration, highest annual concentration ever experienced and time since first exposure). A long-term "excess" risk of silicosis of approximately 1.5/1,000 was estimated among workers with all annual respirable crystalline silica dust concentration estimates less than 0.1 mg/m(3), using the German measurement strategy. This study indicates the importance of proper consideration of exposure information in risk quantification in epidemiological studies.

Assessment of possible airborne impact from nuclear risk sites - Part II: probabilistic analysis of atmospheric transport patterns in Euro-Arctic region

NASA Astrophysics Data System (ADS)

Mahura, A. G.; Baklanov, A. A.

2003-10-01

The probabilistic analysis of atmospheric transport patterns from most important nuclear risk sites in the Euro-Arctic region is performed employing the methodology developed within the "Arctic Risk" Project of the NARP Programme (Baklanov and Mahura, 2003). The risk sites are the nuclear power plants in the Northwest Russia, Finland, Sweden, Lithuania, United Kingdom, and Germany as well as the Novaya Zemlya test site of Russia. The geographical regions of interest are the Northern and Central European countries and Northwest Russia. In this study, the employed research tools are the trajectory model to calculate a multiyear dataset of forward trajectories that originated over the risk site locations, and a set of statistical methods (including exploratory, cluster, and probability fields analyses) for analysis of trajectory modelling results. The probabilistic analyses of trajectory modelling results for eleven sites are presented as a set of various indicators of the risk sites possible impact on geographical regions and countries of interest. The nuclear risk site possible impact (on a particular geographical region, territory, country, site, etc.) due to atmospheric transport from the site after hypothetical accidental release of radioactivity can be properly estimated based on a combined interpretation of the indicators (simple characteristics, atmospheric transport pathways, airflow and fast transport probability fields, maximum reaching distance and maximum possible impact zone, typical transport time and precipitation factor fields) for different time periods (annual, seasonal, and monthly) for any selected site (both separately for each site or grouped for several sites) in the Euro-Arctic region. Such estimation could be the useful input information for the decision-making process, risk assessment, and planning of emergency response systems for sites of nuclear, chemical, and biological danger.

Reducing the risk of burns during electroconvulsive therapy.

PubMed

2011-10-01

Poor contact between electroconvulsive therapy (ECT) electrodes and the skin can result in patient burns during ECT treatment. Proper site preparation and electrode application are essential to ensure adequate contact and to reduce the risk of burns.

Microbial Characterization and Comparison of Isolates During the Mir and ISS Missions

NASA Technical Reports Server (NTRS)

Fontenot, Sondra L.; Castro, Victoria; Bruce, Rebekah; Ott, C. Mark; Pierson, Duane L.

2004-01-01

Spacecraft represent a semi-closed ecosystem that provides a unique model of microbial interaction with other microbes, potential hosts, and their environment. Environmental samples from the Mir Space Station (1995-1998) and the International Space Station (ISS) (2000-Present) were collected and processed to provide insight into the characterization of microbial diversity aboard spacecraft over time and assess any potential health risks to the crew. All microbiota were isolated using standard media-based methodologies. Isolates from Mir and ISS were processed using various methods of analysis, including VITEK biochemical analysis, 16s ribosomal identification, and fingerprinting using rep-PCR analysis. Over the first 41 months of habitation, the diversity of the microbiota from air and surface samples aboard ISS increased from an initial six to 53 different bacterial species. During the same period, fungal diversity increased from 2 to 24 species. Based upon rep-PCR analysis, the majority of isolates were unique suggesting the need for increased sampling frequency and a more thorough analysis of samples to properly characterize the ISS microbiota. This limited fungal and bacterial data from environmental samples acquired during monitoring currently do not indicate a microbial hazard to ISS or any trends suggesting potential health risks.

Task analysis method for procedural training curriculum development.

PubMed

Riggle, Jakeb D; Wadman, Michael C; McCrory, Bernadette; Lowndes, Bethany R; Heald, Elizabeth A; Carstens, Patricia K; Hallbeck, M Susan

2014-06-01

A central venous catheter (CVC) is an important medical tool used in critical care and emergent situations. Integral to proper care in many circumstances, insertion of a CVC introduces the risk of central line-associated blood stream infections and mechanical adverse events; proper training is important for safe CVC insertion. Cognitive task analysis (CTA) methods have been successfully implemented in the medical field to improve the training of postgraduate medical trainees, but can be very time-consuming to complete and require a significant time commitment from many subject matter experts (SMEs). Many medical procedures such as CVC insertion are linear processes with well-documented procedural steps. These linear procedures may not require a traditional CTA to gather the information necessary to create a training curriculum. Accordingly, a novel, streamlined CTA method designed primarily to collect cognitive cues for linear procedures was developed to be used by medical professionals with minimal CTA training. This new CTA methodology required fewer trained personnel, fewer interview sessions, and less time commitment from SMEs than a traditional CTA. Based on this study, a streamlined CTA methodology can be used to efficiently gather cognitive information on linear medical procedures for the creation of resident training curricula and procedural skills assessments.

The changing face of nanomaterials: Risk assessment challenges along the value chain.

PubMed

Mattsson, Mats-Olof; Simkó, Myrtill

2017-03-01

Risk assessment (RA) of manufactured nanomaterials (MNM) is essential for regulatory purposes and risk management activities. Similar to RA of "classical" chemicals, MNM RA requires knowledge about exposure as well as of hazard potential and dose response relationships. What makes MNM RA especially challenging is the multitude of materials (which is expected to increase substantially in the future), the complexity of MNM value chains and life cycles, the accompanying possible changes in material properties over time and in contact with various environmental and organismal milieus, and the difficulties to obtain proper exposure data and to consider the proper dose metric. This article discusses these challenges and also critically overviews the current state of the art regarding MNM RA approaches. Copyright © 2016 Elsevier Inc. All rights reserved.

A longitudinal study on anaemia in children with Plasmodium falciparum infection in the Mount Cameroon region: prevalence, risk factors and perceptions by caregivers

PubMed Central

2013-01-01

Background In heavily endemic malaria areas, it is almost inevitable that malarial infection will be associated with anaemia, although malaria may not be the prime cause of it. Anaemia is a major public health problem in Cameroon. We hypothesized that, factors other than falciparum malaria account for anaemia in the study area. Methods A longitudinal study was conducted among 351 Plasmodium falciparum positive children to determine the prevalence, risk factors and the perception of anaemia by the caregivers in a semi-rural community. The investigative methods included the use of a structured questionnaire, clinical evaluation and laboratory investigations. Results At enrolment the overall prevalence of anaemia as assessed by Hb concentration (Hb < 11 g/dl) was 80.3% (282). Following treatment the prevalence of persistent anaemia was 6% and 46.2% of the children achieved haematological recovery by day 42. Exploratory multiple linear regression analysis showed the following; parasitaemia density (P < 0.01), enlarged spleen (P < 0.05), duration of fever > 2 days (P < 0.01), high white blood cell count (P < 0.001), sex (P < 0.05), iron status indicators (ferritin and transferrin) (P < 0.001), level of education of the caregiver (P < 0.05), management of onset of malaria by caregiver (P < 0.005) and wasting (P < 0.05) to be risk factors for anaemia in children with falciparum infection. Approximately 75.5% (265) of the caregivers had some knowledge about anaemia. Conclusion The identified risk factors revealed the important contributors to the pathogenesis of anaemia in the Mount Cameroon region. Control efforts should therefore be directed towards proper health education emphasizing on proper health seeking behaviour and attitudes of the population. PMID:23497273

A longitudinal study on anaemia in children with Plasmodium falciparum infection in the Mount Cameroon region: prevalence, risk factors and perceptions by caregivers.

PubMed

Sumbele, Irene Ule Ngole; Samje, Moses; Nkuo-Akenji, Theresa

2013-03-05

In heavily endemic malaria areas, it is almost inevitable that malarial infection will be associated with anaemia, although malaria may not be the prime cause of it. Anaemia is a major public health problem in Cameroon. We hypothesized that, factors other than falciparum malaria account for anaemia in the study area. A longitudinal study was conducted among 351 Plasmodium falciparum positive children to determine the prevalence, risk factors and the perception of anaemia by the caregivers in a semi-rural community. The investigative methods included the use of a structured questionnaire, clinical evaluation and laboratory investigations. At enrolment the overall prevalence of anaemia as assessed by Hb concentration (Hb < 11 g/dl) was 80.3% (282). Following treatment the prevalence of persistent anaemia was 6% and 46.2% of the children achieved haematological recovery by day 42. Exploratory multiple linear regression analysis showed the following; parasitaemia density (P < 0.01), enlarged spleen (P < 0.05), duration of fever > 2 days (P < 0.01), high white blood cell count (P < 0.001), sex (P < 0.05), iron status indicators (ferritin and transferrin) (P < 0.001), level of education of the caregiver (P < 0.05), management of onset of malaria by caregiver (P < 0.005) and wasting (P < 0.05) to be risk factors for anaemia in children with falciparum infection. Approximately 75.5% (265) of the caregivers had some knowledge about anaemia. The identified risk factors revealed the important contributors to the pathogenesis of anaemia in the Mount Cameroon region. Control efforts should therefore be directed towards proper health education emphasizing on proper health seeking behaviour and attitudes of the population.

Regulating the unknown: Managing the occupational health risks of nanomedical technologies and nanopharmaceuticals in the research laboratory

NASA Astrophysics Data System (ADS)

Ersin, Ozlem Hacer

Novel technologies and their resultant products demand fresh ways of thinking about pre-market risk analysis and post-market surveillance. A regulatory framework that is responsive to emerging knowledge about the hazards of novel technologies offers repeatable and transparent processes and remains economically and socially feasible. Workers are an especially vulnerable population who are exposed to unknown hazards of novel technologies and serve often as unwitting sentinels of impending risks. This Grounded Theory-based case study identifies gaps in our current ability to regulate novel technologies so as to minimize occupational health risks and offers necessary modifications for an environment that is conducive to proper regulation. Nanopharmaceuticals and the nano-based technologies at their base are used by way of exemplar technologies that are currently taxing the ability of the regulatory system to provide adequate oversight. Ambiguities of definition, absence of a tracking system (of who is doing nanotechnology research), and the paucity of scientific evidence to support risk management efforts are among the findings of the study and need to be addressed as ameliorative steps toward an effective regulatory structure.

Achieving the Proper Balance Between Crew and Public Safety

NASA Technical Reports Server (NTRS)

Gowan, John; Silvestri, Ray; Stahl, Ben; Rosati, Paul; Wilde, Paul

2011-01-01

A paramount objective of all human-rated launch and reentry vehicle developers is to ensure that the risks to both the crew onboard and the public are minimized within reasonable cost, schedule, and technical constraints. Past experience has shown that proper attention to range safety requirements necessary to ensure public safety must be given early in the design phase to avoid additional operational complexities or threats to the safety of people onboard, and the design engineers must give these requirements the same consideration as crew safety requirements. For human spaceflight, the primary purpose and operational concept for any flight safety system is to protect the public while maximizing the likelihood of crew survival. This paper will outline the policy considerations, technical issues, and operational impacts regarding launch and reentry vehicle failure scenarios where crew and public safety are intertwined and thus addressed optimally in an integrated manner. An overview of existing range and crew safety policy requirements will be presented. Application of these requirements and lessons learned from both the Space Shuttle and Constellation Programs will also be discussed. Using these past programs as examples, the paper will detail operational, design, and analysis approaches to mitigate and balance the risks to people onboard and in the public. Manned vehicle perspectives from the Federal Aviation Administration (FAA) and Air Force organizations that oversee public safety will be summarized as well. Finally, the paper will emphasize the need to factor policy, operational, and analysis considerations into the early design trades of new vehicles to help ensure that both crew and public safety are maximized to the greatest extent possible.

Achieving the Proper Balance between Crew & Public Safety

NASA Astrophysics Data System (ADS)

Wilde, P.; Gowan, J.; Silvestri, R.; Stahl, B.; Rosati, P.

2012-01-01

A paramount objective of all human-rated launch and reentry vehicle developers is to ensure that the risks to both the crew onboard and the public are minimized within reasonable cost, schedule, and technical constraints. Past experience has shown that proper attention to range safety requirements necessary to ensure public safety must be given early in the design phase to avoid additional operational complexities or threats to the safety of people onboard, and the design engineers must give these requirements the same consideration as crew safety requirements. For human spaceflight, the primary purpose and operational concept for any flight safety system is to protect the public while maximizing the likelihood of crew survival. This paper will outline the policy considerations, technical issues, and operational impacts regarding launch and reentry vehicle failure scenarios where crew and public safety are intertwined and thus addressed optimally in an integrated manner. An overview of existing range and crew safety policy requirements will be presented. Application of these requirements and lessons learned from both the Space Shuttle and Constellation Programs will also be discussed. Using these past programs as examples, the paper will detail operational, design, and analysis approaches to mitigate and balance the risks to people onboard and in the public. Crewed vehicle perspectives from the Federal Aviation Administration and Air Force organizations that oversee public safety will be summarized as well. Finally, the paper will emphasize the need to factor policy, operational, and analysis considerations into the early design trades of new vehicles to help ensure that both crew and public safety are maximized to the greatest extent possible.

Metformin and the Risk of Cancer

PubMed Central

Suissa, Samy; Azoulay, Laurent

2012-01-01

OBJECTIVE Time-related biases in observational studies of drug effects have been described extensively in different therapeutic areas but less so in diabetes. Immortal time bias, time-window bias, and time-lag bias all tend to greatly exaggerate the benefits observed with a drug. RESEARCH DESIGN AND METHODS These time-related biases are described and shown to be prominent in observational studies that have associated metformin with impressive reductions in the incidence of and mortality from cancer. As a consequence, metformin received much attention as a potential anticancer agent; these observational studies sparked the conduction of randomized, controlled trials of metformin as cancer treatment. However, the spectacular effects reported in these studies are compatible with time-related biases. RESULTS We found that 13 observational studies suffered from immortal time bias; 9 studies had not considered time-window bias, whereas other studies did not consider inherent time-lagging issues when comparing the first-line treatment metformin with second- or third-line treatments. These studies, subject to time-related biases that are avoidable with proper study design and data analysis, led to illusory extraordinarily significant effects, with reductions in cancer risk with metformin ranging from 20 to 94%. Three studies that avoided these biases reported no effect of metformin use on cancer incidence. CONCLUSIONS Although observational studies are important to better understand the effects of drugs, their proper design and analysis is essential to avoid major time-related biases. With respect to metformin, the scientific evidence of its potential beneficial effects on cancer would need to be reassessed critically before embarking on further long and expensive trials. PMID:23173135

33 CFR 83.07 - Risk of collision (Rule 7).

Code of Federal Regulations, 2011 CFR

2011-07-01

... exists. If there is any doubt such risk shall be deemed to exist. (b) Radar. Proper use shall be made of radar equipment if fitted and operational, including long-range scanning to obtain early warning of risk of collision and radar plotting or equivalent systematic observation of detected objects. (c) Scanty...

33 CFR 83.07 - Risk of collision (Rule 7).

Code of Federal Regulations, 2010 CFR

2010-07-01

... exists. If there is any doubt such risk shall be deemed to exist. (b) Radar. Proper use shall be made of radar equipment if fitted and operational, including long-range scanning to obtain early warning of risk of collision and radar plotting or equivalent systematic observation of detected objects. (c) Scanty...

33 CFR 83.07 - Risk of collision (Rule 7).

Code of Federal Regulations, 2013 CFR

2013-07-01

... exists. If there is any doubt such risk shall be deemed to exist. (b) Radar. Proper use shall be made of radar equipment if fitted and operational, including long-range scanning to obtain early warning of risk of collision and radar plotting or equivalent systematic observation of detected objects. (c) Scanty...

33 CFR 83.07 - Risk of collision (Rule 7).

Code of Federal Regulations, 2014 CFR

2014-07-01

... exists. If there is any doubt such risk shall be deemed to exist. (b) Radar. Proper use shall be made of radar equipment if fitted and operational, including long-range scanning to obtain early warning of risk of collision and radar plotting or equivalent systematic observation of detected objects. (c) Scanty...

33 CFR 83.07 - Risk of collision (Rule 7).

Code of Federal Regulations, 2012 CFR

2012-07-01

... exists. If there is any doubt such risk shall be deemed to exist. (b) Radar. Proper use shall be made of radar equipment if fitted and operational, including long-range scanning to obtain early warning of risk of collision and radar plotting or equivalent systematic observation of detected objects. (c) Scanty...

A data-driven approach to quality risk management.

PubMed

Alemayehu, Demissie; Alvir, Jose; Levenstein, Marcia; Nickerson, David

2013-10-01

An effective clinical trial strategy to ensure patient safety as well as trial quality and efficiency involves an integrated approach, including prospective identification of risk factors, mitigation of the risks through proper study design and execution, and assessment of quality metrics in real-time. Such an integrated quality management plan may also be enhanced by using data-driven techniques to identify risk factors that are most relevant in predicting quality issues associated with a trial. In this paper, we illustrate such an approach using data collected from actual clinical trials. Several statistical methods were employed, including the Wilcoxon rank-sum test and logistic regression, to identify the presence of association between risk factors and the occurrence of quality issues, applied to data on quality of clinical trials sponsored by Pfizer. ONLY A SUBSET OF THE RISK FACTORS HAD A SIGNIFICANT ASSOCIATION WITH QUALITY ISSUES, AND INCLUDED: Whether study used Placebo, whether an agent was a biologic, unusual packaging label, complex dosing, and over 25 planned procedures. Proper implementation of the strategy can help to optimize resource utilization without compromising trial integrity and patient safety.

Environmental risk assessment of chemicals and nanomaterials--The best foundation for regulatory decision-making?

PubMed

Syberg, Kristian; Hansen, Steffen Foss

2016-01-15

Environmental risk assessment (ERA) is often considered as the most transparent, objective and reliable decision-making tool for informing the risk management of chemicals and nanomaterials. ERAs are based on the assumption that it is possible to provide accurate estimates of hazard and exposure and, subsequently, to quantify risk. In this paper we argue that since the quantification of risk is dominated by uncertainties, ERAs do not provide a transparent or an objective foundation for decision-making and they should therefore not be considered as a "holy grail" for informing risk management. We build this thesis on the analysis of two case studies (of nonylphenol and nanomaterials) as well as a historical analysis in which we address the scientific foundation for ERAs. The analyses show that ERAs do not properly address all aspects of actual risk, such as the mixture effect and the environmentally realistic risk from nanomaterials. Uncertainties have been recognised for decades, and assessment factors are used to compensate for the lack of realism in ERAs. The assessment factors' values were pragmatically determined, thus lowering the scientific accuracy of the ERAs. Furthermore, the default choice of standard assay for assessing a hazard might not always be the most biologically relevant, so we therefore argue that an ERA should be viewed as a pragmatic decision-making tool among several, and it should not have a special status for informing risk management. In relation to other relevant decision-making tools we discuss the use of chemical alternative assessments (CAAs) and the precautionary principle. Copyright © 2015 Elsevier B.V. All rights reserved.

Mars Exploration Rover Heat Shield Recontact Analysis

NASA Technical Reports Server (NTRS)

Raiszadeh, Behzad; Desai, Prasun N.; Michelltree, Robert

2011-01-01

The twin Mars Exploration Rover missions landed successfully on Mars surface in January of 2004. Both missions used a parachute system to slow the rover s descent rate from supersonic to subsonic speeds. Shortly after parachute deployment, the heat shield, which protected the rover during the hypersonic entry phase of the mission, was jettisoned using push-off springs. Mission designers were concerned about the heat shield recontacting the lander after separation, so a separation analysis was conducted to quantify risks. This analysis was used to choose a proper heat shield ballast mass to ensure successful separation with low probability of recontact. This paper presents the details of such an analysis, its assumptions, and the results. During both landings, the radar was able to lock on to the heat shield, measuring its distance, as it descended away from the lander. This data is presented and is used to validate the heat shield separation/recontact analysis.

Risk Assessment Techniques. A Handbook for Program Management Personnel

DTIC Science & Technology

1983-07-01

tion; not directly usable without further development. 37. Lieber, R.S., "New Approaches for Quantifying Risk and Determining Sharing Arrangements...must be provided. Prediction intervals around cost estimating relationships (CERs) or Monte Carlo simulations will be used as proper in quantifying ... risk ." [emphasis supplied] Para 9.d. "The ISR will address the potential risk in the program office estimate by identifying ’risk’ areas and their

Analysis of risk factors for T. brucei rhodesiense sleeping sickness within villages in south-east Uganda

PubMed Central

Zoller, Thomas; Fèvre, Eric M; Welburn, Susan C; Odiit, Martin; Coleman, Paul G

2008-01-01

Background Sleeping sickness (HAT) caused by T.b. rhodesiense is a major veterinary and human public health problem in Uganda. Previous studies have investigated spatial risk factors for T.b. rhodesiense at large geographic scales, but none have properly investigated such risk factors at small scales, i.e. within affected villages. In the present work, we use a case-control methodology to analyse both behavioural and spatial risk factors for HAT in an endemic area. Methods The present study investigates behavioural and occupational risk factors for infection with HAT within villages using a questionnaire-based case-control study conducted in 17 villages endemic for HAT in SE Uganda, and spatial risk factors in 4 high risk villages. For the spatial analysis, the location of homesteads with one or more cases of HAT up to three years prior to the beginning of the study was compared to all non-case homesteads. Analysing spatial associations with respect to irregularly shaped geographical objects required the development of a new approach to geographical analysis in combination with a logistic regression model. Results The study was able to identify, among other behavioural risk factors, having a family member with a history of HAT (p = 0.001) as well as proximity of a homestead to a nearby wetland area (p < 0.001) as strong risk factors for infection. The novel method of analysing complex spatial interactions used in the study can be applied to a range of other diseases. Conclusion Spatial risk factors for HAT are maintained across geographical scales; this consistency is useful in the design of decision support tools for intervention and prevention of the disease. Familial aggregation of cases was confirmed for T. b. rhodesiense HAT in the study and probably results from shared behavioural and spatial risk factors amongmembers of a household. PMID:18590541

Impact modeling and prediction of attacks on cyber targets

NASA Astrophysics Data System (ADS)

Khalili, Aram; Michalk, Brian; Alford, Lee; Henney, Chris; Gilbert, Logan

2010-04-01

In most organizations, IT (information technology) infrastructure exists to support the organization's mission. The threat of cyber attacks poses risks to this mission. Current network security research focuses on the threat of cyber attacks to the organization's IT infrastructure; however, the risks to the overall mission are rarely analyzed or formalized. This connection of IT infrastructure to the organization's mission is often neglected or carried out ad-hoc. Our work bridges this gap and introduces analyses and formalisms to help organizations understand the mission risks they face from cyber attacks. Modeling an organization's mission vulnerability to cyber attacks requires a description of the IT infrastructure (network model), the organization mission (business model), and how the mission relies on IT resources (correlation model). With this information, proper analysis can show which cyber resources are of tactical importance in a cyber attack, i.e., controlling them enables a large range of cyber attacks. Such analysis also reveals which IT resources contribute most to the organization's mission, i.e., lack of control over them gravely affects the mission. These results can then be used to formulate IT security strategies and explore their trade-offs, which leads to better incident response. This paper presents our methodology for encoding IT infrastructure, organization mission and correlations, our analysis framework, as well as initial experimental results and conclusions.

Bayesian Approach for Flexible Modeling of Semicompeting Risks Data

PubMed Central

Han, Baoguang; Yu, Menggang; Dignam, James J.; Rathouz, Paul J.

2016-01-01

Summary Semicompeting risks data arise when two types of events, non-terminal and terminal, are observed. When the terminal event occurs first, it censors the non-terminal event, but not vice versa. To account for possible dependent censoring of the non-terminal event by the terminal event and to improve prediction of the terminal event using the non-terminal event information, it is crucial to model their association properly. Motivated by a breast cancer clinical trial data analysis, we extend the well-known illness-death models to allow flexible random effects to capture heterogeneous association structures in the data. Our extension also represents a generalization of the popular shared frailty models that usually assume that the non-terminal event does not affect the hazards of the terminal event beyond a frailty term. We propose a unified Bayesian modeling approach that can utilize existing software packages for both model fitting and individual specific event prediction. The approach is demonstrated via both simulation studies and a breast cancer data set analysis. PMID:25274445

[Immigration and health: social inequalities in health disparities in the health system, in welfare and work].

PubMed

Pullini, A

2011-01-01

Within the analysis of the socio-economic context and the data from hospital discharges, the themes of social inequalities, health disparities, determinants of health care are discussed. Regular immigrants versus irregular, wealthy people versus those in poverty, they have access to and receive different health treatments, besides presenting risk conditions significantly different in relation to their social situation. Through the analysis of hospital discharge records as well as data from injuries at work, besides underestimations in foreign people and the greater risk of injuries for immigrants, it is evident how the aspects of inequalities connected to socioeconomic determinants and the different access to health services are pivotal for our health and welfare and that a profound change is required to tackle them properly, focusing on intervention on health care system, according to models which take into account not only evidence based medicine, but also narrative medicine, not only health protection, but also health promotion, so that equity and quality of health care is warranted for everyone.

The Use of Input-Output Control System Analysis for Sustainable Development of Multivariable Environmental Systems

NASA Astrophysics Data System (ADS)

Koliopoulos, T. C.; Koliopoulou, G.

2007-10-01

We present an input-output solution for simulating the associated behavior and optimized physical needs of an environmental system. The simulations and numerical analysis determined the accurate boundary loads and areas that were required to interact for the proper physical operation of a complicated environmental system. A case study was conducted to simulate the optimum balance of an environmental system based on an artificial intelligent multi-interacting input-output numerical scheme. The numerical results were focused on probable further environmental management techniques, with the objective of minimizing any risks and associated environmental impact to protect the quality of public health and the environment. Our conclusions allowed us to minimize the associated risks, focusing on probable cases in an emergency to protect the surrounded anthropogenic or natural environment. Therefore, the lining magnitude could be determined for any useful associated technical works to support the environmental system under examination, taking into account its particular boundary necessities and constraints.

Risk assessment framework on time impact: Infrastructure projects in soft soil during construction stage

NASA Astrophysics Data System (ADS)

Low, W. W.; Wong, K. S.; Lee, J. L.

2018-04-01

With the growth of economy and population, there is an increase in infrastructure construction projects. As such, it is unavoidable to have construction projects on soft soil. Without proper risk management plan, construction projects are vulnerable to different types of risks which will have negative impact on project’s time, cost and quality. Literature review showed that little or none of the research is focused on the risk assessment on the infrastructure project in soft soil. Hence, the aim of this research is to propose a risk assessment framework in infrastructure projects in soft soil during the construction stage. This research was focused on the impact of risks on project time and internal risk factors. The research method was Analytical Hierarchy Process and the sample population was experienced industry experts who have experience in infrastructure projects. Analysis was completed and result showed that for internal factors, the five most significant risks on time element are lack of special equipment, potential contractual disputes and claims, shortage of skilled workers, delay/lack of materials supply, and insolvency of contractor/sub-contractor. Results indicated that resources risk factor play a critical role on project time frame in infrastructure projects in soft soil during the construction stage.

Risk as analysis and risk as feelings: some thoughts about affect, reason, risk, and rationality.

PubMed

Slovic, Paul; Finucane, Melissa L; Peters, Ellen; MacGregor, Donald G

2004-04-01

Modern theories in cognitive psychology and neuroscience indicate that there are two fundamental ways in which human beings comprehend risk. The "analytic system" uses algorithms and normative rules, such as probability calculus, formal logic, and risk assessment. It is relatively slow, effortful, and requires conscious control. The "experiential system" is intuitive, fast, mostly automatic, and not very accessible to conscious awareness. The experiential system enabled human beings to survive during their long period of evolution and remains today the most natural and most common way to respond to risk. It relies on images and associations, linked by experience to emotion and affect (a feeling that something is good or bad). This system represents risk as a feeling that tells us whether it is safe to walk down this dark street or drink this strange-smelling water. Proponents of formal risk analysis tend to view affective responses to risk as irrational. Current wisdom disputes this view. The rational and the experiential systems operate in parallel and each seems to depend on the other for guidance. Studies have demonstrated that analytic reasoning cannot be effective unless it is guided by emotion and affect. Rational decision making requires proper integration of both modes of thought. Both systems have their advantages, biases, and limitations. Now that we are beginning to understand the complex interplay between emotion and reason that is essential to rational behavior, the challenge before us is to think creatively about what this means for managing risk. On the one hand, how do we apply reason to temper the strong emotions engendered by some risk events? On the other hand, how do we infuse needed "doses of feeling" into circumstances where lack of experience may otherwise leave us too "coldly rational"? This article addresses these important questions.

Current trials to reduce surgical intervention in ductal carcinoma in situ of the breast: Critical review.

PubMed

Toss, M; Miligy, I; Thompson, A M; Khout, H; Green, A R; Ellis, I O; Rakha, E A

2017-10-01

The high proportion of ductal carcinoma in situ (DCIS) presented in mammographic screening and the relatively low risk of progression to invasive disease have raised questions related to overtreatment. Following a review of current DCIS management protocols a more conservative approach has been suggested. Clinical trials have been introduced to evaluate the option of avoiding surgical intervention in a proportion of patients with DCIS defined as "low-risk" using certain clinicopathological criteria. These trials can potentially provide evidence-based models of active surveillance (with or without endocrine therapy) as a future management approach. Despite the undisputable fact of our need to address the obvious overtreatment of screen-detected DCIS, some important questions need to be considered regarding these trials including the eligibility criteria and definition of risk, the proportion of patient eligible for inclusion, and the length of time required for proper analysis of the trials' outcome in view of the long-term natural history of DCIS progression particularly the low-risk group. These factors can potentially affect the practicality and future impact of such trials. This review provides critical analysis of current DCIS management trials and highlights critical issues related to their practicality and the expected outcome. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of a Brief but Intensive Remedial Computer Intervention in a Sub-Sample of Kindergartners with Early Literacy Delays

ERIC Educational Resources Information Center

Van der Kooy-Hofland, Verna A. C.; Bus, Adriana G.; Roskos, Kathleen

2012-01-01

Living Letters is an adaptive game designed to promote children's combining of how the proper name sounds with their knowledge of how the name looks. A randomized controlled trial (RCT) was used to experimentally test whether priming for attending to the sound-symbol relationship in the proper name can reduce the risk for developing reading…

Access to Heart Transplantation: A Proper Analysis of the Competing Risks of Death and Transplantation Is Required to Optimize Graft Allocation.

PubMed

Cantrelle, Christelle; Legeai, Camille; Latouche, Aurélien; Tuppin, Philippe; Jasseron, Carine; Sebbag, Laurent; Bastien, Olivier; Dorent, Richard

2017-08-01

Heart allocation systems are usually urgency-based, offering grafts to candidates at high risk of waitlist mortality. In the context of a revision of the heart allocation rules, we determined observed predictors of 1-year waitlist mortality in France, considering the competing risk of transplantation, to determine which candidate subgroups are favored or disadvantaged by the current allocation system. Patients registered on the French heart waitlist between 2010 and 2013 were included. Cox cause-specific hazards and Fine and Gray subdistribution hazards were used to determine candidate characteristics associated with waitlist mortality and access to transplantation. Of the 2053 candidates, 7 variables were associated with 1-year waitlist mortality by the Fine and Gray method including 4 candidate characteristics related to heart failure severity (hospitalization at listing, serum natriuretic peptide level, systolic pulmonary artery pressure, and glomerular filtration rate) and 3 characteristics not associated with heart failure severity but with lower access to transplantation (blood type, age, and body mass index). Observed waitlist mortality for candidates on mechanical circulatory support was like that of others. The heart allocation system strongly modifies the risk of pretransplant mortality related to heart failure severity. An in-depth competing risk analysis is therefore a more appropriate method to evaluate graft allocation systems. This knowledge should help to prioritize candidates in the context of a limited donor pool.

Managing Risks

ERIC Educational Resources Information Center

Osborn, John E.

2006-01-01

Colleges and universities face a wide range of environmental risk. In spite of this, with proper planning, they can avoid emergencies or surprises. Advanced planning, coupled with strategic, technical environmental and legal advice, enable higher-education institutions to keep their environmental budgets under control and predictable. This article…

State of the practice for workers in very short duration work zone operations : educational module.

DOT National Transportation Integrated Search

2012-07-01

After finishing this module, you will know : WHAT should be considered as Very Short Duration Operations (VSDOs) : WHY is risk assessment important for VSDOs : HOW to properly assess risk and make better judgments in VSDOs

The Common Risk Model for Dams: A Portfolio Approach to Security Risk Assessments

DTIC Science & Technology

2013-06-01

and threat estimates in a way that accounts for the relationships among these variables. The CRM -D can effectively quantify the benefits of...consequence, vulnerability, and threat estimates in a way that properly accounts for the relationships among these variables. The CRM -D can effectively...Common RiskModel ( CRM ) for evaluating and comparing risks associated with the nation’s critical infrastructure. This model incorporates commonly used risk

A pilot investigation on impact of participation in a long-term follow-up clinic (LTFU) on breast cancer and cardiovascular screening among women who received chest radiation for Hodgkin lymphoma.

PubMed

Baxstrom, K; Peterson, B A; Lee, C; Vogel, R I; Blaes, A H

2018-02-07

Women treated with chest radiation for Hodgkin lymphoma (HL) are at significantly increased risk of breast cancer and cardiovascular disease. HL survivors are recommended to have annual dual screening with mammogram (MMG) and breast magnetic resonance imaging (MRI). They are also recommended to undergo echocardiogram (echo) 5 years after completion of radiation. We performed a pilot study to characterize the women who are and are not receiving proper dual screening for breast cancer and baseline echo, and to examine the impact of a LTFU clinic consultation on screening. A retrospective chart review of 114 women treated for HL at University of Minnesota (UMN) between 1993 and 2009 was performed. Demographics, disease and treatment history (age at diagnosis, stage, radiation dose and field, chemotherapy, recurrence) were assessed, as well as screening practices (MMG, MRI, both and echo), participation in LTFU clinic, and recommendations from providers. Data was summated in yes/no (y/n) format; statistical analysis was performed using chi-squared and Fisher's exact tests. Breast cancer and cardiovascular screening outcomes were compared by participation in the LTFU clinic (y/n) using Fisher's exact tests. P values < 0.05 were considered statistically significant. Forty-one of 114 women met inclusion criteria and had follow-up data for analysis. Median age at diagnosis was 29 years; 67.6% were diagnosed at stage IIa. Median dose of radiation was 3570 cGy. 56.1% participated in the LTFU clinic at the UMN. 36.6% had dual screening with both MMG and MRI, 41.5% had screening with only MMG, and 19.5% had no screening performed. Women were more likely to have dual screening if they were seen in LTFU clinic vs not seen in LTFU clinic (52.2 vs 16.7%, p = 0.02). 67.5% of women were screened with echo; women were also more likely to have screening with echo if seen in LTFU clinic vs not seen (86.4 vs 44.4%, p = 0.007). Many women are not getting the proper dual screening for breast cancer despite their increased risk, with only 36.6% of our study sample getting dual screening. Having a consultation in a LTFU clinic increases dual screening for breast cancer and echo screening for cardiovascular disease. Proper screening allows for detection of secondary breast cancer at earlier stages where treatment can be local therapy. Diagnosing CV disease early could allow for proper preventative treatment or intervention.

[Big Data- challenges and risks].

PubMed

Krauß, Manuela; Tóth, Tamás; Hanika, Heinrich; Kozlovszky, Miklós; Dinya, Elek

2015-12-06

The term "Big Data" is commonly used to describe the growing mass of information being created recently. New conclusions can be drawn and new services can be developed by the connection, processing and analysis of these information. This affects all aspects of life, including health and medicine. The authors review the application areas of Big Data, and present examples from health and other areas. However, there are several preconditions of the effective use of the opportunities: proper infrastructure, well defined regulatory environment with particular emphasis on data protection and privacy. These issues and the current actions for solution are also presented.

GIS-based spatial statistical analysis of risk areas for liver flukes in Surin Province of Thailand.

PubMed

Rujirakul, Ratana; Ueng-arporn, Naporn; Kaewpitoon, Soraya; Loyd, Ryan J; Kaewthani, Sarochinee; Kaewpitoon, Natthawut

2015-01-01

It is urgently necessary to be aware of the distribution and risk areas of liver fluke, Opisthorchis viverrini, for proper allocation of prevention and control measures. This study aimed to investigate the human behavior, and environmental factors influencing the distribution in Surin Province of Thailand, and to build a model using stepwise multiple regression analysis with a geographic information system (GIS) on environment and climate data. The relationship between the human behavior, attitudes (<50%; X111), environmental factors like population density (148-169 pop/km2; X73), and land use as wetland (X64), were correlated with the liver fluke disease distribution at 0.000, 0.034, and 0.006 levels, respectively. Multiple regression analysis, by equations OV=-0.599+0.005(population density (148-169 pop/km2); X73)+0.040 (human attitude (<50%); X111)+0.022 (land used (wetland; X64), was used to predict the distribution of liver fluke. OV is the patients of liver fluke infection, R Square=0.878, and, Adjust R Square=0.849. By GIS analysis, we found Si Narong, Sangkha, Phanom Dong Rak, Mueang Surin, Non Narai, Samrong Thap, Chumphon Buri, and Rattanaburi to have the highest distributions in Surin province. In conclusion, the combination of GIS and statistical analysis can help simulate the spatial distribution and risk areas of liver fluke, and thus may be an important tool for future planning of prevention and control measures.

Cardio-Metabolic Benefits of Plant-Based Diets

PubMed Central

Levin, Susan; Barnard, Neal

2017-01-01

Cardio-metabolic disease, namely ischemic heart disease, stroke, obesity, and type 2 diabetes, represent substantial health and economic burdens. Almost one half of cardio-metabolic deaths in the U.S. might be prevented through proper nutrition. Plant-based (vegetarian and vegan) diets are an effective strategy for improving nutrient intake. At the same time, they are associated with decreased all-cause mortality and decreased risk of obesity, type 2 diabetes, and coronary heart disease. Evidence suggests that plant-based diets may reduce the risk of coronary heart disease events by an estimated 40% and the risk of cerebral vascular disease events by 29%. These diets also reduce the risk of developing metabolic syndrome and type 2 diabetes by about one half. Properly planned vegetarian diets are healthful, effective for weight and glycemic control, and provide metabolic and cardiovascular benefits, including reversing atherosclerosis and decreasing blood lipids and blood pressure. The use of plant-based diets as a means of prevention and treatment of cardio-metabolic disease should be promoted through dietary guidelines and recommendations. PMID:28792455

Cardio-Metabolic Benefits of Plant-Based Diets.

PubMed

Kahleova, Hana; Levin, Susan; Barnard, Neal

2017-08-09

Cardio-metabolic disease, namely ischemic heart disease, stroke, obesity, and type 2 diabetes, represent substantial health and economic burdens. Almost one half of cardio-metabolic deaths in the U.S. might be prevented through proper nutrition. Plant-based (vegetarian and vegan) diets are an effective strategy for improving nutrient intake. At the same time, they are associated with decreased all-cause mortality and decreased risk of obesity, type 2 diabetes, and coronary heart disease. Evidence suggests that plant-based diets may reduce the risk of coronary heart disease events by an estimated 40% and the risk of cerebral vascular disease events by 29%. These diets also reduce the risk of developing metabolic syndrome and type 2 diabetes by about one half. Properly planned vegetarian diets are healthful, effective for weight and glycemic control, and provide metabolic and cardiovascular benefits, including reversing atherosclerosis and decreasing blood lipids and blood pressure. The use of plant-based diets as a means of prevention and treatment of cardio-metabolic disease should be promoted through dietary guidelines and recommendations.

Planning for hazardous campus waste collection.

PubMed

Liu, Kun-Hsing; Shih, Shao-Yang; Kao, Jehng-Jung

2011-05-15

This study examines a procedure developed for planning a nation-wide hazardous campus waste (HCW) collection system. Alternative HCW plans were designed for different collection frequencies, truckloads, storage limits, and also for establishing an additional transfer station. Two clustering methods were applied to group adjacent campuses into clusters based on their locations, HCW quantities, the type of vehicles used and collection frequencies. Transportation risk, storage risk, and collection cost are the major criteria used to evaluate the feasibility of each alternative. Transportation risk is determined based on the accident rates for each road type and collection distance, while storage risk is calculated by estimating the annual average HCW quantity stored on campus. Alternatives with large trucks can reduce both transportation risk and collection cost, but their storage risks would be significantly increased. Alternatives that collect neighboring campuses simultaneously can effectively reduce storage risks as well as collection cost if the minimum quantity to collect for each group of neighboring campuses can be properly set. The three transfer station alternatives evaluated for northern Taiwan are cost effective and involve significantly lower transportation risk. The procedure proposed is expected to facilitate decision making and to support analyses for formulating a proper nation-wide HCW collection plan. Copyright © 2011 Elsevier B.V. All rights reserved.

Risk factors for proper oral language development in children: a systematic literature review.

PubMed

Gurgel, Léia Gonçalves; Vidor, Deisi Cristina Gollo Marques; Joly, Maria Cristina Rodrigues Azevedo; Reppold, Caroline Tozzi

2014-01-01

To conduct a systematic review of literature production related to risk factors for proper oral language development in children. We used the terms "child language," "risk factors," and "randomized controlled trial" in MEDLINE (accessed via PubMed), Lilacs, SciELO, and The Cochrane Library from January 1980 to February 2014. Randomized controlled trials involving the study of some risk factors related to child language were included. Works with individuals who were not from the age group 0-12 years and presented no reliable definition of risk factors were excluded. The research findings were classified according to their theme and categorized methodological aspects. We observed the lack of a standardized list of risk factors for language available for health professionals. The main risk factor mentioned was family dynamics, followed by interaction with parents, immediate social environment, and encouragement given to the child in the first years of life. It was also observed that organic hazards such as brain injury, persistent otitis media, and cardiac surgery, besides the type of food and parental counseling, may be related to language disorders. More randomized controlled trials involving the evaluation of risk factors for child language and the creation of further studies involving children above 6 years of age and males are needed.

Shoulder arthroscopy: the basics.

PubMed

Farmer, Kevin W; Wright, Thomas W

2015-04-01

Shoulder arthroscopy is a commonly performed and accepted procedure for a wide variety of pathologies. Surgeon experience, patient positioning, knowledge of surgical anatomy, proper portal placement, and proper use of instrumentation can improve technical success and minimize complication risks. This article details the surgical anatomy, indications, patient positioning, portal placement, instrumentation, and complications for basic shoulder arthroscopy. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Risk of Gonadoblastoma Development in Patients with Turner Syndrome with Cryptic Y Chromosome Material.

PubMed

Kwon, Ahreum; Hyun, Sei Eun; Jung, Mo Kyung; Chae, Hyun Wook; Lee, Woo Jung; Kim, Tae Hyuk; Kim, Duk Hee; Kim, Ho-Seong

2017-06-01

Current guidelines recommend that testing for Y chromosome material should be performed only in patients with Turner syndrome harboring a marker chromosome and exhibiting virilization in order to detect individuals who are at high risk of gonadoblastoma. However, cryptic Y chromosome material is suggested to be a risk factor for gonadoblastoma in patients with Turner syndrome. Here, we aimed to estimate the frequency of cryptic Y chromosome material in patients with Turner syndrome and determine whether Y chromosome material increased the risk for development of gonadoblastoma. A total of 124 patients who were diagnosed with Turner syndrome by conventional cytogenetic techniques underwent additional molecular analysis to detect cryptic Y chromosome material. In addition, patients with Turner syndrome harboring Y chromosome cell lines had their ovaries removed prophylactically. Finally, we assessed the occurrence of gonadoblastoma in patients with Turner syndrome. Molecular analysis demonstrated that 10 patients had Y chromosome material among 118 patients without overt Y chromosome (8.5%). Six patients with overt Y chromosome and four patients with cryptic Y chromosome material underwent oophorectomy. Histopathological analysis revealed that the occurrence of gonadoblastoma in the total group was 2.4%, and gonadoblastoma occurred in one of six patients with an overt Y chromosome (16.7%) and 2 of 10 patients with cryptic Y chromosome material (20.0%). The risk of developing gonadoblastoma in patients with cryptic Y chromosome material was similar to that in patients with overt Y chromosome. Therefore, molecular screening for Y chromosome material should be recommended for all patients with Turner syndrome to detect individuals at a high risk of gonadoblastoma and to facilitate proper management of the disease.

A Protocol-Based Decision for Choosing a Proper Surgical Treatment Option for Carotid Artery Stenosis.

PubMed

Jang, E-Wook; Chung, Joonho; Seo, Kwon-Duk; Suh, Sang Hyun; Kim, Yong Bae; Lee, Kyung-Yul

2015-06-01

There are two established surgical treatment options for carotid artery stenosis. Carotid endarterectomy (CEA) has been accepted as a gold standard for surgical treatment while carotid artery stenting (CAS) has recently become an alternative option. Each treatment option has advantages and disadvantages for the treatment outcomes. We propose a protocol for selection of a proper surgical treatment option for carotid artery stenosis. A total of 192 published articles on management of carotid artery stenosis were reviewed. Preoperatively considerable factors which had been repeatedly noted in those articles for the risk/benefits of CEA or CAS were selected. According to those factors, a protocol with four categories was established. CEA or CAS is indicated when the patient has a symptomatic stenosis ≥ 50%, or when the patient has an asymptomatic stenosis ≥ 80%. Each treatment option has absolute indications and favorable indications. Each absolute indication is scored with three points, and each favorable indication, one point. Based on the highest scores, a proper treatment option (CEA or CAS) is selected. We have been treating patients according to this protocol and evaluating the outcomes of our protocol-based decision because this protocol might be helpful in assessment of risk/benefit for selection of a proper surgical treatment option in patients with carotid artery stenosis.

Where Have All the Scientific Data Gone? LIS Perspective on the Data-at-Risk Predicament

ERIC Educational Resources Information Center

Thompson, Cheryl A.; Robertson, W. Davenport; Greenberg, Jane

2014-01-01

Scientists produce vast amounts of data that often are not preserved properly or do not have inventories, placing them at risk. As part of an effort to more fully understand the data-at-risk predicament, researchers who were engaged in the DARI project at UNC's Metadata Research Center surveyed information custodians working in a range of…

Integration of Nutrition-Related Components by Early Childhood Education Professionals into Their Individual Work with Children at Risk

ERIC Educational Resources Information Center

Shor, Ron; Friedman, Adina

2009-01-01

Poor nutrition is a major risk factor affecting proper development of children. However, there is limited knowledge about the way in which this subject is being integrated into professionals' work in early childhood education programs dealing with situations of children-at-risk. A study on this subject was conducted with 60 professionals who…

A data-driven approach to quality risk management

PubMed Central

Alemayehu, Demissie; Alvir, Jose; Levenstein, Marcia; Nickerson, David

2013-01-01

Aim: An effective clinical trial strategy to ensure patient safety as well as trial quality and efficiency involves an integrated approach, including prospective identification of risk factors, mitigation of the risks through proper study design and execution, and assessment of quality metrics in real-time. Such an integrated quality management plan may also be enhanced by using data-driven techniques to identify risk factors that are most relevant in predicting quality issues associated with a trial. In this paper, we illustrate such an approach using data collected from actual clinical trials. Materials and Methods: Several statistical methods were employed, including the Wilcoxon rank-sum test and logistic regression, to identify the presence of association between risk factors and the occurrence of quality issues, applied to data on quality of clinical trials sponsored by Pfizer. Results: Only a subset of the risk factors had a significant association with quality issues, and included: Whether study used Placebo, whether an agent was a biologic, unusual packaging label, complex dosing, and over 25 planned procedures. Conclusion: Proper implementation of the strategy can help to optimize resource utilization without compromising trial integrity and patient safety. PMID:24312890

Managing Mentoring Programs.

ERIC Educational Resources Information Center

IUME Briefs, 1992

1992-01-01

Some programs for helping at-risk youth achieve excellent results, while others do not. One reason for program success can be proper management. Mentoring is a promising strategy for helping at-risk youth. Planners who want to create effective mentoring programs should look at the implementation experiences of other youth programs. Evaluations…

42 CFR 485.639 - Condition of participation: Surgical services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... podiatric medicine. (b) Anesthetic risk and evaluation. (1) A qualified practitioner, as specified in... section, must examine each patient before surgery to evaluate the risk of anesthesia. (3) Before discharge from the CAH, each patient must be evaluated for proper anesthesia recovery by a qualified practitioner...

42 CFR 416.42 - Condition for coverage-Surgical services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... accordance with approved policies and procedures of the ASC. (a) Standard: Anesthetic risk and evaluation. (1) A physician must examine the patient immediately before surgery to evaluate the risk of anesthesia... applicable State health and safety laws, standards of practice, and ASC policy, for proper anesthesia...

42 CFR 485.639 - Condition of participation: Surgical services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... podiatric medicine. (b) Anesthetic risk and evaluation. (1) A qualified practitioner, as specified in... section, must examine each patient before surgery to evaluate the risk of anesthesia. (3) Before discharge from the CAH, each patient must be evaluated for proper anesthesia recovery by a qualified practitioner...

42 CFR 416.42 - Condition for coverage-Surgical services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... accordance with approved policies and procedures of the ASC. (a) Standard: Anesthetic risk and evaluation. (1) A physician must examine the patient immediately before surgery to evaluate the risk of anesthesia... applicable State health and safety laws, standards of practice, and ASC policy, for proper anesthesia...

Integrated CLL Scoring System, a New and Simple Index to Predict Time to Treatment and Overall Survival in Patients With Chronic Lymphocytic Leukemia.

PubMed

Visentin, Andrea; Facco, Monica; Frezzato, Federica; Castelli, Monica; Trimarco, Valentina; Martini, Veronica; Gattazzo, Cristina; Severin, Filippo; Chiodin, Giorgia; Martines, Annalisa; Bonaldi, Laura; Gianesello, Ilaria; Pagnin, Elisa; Boscaro, Elisa; Piazza, Francesco; Zambello, Renato; Semenzato, Gianpietro; Trentin, Livio

2015-10-01

Several prognostic factors have been identified to predict the outcome of patients with chronic lymphocytic leukemia (CLL), but only a few studies analyzed more markers together. Taking advantage of a population of 608 patients, we identified the strongest prognostic markers of survival and, subsequently, in a cohort of 212 patients we integrated data of cytogenetic lesions, IGHV mutational status, and CD38 expression in a new and easy scoring system we called the integrated CLL scoring system (ICSS). ICSS defines 3 groups of risk: (1) low risk (patients with 13q(-) or normal fluorescence in-situ hybridization analysis results, mutated IGHV, and CD38) (2) high risk (all 11q(-) or 17p(-) patients and/or all unmutated IGHV and CD38(+) patients); and (3) intermediate risk (all remaining patients). Using only these 3 already available prognostic factors, we were able to properly redefine patients and better predict the clinical course of the disease. ICSS could become a useful tool for CLL patients' management. Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluating the Safety In Numbers effect for pedestrians at urban intersections.

PubMed

Murphy, Brendan; Levinson, David M; Owen, Andrew

2017-09-01

Assessment of collision risk between pedestrians and automobiles offers a powerful and informative tool in urban planning applications, and can be leveraged to inform proper placement of improvements and treatment projects to improve pedestrian safety. Such assessment can be performed using existing datasets of crashes, pedestrian counts, and automobile traffic flows to identify intersections or corridors characterized by elevated collision risks to pedestrians. The Safety In Numbers phenomenon, which refers to the observable effect that pedestrian safety is positively correlated with increased pedestrian traffic in a given area (i.e. that the individual per-pedestrian risk of a collision decreases with additional pedestrians), is a readily observed phenomenon that has been studied previously, though its directional causality is not yet known. A sample of 488 intersections in Minneapolis were analyzed, and statistically-significant log-linear relationships between pedestrian traffic flows and the per-pedestrian crash risk were found, indicating the Safety In Numbers effect. Potential planning applications of this analysis framework towards improving pedestrian safety in urban environments are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

On Performance Analysis of Protective Jamming Schemes in Wireless Sensor Networks.

PubMed

Li, Xuran; Dai, Hong-Ning; Wang, Hao; Xiao, Hong

2016-11-24

Wireless sensor networks (WSNs) play an important role in Cyber Physical Social Sensing (CPSS) systems. An eavesdropping attack is one of the most serious threats to WSNs since it is a prerequisite for other malicious attacks. In this paper, we propose a novel anti-eavesdropping mechanism by introducing friendly jammers to wireless sensor networks (WSNs). In particular, we establish a theoretical framework to evaluate the eavesdropping risk of WSNs with friendly jammers and that of WSNs without jammers. Our theoretical model takes into account various channel conditions such as the path loss and Rayleigh fading, the placement schemes of jammers and the power controlling schemes of jammers. Extensive results show that using jammers in WSNs can effectively reduce the eavesdropping risk. Besides, our results also show that the appropriate placement of jammers and the proper assignment of emitting power of jammers can not only mitigate the eavesdropping risk but also may have no significant impairment to the legitimate communications.

Androgens and Androgen Derivatives: Science, Myths, and Theories: Explored From a Special Operations Perspective.

PubMed

Givens, Melissa L; Deuster, Patricia

2015-01-01

Androgen use outside of legitimate medical therapy is a perceived concern that is drawing attention across military and specifically Special Operations Forces (SOF) communities. For leadership and the medical community to properly address the issue and relate to those individuals who are using or considering use, it will be crucial to understand the scope of the problem. Limited data suggest that the prevalence of androgen use may be increasing, and inferences made from the scientific literature suggest that SOF may be a population of concern. While risks of androgen use are well known, there are little data specific to military performance that can be applied to a rigorous risk:benefit analysis, allowing myths and poorly supported theories to perpetuate within the community. Further efforts to define the potential benefits balanced against the short- and long-term risks should be undertaken. Providers within the SOF community should arm themselves with information to engage androgen users and leadership in meaningful discussion regarding androgen use. 2015.

On Performance Analysis of Protective Jamming Schemes in Wireless Sensor Networks

PubMed Central

Li, Xuran; Dai, Hong-Ning; Wang, Hao; Xiao, Hong

2016-01-01

Wireless sensor networks (WSNs) play an important role in Cyber Physical Social Sensing (CPSS) systems. An eavesdropping attack is one of the most serious threats to WSNs since it is a prerequisite for other malicious attacks. In this paper, we propose a novel anti-eavesdropping mechanism by introducing friendly jammers to wireless sensor networks (WSNs). In particular, we establish a theoretical framework to evaluate the eavesdropping risk of WSNs with friendly jammers and that of WSNs without jammers. Our theoretical model takes into account various channel conditions such as the path loss and Rayleigh fading, the placement schemes of jammers and the power controlling schemes of jammers. Extensive results show that using jammers in WSNs can effectively reduce the eavesdropping risk. Besides, our results also show that the appropriate placement of jammers and the proper assignment of emitting power of jammers can not only mitigate the eavesdropping risk but also may have no significant impairment to the legitimate communications. PMID:27886154

Musculoskeletal Injury: Risks Prevention and First Aid,

DTIC Science & Technology

1986-09-08

games and sports like tennis and soccer. Management of risks will be discussed, but because of our imprecise knowledge of risk factors only general...College of Sports Medicine Position Statement on Proper and Improper Weight Loss Programs). 3 Female sex has also been implicated as a risk factor for...particular sport of interest should be consulted for specific stretching routines. The cool-down, like the warm-up, is thought to be beneficial in preventing

The Development Of Indonesias Doctrine for Special Hostage Rescue Operations

DTIC Science & Technology

2015-12-01

third involved conducting an infiltration to the target area with a rubber boat (the “rubber duck ” operation) and then subsequently infiltrating the...risk impacted to one’s own force or a friendly force. A proper risk assessment involves identifying possible hazards , assessing possible hazards

Impacts of 17α-ethynylestradiol exposure on metabolite profiles of zebrafish (Danio rerio) liver cells

EPA Science Inventory

Endocrine disrupting chemicals (EDCs) that are frequently detected in bodies of water downstream from sewage treatment facilities can have adverse impacts on fish and other aquatic organisms. To properly assess risk(s) from EDCs, tools are needed that can establish linkages from ...

Stoppage in Autism Spectrum Disorders

ERIC Educational Resources Information Center

Grønborg, Therese K.; Hansen, Stefan N.; Nielsen, Svend V.; Skytthe, Axel; Parner, Erik T.

2015-01-01

Stoppage refers to changes in reproductive behavior following the birth of a child with a severe disease. The presence of stoppage can bias estimates of sibling recurrence risk if not properly addressed. If stoppage occurs non-randomly (differential stoppage), it is possibly an additional source of bias in sibling recurrence risk estimation. This…

Plenary lecture: innovative modeling approaches applicable to risk assessments

USDA-ARS?s Scientific Manuscript database

Proper identification of safe and unsafe food at the processing plant is important for maximizing the public health benefit of food by ensuring both its consumption and safety. Risk assessment is a holistic approach to food safety that consists of four steps: 1) hazard identification; 2) exposure a...

42 CFR 485.639 - Condition of participation: Surgical services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... surgery or dental medicine; or (3) A doctor of podiatric medicine. (b) Anesthetic risk and evaluation. (1... the risk of anesthesia. (3) Before discharge from the CAH, each patient must be evaluated for proper anesthesia recovery by a qualified practitioner, as specified in paragraph (c) of this section. (c...

42 CFR 485.639 - Condition of participation: Surgical services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... surgery or dental medicine; or (3) A doctor of podiatric medicine. (b) Anesthetic risk and evaluation. (1... the risk of anesthesia. (3) Before discharge from the CAH, each patient must be evaluated for proper anesthesia recovery by a qualified practitioner, as specified in paragraph (c) of this section. (c...

42 CFR 485.639 - Condition of participation: Surgical services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... surgery or dental medicine; or (3) A doctor of podiatric medicine. (b) Anesthetic risk and evaluation. (1... the risk of anesthesia. (3) Before discharge from the CAH, each patient must be evaluated for proper anesthesia recovery by a qualified practitioner, as specified in paragraph (c) of this section. (c...

THE IMPORTANCE OF PROPER INTENSITY CALIBRATION FOR RAMAN ANALYSIS OF LOW-LEVEL ANALYTES IN WATER

EPA Science Inventory

Modern dispersive Raman spectroscopy offers unique advantages for the analysis of low-concentration analytes in aqueous solution. However, we have found that proper intensity calibration is critical for obtaining these benefits. This is true not only for producing spectra with ...

NPP financial and regulatory risks-Importance of a balanced and comprehensive nuclear law for a newcomer country considering nuclear power programme

DOE Office of Scientific and Technical Information (OSTI.GOV)

Manan, J. A. N. Abd, E-mail: jamalan@tnb.com.my; Mostafa, N. A.; Salim, M. F.

The nature of Nuclear Power Plant (NPP) projects are: long duration (10-15 years for new build), high capital investment, reasonable risks and highly regulated industries to meet national and international requirement on Safety, Security, Safeguards (3S) and Liabilities. It requires long term planning and commitment from siting to final disposal of waste/spent fuel. Potential financial and regulatory risks are common in massive NPP projects and will be magnified in the case of using unproven technology. If the risks are not properly managed, it can lead to high project and operation costs, and, fail to fulfil its objectives to provide compatiblemore » electricity prices and. energy security. To ensure successful, the government and investors need to ensure that the NPP project is bankable with low cost of project and funding, have fair treatment and proper risk mitigation, and able to complete on time with no cost overrun. One of the requirements as prerequisite for the development of NPP as stipulated by the International Atomic Energy Agency (IAEA) is the establishment of a Legal and Regulatory Framework. The main objective of nuclear law is to ensure that the activities and projects carried-out in the country are legal and compliant to national and international requirements. The law should also be able to provide fair treatment of risks on its activities that is acceptable to investors. The challenge for a newcomer country is to develop a balanced and comprehensive national nuclear law that meet these objectives while taking into consideration various stakeholders’ interest without compromising on safety, security, safeguard, liability requirements and other international obligations. This paper highlights the nature of NPP projects, its potential and associated financial and regulatory risks, and its major concerns and challenges. It proposes possible risks treatment and mitigation through the formulation of a balanced and comprehensive legislation by clear understanding of various requirements of public, regulators, investors, financial institutions, international community, operator and other important stakeholders. Ambiguities and uncertainties, especially with regards to certain conditions and requirements should be minimised by emulating good practices of experienced nuclear regulators. The imposition of various financial requirements such as funds for decommissioning, radioactive waste management, financial security, nuclear liabilities and licensing fees are necessary, but at the same time the quantum needs to be clearly defined. Concerns on absolute liability of the operators need to be addressed through a creation of necessary and proper nuclear insurance legislations to mitigate operator S nuclear liability obligations and other financial risks. Another major risk to investors is the possibility of public resistance which will not only can hinder the construction but can also stop operation of the nuclear power plant which will contribute to huge losses to investors and countries. This may require a provision in the legislation that provide proper compensation for these situations and at the same time to allow operators to engage in nuclear promotional activities, such as community benefit and public consultation as voluntary initiatives. Through proper planning, research, consultation and execution, the proposed nuclear law shall be able to promote good regulatory practices for public and investors’ confidence and benefit. Early involvement of various stakeholders is essential as a platform for regular communications between regulators and interested parties. Stakeholders’ participation in the NPP programme and law developments will also promote transparency of the projects while upholding the independency of the regulators.« less

NPP financial and regulatory risks-Importance of a balanced and comprehensive nuclear law for a newcomer country considering nuclear power programme

NASA Astrophysics Data System (ADS)

Manan, J. A. N. Abd; Mostafa, N. A.; Salim, M. F.

2015-04-01

The nature of Nuclear Power Plant (NPP) projects are: long duration (10-15 years for new build), high capital investment, reasonable risks and highly regulated industries to meet national & international requirement on Safety, Security, Safeguards (3S) and Liabilities. It requires long term planning and commitment from siting to final disposal of waste/spent fuel. Potential financial and regulatory risks are common in massive NPP projects and will be magnified in the case of using unproven technology. If the risks are not properly managed, it can lead to high project and operation costs, and, fail to fulfil its objectives to provide compatible electricity prices and. energy security. To ensure successful, the government and investors need to ensure that the NPP project is bankable with low cost of project and funding, have fair treatment and proper risk mitigation, and able to complete on time with no cost overrun. One of the requirements as prerequisite for the development of NPP as stipulated by the International Atomic Energy Agency (IAEA) is the establishment of a Legal and Regulatory Framework. The main objective of nuclear law is to ensure that the activities and projects carried-out in the country are legal and compliant to national and international requirements. The law should also be able to provide fair treatment of risks on its activities that is acceptable to investors. The challenge for a newcomer country is to develop a balanced and comprehensive national nuclear law that meet these objectives while taking into consideration various stakeholders' interest without compromising on safety, security, safeguard, liability requirements and other international obligations. This paper highlights the nature of NPP projects, its potential and associated financial and regulatory risks, and its major concerns and challenges. It proposes possible risks treatment and mitigation through the formulation of a balanced and comprehensive legislation by clear understanding of various requirements of public, regulators, investors, financial institutions, international community, operator and other important stakeholders. Ambiguities and uncertainties, especially with regards to certain conditions and requirements should be minimised by emulating good practices of experienced nuclear regulators. The imposition of various financial requirements such as funds for decommissioning, radioactive waste management, financial security, nuclear liabilities and licensing fees are necessary, but at the same time the quantum needs to be clearly defined. Concerns on absolute liability of the operators need to be addressed through a creation of necessary and proper nuclear insurance legislations to mitigate operator S nuclear liability obligations and other financial risks. Another major risk to investors is the possibility of public resistance which will not only can hinder the construction but can also stop operation of the nuclear power plant which will contribute to huge losses to investors and countries. This may require a provision in the legislation that provide proper compensation for these situations and at the same time to allow operators to engage in nuclear promotional activities, such as community benefit and public consultation as voluntary initiatives. Through proper planning, research, consultation and execution, the proposed nuclear law shall be able to promote good regulatory practices for public and investors' confidence and benefit. Early involvement of various stakeholders is essential as a platform for regular communications between regulators and interested parties. Stakeholders' participation in the NPP programme and law developments will also promote transparency of the projects while upholding the independency of the regulators.

A quantitative risk-assessment system (QR-AS) evaluating operation safety of Organic Rankine Cycle using flammable mixture working fluid.

PubMed

Tian, Hua; Wang, Xueying; Shu, Gequn; Wu, Mingqiang; Yan, Nanhua; Ma, Xiaonan

2017-09-15

Mixture of hydrocarbon and carbon dioxide shows excellent cycle performance in Organic Rankine Cycle (ORC) used for engine waste heat recovery, but the unavoidable leakage in practical application is a threat for safety due to its flammability. In this work, a quantitative risk assessment system (QR-AS) is established aiming at providing a general method of risk assessment for flammable working fluid leakage. The QR-AS covers three main aspects: analysis of concentration distribution based on CFD simulations, explosive risk assessment based on the TNT equivalent method and risk mitigation based on evaluation results. A typical case of propane/carbon dioxide mixture leaking from ORC is investigated to illustrate the application of QR-AS. According to the assessment results, proper ventilation speed, safe mixture ratio and location of gas-detecting devices have been proposed to guarantee the security in case of leakage. The results revealed that this presented QR-AS was reliable for the practical application and the evaluation results could provide valuable guidance for the design of mitigation measures to improve the safe performance of ORC system. Copyright © 2017 Elsevier B.V. All rights reserved.

Groundwater pollution risk assessment. Application to different carbonate aquifers in south Spain

NASA Astrophysics Data System (ADS)

Jimenez Madrid, A.; Martinez Navarrete, C.; Carrasco Cantos, F.

2009-04-01

Water protection has been considered one of the most important environmental goals in the European politics since the 2000/60/CE Water Framework Directive came into force in 2000, and more specifically in 2006 with the 2006/118/CE Directive on groundwater protection. As one of the necessary requirements to tackle groundwater protection, a pollution risk assessment has been made through the analysis of both the existing hazard human activities map and the intrinsic aquifer vulnerability map, by applying the methodologies proposed by COST Action 620 in an experimental study site in south Spain containing different carbonated aquifers, which supply 8 towns ranging from 2000 to 2500 inhabitants. In order to generate both maps it was necessary to make a field inventory over a 1:10000 topographic base map, followed by Geographic Information System (GIS) processing. The outcome maps show a clear spatial distribution of both pollution risk and intrinsic vulnerability of the carbonated aquifers studied. As a final result, a map of the intensity of groundwater pollution risk is presented, representing and important base for the development of a proper methodology for the protection of groundwater resources for human consumption protection. Keywords. Hazard, Vulnerability, Risk, SIG, Protection

Demand and capacity planning in the emergency department: how to do it.

PubMed

Higginson, I; Whyatt, J; Silvester, K

2011-02-01

Unless emergency departments have adequate capacity to meet demand, they will fail to meet clinical and performance standards and will be operating in the 'coping zone'. This carries risks both for staff and patients. As part of a quality improvement programme, the authors undertook an in-depth analysis of demand and capacity for an emergency department in the UK. The paper describes this rigorous approach to capacity planning, which draws on techniques from other industries. Proper capacity planning is vital, but is often poorly done. Planning using aggregated data will lead to inadequate capacity. Understanding demand, and particularly the variation in that demand, is critical to success. Analysis of emergency department demand and capacity is the first step towards effective workforce planning and process redesign.

Communicating the risks, and the benefits, of nanotechnology

PubMed Central

Schuler, Emmanuelle

2009-01-01

Issues surrounding the wide spectrum of (perceived) risks and possible benefits associated with the rapid advance of modern nanotechnology are deliberated. These include the current realities of nanotechnological hazards, their impact vis-à-vis perceived nanotech-risks and perceived nanotech-benefits, and the consequent repercussions on the public and society. It is argued that both the risks and the benefits of nanoscientific advances must be properly communicated if the public is to support this emerging technology. PMID:19823594

Extramedullary plasmacytomas in the context of multiple myeloma.

PubMed

Aguado, Beatriz; Iñigo, Belen; Sastre, Jose L; Oriol, Albert

2011-11-01

Plasmacytoma is a frequent complication of multiple myeloma, either at diagnosis or within disease progression. The extramedullary disease confers a poorer prognosis and is biologically distinct with high-risk molecular and histological features, being resistant to conventional treatments. Radiation therapy remains the most effective treatment for extramedullary lesions to achieve local control. There are very limited data from randomized trials regarding the most appropriate systemic treatment. Case reports such as those presented here, as well as retrospective analysis of series, suggest that lenalidomide is an effective agent, in combination with dexamethasone, in this setting. Additional studies are needed to define the proper management of this condition.

Effect-directed analysis supporting monitoring of aquatic ...

EPA Pesticide Factsheets

Aquatic environments are often contaminated with complex mixtures of chemicals that may pose a risk to ecosystems and human health. This contamination cannot be addressed with target analysis alone but tools are required to reduce this complexity and identify those chemicals that might cause adverse effects. Effect-directed analysis (EDA) is designed to meet this challenge and faces increasing interest in water and sediment quality monitoring. Thus, the present paper summarizes current experience with the EDA approach and the tools required,and provides practical advice on their application. The paper highlights the need for proper problem formulation and gives general advice for study design. As the EDA approach is directed by toxicity, basic principles for the selection of bioassays are given as well as a comprehensive compilation of appropriate assays, includingtheir strengths andweaknesses. A specific focus is given to strategies for sampling, extraction and bioassay dosing since they strongly impact prioritization of toxicants in EDA. Reduction of sample complexity mainly relies onfractionation procedures, which are discussed in this paper, including quality assurance and quality control. Automated combinations of fractionation, biotesting and chemical analysis using so-called hyphenated tools can enhance the throughput and might reduce the risk of artifacts in laboratory work. The key to determiningthe chemical structures causing effects is analytical toxi

ACR Appropriateness Criteria® Headache-Child.

PubMed

Hayes, Laura L; Palasis, Susan; Bartel, Twyla B; Booth, Timothy N; Iyer, Ramesh S; Jones, Jeremy Y; Kadom, Nadja; Milla, Sarah S; Myseros, John S; Pakalnis, Ann; Partap, Sonia; Robertson, Richard L; Ryan, Maura E; Saigal, Gaurav; Soares, Bruno P; Tekes, Aylin; Karmazyn, Boaz K

2018-05-01

Headaches in children are not uncommon and have various causes. Proper neuroimaging of these children is very specific to the headache type. Care must be taken to choose and perform the most appropriate initial imaging examination in order to maximize the ability to properly determine the cause with minimum risk to the child. This evidence-based report discusses the different headache types in children and provides appropriate guidelines for imaging these children. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Quantification and site-specification of the support practice factor when mapping soil erosion risk associated with olive plantations in the Mediterranean island of Crete.

PubMed

Karydas, Christos G; Sekuloska, Tijana; Silleos, Georgios N

2009-02-01

Due to inappropriate agricultural management practices, soil erosion is becoming one of the most dangerous forms of soil degradation in many olive farming areas in the Mediterranean region, leading to significant decrease of soil fertility and yield. In order to prevent further soil degradation, proper measures are necessary to be locally implemented. In this perspective, an increase in the spatial accuracy of remote sensing datasets and advanced image analysis are significant tools necessary and efficient for mapping soil erosion risk on a fine scale. In this study, the Revised Universal Soil Loss Equation (RUSLE) was implemented in the spatial domain using GIS, while a very high resolution satellite image, namely a QuickBird image, was used for deriving cover management (C) and support practice (P) factors, in order to map the risk of soil erosion in Kolymvari, a typical olive farming area in the island of Crete, Greece. The results comprised a risk map of soil erosion when P factor was taken uniform (conventional approach) and a risk map when P factor was quantified site-specifically using object-oriented image analysis. The results showed that the QuickBird image was necessary in order to achieve site-specificity of the P factor and therefore to support fine scale mapping of soil erosion risk in an olive cultivation area, such as the one of Kolymvari in Crete. Increasing the accuracy of the QB image classification will further improve the resulted soil erosion mapping.

Gateway Effects: Why the Cited Evidence Does Not Support Their Existence for Low-Risk Tobacco Products (and What Evidence Would).

PubMed

Phillips, Carl V

2015-05-21

It is often claimed that low-risk drugs still create harm because of "gateway effects", in which they cause the use of a high-risk alternative. Such claims are popular among opponents of tobacco harm reduction, claiming that low-risk tobacco products (e.g., e-cigarettes, smokeless tobacco) cause people to start smoking, sometimes backed by empirical studies that ostensibly support the claim. However, these studies consistently ignore the obvious alternative causal pathways, particularly that observed associations might represent causation in the opposite direction (smoking causes people to seek low-risk alternatives) or confounding (the same individual characteristics increase the chance of using any tobacco product). Due to these complications, any useful analysis must deal with simultaneity and confounding by common cause. In practice, existing analyses seem almost as if they were designed to provide teaching examples about drawing simplistic and unsupported causal conclusions from observed associations. The present analysis examines what evidence and research strategies would be needed to empirically detect such a gateway effect, if there were one, explaining key methodological concepts including causation and confounding, examining the logic of the claim, identifying potentially useful data, and debunking common fallacies on both sides of the argument, as well as presenting an extended example of proper empirical testing. The analysis demonstrates that none of the empirical studies to date that are purported to show a gateway effect from tobacco harm reduction products actually does so. The observations and approaches can be generalized to other cases where observed association of individual characteristics in cross-sectional data could result from any of several causal relationships.

Gateway Effects: Why the Cited Evidence Does Not Support Their Existence for Low-Risk Tobacco Products (and What Evidence Would)

PubMed Central

Phillips, Carl V.

2015-01-01

It is often claimed that low-risk drugs still create harm because of “gateway effects”, in which they cause the use of a high-risk alternative. Such claims are popular among opponents of tobacco harm reduction, claiming that low-risk tobacco products (e.g., e-cigarettes, smokeless tobacco) cause people to start smoking, sometimes backed by empirical studies that ostensibly support the claim. However, these studies consistently ignore the obvious alternative causal pathways, particularly that observed associations might represent causation in the opposite direction (smoking causes people to seek low-risk alternatives) or confounding (the same individual characteristics increase the chance of using any tobacco product). Due to these complications, any useful analysis must deal with simultaneity and confounding by common cause. In practice, existing analyses seem almost as if they were designed to provide teaching examples about drawing simplistic and unsupported causal conclusions from observed associations. The present analysis examines what evidence and research strategies would be needed to empirically detect such a gateway effect, if there were one, explaining key methodological concepts including causation and confounding, examining the logic of the claim, identifying potentially useful data, and debunking common fallacies on both sides of the argument, as well as presenting an extended example of proper empirical testing. The analysis demonstrates that none of the empirical studies to date that are purported to show a gateway effect from tobacco harm reduction products actually does so. The observations and approaches can be generalized to other cases where observed association of individual characteristics in cross-sectional data could result from any of several causal relationships. PMID:26006122

Financing Projects That Use Clean Energy Technologies: An Overview of Barriers and Opportunities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goldman, D. P.; McKenna, J. J.; Murphy, L. M.

2005-10-01

Project finance is asset-based financing, meaning that the project lenders have recourse only to the underlying assets of a project. It involves both debt and equity, where the debt-to-equity ratio is typically large (e.g., 70% debt to 30% equity). Debt is used when available and when it is the least expensive form of financing, with equity still needed for credit worthiness. Most important, revenue from the project must be able to generate a return to the equity investors, and pay for interest and principal on the debt, transaction costs associated with developing and structuring the project, and operations and maintenancemore » costs. Successful project financing must provide a structure to manage and share risks in an optimal way that benefits all participants, allocating risks to those entities that are able to mitigate each specific risk, and to share information about putting risk management in the proper hands at the proper stage of project development. Contractual agreements are, thus, important in risk mitigation. Today's project financing typically involves the creation of a stand-alone project company that is the legal owner of the project assets, and that has contractual agreements with other parties.« less

7 CFR 407.11 - Area risk protection insurance for corn.

Code of Federal Regulations, 2014 CFR

2014-01-01

... addition to the definition contained in the Area Risk Protection Insurance Basic Provisions, corn seed that... accepted application; (3) Properly planted by the final planting date and reported on or before the acreage reporting date; (4) Planted with the intent to be harvested; and (5) Not planted into an established grass...

7 CFR 407.10 - Area risk protection insurance for barley.

Code of Federal Regulations, 2014 CFR

2014-01-01

... definition contained in the Area Risk Protection Insurance Basic Provisions, land on which seed is initially... application; (b) Properly planted by the final planting date and reported on or before the acreage reporting date; (c) Planted with the intent to be harvested; (d) Not planted into an established grass or legume...

a New Method for Fmeca Based on Fuzzy Theory and Expert System

NASA Astrophysics Data System (ADS)

Byeon, Yoong-Tae; Kim, Dong-Jin; Kim, Jin-O.

2008-10-01

Failure Mode Effects and Criticality Analysis (FMECA) is one of most widely used methods in modern engineering system to investigate potential failure modes and its severity upon the system. FMECA evaluates criticality and severity of each failure mode and visualize the risk level matrix putting those indices to column and row variable respectively. Generally, those indices are determined subjectively by experts and operators. However, this process has no choice but to include uncertainty. In this paper, a method for eliciting expert opinions considering its uncertainty is proposed to evaluate the criticality and severity. In addition, a fuzzy expert system is constructed in order to determine the crisp value of risk level for each failure mode. Finally, an illustrative example system is analyzed in the case study. The results are worth considering in deciding the proper policies for each component of the system.

Mining injuries in Serbian underground coal mines -- a 10-year study.

PubMed

Stojadinović, Saša; Svrkota, Igor; Petrović, Dejan; Denić, Miodrag; Pantović, Radoje; Milić, Vitomir

2012-12-01

Mining, especially underground coal mining, has always been a dangerous occupation. Injuries, unfortunately, even those resulting in death, are one of the major occupational risks that all miners live with. Despite the fact that all workers are aware of the risk, efforts must be and are being made to increase the safety of mines. Injury monitoring and data analysis can provide us with valuable data on the causes of accidents and enable us to establish a correlation between the conditions in the work environment and the number of injuries, which can further lead to proper preventive measures. This article presents the data on the injuries in Serbian coal mines during a 10-year period (2000-2009). The presented results are only part of an ongoing study whose aim is to assess the safety conditions in Serbian coal mines and classify them according to that assessment. Copyright © 2011 Elsevier Ltd. All rights reserved.

Bayesian Network Meta-Analysis for Unordered Categorical Outcomes with Incomplete Data

ERIC Educational Resources Information Center

Schmid, Christopher H.; Trikalinos, Thomas A.; Olkin, Ingram

2014-01-01

We develop a Bayesian multinomial network meta-analysis model for unordered (nominal) categorical outcomes that allows for partially observed data in which exact event counts may not be known for each category. This model properly accounts for correlations of counts in mutually exclusive categories and enables proper comparison and ranking of…

Integrating Model-Based Verification into Software Design Education

ERIC Educational Resources Information Center

Yilmaz, Levent; Wang, Shuo

2005-01-01

Proper design analysis is indispensable to assure quality and reduce emergent costs due to faulty software. Teaching proper design verification skills early during pedagogical development is crucial, as such analysis is the only tractable way of resolving software problems early when they are easy to fix. The premise of the presented strategy is…

Trust in the safety of tourist destinations: hard to gain, easy to lose? New insights on the asymmetry principle.

PubMed

Eitzinger, Claudia; Wiedemann, Peter M

2008-08-01

According to the asymmetry principle of trust, negative events decrease trust to a much higher extent than positive events increase trust. The study at hand intended to verify whether this notion of asymmetry holds true with respect to trust in the safety of tourist destinations. Thus, in contrast to previous research that analyzed trust asymmetry in the context of involuntary technological risks, the present study evaluates the validity of the asymmetry principle of trust in the context of voluntary tourism risks. The hypothesis that negative or risky information on destination safety (absence of proper safety measures and conditions) has a higher impact on distrust than, conversely, positive or nonrisk information on destination safety (provision of proper safety measures and conditions) has on trust was tested in an online survey (N= 640). In contrast to the asymmetry pattern found by Slovic (1993), results of the current work suggest symmetry rather than asymmetry of trust. The presence of proper safety measures and conditions (positive or nonrisk information) was found to have at least the same-and in some cases an even higher-impact on trust than the absence of such measures and conditions (negative or risky information) had on distrust. Findings provide empirical evidence for the thesis that the prevalence of trust asymmetry is dependent on the risk source and demonstrate that trust is symmetric rather than asymmetric in the context of voluntary tourism risks. Furthermore, results imply an influence of positive versus negative expectations as well as of prior trusting relationships on the occurrence of the asymmetry principle.

Role of staging laparoscopy in the management of Pancreatic Duct Carcinoma (PDAC): Single-center experience from a tertiary hospital in Brazil.

PubMed

de Jesus, Victor Hugo Fonseca; da Costa Junior, Wilson Luiz; de Miranda Marques, Tomás Mansur Duarte; Diniz, Alessandro Landskron; de Castro Ribeiro, Héber Salvador; de Godoy, André Luis; de Farias, Igor Correia; Coimbra, Felipe José Fernandez

2018-04-01

Proper staging is critical to the management of pancreatic ductal carcinoma (PDAC). Laparoscopy has been used to stage patients without gross metastatic disease with variable success. We aimed to identify the frequency of patients diagnosed by laparoscopy with occult metastatic disease. Also, we looked for variables related to a higher chance of occult metastasis. Patients with PDAC submitted to staging laparoscopy either immediately before pancreatectomy or as a separate procedure between January 2010 and December 2016 were included. None presented gross metastatic disease at initial staging. We used logistic regression to search for variables associated with metastatic disease. The study population consisted of 63 patients. Among all patients, nine (16.7%) had occult metastases at laparoscopy. Unresectable tumor (Odds ratio = 18.0, P = 0.03), increasing tumor size (Odds ratio = 1.36, P = 0.01), and abdominal pain (Odds ratio = 5.6, P = 0.04) significantly predicted the risk of occult metastases in univariate analysis. In multivariate analysis, only tumor size predicted the risk of occult metastases. Laparoscopy remains a valuable tool in PDAC staging. Patients with either large or unresectable tumors, or presenting with abdominal pain present the highest risk for occult intra-abdominal metastases. © 2018 Wiley Periodicals, Inc.

Impact of quasar proper motions on the alignment between the International Celestial Reference Frame and the Gaia reference frame

NASA Astrophysics Data System (ADS)

Liu, J.-C.; Malkin, Z.; Zhu, Z.

2018-03-01

The International Celestial Reference Frame (ICRF) is currently realized by the very long baseline interferometry (VLBI) observations of extragalactic sources with the zero proper motion assumption, while Gaia will observe proper motions of these distant and faint objects to an accuracy of tens of microarcseconds per year. This paper investigates the difference between VLBI and Gaia quasar proper motions and it aims to understand the impact of quasar proper motions on the alignment of the ICRF and Gaia reference frame. We use the latest time series data of source coordinates from the International VLBI Service analysis centres operated at Goddard Space Flight Center (GSF2017) and Paris observatory (OPA2017), as well as the Gaia auxiliary quasar solution containing 2191 high-probability optical counterparts of the ICRF2 sources. The linear proper motions in right ascension and declination of VLBI sources are derived by least-squares fits while the proper motions for Gaia sources are simulated taking into account the acceleration of the Solar system barycentre and realistic uncertainties depending on the source brightness. The individual and global features of source proper motions in GSF2017 and OPA2017 VLBI data are found to be inconsistent, which may result from differences in VLBI observations, data reduction and analysis. A comparison of the VLBI and Gaia proper motions shows that the accuracies of the components of rotation and glide between the two systems are 2-4 μas yr- 1 based on about 600 common sources. For the future alignment of the ICRF and Gaia reference frames at different wavelengths, the proper motions of quasars must necessarily be considered.

Pretest probability estimation in the evaluation of patients with possible deep vein thrombosis.

PubMed

Vinson, David R; Patel, Jason P; Irving, Cedric S

2011-07-01

An estimation of pretest probability is integral to the proper interpretation of a negative compression ultrasound in the diagnostic assessment of lower-extremity deep vein thrombosis. We sought to determine the rate, method, and predictors of pretest probability estimation in such patients. This cross-sectional study of outpatients was conducted in a suburban community hospital in 2006. Estimation of pretest probability was done by enzyme-linked immunosorbent assay d-dimer, Wells criteria, and unstructured clinical impression. Using logistic regression analysis, we measured predictors of documented risk assessment. A cohort analysis was undertaken to compare 3-month thromboembolic outcomes between risk groups. Among 524 cases, 289 (55.2%) underwent pretest probability estimation using the following methods: enzyme-linked immunosorbent assay d-dimer (228; 43.5%), clinical impression (106; 20.2%), and Wells criteria (24; 4.6%), with 69 (13.2%) patients undergoing a combination of at least two methods. Patient factors were not predictive of pretest probability estimation, but the specialty of the clinician was predictive; emergency physicians (P < .0001) and specialty clinicians (P = .001) were less likely than primary care clinicians to perform risk assessment. Thromboembolic events within 3 months were experienced by 0 of 52 patients in the explicitly low-risk group, 4 (1.8%) of 219 in the explicitly moderate- to high-risk group, and 1 (0.4%) of 226 in the group that did not undergo explicit risk assessment. Negative ultrasounds in the workup of deep vein thrombosis are commonly interpreted in isolation apart from pretest probability estimations. Risk assessments varied by physician specialties. Opportunities exist for improvement in the diagnostic evaluation of these patients. Copyright © 2011 Elsevier Inc. All rights reserved.

Extreme Weather Risk Assessment: The Case of Jiquilisco, El Salvador

NASA Astrophysics Data System (ADS)

Melendez, Karla; Ceppi, Claudia; Molero, Juanjo; Rios Insua, David

2014-05-01

All major climate models predict increases in both global and regional mean temperatures throughout this century, under different scenarios concerning future trends in population growth or economic and technological development. This consistency of results across models has strengthened the evidence about global warming. Despite the convincing facts and findings of climate researchers, there is still a great deal of skepticism around climate change. There is somewhat less consensus about some of the consequences of climate change, for example in reference to extreme weather changes, in particular as regards more local scales. However, such changes seem to have already considerable impact in many regions across the world in terms of lives, economic losses, and required changes in lifestyles. This may demand appropriate policy responses both at national and local levels. Our work provides a framework for extreme weather multithreat risk management, based on probabilistic risk assessment (PRA). This may be useful in comparing the effectiveness of different actions to manage risks and inform judgment concerning the appropriate resource allocation to mitigate the risks. The methodology has been applied to the case study of the "El Marillo II" community, located in the municipality of Jiquilisco in El Salvador. There, the main problem related with extreme weather conditions are the frequent floods caused by rainfall, hurricanes , and water increases in the Lempa river nearby located. However, droughts are also very relevant. Based on several sources like SNET, newspapers, field visits to the region and interviews, we have built a detailed database that comprises extreme weather daily data from January 1971 until December 2011. Forecasting models for floods and droughts were built suggesting the need to properly manage the risks. We subsequently obtained the optimal portfolio of countermeasures, given the budget constraints. KEYWORDS: CLIMATE CHANGE, EXTREME WEATHER, RISK ANALYSIS, DECISION ANALYSIS, EL SALVADOR.

Season and preterm birth in Norway: A cautionary tale

PubMed Central

Weinberg, Clarice R; Shi, Min; DeRoo, Lisa A; Basso, Olga; Skjærven, Rolv

2015-01-01

Background: Preterm birth is a common, costly and dangerous pregnancy complication. Seasonality of risk would suggest modifiable causes. Methods: We examine seasonal effects on preterm birth, using data from the Medical Birth Registry of Norway (2 321 652 births), and show that results based on births are misleading and a fetuses-at-risk approach is essential. In our harmonic-regression Cox proportional hazards model we consider fetal risk of birth between 22 and 37 completed weeks of gestation. We examine effects of both day of year of conception (for early effects) and day of ongoing gestation (for seasonal effects on labour onset) as modifiers of gestational-age-based risk. Results: Naïve analysis of preterm rates across days of birth shows compelling evidence for seasonality (P < 10−152). However, the reconstructed numbers of conceptions also vary with season (P < 10−307), confounding results by inducing seasonal variation in the age distribution of the fetal population at risk. When we instead properly treat fetuses as the individuals at risk, restrict analysis to pregnancies with relatively accurate ultrasound-based assessment of gestational age (available since 1998) and adjust for socio-demographic factors and maternal smoking, we find modest effects of both time of year of conception and time of year at risk, with peaks for early preterm near early January and early July. Conclusions: Analyses of seasonal effects on preterm birth are demonstrably vulnerable to confounding by seasonality of conception, measurement error in conception dating, and socio-demographic factors. The seasonal variation based on fetuses reveals two peaks for early preterm, coinciding with New Year’s Day and the early July beginning of Norway’s summer break, and may simply reflect a holiday-related pattern of unintended conception. PMID:26045507

Evaluation of an active learning module to teach hazard and risk in Hazard Analysis and Critical Control Points (HACCP) classes.

PubMed

Oyarzabal, Omar A; Rowe, Ellen

2017-04-01

The terms hazard and risk are significant building blocks for the organization of risk-based food safety plans. Unfortunately, these terms are not clear for some personnel working in food manufacturing facilities. In addition, there are few examples of active learning modules for teaching adult participants the principles of hazard analysis and critical control points (HACCP). In this study, we evaluated the effectiveness of an active learning module to teach hazard and risk to participants of HACCP classes provided by the University of Vermont Extension in 2015 and 2016. This interactive module is comprised of a questionnaire; group playing of a dice game that we have previously introduced in the teaching of HACCP; the discussion of the terms hazard and risk; and a self-assessment questionnaire to evaluate the teaching of hazard and risk. From 71 adult participants that completed this module, 40 participants (56%) provided the most appropriate definition of hazard, 19 participants (27%) provided the most appropriate definition of risk, 14 participants (20%) provided the most appropriate definitions of both hazard and risk, and 23 participants (32%) did not provide an appropriate definition for hazard or risk. Self-assessment data showed an improvement in the understanding of these terms (P < 0.05). Thirty participants (42%) stated that the most valuable thing they learned with this interactive module was the difference between hazard and risk, and 40 participants (65%) responded that they did not attend similar presentations in the past. The fact that less than one third of the participants answered properly to the definitions of hazard and risk at baseline is not surprising. However, these results highlight the need for the incorporation of modules to discuss these important food safety terms and include more active learning modules to teach food safety classes. This study suggests that active learning helps food personnel better understand important food safety terms that serve as building blocks for the understanding of more complex food safety topics.

Breathing Easy

EPA Pesticide Factsheets

This fact sheet provides practical information and guidance to auto refinish shops on proper ventilation of paint mixing rooms, including ventilation system basics and diagrams, risk reduction ideas, common mistakes, tips, and design considerations.

Reviewing the economic efficiency of disaster risk management

NASA Astrophysics Data System (ADS)

Mechler, Reinhard

2013-04-01

There is a lot of rhetoric suggesting that disaster risk management (DRM) pays, yet surprisingly little in the way of hard facts. Cost-benefit analysis (CBA) is one major tool that can provide quantitative information about the prioritization of disaster risk management (DRM) (and climate adaptation) based on economic principles. Yet, on a global scale, there has been surprisingly little robust evidence on the economic efficiency and benefits of risk management measures. This review shows that for the limited evidence reported the economic case for DRM across a range of hazards is strong and that the benefits of investing in DRM outweigh the costs of doing so, on average, by about four times the cost in terms of avoided and reduced losses. Most studies using a CBA approach focus on structural DRM and most information has been made available on physical flood prevention. There have been some limited studies on preparedness and risk financing. The global evidence base is limited and estimates appear not very solid, and overall, in line with the conclusion of the recent IPCC SREX report, there is limited evidence and medium agreement across the literature. Some of the factors behind the limited robustness are inherent to CBA more widely: these challenges comprise the inability to price intangibles, evaluating strategies rather than single projects, difficulties in assessing softer rather than infrastructure-related options, choices regarding a proper discount rate, lack of accounting for the distribution of benefits and costs and difficulties with assessing nonmarket values such as those related to health, the environment, or public goods. Although techniques exist to address some of these challenges, they are not very likely to easily go away. Other challenges associated specifically with DRM, such as the need and difficulty to undertake risk -based analysis can be overcome, and there have been manuals and reports providing a way forward. In an age of austerity, cost-benefit analysis continues to be an important tool for prioritising efficient DRM measures, yet with a shifting emphasis from infrastructure-based options (hard resilience) to preparedness and systemic interventions (soft resilience), other tools such as cost-effectiveness analysis, multi-criteria analysis and robust decision-making approaches deserve more attention.

Administrative database research has unique characteristics that can risk biased results.

PubMed

van Walraven, Carl; Austin, Peter

2012-02-01

The provision of health care frequently creates digitized data--such as physician service claims, medication prescription records, and hospitalization abstracts--that can be used to conduct studies termed "administrative database research." While most guidelines for assessing the validity of observational studies apply to administrative database research, the unique data source and analytical opportunities for these studies create risks that can make them uninterpretable or bias their results. Nonsystematic review. The risks of uninterpretable or biased results can be minimized by; providing a robust description of the data tables used, focusing on both why and how they were created; measuring and reporting the accuracy of diagnostic and procedural codes used; distinguishing between clinical significance and statistical significance; properly accounting for any time-dependent nature of variables; and analyzing clustered data properly to explore its influence on study outcomes. This article reviewed these five issues as they pertain to administrative database research to help maximize the utility of these studies for both readers and writers. Copyright © 2012 Elsevier Inc. All rights reserved.

An ethnographic study of classifying and accounting for risk at the sharp end of medical wards.

PubMed

Dixon-Woods, Mary; Suokas, Anu; Pitchforth, Emma; Tarrant, Carolyn

2009-08-01

An understanding of how staff identify, classify, narrativise and orient to patient safety risks is important in understanding responses to efforts to effect change. We report an ethnographic study of four medical wards in the UK, in hospitals that were participating in the Health Foundation's Safer Patients Initiative, an organisation-wide patient safety programme. Data analysis of observations and 49 interviews with staff was based on the constant comparative method. We found that staff engaged routinely in practices of determining what gets to count as a risk, how such risks should properly be managed, and how to account for what they do. Staff practices and reasoning in relation to risk emerged through their practical engagement in the everyday work of the wards, but were also shaped by social imperatives. Risks, in the environment we studied, were not simply risks to patient safety; when things went wrong, professional identity was at risk too. Staff oriented to risks in the context of busy and complex ward environments, which influenced how they accounted for risk. Reasoning about risk was influenced by judgements about which values should be promoted when caring for patients, by social norms, by risk-spreading logics, and by perceptions of the extent to which particular behaviours and actions were coupled to outcomes and were blameworthy. These ways of identifying, evaluating and addressing risks are likely to be highly influential in staff responses to efforts to effect change, and highlight the challenges in designing and implementing patient safety interventions.

The Medical Risks and Benefits of Sauna, Steam Bath, and Whirlpool Use.

ERIC Educational Resources Information Center

Duda, Marty

1987-01-01

Saunas, steam baths, and whirlpools--popular fixtures at health clubs--are safe means of relaxation if used properly. Ignoring the recommendations for moderate, commonsense enjoyment of these baths may expose users to health risks, including sudden death, arrhythmias, and skin infections. A guide to safe use of such baths is presented. (Author/CB)

Software Technology for Adaptable, Reliable Systems (STARS): UUS40 - Risk-Reduction Reasoning-Based Development Paradigm Tailored to Navy C2 Systems

DTIC Science & Technology

1991-07-30

4 Management reviews, engineering and WBS -Spiral 0 -5 *Risk Management Planning -Spiral 0-5 ,41.- Unrelsi ugt .Proper initial planning -Spiral 0.1...Reusability issues for trusted systems are associated closely with maintenance issues. Reuse theory and practice for highly trusted systems will require

Mammary gland morphology and gene expression signature of prepubertal male and female rats following exposure to exogenous estradiol

USDA-ARS?s Scientific Manuscript database

In order to properly screen environmental chemicals for potential toxic effects such as increased cancer risk and risk of infertility resulting from actions similar to those of female sex steroids such as estrogens, it is essential to understand the effects of treatment with the most important femal...

Retention and Risk Factors for Attrition in a Large Public Health ART Program in Myanmar: A Retrospective Cohort Analysis

PubMed Central

Thida, Aye; Tun, Sai Thein Than; Zaw, Sai Ko Ko; Lover, Andrew A.; Cavailler, Philippe; Chunn, Jennifer; Aye, Mar Mar; Par, Par; Naing, Kyaw Win; Zan, Kaung Nyunt; Shwe, Myint; Kyaw, Thar Tun; Waing, Zaw Htoon; Clevenbergh, Philippe

2014-01-01

Background The outcomes from an antiretroviral treatment (ART) program within the public sector in Myanmar have not been reported. This study documents retention and the risk factors for attrition in a large ART public health program in Myanmar. Methods A retrospective analysis of a cohort of adult patients enrolled in the Integrated HIV Care (IHC) Program between June 2005 and October 2011 and followed up until April 2012 is presented. The primary outcome was attrition (death or loss-follow up); a total of 10,223 patients were included in the 5-year cumulative survival analysis. Overall 5,718 patients were analyzed for the risk factors for attrition using both logistic regression and flexible parametric survival models. Result The mean age was 36 years, 61% of patients were male, and the median follow up was 13.7 months. Overall 8,564 (84%) patients were retained in ART program: 750 (7%) were lost to follow-up and 909 (9%) died. During the 3 years follow-up, 1,542 attritions occurred over 17,524 person years at risk, giving an incidence density of 8.8% per year. The retention rates of participants at 12, 24, 36, 48 and 60 months were 86, 82, 80, 77 and 74% respectively. In multivariate analysis, being male, having high WHO staging, a low CD4 count, being anaemic or having low BMI at baseline were independent risk factors for attrition; tuberculosis (TB) treatment at ART initiation, a prior ART course before program enrollment and literacy were predictors for retention in the program. Conclusion High retention rate of IHC program was documented within the public sector in Myanmar. Early diagnosis of HIV, nutritional support, proper investigation and treatment for patients with low CD4 counts and for those presenting with anaemia are crucial issues towards improvement of HIV program outcomes in resource-limited settings. PMID:25268903

Retention and risk factors for attrition in a large public health ART program in Myanmar: a retrospective cohort analysis.

PubMed

Thida, Aye; Tun, Sai Thein Than; Zaw, Sai Ko Ko; Lover, Andrew A; Cavailler, Philippe; Chunn, Jennifer; Aye, Mar Mar; Par, Par; Naing, Kyaw Win; Zan, Kaung Nyunt; Shwe, Myint; Kyaw, Thar Tun; Waing, Zaw Htoon; Clevenbergh, Philippe

2014-01-01

The outcomes from an antiretroviral treatment (ART) program within the public sector in Myanmar have not been reported. This study documents retention and the risk factors for attrition in a large ART public health program in Myanmar. A retrospective analysis of a cohort of adult patients enrolled in the Integrated HIV Care (IHC) Program between June 2005 and October 2011 and followed up until April 2012 is presented. The primary outcome was attrition (death or loss-follow up); a total of 10,223 patients were included in the 5-year cumulative survival analysis. Overall 5,718 patients were analyzed for the risk factors for attrition using both logistic regression and flexible parametric survival models. The mean age was 36 years, 61% of patients were male, and the median follow up was 13.7 months. Overall 8,564 (84%) patients were retained in ART program: 750 (7%) were lost to follow-up and 909 (9%) died. During the 3 years follow-up, 1,542 attritions occurred over 17,524 person years at risk, giving an incidence density of 8.8% per year. The retention rates of participants at 12, 24, 36, 48 and 60 months were 86, 82, 80, 77 and 74% respectively. In multivariate analysis, being male, having high WHO staging, a low CD4 count, being anaemic or having low BMI at baseline were independent risk factors for attrition; tuberculosis (TB) treatment at ART initiation, a prior ART course before program enrollment and literacy were predictors for retention in the program. High retention rate of IHC program was documented within the public sector in Myanmar. Early diagnosis of HIV, nutritional support, proper investigation and treatment for patients with low CD4 counts and for those presenting with anaemia are crucial issues towards improvement of HIV program outcomes in resource-limited settings.

Alcohol Consumption and the Risk of Type 2 Diabetes: A Systematic Review and Dose-Response Meta-analysis of More Than 1.9 Million Individuals From 38 Observational Studies.

PubMed

Knott, Craig; Bell, Steven; Britton, Annie

2015-09-01

Observational studies indicate that moderate levels of alcohol consumption may reduce the risk of type 2 diabetes. In addition to providing an updated summary of the existing literature, this meta-analysis explored whether reductions in risk may be the product of misclassification bias. A systematic search was undertaken, identifying studies that reported a temporal association between alcohol consumption and the risk of type 2 diabetes. No restrictions were placed upon the language or date of publication. Non-English publications were, where necessary, translated using online translation tools. Models were constructed using fractional polynomial regression to determine the best-fitting dose-response relationship between alcohol intake and type 2 diabetes, with a priori testing of sex and referent group interactions. Thirty-eight studies met the selection criteria, representing 1,902,605 participants and 125,926 cases of type 2 diabetes. A conventional noncurrent drinking category was reported by 33 studies, while five reported a never-drinking category. Relative to combined abstainers, reductions in the risk of type 2 diabetes were present at all levels of alcohol intake <63 g/day, with risks increasing above this threshold. Peak risk reduction was present between 10-14 g/day at an 18% decrease in hazards. Stratification of available data revealed that reductions in risk may be specific to women only and absent in studies that adopted a never-drinking abstention category or sampled an Asian population region. Reductions in risk among moderate alcohol drinkers may be confined to women and non-Asian populations. Although based on a minority of studies, there is also the possibility that reductions in risk may have been overestimated by studies using a referent group contaminated by less healthy former drinkers. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Incidence of low risk human papillomavirus in oral cancer: a real time PCR study on 278 patients.

PubMed

Palmieri, A; Scapoli, L; Martinelli, M; Pezzetti, F; Girardi, A; Spinelli, G; Lucchese, A; Carinci, F

2011-01-01

Squamous cell carcinoma is the most frequent malignant tumour of the oral cavity. It is widely known that tobacco and alcohol consumption are the major causes of the development of oral squamous cell carcinoma (OSCC). The human papilloma virus infection has also been postulated as a risk factor for squamous cell carcinoma, although conflicting results have been reported. The aim of this study is to evaluate the presence of high-risk and low-risk type human papillomavirus in a large sample of squamous cell carcinoma limited to the oral cavity by means of quantitative real-time polymerase chain reaction. Data were obtained from 278 squamous cell carcinoma limited to oral cavity proper. Sequencing revealed that 5 samples were positive for HPV type 16, 5 for HPV type 11, and 1 for HPV type 6. Human papillomavirus 11 was detected in 5 tumours out of the 278 examined. The prevalence rate for Human papillomavirus 11 was 1.8% (C.I. 0.7-3.9). The matched case-controls analysis indicated that the prevalence among controls did not significantly differ with respect to cases and that Human papillomavirus 11 alone did not correlate with squamous cell carcinoma.

Crash risk analysis during fog conditions using real-time traffic data.

PubMed

Wu, Yina; Abdel-Aty, Mohamed; Lee, Jaeyoung

2018-05-01

This research investigates the changes of traffic characteristics and crash risks during fog conditions. Using real-time traffic flow and weather data at two regions in Florida, the traffic patterns at the fog duration were compared to the traffic patterns at the clear duration. It was found that the average 5-min speed and the average 5-min volume were prone to decreasing during fog. Based on previous studies, a "Crash Risk Increase Indicator (CRII)" was proposed to explore the differences of crash risk between fog and clear conditions. A binary logistic regression model was applied to link the increase of crash risks with traffic flow characteristics. The results suggested that the proposed indicator worked well in evaluating the increase of crash risk under fog condition. It was indicated that the crash risk was prone to increase at ramp vicinities in fog conditions. Also, the average 5-min volume during fog and the lane position are important factors for crash risk increase. The differences between the regions were also explored in this study. The results indicated that the locations with heavier traffic or locations at the lanes that were closest to the median in Region 2 were more likely to observe an increase in crash risks in fog conditions. It is expected that the proposed indicator can help identify the dangerous traffic status under fog conditions and then proper ITS technologies can be implemented to enhance traffic safety when the visibility declines. Copyright © 2017 Elsevier Ltd. All rights reserved.

Chemical Safety Alert: Rupture Hazard of Pressure Vessels

EPA Pesticide Factsheets

Pressure vessels or boilers can fail catastrophically if they are not properly designed, constructed, operated, inspected, tested, or repaired. Risk increases if vessels contents are toxic, corrosive, reactive, or flammable.

Cytomegalovirus (CMV) and Pregnancy

MedlinePlus

... way to prevent infection is to practice good hygiene, particularly proper hand washing. An interventional study in ... a CMV infection found that teaching about good hygiene (and practicing good hygiene) reduced the risk of ...

Commercial mortgages: An underutilized channel for scaling energy efficiency investments?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mathew, Paul; Wallace, Nancy; Alschuler, Elena

2016-02-01

Commercial mortgages currently do not fully account for energy factors in underwriting and valuation, particularly as it relates to the impact of energy costs and volatility on an owner’s net operating income. As a consequence, energy efficiency is not properly valued and energy risks are not properly assessed and mitigated. Commercial mortgages are a large lever and could be a significant channel for scaling energy efficiency investments. A pilot analysis of loans with different mortgage contract structures and locations showed that when energy cost volatility was included in mortgage valuation, a 20% reduction in energy use resulted in a 1.3%more » average increase in mortgage value. This suggests that the explicit inclusion of energy use and volatility in mortgage valuation can send a strong price signal that financially rewards and values energy efficiency in commercial properties. This paper presents findings from a scoping study addressing energy factors in commercial mortgages. First, we present a review of current practices as it relates to incorporating energy factors into commercial mortgage underwriting and valuation. Next, we detail the impacts of energy factors on property values, net operating income and mortgage valuation. Building operational practices alone can result in energy use variations from -17% to 87%. Finally, we present a set of proposed interventions to properly address energy factors in commercial mortgages, based on extensive discussions with stakeholders including mortgage originators, underwriters, building owners and regulators.« less

Electromechanical actuators affected by multiple failures: Prognostic method based on spectral analysis techniques

NASA Astrophysics Data System (ADS)

Belmonte, D.; Vedova, M. D. L. Dalla; Ferro, C.; Maggiore, P.

2017-06-01

The proposal of prognostic algorithms able to identify precursors of incipient failures of primary flight command electromechanical actuators (EMA) is beneficial for the anticipation of the incoming failure: an early and correct interpretation of the failure degradation pattern, in fact, can trig an early alert of the maintenance crew, who can properly schedule the servomechanism replacement. An innovative prognostic model-based approach, able to recognize the EMA progressive degradations before his anomalous behaviors become critical, is proposed: the Fault Detection and Identification (FDI) of the considered incipient failures is performed analyzing proper system operational parameters, able to put in evidence the corresponding degradation path, by means of a numerical algorithm based on spectral analysis techniques. Subsequently, these operational parameters will be correlated with the actual EMA health condition by means of failure maps created by a reference monitoring model-based algorithm. In this work, the proposed method has been tested in case of EMA affected by combined progressive failures: in particular, partial stator single phase turn to turn short-circuit and rotor static eccentricity are considered. In order to evaluate the prognostic method, a numerical test-bench has been conceived. Results show that the method exhibit adequate robustness and a high degree of confidence in the ability to early identify an eventual malfunctioning, minimizing the risk of fake alarms or unannounced failures.

Hazardous chemical incidents in schools--United States, 2002-2007.

PubMed

2008-11-07

Chemicals that can cause adverse health effects are used in many elementary and secondary schools (e.g., in chemistry laboratories, art classrooms, automotive repair areas, printing and other vocational shops, and facility maintenance areas). Every year, unintentional and intentional releases of these chemicals, or related fires or explosions, occur in schools, causing injuries, costly cleanups, and lost school days. The federal Agency for Toxic Substances and Disease Registry (ATSDR) conducts national public health surveillance of chemical incidents through its Hazardous Substances Emergency Events Surveillance (HSEES) system. To identify school-related incidents and elucidate their causes and consequences to highlight the need for intervention, ATSDR conducted an analysis of HSEES data for 2002-2007. During that period, 423 chemical incidents in elementary and secondary schools were reported by 15 participating states. Mercury was the most common chemical released. The analysis found that 62% of reported chemical incidents at elementary and secondary schools resulted from human error (i.e., mistakes in the use or handling of a substance), and 30% of incidents resulted in at least one acute injury. Proper chemical use and management (e.g., keeping an inventory and properly storing, labeling, and disposing of chemicals) is essential to protect school building occupants. Additional education directed at raising awareness of the problem and providing resources to reduce the risk is needed to ensure that schools are safe from unnecessary dangers posed by hazardous chemicals.

Reverse engineering a 'responsible drinking' campaign to assess strategic intent.

PubMed

Pettigrew, Simone; Biagioni, Nicole; Daube, Mike; Stafford, Julia; Jones, Sandra C; Chikritzhs, Tanya

2016-06-01

The alcohol industry produces 'responsible drinking' advertising campaigns. There is concern that these may promote drinking while persuading governments and the general public that the industry is acting responsibly. This paper examined young people's thoughts and feelings in response to one of these campaigns in Australia. A qualitative analysis of introspection data provided by young drinkers after exposure to a responsible drinking advertisement produced by DrinkWise called 'How to Drink Properly'. Perth, Western Australia. Forty-eight 18-21-year-old drinkers. The qualitative data were imported into NVivo10 and coded according to the various stages of advertising effects frameworks. A thematic analysis approach was used to identify patterns in the data relating to (i) perceptions of the source and purpose of the advertisement and (ii) any resulting attitudinal or behavioural outcomes. Despite the sample comprising mainly high-risk drinkers, participants were generally unable to relate to the heavy drinkers depicted in the DrinkWise advertisement. This disassociation resulted in a perceived lack of need to modify their own drinking behaviours. Instead, the study participants found the advertisement to be entertaining and supportive of existing social norms relating to heavy drinking among members of this age group. The 'How to Drink Properly' advertisement by Drinkwise in Australia may reinforce existing drinking attitudes and behaviours among young drinkers. © 2016 Society for the Study of Addiction.

Adoption of Building Information Modelling in project planning risk management

NASA Astrophysics Data System (ADS)

Mering, M. M.; Aminudin, E.; Chai, C. S.; Zakaria, R.; Tan, C. S.; Lee, Y. Y.; Redzuan, A. A.

2017-11-01

An efficient and effective risk management required a systematic and proper methodology besides knowledge and experience. However, if the risk management is not discussed from the starting of the project, this duty is notably complicated and no longer efficient. This paper presents the adoption of Building Information Modelling (BIM) in project planning risk management. The objectives is to identify the traditional risk management practices and its function, besides, determine the best function of BIM in risk management and investigating the efficiency of adopting BIM-based risk management during the project planning phase. In order to obtain data, a quantitative approach is adopted in this research. Based on data analysis, the lack of compliance with project requirements and failure to recognise risk and develop responses to opportunity are the risks occurred when traditional risk management is implemented. When using BIM in project planning, it works as the tracking of cost control and cash flow give impact on the project cycle to be completed on time. 5D cost estimation or cash flow modeling benefit risk management in planning, controlling and managing budget and cost reasonably. There were two factors that mostly benefit a BIM-based technology which were formwork plan with integrated fall plan and design for safety model check. By adopting risk management, potential risks linked with a project and acknowledging to those risks can be identified to reduce them to an acceptable extent. This means recognizing potential risks and avoiding threat by reducing their negative effects. The BIM-based risk management can enhance the planning process of construction projects. It benefits the construction players in various aspects. It is important to know the application of BIM-based risk management as it can be a lesson learnt to others to implement BIM and increase the quality of the project.

Aerodynamic Challenges for the Mars Science Laboratory Entry, Descent and Landing

NASA Technical Reports Server (NTRS)

Schoenenberger, Mark; Dyakonov, Artem; Buning, Pieter; Scallion, William; Norman, John Van

2009-01-01

An overview of several important aerodynamics challenges new to the Mars Science Laboratory (MSL) entry vehicle are presented. The MSL entry capsule is a 70 degree sphere cone-based on the original Mars Viking entry capsule. Due to payload and landing accuracy requirements, MSL will be flying at the highest lift-to-drag ratio of any capsule sent to Mars (L/D = 0.24). The capsule will also be flying a guided entry, performing bank maneuvers, a first for Mars entry. The system's mechanical design and increased performance requirements require an expansion of the MSL flight envelope beyond those of historical missions. In certain areas, the experience gained by Viking and other recent Mars missions can no longer be claimed as heritage information. New analysis and testing is re1quired to ensure the safe flight of the MSL entry vehicle. The challenge topics include: hypersonic gas chemistry and laminar-versus-turbulent flow effects on trim angle, a general risk assessment of flying at greater angles-of-attack than Viking, quantifying the aerodynamic interactions induced by a new reaction control system and a risk assessment of recontact of a series of masses jettisoned prior to parachute deploy. An overview of the analysis and tests being conducted to understand and reduce risk in each of these areas is presented. The need for proper modeling and implementation of uncertainties for use in trajectory simulation has resulted in a revision of prior models and additional analysis for the MSL entry vehicle. The six degree-of-freedom uncertainty model and new analysis to quantify roll torque dispersions are presented.

Arsenic Speciation in Fish Products and Seafood as a Prerequisite for Proper Risk Assessment

PubMed Central

Orletti, Roberta; Chessa, Giannina; Carloni, Cristiano; Griffoni, Francesco; Palombo, Paolo; Velieri, Francesco

2015-01-01

The Boi Cerbus lagoon, facing a mining and industrial site in Sardinia (Italy), is an important fishing area for the local population. Previous studies showed high concentrations of total arsenic (Astot) in fish, molluscs and crustaceans sampled in the lagoon, and a possible exceeding of the provisional tolerable weekly intake set by the Joint FAO/WHO Expert Committee on Food Additives by some local consumer groups. However, the percentage of inorganic As (Asinorg) should be known for a correct assessment of potential risk, as its toxicity is much higher than that of the organic forms. Eighty samples of 14 different species of fish, molluscs and crustaceans, sampled in the Boi Cerbus lagoon in 3 different seasons (winter, spring and summer), were analysed for Astot by inductively coupled plasma mass spectrometry (ICP-MS) and Asinorg by high performance liquid chromatography-ICP-MS. All the data obtained from the analysis were statistically processed to evaluate significant differences based on season, taxon and habitat, in preparation for a subsequent risk assessment. PMID:27800381

Spatial-temporal and cancer risk assessment of selected hazardous air pollutants in Seattle.

PubMed

Wu, Chang-fu; Liu, L-J Sally; Cullen, Alison; Westberg, Hal; Williamson, John

2011-01-01

In the Seattle Air Toxics Monitoring Pilot Program, we measured 15 hazardous air pollutants (HAPs) at 6 sites for more than a year between 2000 and 2002. Spatial-temporal variations were evaluated with random-effects models and principal component analyses. The potential health risks were further estimated based on the monitored data, with the incorporation of the bootstrapping technique for the uncertainty analysis. It is found that the temporal variability was generally higher than the spatial variability for most air toxics. The highest temporal variability was observed for tetrachloroethylene (70% temporal vs. 34% spatial variability). Nevertheless, most air toxics still exhibited significant spatial variations, even after accounting for the temporal effects. These results suggest that it would require operating multiple air toxics monitoring sites over a significant period of time with proper monitoring frequency to better evaluate population exposure to HAPs. The median values of the estimated inhalation cancer risks ranged between 4.3 × 10⁻⁵ and 6.0 × 10⁻⁵, with the 5th and 95th percentile levels exceeding the 1 in a million level. VOCs as a whole contributed over 80% of the risk among the HAPs measured and arsenic contributed most substantially to the overall risk associated with metals. Copyright © 2010 Elsevier Ltd. All rights reserved.

Megacity Indicator System for Disaster Risk Management in Istanbul (MegaIST)

NASA Astrophysics Data System (ADS)

Yahya Menteşe, Emin; Kılıç, Osman; Baş, Mahmut; Khazai, Bijan; Ergün Konukcu, Betul; Emre Basmacı, Ahmet

2017-04-01

Decision makers need tools to understand the priorities and to set up benchmarks and track progress in their disaster risk reduction activities, so that they can justify their decisions and investments. In this regard, Megacity Indicator System for Disaster Risk Management (MegaIST), is developed in order to be used in disaster risk management studies, for decision makers and managers to establish right strategies and proper risk reduction actions, enhance resource management and investment decisions, set priorities, monitor progress in DRM and validate decisions taken with the aim of helping disaster oriented urban redevelopment, inform investors about risk profile of the city and providing a basis for dissemination and sharing of risk components with related stakeholders; by Directorate of Earthquake and Ground Research of Istanbul Metropolitan Municipality (IMM). MegaIST achieves these goals by analyzing the earthquake risk in three separate but complementary sub-categories consisting of "urban seismic risk, coping capacity and disaster risk management index" in an integrated way. MegaIST model fosters its analyses by presenting the outputs in a simple and user friendly format benefiting from GIS technology that ensures the adoptability of the model's use. Urban seismic risk analysis includes two components, namely; Physical Risk and Social Vulnerability Analysis. Physical risk analysis is based on the possible physical losses (such as building damage, casualties etc.) due to an earthquake while social vulnerability is considered as a factor that increases the results of the physical losses in correlation with the level of education, health, economic status and disaster awareness/preparedness of society. Coping capacity analysis is carried out with the aim of understanding the readiness of the Municipality to respond and recover from a disaster in Istanbul can be defined both in terms of the Municipality's operational capacities - the capacity of the Municipality in terms of the demand on its resources to respond to emergencies and restore services - as well as functional capacities - the policies and planning measures at the Municipality which lead to reduction of risk and protection of people. Disaster Risk Management Index (DRMI) is used as "control system" within the conceptual framework of MegaIST. This index has been developed to understand impact of corporate governance and enforcement structures and policies on total Urban Seismic Risk and in order to make the performance evaluation. Also, DRMI is composed of macro indicators that are developed in order to monitor progress in reducing disaster risk management of institution. They are presented in four broad indicator groups: Legal and Institutional Requirements, Risk Reduction Implementation and Preparedness Activities, Readiness to Respond and Recover, and Strategy and Coordination. As a result; in MegaIST, with the identification and analysis of physical and social vulnerabilities along with coping capacity and disaster risk management performance indicators; an integrated and analytical decision support system has been established to enhance DRM process and reach to a disaster resilient urban environment.

Factor Analysis with EM Algorithm Never Gives Improper Solutions when Sample Covariance and Initial Parameter Matrices Are Proper

ERIC Educational Resources Information Center

Adachi, Kohei

2013-01-01

Rubin and Thayer ("Psychometrika," 47:69-76, 1982) proposed the EM algorithm for exploratory and confirmatory maximum likelihood factor analysis. In this paper, we prove the following fact: the EM algorithm always gives a proper solution with positive unique variances and factor correlations with absolute values that do not exceed one,…

Age- and sex-specific causal effects of adiposity on cardiovascular risk factors.

PubMed

Fall, Tove; Hägg, Sara; Ploner, Alexander; Mägi, Reedik; Fischer, Krista; Draisma, Harmen H M; Sarin, Antti-Pekka; Benyamin, Beben; Ladenvall, Claes; Åkerlund, Mikael; Kals, Mart; Esko, Tõnu; Nelson, Christopher P; Kaakinen, Marika; Huikari, Ville; Mangino, Massimo; Meirhaeghe, Aline; Kristiansson, Kati; Nuotio, Marja-Liisa; Kobl, Michael; Grallert, Harald; Dehghan, Abbas; Kuningas, Maris; de Vries, Paul S; de Bruijn, Renée F A G; Willems, Sara M; Heikkilä, Kauko; Silventoinen, Karri; Pietiläinen, Kirsi H; Legry, Vanessa; Giedraitis, Vilmantas; Goumidi, Louisa; Syvänen, Ann-Christine; Strauch, Konstantin; Koenig, Wolfgang; Lichtner, Peter; Herder, Christian; Palotie, Aarno; Menni, Cristina; Uitterlinden, André G; Kuulasmaa, Kari; Havulinna, Aki S; Moreno, Luis A; Gonzalez-Gross, Marcela; Evans, Alun; Tregouet, David-Alexandre; Yarnell, John W G; Virtamo, Jarmo; Ferrières, Jean; Veronesi, Giovanni; Perola, Markus; Arveiler, Dominique; Brambilla, Paolo; Lind, Lars; Kaprio, Jaakko; Hofman, Albert; Stricker, Bruno H; van Duijn, Cornelia M; Ikram, M Arfan; Franco, Oscar H; Cottel, Dominique; Dallongeville, Jean; Hall, Alistair S; Jula, Antti; Tobin, Martin D; Penninx, Brenda W; Peters, Annette; Gieger, Christian; Samani, Nilesh J; Montgomery, Grant W; Whitfield, John B; Martin, Nicholas G; Groop, Leif; Spector, Tim D; Magnusson, Patrik K; Amouyel, Philippe; Boomsma, Dorret I; Nilsson, Peter M; Järvelin, Marjo-Riitta; Lyssenko, Valeriya; Metspalu, Andres; Strachan, David P; Salomaa, Veikko; Ripatti, Samuli; Pedersen, Nancy L; Prokopenko, Inga; McCarthy, Mark I; Ingelsson, Erik

2015-05-01

Observational studies have reported different effects of adiposity on cardiovascular risk factors across age and sex. Since cardiovascular risk factors are enriched in obese individuals, it has not been easy to dissect the effects of adiposity from those of other risk factors. We used a Mendelian randomization approach, applying a set of 32 genetic markers to estimate the causal effect of adiposity on blood pressure, glycemic indices, circulating lipid levels, and markers of inflammation and liver disease in up to 67,553 individuals. All analyses were stratified by age (cutoff 55 years of age) and sex. The genetic score was associated with BMI in both nonstratified analysis (P = 2.8 × 10(-107)) and stratified analyses (all P < 3.3 × 10(-30)). We found evidence of a causal effect of adiposity on blood pressure, fasting levels of insulin, C-reactive protein, interleukin-6, HDL cholesterol, and triglycerides in a nonstratified analysis and in the <55-year stratum. Further, we found evidence of a smaller causal effect on total cholesterol (P for difference = 0.015) in the ≥55-year stratum than in the <55-year stratum, a finding that could be explained by biology, survival bias, or differential medication. In conclusion, this study extends previous knowledge of the effects of adiposity by providing sex- and age-specific causal estimates on cardiovascular risk factors. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Sleep and Athletic Performance.

PubMed

Watson, Andrew M

Sleep is an essential component of health and well-being, with significant impacts on physical development, emotional regulation, cognitive performance, and quality of life. Along with being an integral part of the recovery and adaptive process between bouts of exercise, accumulating evidence suggests that increased sleep duration and improved sleep quality in athletes are associated with improved performance and competitive success. In addition, better sleep may reduce the risk of both injury and illness in athletes, not only optimizing health but also potentially enhancing performance through increased participation in training. Despite this, most studies have found that athletes fail to obtain the recommended amount of sleep, threatening both performance and health. Athletes face a number of obstacles that can reduce the likelihood of obtaining proper sleep, such as training and competition schedules, travel, stress, academic demands, and overtraining. In addition, athletes have been found to demonstrate poor self-assessment of their sleep duration and quality. In light of this, athletes may require more careful monitoring and intervention to identify individuals at risk and promote proper sleep to improve both performance and overall health. This review attempts to highlight the recent literature regarding sleep issues in athletes, the effects of sleep on athletic performance, and interventions to enhance proper sleep in athletes.

Photometric detection of high proper motions in dense stellar fields using difference image analysis

NASA Astrophysics Data System (ADS)

Eyer, L.; Woźniak, P. R.

2001-10-01

The difference image analysis (DIA) of the images obtained by the Optical Gravitational Lensing Experiment (OGLE-II) revealed a peculiar artefact in the sample of stars proposed as variable by Woźniak in one of the Galactic bulge fields: the occurrence of pairs of candidate variables showing anti-correlated light curves monotonic over a period of 3yr. This effect can be understood, quantified and related to the stellar proper motions. DIA photometry supplemented with a simple model offers an effective and easy way to detect high proper motion stars in very dense stellar fields, where conventional astrometric searches are extremely inefficient.

Unlicensed pharmaceutical preparations for clinical patient care: Ensuring safety.

PubMed

de Wilde, Sofieke; de Jong, Maria G H; Le Brun, Paul P H; Guchelaar, Henk-Jan; Schimmel, Kirsten J M

2018-01-01

Most medicinal products dispensed to patients have marketing authorization (MA) to ensure high quality of the product, safety, and efficacy. However, in daily practice, to treat patients adequately, there is a medical need for drugs that do not hold MA. To meet this medical need, medicinal products are used in clinical care without MA (unlicensed), such as products prepared by (local) pharmacies: the pharmaceutical preparations. Three types of pharmaceutical preparations are distinguished: (i) reconstitution in excess of summary of product characteristics; (ii) adaptation of a licensed medicinal product (outside its official labeling); (iii) medicinal products from an active pharmaceutical ingredient. Although unlicensed, patients may expect the same quality for these unlicensed pharmaceutical preparations as for the licensed medicinal products. To assure this quality, a proper risk-benefit assessment and proper documentation in (centralized) patient registries and linking to a national pharmacovigilance database should be in place. Based on a risk assessment matrix, requirements for quality assurance can be determined, which has impact on the level of documentation of a pharmaceutical preparation. In this paper, the approach for good documentation including quality assurance and benefit-risk assessment will be discussed and possibilities for patient registries are described to make these crucial preparations available for regular patient care. KEY POINTS Ensuring pharmaceutical quality and performing a proper benefit-risk assessment will guarantee safe use of pharmaceutical preparations. Good documentation of (ultra-)orphan treatments can be collected in centralized patient registries and should be combined with existing information in (inter)national databases and self-reflection of patients. Linking patient registries to a centralized database for adverse drug events is highly recommended as it increases safety control of the (ultra) orphan pharmaceutical preparations. Copyright © 2017 John Wiley & Sons, Ltd.

Examining Cybersecurity of Cyberphysical Systems for Critical Infrastructures Through Work Domain Analysis.

PubMed

Wang, Hao; Lau, Nathan; Gerdes, Ryan M

2018-04-01

The aim of this study was to apply work domain analysis for cybersecurity assessment and design of supervisory control and data acquisition (SCADA) systems. Adoption of information and communication technology in cyberphysical systems (CPSs) for critical infrastructures enables automated and distributed control but introduces cybersecurity risk. Many CPSs employ SCADA industrial control systems that have become the target of cyberattacks, which inflict physical damage without use of force. Given that absolute security is not feasible for complex systems, cyberintrusions that introduce unanticipated events will occur; a proper response will in turn require human adaptive ability. Therefore, analysis techniques that can support security assessment and human factors engineering are invaluable for defending CPSs. We conducted work domain analysis using the abstraction hierarchy (AH) to model a generic SCADA implementation to identify the functional structures and means-ends relations. We then adopted a case study approach examining the Stuxnet cyberattack by developing and integrating AHs for the uranium enrichment process, SCADA implementation, and malware to investigate the interactions between the three aspects of cybersecurity in CPSs. The AHs for modeling a generic SCADA implementation and studying the Stuxnet cyberattack are useful for mapping attack vectors, identifying deficiencies in security processes and features, and evaluating proposed security solutions with respect to system objectives. Work domain analysis is an effective analytical method for studying cybersecurity of CPSs for critical infrastructures in a psychologically relevant manner. Work domain analysis should be applied to assess cybersecurity risk and inform engineering and user interface design.

Evaluation of the impacts of cooperative adaptive cruise control on reducing rear-end collision risks on freeways.

PubMed

Li, Ye; Wang, Hao; Wang, Wei; Xing, Lu; Liu, Shanwen; Wei, Xueyan

2017-01-01

Although plenty of studies have been conducted recently about the impacts of cooperative adaptive cruise control (CACC) system on traffic efficiency, there are few researches analyzing the safety effects of this advanced driving-assistant system. Thus, the primary objective of this study is to evaluate the impacts of the CACC system on reducing rear-end collision risks on freeways. The CACC model is firstly developed, which is based on the Intelligent Driver Model (IDM). Then, two surrogated safety measures, derived from the time-to-collision (TTC), denoting time exposed time-to-collision (TET) and time integrated time-to-collision (TIT), are introduced for quantifying the collision risks. And the safety effects are analyzed both theoretically and experimentally, by the linear stability analysis and simulations. The theoretical and simulation results conformably indicate that the CACC system brings dramatic benefits for reducing rear-end collision risks (TET and TIT are reduced more than 90%, respectively), when the desired time headway and time delay are set properly. The sensitivity analysis indicates there are few differences among different values of the threshold of TTC and the length of a CACC platoon. The results also show that the safety improvements weaken with the decrease of the penetration rates of CACC on the market and the increase of time delay between platoons. We also evaluate the traffic efficiency of the CACC system with different desired time headway. Copyright © 2016 Elsevier Ltd. All rights reserved.

77 FR 546 - Adjustment of Nationwide Significant Risk Threshold

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-05

...In accordance with Appendix D to Title 49 Code of Federal Regulations (CFR) Part 222, Use of Locomotive Horns at Highway-Rail Grade Crossings, FRA is updating the Nationwide Significant Risk Threshold (NSRT). This action is needed to ensure that the public has the proper threshold of permissible risk for calculating quiet zones established in relationship to the NSRT. This is the fifth update to the NSRT, which has fallen from 14,007 to 13,722.

75 FR 82136 - Adjustment of Nationwide Significant Risk Threshold

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-29

...In accordance with Appendix D to Title 49 Code of Federal Regulations (CFR) Part 222, Use of Locomotive Horns at Highway-Rail Grade Crossings, FRA is updating the Nationwide Significant Risk Threshold (NSRT). This action is needed to ensure that the public has the proper threshold of permissible risk for calculating quiet zones established in relationship to the NSRT. This is the fourth update to the NSRT, which has fallen from 18,775 to 14,007.

78 FR 70623 - Adjustment of Nationwide Significant Risk Threshold

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-26

...In accordance with appendix D to title 49 Code of Federal Regulations (CFR) part 222, Use of Locomotive Horns at Public Highway- Rail Grade Crossings, FRA is updating the Nationwide Significant Risk Threshold (NSRT). This action is needed to ensure that the public has the proper threshold of permissible risk for calculating quiet zones established in relationship to the NSRT. This is the sixth update to the NSRT, which is increasing from 13,722 to 14,347.

Pyroglyphid mites as a source of work-related allergens.

PubMed

Macan, Jelena; Kanceljak-Macan, Božica; Milković-Kraus, Sanja

2012-01-01

Pyroglyphid mites are primarily associated with allergen exposure at home; hence the name house dust mites. However, we have found numerous studies reporting pyroglyhid mite levels in public and occupational settings. This review presents the findings of house dust mite allergens (family Pyroglyphidae, species Dermatophagoides) as potential work-related risk factors and proposes occupations at risk of house dust mite-related diseases. Pyroglyphid mites or their allergens are found in various workplaces, but clinically relevant exposures have been observed in hotels, cinemas, schools, day-care centres, libraries, public transportation (buses, trains, taxies, and airplanes), fishing-boats, submarines, poultry farms, and churches. Here we propose a classification of occupational risk as low (occasional exposure to mite allergen levels up to 2 μg g(-1)), moderate (exposure between 2 μg g(-1) and 10 μg g(-1)), and high (exposure >10 μg g(-1)). The classification of risk should include factors relevant for indoor mite population (climate, building characteristics, and cleaning schedule). To avoid development or aggravation of allergies associated with exposure to house dust mites at work, occupational physicians should assess exposure risk at work, propose proper protection, provide vocational guidance to persons at risk and conduct pre-employment and periodic examinations to diagnose new allergy cases. Protection at work should aim to control dust mite levels at work. Measures may include proper interior design and regular cleaning and building maintenance.

Factors Surgical Team Members Perceive Influence Choices of Wearing or Not Wearing Personal Protective Equipment during Operative/Invasive Procedures

ERIC Educational Resources Information Center

Cuming, Richard G.

2009-01-01

Exposure to certain bloodborne pathogens can prematurely end a person's life. Healthcare workers (HCWs), especially those who are members of surgical teams, are at increased risk of exposure to these pathogens. The proper use of personal protective equipment (PPE) during operative/invasive procedures reduces that risk. Despite this, some HCWs fail…

Prevention of Infection in Orthopedic Prosthetic Surgery.

PubMed

Chirca, Ioana; Marculescu, Camelia

2017-06-01

Total joint arthroplasty is a generally safe orthopedic procedure; however, infection is a potentially devastating complication. Multiple risk factors have been identified for development of prosthetic joint infections. Identification of patients at risk and preoperative correction of known risk factors, such as smoking, diabetes mellitus, anemia, malnutrition, and decolonization of Staphylococcus carriers, represent well-established actions to decrease the infection risk. Careful operative technique, proper draping and skin preparation, and appropriate selection and dosing of antimicrobials for perioperative prophylaxis are also very important in prevention of infection. Published by Elsevier Inc.

A probabilistic method for computing quantitative risk indexes from medical injuries compensation claims.

PubMed

Dalle Carbonare, S; Folli, F; Patrini, E; Giudici, P; Bellazzi, R

2013-01-01

The increasing demand of health care services and the complexity of health care delivery require Health Care Organizations (HCOs) to approach clinical risk management through proper methods and tools. An important aspect of risk management is to exploit the analysis of medical injuries compensation claims in order to reduce adverse events and, at the same time, to optimize the costs of health insurance policies. This work provides a probabilistic method to estimate the risk level of a HCO by computing quantitative risk indexes from medical injury compensation claims. Our method is based on the estimate of a loss probability distribution from compensation claims data through parametric and non-parametric modeling and Monte Carlo simulations. The loss distribution can be estimated both on the whole dataset and, thanks to the application of a Bayesian hierarchical model, on stratified data. The approach allows to quantitatively assessing the risk structure of the HCO by analyzing the loss distribution and deriving its expected value and percentiles. We applied the proposed method to 206 cases of injuries with compensation requests collected from 1999 to the first semester of 2007 by the HCO of Lodi, in the Northern part of Italy. We computed the risk indexes taking into account the different clinical departments and the different hospitals involved. The approach proved to be useful to understand the HCO risk structure in terms of frequency, severity, expected and unexpected loss related to adverse events.

Ethics and transparent risk communication start with proper risk assessment methodologies

NASA Astrophysics Data System (ADS)

Oboni, Franco; Oboni, Cesar

2014-05-01

We will use throught this paper a "dialogue" between two professionals. One is aware of the misleading character of many risk assessments and wants to foster better approaches. A discomforting set of statements sets the background of the "story": public reactions to risk assessments are generally negative, the developer find it difficult to understand the reasons for general public negative reactions, many projects get often rejected without valid reasons by the public, anywhere in the world. Common practice approaches in Risk Assessment are discussed from the angle of public rejection, taking into account various studies that explicitly expose common practices limitations and voids. The hiatus between rational and well-balanced risk assessments and common practices is explored. Finally solutions to overcome the limitations of common practices and deliver to the public more realistic risk assessment on which to build a widespread consensus are reviewed. The paper conclusions relate to the need of: properly communicating risk throughout the life of a project, from cradle to grave, avoiding conflict of interest, having estimates that are understandable to foster good understanding of what a risk assessment can bring to better Human existence, in an ethical and fair way. The paper delivers a list of possible remedies and shows that "Common Practices" do not equate to "Best Practices": common practices are not to be proposed/used any longer if we want to avoid public distrust and misrepresentations. Many of the "modern" issues ranging from public distrust to insurance denial could be relieved or mitigated ahead of time if misrepresentation was kept at bay using five simple rules. Common practice Risk Assessments, especially those developed under conflict of interest situations, generally misrepresent risks and fail to give the "big picture", hence do not help taking valid decision and are prone to generating/fostering public distrust.

[MANAGEMENT OF HEALTHCARE WASTE IN THE HOSPITAL SETTING. UNDERSTANDING RISK MANAGEMENT].

PubMed

Galimany-Masclans, Jordi; Torres-Egea, Pilar; Sancho-Agredano, Raúl; Girbau-García, Ma Rosa; Fabrellas, Núria; Torrens-Garcia, Ma Llum; Martínez-Estalella, Gemma

2015-05-01

The sanitary waste represents a potential hazard for health workers. Given the high risk of infection in labor accidents, the correct management of sanitary waste minimizes this risk and improves labor and environment conditions. To identify risk perception with health professionals in relation to the advanced sorting and management of healthcare waste (HW). The current study is a descriptive, cross-sectional. The sample size was 177 health workers (nurse assistants, nurses, physicians, lab technicians) from three hospitals in Barcelona (Catalonia). Homemade questionnaire and questions with a free and spontaneous association and incomplete sentences were used to analyze labor variables, perception of risk and personal security through a Likert scale. Using a score from 1 (the lowest perception of risk) to 5 (the high perception of risk) to assess the risk perception, the average value for nurse assistants, nurses, physicians, and lab technicians was 3.71, 3.75, 3.83 and 4.03, respectively. Referring to items with free and spontaneous response association, 44.8% of workers consider HW as a biohazard, 29.6% consider it as waste material, 22.1% state that it must be managed properly and 3.5% described it as unknown residues. The results suggest that all health professionals generally have a perception of high risk. The lab technicians have a higher perception of the real risk of inadequate management of HW A 63.2% report that everyone has to make a proper management to preserve their occupational health; the 59% consider that the HW are a biological risk to the general population and only the 47.8% that are harmful to public health. Although it should be noted that only 44.8% think that HW are toxic and dangerous.

From lead optimization to NDA approval for a new antimicrobial: Use of pre-clinical effect models and pharmacokinetic/pharmacodynamic mathematical modeling.

PubMed

Drusano, G L

2016-12-15

Because of our current crisis of resistance, particularly in nosocomial pathogens, the discovery and development of new antimicrobial agents has become a societal imperative. Changes in regulatory pathways by the Food and Drug Administration and the European Medicines Agency place great emphasis on the use of preclinical models coupled with pharmacokinetic/pharmacodynamic analysis to rapidly and safely move new molecular entities with activity against multi-resistant pathogens through the approval process and into the treatment of patients. In this manuscript, the use of the murine pneumonia system and the Hollow Fiber Infection Model is displayed and the way in which the mathematical analysis of the data arising from these models contributes to the robust choice of dose and schedule for Phase 3 clinical trials is shown. These data and their proper analysis act to de-risk the conduct of Phase 3 trials for anti-infective agents. These trials are the most expensive part of drug development. Further, given the seriousness of the infections treated, they represent the riskiest element for patients. Consequently, these preclinical model systems and their proper analysis have become a central part of accelerated anti-infective development. A final contention of this manuscript is that it is possible to embed these models and in particular, the Hollow Fiber Infection Model earlier in the drug discovery/development process. Examples of 'dynamic driver switching' and the impact of this phenomenon on clinical trial outcome are provided. Identifying dynamic drivers early in drug discovery may lead to improved decision making in the lead optimization process, resulting in the best molecules transitioning to clinical development. Copyright © 2016 Elsevier Ltd. All rights reserved.

Initial 12-h operative fluid volume is an independent risk factor for pleural effusion after hepatectomy.

PubMed

Cheng, Xiang; Wu, Jia-Wei; Sun, Ping; Song, Zi-Fang; Zheng, Qi-Chang

2016-12-01

Pleural effusion after hepatectomy is associated with significant morbidity and prolonged hospital stays. Several studies have addressed the risk factors for postoperative pleural effusion. However, there are no researches concerning the role of the initial 12-h operative fluid volume. The aim of this study was to evaluate whether the initial 12-h operative fluid volume during liver resection is an independent risk factor for pleural effusion after hepatectomy. In this study, we retrospectively analyzed clinical data of 470 patients consecutively undergoing elective hepatectomy between January 2011 and December 2012. We prospectively collected and retrospectively analyzed baseline and clinical data, including preoperative, intraoperative, and postoperative variables. Univariate and multivariate analyses were carried out to identify whether the initial 12-h operative fluid volume was an independent risk factor for pleural effusion after hepatectomy. The multivariate analysis identified 2 independent risk factors for pleural effusion: operative time [odds ratio (OR)=10.2] and initial 12-h operative fluid volume (OR=1.0003). Threshold effect analyses revealed that the initial 12 h operative fluid volume was positively correlated with the incidence of pleural effusion when the initial 12-h operative fluid volume exceeded 4636 mL. We conclude that the initial 12-h operative fluid volume during liver resection and operative time are independent risk factors for pleural effusion after hepatectomy. Perioperative intravenous fluids should be restricted properly.

Tsunami risk mapping simulation for Malaysia

USGS Publications Warehouse

Teh, S.Y.; Koh, H. L.; Moh, Y.T.; De Angelis, D. L.; Jiang, J.

2011-01-01

The 26 December 2004 Andaman mega tsunami killed about a quarter of a million people worldwide. Since then several significant tsunamis have recurred in this region, including the most recent 25 October 2010 Mentawai tsunami. These tsunamis grimly remind us of the devastating destruction that a tsunami might inflict on the affected coastal communities. There is evidence that tsunamis of similar or higher magnitudes might occur again in the near future in this region. Of particular concern to Malaysia are tsunamigenic earthquakes occurring along the northern part of the Sunda Trench. Further, the Manila Trench in the South China Sea has been identified as another source of potential tsunamigenic earthquakes that might trigger large tsunamis. To protect coastal communities that might be affected by future tsunamis, an effective early warning system must be properly installed and maintained to provide adequate time for residents to be evacuated from risk zones. Affected communities must be prepared and educated in advance regarding tsunami risk zones, evacuation routes as well as an effective evacuation procedure that must be taken during a tsunami occurrence. For these purposes, tsunami risk zones must be identified and classified according to the levels of risk simulated. This paper presents an analysis of tsunami simulations for the South China Sea and the Andaman Sea for the purpose of developing a tsunami risk zone classification map for Malaysia based upon simulated maximum wave heights. ?? 2011 WIT Press.

Risk Classification with an Adaptive Naive Bayes Kernel Machine Model.

PubMed

Minnier, Jessica; Yuan, Ming; Liu, Jun S; Cai, Tianxi

2015-04-22

Genetic studies of complex traits have uncovered only a small number of risk markers explaining a small fraction of heritability and adding little improvement to disease risk prediction. Standard single marker methods may lack power in selecting informative markers or estimating effects. Most existing methods also typically do not account for non-linearity. Identifying markers with weak signals and estimating their joint effects among many non-informative markers remains challenging. One potential approach is to group markers based on biological knowledge such as gene structure. If markers in a group tend to have similar effects, proper usage of the group structure could improve power and efficiency in estimation. We propose a two-stage method relating markers to disease risk by taking advantage of known gene-set structures. Imposing a naive bayes kernel machine (KM) model, we estimate gene-set specific risk models that relate each gene-set to the outcome in stage I. The KM framework efficiently models potentially non-linear effects of predictors without requiring explicit specification of functional forms. In stage II, we aggregate information across gene-sets via a regularization procedure. Estimation and computational efficiency is further improved with kernel principle component analysis. Asymptotic results for model estimation and gene set selection are derived and numerical studies suggest that the proposed procedure could outperform existing procedures for constructing genetic risk models.

Risk-based prioritization method for the classification of groundwater pesticide pollution from agricultural regions.

PubMed

Yang, Yu; Lian, Xin-Ying; Jiang, Yong-Hai; Xi, Bei-Dou; He, Xiao-Song

2017-11-01

Agricultural regions are a significant source of groundwater pesticide pollution. To ensure that agricultural regions with a significantly high risk of groundwater pesticide contamination are properly managed, a risk-based ranking method related to groundwater pesticide contamination is needed. In the present paper, a risk-based prioritization method for the classification of groundwater pesticide pollution from agricultural regions was established. The method encompasses 3 phases, including indicator selection, characterization, and classification. In the risk ranking index system employed here, 17 indicators involving the physicochemical properties, environmental behavior characteristics, pesticide application methods, and inherent vulnerability of groundwater in the agricultural region were selected. The boundary of each indicator was determined using K-means cluster analysis based on a survey of a typical agricultural region and the physical and chemical properties of 300 typical pesticides. The total risk characterization was calculated by multiplying the risk value of each indicator, which could effectively avoid the subjectivity of index weight calculation and identify the main factors associated with the risk. The results indicated that the risk for groundwater pesticide contamination from agriculture in a region could be ranked into 4 classes from low to high risk. This method was applied to an agricultural region in Jiangsu Province, China, and it showed that this region had a relatively high risk for groundwater contamination from pesticides, and that the pesticide application method was the primary factor contributing to the relatively high risk. The risk ranking method was determined to be feasible, valid, and able to provide reference data related to the risk management of groundwater pesticide pollution from agricultural regions. Integr Environ Assess Manag 2017;13:1052-1059. © 2017 SETAC. © 2017 SETAC.

[Analysis of women nutritional status during pregnancy--a survey].

PubMed

Selwet, Monika; Machura, Mariola; Sipiński, Adam; Kuna, Anna; Kazimierczak, Małgorzata

2004-01-01

The proper diet is one of the most important factor during pregnancy. The general knowledge about proper nourishment during pregnancy allows the women to avoid quantitative and qualitative nourishment mistakes. Because of this--the salubrious education in this aspect is very important. The aim of the study is to analyze the proper nourishment during pregnancy particularly in professionally active women and those who don't work during pregnancy.

[Human risk factors and injuries due to road accidents: analysis of current data].

PubMed

Marchetti, Pierpaolo; Morandi, Anna; Lombardo, Carlo; Gigli Berzolari, Francesca; Bruno, Vincenzo; Marinoni, Alessandra

2009-01-01

several studies have shown that most road accidents are due to human factors, and that these are strongly linked to a drive's age and sex. The aim of this study is to test the role that some human factors play in road accidents by analysing current road accident data in the Province of Pavia, in Northern Italy. road accidents that occurred in 2004 were analysed by integrating the paper database of the vehicle licensing office, properly computerised, with the 911 database of the Province of Pavia. This study has been carried out by analysing 1.347 road accidents and the associated 2.908 drivers of motorised vehicles. Northern Italy, the Province of Pavia. the death rate of drivers of 2-wheeled vehicles is almost nine times higher than that of 4-wheeled vehicles. Analysis shows that females are twice as exposed to road accidents than males; it also shows the benefits of extensive road education training and of being aged 30-64 and older. Drivers who have already been punished and have had their driving license scores reduced are likely to respond rapidly when in a dangerous situation and also to be without blame after an accident. Motorcycle riders are 25 times more likely to suffer serious injury than drivers of cars. Additionally, the risk of a woman being seriously injured is higher than for a man. females, young drivers and motorcycle riders who have not previously been penalised for a previous traffic violation have a higher risk of being seriously injured; females and motorcycle riders are also at greater risk of being seriously injured. We hope that this analysis will be used to improve preventative interventions for road accidents.r.

Problem formulation for risk assessment of combined exposures to chemicals and other stressors in humans.

PubMed

Solomon, Keith R; Wilks, Martin F; Bachman, Ammie; Boobis, Alan; Moretto, Angelo; Pastoor, Timothy P; Phillips, Richard; Embry, Michelle R

2016-11-01

When the human health risk assessment/risk management paradigm was developed, it did not explicitly include a "problem formulation" phase. The concept of problem formulation was first introduced in the context of ecological risk assessment (ERA) for the pragmatic reason to constrain and focus ERAs on the key questions. However, this need also exists for human health risk assessment, particularly for cumulative risk assessment (CRA), because of its complexity. CRA encompasses the combined threats to health from exposure via all relevant routes to multiple stressors, including biological, chemical, physical and psychosocial stressors. As part of the HESI Risk Assessment in the 21st Century (RISK21) Project, a framework for CRA was developed in which problem formulation plays a critical role. The focus of this effort is primarily on a chemical CRA (i.e., two or more chemicals) with subsequent consideration of non-chemical stressors, defined as "modulating factors" (ModFs). Problem formulation is a systematic approach that identifies all factors critical to a specific risk assessment and considers the purpose of the assessment, scope and depth of the necessary analysis, analytical approach, available resources and outcomes, and overall risk management goal. There are numerous considerations that are specific to multiple stressors, and proper problem formulation can help to focus a CRA to the key factors in order to optimize resources. As part of the problem formulation, conceptual models for exposures and responses can be developed that address these factors, such as temporal relationships between stressors and consideration of the appropriate ModFs.

WASTE RESEARCH STRATEGY

EPA Science Inventory

The Waste Research Strategy covers research necessary to support both the proper management of solid and hazardous wastes and the effective remediation of contaminated waste sites. This research includes improving the assessment of existing environmental risks, as well as develop...

[Manual material handling risk assessment and ergonomic improvement in foodstuff retailing company].

PubMed

Maso, S; Maccà, I; Simonetti, A; Scopa, P; Paruzzolo, P; Bonacci, A; Murgolo, I; Bartolucci, G B

2011-01-01

The aim of this study is to assess and reduce the risk due to manual material handling in a company involved in the foodstuff retailing. The risk assessment was performed by NIOSH Variable Lifing Index in 13 different occupational conditions. As result the risk was present in any case, with VLI values ranging from 2.12 to 2.81. A good risk reduction has been accomplished correcting properly the most important multiplier involved in the computation of the revised NIOSH Lifting equation (lifting frequency and weight of heavier products). Even if the performed risk reduction has been significant, the residual risk is still higher than the level of acceptability.

The safety of non-incineration waste disposal devices in four hospitals of Tehran

PubMed Central

Farshad, Aliasghar; Gholami, Hamid; Farzadkia, Mahdi; Mirkazemi, Roksana; Kermani, Majid

2014-01-01

Background: The safe management of hospital waste is a challenge in many developing countries. Objectives: The aim of this study was to compare volatile organic compounds (VOCs) emissions and the microbial disinfectant safety in non-incineration waste disposal devices. Methods: VOC emissions and microbial infections were measured in four non-incineration waste disposal devices including: autoclave with and without a shredder, dry heat system, and hydroclave. Using NIOSH and US EPA-TO14 guidelines, the concentration and potential risk of VOCs in emitted gases from four devices were assessed. ProSpore2 biological indicators were used to assess the microbial analysis of waste residue. Results: There was a significant difference in the type and concentration of VOCs and microbial infection of residues in the four devices. Emissions from the autoclave with a shredder had the highest concentration of benzene, ethyl benzene, xylene, and BTEX, and emissions from the hydroclave had the highest concentration of toluene. The highest level of microbial infection was observed in the residues of the autoclave without a shredder. Conclusions: There is an increased need for proper regulation and control of non-incinerator devices and for monitoring and proper handling of these devices in developing countries. PMID:25000113

Estimating the Prevalence of Heat-Related Symptoms and Sun Safety-Related Behavior among Latino Farmworkers in Eastern North Carolina.

PubMed

Kearney, Gregory D; Hu, Hui; Xu, Xiaohui; Hall, Marla B; Balanay, Jo Anne G

2016-01-01

In hot weather, thermal heat generated by the body, combined with environmental heat from the sun, can lead outdoor workers to experience heat-related stress, severe illness, or even death. The aims of this study were to estimate the prevalence of heat-related symptoms and potential risk factors associated with sun safety-related behavior among Latino farmworkers. Data from interviewer-administered questionnaires were collected from a cross-sectional survey among farmworkers (N = 158) from August to September 2013. Data analysis assessed associations between work activities, sun safety behavior, and the prevalence of heat-related illness (HRI) symptoms among workers. Nearly two thirds (72%) of farmworkers experienced at least one HRI symptom and lacked proper cooling methods when working outdoors. Most workers reported wearing long-sleeved shirts (85%), long pants (98%), and baseball caps (93%). The prevalence of having one HRI symptom was 72% and 27% among workers having three or more HRI symptoms. The majority of farmworkers experience symptoms of HRI and are not provided with proper shade protection when working outdoors. Increased emphasis on administrative controls, particularly educating field supervisors and workers on how to avoid and recognize HRI, should be a priority.

Genetic risks and healthy choices: creating citizen-consumers of genetic services through empowerment and facilitation.

PubMed

Harvey, Alison

2010-03-01

Genetic testing to identify susceptibility to a variety of common complex diseases is increasingly becoming available. In this article, focusing on the development of genetic susceptibility testing for diet-related disease, I examine the emergence of direct-to-the-consumer genetic testing services and the (re)configuration of healthcare provision, both within and outside the specialist genetics service, in the UK. I identify two key techniques within these practices: empowerment and facilitation. Using Foucauldian social theory, I show that empowerment and facilitation are being positioned as tools for the creation of citizen-consumers who will make appropriate dietary choices, based on the results of their genetic analysis. Through these techniques, individuals are transformed into properly entrepreneurial citizens who will, through judicious choices, act to maximise their 'vital capital' (their health) and the capital of the social body. I argue that the user of these services is not purely an economic figure, making rational choices as a consumer, but that her configuration as a citizen-consumer who avails herself of genetic information and services in a proper manner ensures that she is fit to contribute to the economic life of our present.

The safety of non-incineration waste disposal devices in four hospitals of Tehran.

PubMed

Farshad, Aliasghar; Gholami, Hamid; Farzadkia, Mahdi; Mirkazemi, Roksana; Kermani, Majid

2014-01-01

The safe management of hospital waste is a challenge in many developing countries. The aim of this study was to compare volatile organic compounds (VOCs) emissions and the microbial disinfectant safety in non-incineration waste disposal devices. VOC emissions and microbial infections were measured in four non-incineration waste disposal devices including: autoclave with and without a shredder, dry heat system, and hydroclave. Using NIOSH and US EPA-TO14 guidelines, the concentration and potential risk of VOCs in emitted gases from four devices were assessed. ProSpore2 biological indicators were used to assess the microbial analysis of waste residue. There was a significant difference in the type and concentration of VOCs and microbial infection of residues in the four devices. Emissions from the autoclave with a shredder had the highest concentration of benzene, ethyl benzene, xylene, and BTEX, and emissions from the hydroclave had the highest concentration of toluene. The highest level of microbial infection was observed in the residues of the autoclave without a shredder. There is an increased need for proper regulation and control of non-incinerator devices and for monitoring and proper handling of these devices in developing countries.

Network model of bilateral power markets based on complex networks

NASA Astrophysics Data System (ADS)

Wu, Yang; Liu, Junyong; Li, Furong; Yan, Zhanxin; Zhang, Li

2014-06-01

The bilateral power transaction (BPT) mode becomes a typical market organization with the restructuring of electric power industry, the proper model which could capture its characteristics is in urgent need. However, the model is lacking because of this market organization's complexity. As a promising approach to modeling complex systems, complex networks could provide a sound theoretical framework for developing proper simulation model. In this paper, a complex network model of the BPT market is proposed. In this model, price advantage mechanism is a precondition. Unlike other general commodity transactions, both of the financial layer and the physical layer are considered in the model. Through simulation analysis, the feasibility and validity of the model are verified. At same time, some typical statistical features of BPT network are identified. Namely, the degree distribution follows the power law, the clustering coefficient is low and the average path length is a bit long. Moreover, the topological stability of the BPT network is tested. The results show that the network displays a topological robustness to random market member's failures while it is fragile against deliberate attacks, and the network could resist cascading failure to some extent. These features are helpful for making decisions and risk management in BPT markets.

OH maser proper motions in Cepheus A

NASA Astrophysics Data System (ADS)

Migenes, V.; Cohen, R. J.; Brebner, G. C.

1992-02-01

MERLIN measurements made between 1982 and 1989 reveal proper motions of OH masers in the source Cepheus A. The proper motions are typically a few milliarcsec per year, and are mainly directed away from the central H II regions. Statistical analysis of the data suggests an expansion time-scale of some 300 yr. The distance of the source implied by the proper motions is 320+140/-80 pc, assuming that the expansion is isotropic. The proper motions can be reconciled with the larger distance of 730 pc which is generally accepted, provided that the masers are moving at large angles to the line of sight. The expansion time-scale agrees with that of the magnetic field decay recently reported by Cohen, et al. (1990).

Intelligent seismic risk mitigation system on structure building

NASA Astrophysics Data System (ADS)

Suryanita, R.; Maizir, H.; Yuniorto, E.; Jingga, H.

2018-01-01

Indonesia located on the Pacific Ring of Fire, is one of the highest-risk seismic zone in the world. The strong ground motion might cause catastrophic collapse of the building which leads to casualties and property damages. Therefore, it is imperative to properly design the structural response of building against seismic hazard. Seismic-resistant building design process requires structural analysis to be performed to obtain the necessary building responses. However, the structural analysis could be very difficult and time consuming. This study aims to predict the structural response includes displacement, velocity, and acceleration of multi-storey building with the fixed floor plan using Artificial Neural Network (ANN) method based on the 2010 Indonesian seismic hazard map. By varying the building height, soil condition, and seismic location in 47 cities in Indonesia, 6345 data sets were obtained and fed into the ANN model for the learning process. The trained ANN can predict the displacement, velocity, and acceleration responses with up to 96% of predicted rate. The trained ANN architecture and weight factors were later used to build a simple tool in Visual Basic program which possesses the features for prediction of structural response as mentioned previously.

Clinical and Prognostic Effect of Plasma Fibrinogen in Renal Cell Carcinoma: A Meta-Analysis.

PubMed

Tian, Yuejun; Hong, Mei; Jing, Suoshi; Liu, Xingchen; Wang, Hanzhang; Wang, Xinping; Kaushik, Dharam; Rodriguez, Ronald; Wang, Zhiping

2017-01-01

Background . Although numerous studies have shown that plasma fibrinogen is linked to renal cell carcinoma (RCC) risk, the consistency and magnitude of the effect of plasma fibrinogen are unclear. The aim of the study was to explore the association between plasma fibrinogen and RCC prognosis. Methods . An electronic search of Embase, PubMed/MEDLINE, and the Cochrane databases was performed to identify relevant studies published prior to June 1, 2016. Results . A total of 3744 patients with RCC from 7 published studies were included in the meta-analysis. The prognostic and clinical relevance of plasma fibrinogen are evaluated in RCC patients. Statistical significance of the combined hazard ratio (HR) was detected for overall survival, cancer-specific survival, and disease-free survival. Our pooled results showed that elevated plasma fibrinogen was significantly associated with clinical stage and Fuhrman grading. The level of plasma fibrinogen was not found to be associated with tumor type and gender. Conclusions . Elevated plasma fibrinogen is a strong indicator of poorer prognosis of patients with RCC, whereas the plasma fibrinogen is not significantly associated with tumor type. Therefore, plasma fibrinogen could be used in patients with RCC for risk stratification and decision providing a proper therapeutic strategy.

The natech events during the 17 August 1999 Kocaeli earthquake: aftermath and lessons learned

NASA Astrophysics Data System (ADS)

Girgin, S.

2011-04-01

Natural-hazard triggered technological accidents (natechs) at industrial facilities have been recognized as an emerging risk. Adequate preparedness, proper emergency planning, and effective response are crucial for the prevention of natechs and mitigation of the consequences. Under the conditions of a natural disaster, the limited resources, the possible unavailability of mitigation measures, and the lack of adequate communication complicate the management of natechs. The analysis of past natechs is crucial for learning lessons and for preventing or preparing for future natechs. The 17 August 1999, Kocaeli earthquake, which was a devastating disaster hitting one of the most industrialized regions of Turkey, offers opportunities in this respect. Among many natechs that occurred due to the earthquake, the massive fire at the TUPRAS Izmit refinery and the acrylonitrile spill at the AKSA acrylic fiber production plant were especially important and highlight problems in the consideration of natechs in emergency planning, response to industrial emergencies during natural hazards, and information to the public during and following the incidents. The analysis of these events shows that even the largest and seemingly well-prepared facilities can be vulnerable to natechs if risks are not considered adequately.

A multi-criteria decision analysis of management alternatives for anaerobically digested kraft pulp mill sludge

PubMed Central

Eikelboom, Martijn; Lopes, Alice do Carmo Precci; Silva, Claudio Mudadu; Rodrigues, Fábio de Ávila; Zanuncio, José Cola

2018-01-01

The Multi-Criteria Decision Analysis (MCDA) procedure was used to compare waste management options for kraft pulp mill sludge following its anaerobic digestion. Anaerobic digestion of sludge is advantageous because it produces biogas that may be used to generate electricity, heat and biofuels. However, adequate management of the digested sludge is essential. Landfill disposal is a non-sustainable waste management alternative. Kraft pulp mill digested sludge applied to land may pose risks to the environment and public health if the sludge has not been properly treated. This study is aimed to compare several recycling alternatives for anaerobically digested sludge from kraft pulp mills: land application, landfill disposal, composting, incineration, pyrolysis/gasification, and biofuel production by algae. The MCDA procedure considered nine criteria into three domains to compare digested sludge recycling alternatives in a kraft pulp mill: environmental (CO2 emission, exposure to pathogens, risk of pollution, material and energy recovery), economic (overall costs, value of products) and technical (maintenance and operation, feasibility of implementation). The most suitable management options for digested sludge from kraft pulp mills were found to be composting and incineration (when the latter was coupled with recycling ash to the cement industry). Landfill disposal was the worst option, presenting low performance in feasibility of implementation, risk of pollution, material and energy recovery. PMID:29298296

Abnormal splenic artery diameter/hepatic artery diameter ratio in cirrhosis-induced portal hypertension

PubMed Central

Zeng, Dao-Bing; Dai, Chuan-Zhou; Lu, Shi-Chun; He, Ning; Wang, Wei; Li, Hong-Jun

2013-01-01

AIM: To determine an optimal cutoff value for abnormal splenic artery diameter/proper hepatic artery diameter (S/P) ratio in cirrhosis-induced portal hypertension. METHODS: Patients with cirrhosis and portal hypertension (n = 770) and healthy volunteers (n = 31) underwent volumetric computed tomography three-dimensional vascular reconstruction to measure the internal diameters of the splenic artery and proper hepatic artery to calculate the S/P ratio. The cutoff value for abnormal S/P ratio was determined using receiver operating characteristic curve analysis, and the prevalence of abnormal S/P ratio and associations between abnormal S/P ratio and major complications of portal hypertension were studied using logistic regression. RESULTS: The receiver operating characteristic analysis showed that the cutoff points for abnormal splenic artery internal diameter and S/P ratio were > 5.19 mm and > 1.40, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value were 74.2%, 45.2%, 97.1%, and 6.6%, respectively. The prevalence of an abnormal S/P ratio in the patients with cirrhosis and portal hypertension was 83.4%. Patients with a higher S/P ratio had a lower risk of developing ascites [odds ratio (OR) = 0.708, 95%CI: 0.508-0.986, P = 0.041] and a higher risk of developing esophageal and gastric varices (OR = 1.483, 95%CI: 1.010-2.175, P = 0.044) and forming collateral circulation (OR = 1.518, 95%CI: 1.033-2.230, P = 0.034). After splenectomy, the portal venous pressure and maximum and mean portal venous flow velocities were reduced, while the flow rate and maximum and minimum flow velocities of the hepatic artery were increased (P < 0.05). CONCLUSION: The prevalence of an abnormal S/P ratio is high in patients with cirrhosis and portal hypertension, and it can be used as an important marker of splanchnic hemodynamic disturbances. PMID:23483462

Prognostic Classification Factors Associated With Development of Multiple Autoantibodies, Dysglycemia, and Type 1 Diabetes-A Recursive Partitioning Analysis.

PubMed

Xu, Ping; Krischer, Jeffrey P

2016-06-01

To define prognostic classification factors associated with the progression from single to multiple autoantibodies, multiple autoantibodies to dysglycemia, and dysglycemia to type 1 diabetes onset in relatives of individuals with type 1 diabetes. Three distinct cohorts of subjects from the Type 1 Diabetes TrialNet Pathway to Prevention Study were investigated separately. A recursive partitioning analysis (RPA) was used to determine the risk classes. Clinical characteristics, including genotype, antibody titers, and metabolic markers were analyzed. Age and GAD65 autoantibody (GAD65Ab) titers defined three risk classes for progression from single to multiple autoantibodies. The 5-year risk was 11% for those subjects >16 years of age with low GAD65Ab titers, 29% for those ≤16 years of age with low GAD65Ab titers, and 45% for those subjects with high GAD65Ab titers regardless of age. Progression to dysglycemia was associated with islet antigen 2 Ab titers, and 2-h glucose and fasting C-peptide levels. The 5-year risk is 28%, 39%, and 51% for respective risk classes defined by the three predictors. Progression to type 1 diabetes was associated with the number of positive autoantibodies, peak C-peptide level, HbA1c level, and age. Four risk classes defined by RPA had a 5-year risk of 9%, 33%, 62%, and 80%, respectively. The use of RPA offered a new classification approach that could predict the timing of transitions from one preclinical stage to the next in the development of type 1 diabetes. Using these RPA classes, new prevention techniques can be tailored based on the individual prognostic risk characteristics at different preclinical stages. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Medical Surveillance Monthly Report

DTIC Science & Technology

2016-12-01

sure to ultraviolet radiation is the major risk factor for NMSC, personal pro- tective measures such as wearing proper clothing, decreasing time in...tone and light-colored eyes and hair, and envi- ronmental factors, particularly exposure to solar ultraviolet (UV) radiation .4 In the U.S., the... radiation is well accepted as a risk factor as evidenced by observed patterns or the anatomic distributions of NMSCs, higher rates by latitude, higher

Epidemiologic methods in clinical trials.

PubMed

Rothman, K J

1977-04-01

Epidemiologic methods developed to control confounding in non-experimental studies are equally applicable for experiments. In experiments, most confounding is usually controlled by random allocation of subjects to treatment groups, but randomization does not preclude confounding except for extremely large studies, the degree of confounding expected being inversely related to the size of the treatment groups. In experiments, as in non-experimental studies, the extent of confounding for each risk indicator should be assessed, and if sufficiently large, controlled. Confounding is properly assessed by comparing the unconfounded effect estimate to the crude effect estimate; a common error is to assess confounding by statistical tests of significance. Assessment of confounding involves its control as a prerequisite. Control is most readily and cogently achieved by stratification of the data, though with many factors to control simultaneously, multivariate analysis or a combination of multivariate analysis and stratification might be necessary.

The Importance of Experimental Design, Quality Assurance, and Control in Plant Metabolomics Experiments.

PubMed

Martins, Marina C M; Caldana, Camila; Wolf, Lucia Daniela; de Abreu, Luis Guilherme Furlan

2018-01-01

The output of metabolomics relies to a great extent upon the methods and instrumentation to identify, quantify, and access spatial information on as many metabolites as possible. However, the most modern machines and sophisticated tools for data analysis cannot compensate for inappropriate harvesting and/or sample preparation procedures that modify metabolic composition and can lead to erroneous interpretation of results. In addition, plant metabolism has a remarkable degree of complexity, and the number of identified compounds easily surpasses the number of samples in metabolomics analyses, increasing false discovery risk. These aspects pose a large challenge when carrying out plant metabolomics experiments. In this chapter, we address the importance of a proper experimental design taking into consideration preventable complications and unavoidable factors to achieve success in metabolomics analysis. We also focus on quality control and standardized procedures during the metabolomics workflow.

The white (male) effect and risk perception: can equality make a difference?

PubMed

Olofsson, Anna; Rashid, Saman

2011-06-01

Previous research has shown that white males have a relatively low perception of risks, known as the "white male effect" (WME). Many of the explanations of this effect refer to the privileged position of this particular demographic group in society, adducing white males' socio-economic resources, sense of control, worldviews, etc. It can thus be argued that inequality leads women and ethnic minorities to have higher risk perception than men and the ethnic majority. Therefore, the aim of this study is to investigate the WME in a gender-equal country, Sweden, to see if the pattern is similar to previous studies from the comparably less gender-equal United States. The empirical analyses are based on a national survey (n= 1,472) on the perception of risk conducted in Sweden in the winter of 2005. The results show that in Sweden there is no significant difference between men and women in risk perception, while people with foreign backgrounds perceive risks higher than native people. The chief finding is that there is no WME in Sweden, which we concluded results from the relative equality between the sexes in the country. On the other hand, ethnicity serves as a marker of inequality and discrimination in Sweden. Consequently, ethnicity, in terms of foreign background, mediates inequality, resulting in high risk perception. Equality therefore seems to be a fruitful concept with which to examine differences in risk perception between groups in society, and we propose that the "societal inequality effect" is a more proper description than the "WME." © 2011 Society for Risk Analysis.

76 FR 59134 - Medicare and Medicaid Programs; Approval of the Joint Commission's Continued Deeming Authority...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-23

... a qualified practitioner examine each patient before surgery to evaluate the risk of anesthesia. To... requirement that a qualified practitioner must evaluate each patient for proper anesthesia recovery before...

Evaluation of Kidney Donors: Core Curriculum 2018.

PubMed

Sawinski, Deirdre; Locke, Jayme E

2018-05-01

Nearly 100,000 patients are waiting for a kidney transplant, yet each year only 11,000 undergo transplantation with a deceased donor kidney. Annual death rates among waitlist registrants range from 5% to 15%; many die before receiving a transplant. Not surprisingly, registrants turn to family and friends to become living kidney donors on their behalf. Living kidney donor selection practices aim to quantify lifetime risk for kidney failure based on a candidate's predonation demographic and health characteristics. It has been established that estimated lifetime risk for kidney failure varies considerably based on predonation comorbid conditions, and as such, it is of paramount importance that potential living donor candidates undergo proper medical, surgical, and psychosocial screening before donation. This installment of AJKD's Core Curriculum in Nephrology provides readers with the tools necessary for proper evaluation of living kidney donor candidates. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Dermatologic radiotherapy and thyroid cancer. Dose measurements and risk quantification.

PubMed

Goldschmidt, H; Gorson, R O; Lassen, M

1983-05-01

Thyroid doses for various dermatologic radiation techniques were measured with thermoluminescent dosimeters and ionization rate meters in an Alderson-Rando anthropomorphic phantom. The effects of changes in radiation quality and of the use or nonuse of treatment cones and thyroid shields were evaluated in detail. The results indicate that the potential risk of radiogenic thyroid cancer is very small when proper radiation protection measures are used. The probability of radiogenic thyroid cancer developing and the potential mortality risk were assessed quantitatively for each measurement. The quantification of radiation risks allows comparisons with risks of other therapeutic modalities and the common hazards of daily life.

Effect of Varying Posterior Cruciate Ligament (PCL) Recessions on Kinematics and Ligament Strains with Cruciate Retaining Total Knee Prostheses.

PubMed

Schwarzkopf, Ran; Laster, Scott K; Cross, Michael B; Lenz, Nathaniel M

2016-04-01

Proper ligament tension in flexion with posterior cruciate retaining (CR) total knee arthroplasty (TKA) has long been associated with clinical success. The purpose of this study was to determine the effect of varying levels of posterior cruciate ligament (PCL) release on the tibiofemoral kinematics and PCL strain. A computational analysis was performed and varying levels of PCL release were simulated. Tibiofemoral kinematics was evaluated. The maximum PCL strain was determined for each bundle to evaluate the risk of rupture based on the failure strain. The femoral AP position shifted anteriorly as the PCL stiffness was reduced. PCL strain in both bundles increased as stiffness was reduced. The model predicts that the AL bundle should not rupture for a 75% release. Risk of PM bundle rupture is greater than AL bundle. Our findings suggest that a partial PCL release impacts tibiofemoral kinematics and ligament tension and strain. The relationship is dynamic and care should be taken when seeking optimal balance intra-operatively.

Preliminary Recommendations for the Collection, Storage, and Analysis of UAS Safety Data

NASA Technical Reports Server (NTRS)

Enomoto, Francis; Bushnell, David; Denney, Ewen; Pai, Ganesh; Schumann, Johann

2013-01-01

Although the use of UASs in military and public service operations is proliferating, civilian use of UASs remains limited in the United States today. With efforts underway to accommodate and integrate UASs into the NAS, a proactive understanding of safety issues, i.e., the unique hazards and the corresponding risks that UASs pose not only through their operations for commercial purposes, but also to existing operations in the NAS, is especially important so as to (a) support the development of a sound regulatory basis, (b) regulate, design and properly equip UASs, and (c) effectively mitigate the risks posed. Data, especially about system and component failures, incidents, and accidents, provides valuable insight into how performance and operational capabilities/limitations contribute to hazards. Since the majority of UAS operations today take place in a context that is significantly different from the norm in civil aviation, i.e., with different operational goals and standards, identifying that which constitutes useful and sufficient data on UASs and their operations is a substantial research challenge.

Carotid intima-media thickness: ultrasound measurement, prognostic value and role in clinical practice.

PubMed

Nair, Satheesh Balakrishnan; Malik, Rayaz; Khattar, Rajdeep S

2012-12-01

Ultrasound measurement of carotid intima-media thickness (IMT) has become a valuable tool for detecting and monitoring progression of atherosclerosis and recently published recommendations provide guidance for proper standardisation of these measurements. Important determinants of carotid IMT include age, gender, systolic blood pressure, diabetes mellitus and serum cholesterol levels. Many studies have shown carotid IMT to correlate with the severity of coronary atherosclerosis assessed by CT coronary calcification scores, coronary angiography and intravascular ultrasound. Consistent with its correlation with cardiovascular risk factors and coronary artery disease, a meta-analysis of large observational studies has shown carotid IMT to be a strong predictor of future cardiovascular events. Moreover, in patients with established coronary artery disease a reduction in carotid IMT has been shown to translate into a reduction in future cardiovascular events. Consensus statements now also recommend carotid IMT measurements to further refine the prognostic assessment of patients traditionally considered to be at an intermediate risk of cardiovascular disease.

Analysis of Geometric Shifts and Proper Setup-Margin in Prostate Cancer Patients Treated With Pelvic Intensity-Modulated Radiotherapy Using Endorectal Ballooning and Daily Enema for Prostate Immobilization.

PubMed

Jeong, Songmi; Lee, Jong Hoon; Chung, Mi Joo; Lee, Sea Won; Lee, Jeong Won; Kang, Dae Gyu; Kim, Sung Hwan

2016-01-01

We evaluate geometric shifts of daily setup for evaluating the appropriateness of treatment and determining proper margins for the planning target volume (PTV) in prostate cancer patients.We analyzed 1200 sets of pretreatment megavoltage-CT scans that were acquired from 40 patients with intermediate to high-risk prostate cancer. They received whole pelvic intensity-modulated radiotherapy (IMRT). They underwent daily endorectal ballooning and enema to limit intrapelvic organ movement. The mean and standard deviation (SD) of daily translational shifts in right-to-left (X), anterior-to-posterior (Y), and superior-to-inferior (Z) were evaluated for systemic and random error.The mean ± SD of systemic error (Σ) in X, Y, Z, and roll was 2.21 ± 3.42 mm, -0.67 ± 2.27 mm, 1.05 ± 2.87 mm, and -0.43 ± 0.89°, respectively. The mean ± SD of random error (δ) was 1.95 ± 1.60 mm in X, 1.02 ± 0.50 mm in Y, 1.01 ± 0.48 mm in Z, and 0.37 ± 0.15° in roll. The calculated proper PTV margins that cover >95% of the target on average were 8.20 (X), 5.25 (Y), and 6.45 (Z) mm. Mean systemic geometrical shifts of IMRT were not statistically different in all transitional and three-dimensional shifts from early to late weeks. There was no grade 3 or higher gastrointestinal or genitourianry toxicity.The whole pelvic IMRT technique is a feasible and effective modality that limits intrapelvic organ motion and reduces setup uncertainties. Proper margins for the PTV can be determined by using geometric shifts data.

Analysis of Geometric Shifts and Proper Setup-Margin in Prostate Cancer Patients Treated With Pelvic Intensity-Modulated Radiotherapy Using Endorectal Ballooning and Daily Enema for Prostate Immobilization

PubMed Central

Jeong, Songmi; Lee, Jong Hoon; Chung, Mi Joo; Lee, Sea Won; Lee, Jeong Won; Kang, Dae Gyu; Kim, Sung Hwan

2016-01-01

Abstract We evaluate geometric shifts of daily setup for evaluating the appropriateness of treatment and determining proper margins for the planning target volume (PTV) in prostate cancer patients. We analyzed 1200 sets of pretreatment megavoltage-CT scans that were acquired from 40 patients with intermediate to high-risk prostate cancer. They received whole pelvic intensity-modulated radiotherapy (IMRT). They underwent daily endorectal ballooning and enema to limit intrapelvic organ movement. The mean and standard deviation (SD) of daily translational shifts in right-to-left (X), anterior-to-posterior (Y), and superior-to-inferior (Z) were evaluated for systemic and random error. The mean ± SD of systemic error (Σ) in X, Y, Z, and roll was 2.21 ± 3.42 mm, −0.67 ± 2.27 mm, 1.05 ± 2.87 mm, and −0.43 ± 0.89°, respectively. The mean ± SD of random error (δ) was 1.95 ± 1.60 mm in X, 1.02 ± 0.50 mm in Y, 1.01 ± 0.48 mm in Z, and 0.37 ± 0.15° in roll. The calculated proper PTV margins that cover >95% of the target on average were 8.20 (X), 5.25 (Y), and 6.45 (Z) mm. Mean systemic geometrical shifts of IMRT were not statistically different in all transitional and three-dimensional shifts from early to late weeks. There was no grade 3 or higher gastrointestinal or genitourianry toxicity. The whole pelvic IMRT technique is a feasible and effective modality that limits intrapelvic organ motion and reduces setup uncertainties. Proper margins for the PTV can be determined by using geometric shifts data. PMID:26765418

Philosophy on astronaut protection: A physician`s perspective

DOE Office of Scientific and Technical Information (OSTI.GOV)

Holloway, H

The National Aeronautics and Space Administration has a responsibility to assure that proper ethical standards are applied in establishing and applying limits for the control of radiation doses to the astronauts. Such a responsibility obviously includes assuring that the astronauts are properly informed of the hazards associated with individuals missions and that they agree to accept the associated risks. The responsibility, however, does not end there. It includes a need to discuss how to initiate a discourse for developing the related ethical standards and how to determine who should be involved in their establishment. To assure that such proper communicationsmore » on matters that encompass the realms of policy, science, politics, and ethics. There is also a need to mesh public perceptions with those of the scientific and technical community. This will be a monumental undertaking.« less

INTERNAL PROPER MOTIONS IN THE ESKIMO NEBULA

DOE Office of Scientific and Technical Information (OSTI.GOV)

García-Díaz, Ma. T.; Gutiérrez, L.; Steffen, W.

We present measurements of internal proper motions at more than 500 positions of NGC 2392, the Eskimo Nebula, based on images acquired with WFPC2 on board the Hubble Space Telescope at two epochs separated by 7.695 yr. Comparisons of the two observations clearly show the expansion of the nebula. We measured the amplitude and direction of the motion of local structures in the nebula by determining their relative shift during that interval. In order to assess the potential uncertainties in the determination of proper motions in this object, in general, the measurements were performed using two different methods, used previously in themore » literature. We compare the results from the two methods, and to perform the scientific analysis of the results we choose one, the cross-correlation method, because it is more reliable. We go on to perform a ''criss-cross'' mapping analysis on the proper motion vectors, which helps in the interpretation of the velocity pattern. By combining our results of the proper motions with radial velocity measurements obtained from high resolution spectroscopic observations, and employing an existing 3D model, we estimate the distance to the nebula to be 1.3 kpc.« less

Blue enhanced light sources: opportunities and risks

NASA Astrophysics Data System (ADS)

Lang, Dieter

2012-03-01

Natural daylight is characterized by high proportions of blue light. By proof of a third type of photoreceptor in the human eye which is only sensitive in this spectral region and by subsequent studies it has become obvious that these blue proportions are essential for human health and well being. In various studies beneficial effects of indoor lighting with higher blue spectral proportions have been proven. On the other hand with increasing use of light sources having enhanced blue light for indoor illumination questions are arising about potential health risks attributed to blue light. Especially LED are showing distinct emission characteristics in the blue. Recently the French agency for food, environmental and occupational health & safety ANSES have raised the question on health issues related to LED light sources and have claimed to avoid use of LED for lighting in schools. In this paper parameters which are relevant for potential health risks will be shown and their contribution to risk factors will quantitatively be discussed. It will be shown how to differentiate between photometric parameters for assessment of beneficial as well as hazardous effects. Guidelines will be discussed how blue enhanced light sources can be used in applications to optimally support human health and well being and simultaneously avoid any risks attributed to blue light by a proper design of lighting parameters. In the conclusion it will be shown that no inherent health risks are related to LED lighting with a proper lighting design.

A 3-Protein Expression Signature of Neuroblastoma for Outcome Prediction.

PubMed

Xie, Yi; Xu, Hua; Fang, Fang; Li, Zhiheng; Zhou, Huiting; Pan, Jian; Guo, Wanliang; Zhu, Xueming; Wang, Jian; Wu, Yi

2018-05-22

Neuroblastoma (NB) is the most common extracranial solid tumor in children with contrasting outcomes. Precise risk assessment contributes to prognosis prediction, which is critical for treatment strategy decisions. In this study, we developed a 3-protein predictor model, including the neural stem cell marker Msi1, neural differentiation marker ID1, and proliferation marker proliferating cell nuclear antigen (PCNA), to improve clinical risk assessment of patients with NB. Kaplan-Meier analysis in the microarray data (GSE16476) revealed that low expression of ID1 and high expression of Msi1 and PCNA were associated with poor prognosis in NB patients. Combined application of these 3 markers to constitute a signature further stratified NB patients into different risk subgroups can help obtain more accurate prediction performance. Survival prognostic power of age and Msi1_ID1_PCNA signature by receiver operating characteristics analysis showed that this signature predicted more effectively and sensitively compared with classic risk stratification system, compensating for the deficiency of the prediction function of the age. Furthermore, we validated the expressions of these 3 proteins in neuroblastic tumor spectrum tissues by immunohistochemistry revealed that Msi1 and PCNA exhibited increased expression in NB compared with intermedial ganglioneuroblastoma and benign ganglioneuroma, whereas ID1 levels were reduced in NB. In conclusion, we established a robust risk assessment predictor model based on simple immunohistochemistry for therapeutic decisions of NB patients.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/.

Determinants of moderate-to-severe anaemia among women of reproductive age in Tanzania: analysis of data from the 2010 Tanzania Demographic and Health Survey.

PubMed

Wilunda, Calistus; Massawe, Siriel; Jackson, Caroline

2013-12-01

To identify determinants of moderate-to-severe anaemia among women of reproductive age in Tanzania. We included participants from the 2010 Tanzania Demographic and Health Survey, which collected data on socio-demographic and maternal health and determined haemoglobin levels from blood samples. We performed logistic regression to calculate adjusted odds ratios for associations between socio-demographic, contextual, reproductive and lifestyle factors, and moderate-to-severe anaemia and investigated interactions between certain risk factors. Of 9477 women, 20.1% were anaemic. Pregnancy was significantly associated with anaemia (adjusted OR 1.75, 95% CI 1.43-2.15), but the effect varied significantly by urban/rural residence, wealth and education. The effect of pregnancy was stronger in women without education and those who were in lower wealth groups, with significant interactions observed for each of these factors. Education was associated with a lower anaemia risk, particularly in the poorest group (OR 0.58, 95% CI 0.43-0.80), and in pregnant women. The risk of anaemia fell with rising iron supplementation coverage. Lack of toilet facilities increased anaemia risk (OR 1.26, 95% CI 1.00-1.60), whereas using hormonal contraception reduced it. There was no association with age, urban/rural residence, wealth or type of cooking fuel in adjusted analysis. Pregnant women in Tanzania are particularly at risk of moderate-to-severe anaemia, with the effect modified by urban/rural residence, education and wealth. Prevention interventions should target women with lower education or without proper sanitation facilities, and women who are pregnant, particularly if they are uneducated or in lower wealth groups. © 2013 John Wiley & Sons Ltd.

Combining operational models and data into a dynamic vessel risk assessment tool for coastal regions

NASA Astrophysics Data System (ADS)

Fernandes, R.; Braunschweig, F.; Lourenço, F.; Neves, R.

2015-07-01

The technological evolution in terms of computational capacity, data acquisition systems, numerical modelling and operational oceanography is supplying opportunities for designing and building holistic approaches and complex tools for newer and more efficient management (planning, prevention and response) of coastal water pollution risk events. A combined methodology to dynamically estimate time and space variable shoreline risk levels from ships has been developed, integrating numerical metocean forecasts and oil spill simulations with vessel tracking automatic identification systems (AIS). The risk rating combines the likelihood of an oil spill occurring from a vessel navigating in a study area - Portuguese Continental shelf - with the assessed consequences to the shoreline. The spill likelihood is based on dynamic marine weather conditions and statistical information from previous accidents. The shoreline consequences reflect the virtual spilled oil amount reaching shoreline and its environmental and socio-economic vulnerabilities. The oil reaching shoreline is quantified with an oil spill fate and behaviour model running multiple virtual spills from vessels along time. Shoreline risks can be computed in real-time or from previously obtained data. Results show the ability of the proposed methodology to estimate the risk properly sensitive to dynamic metocean conditions and to oil transport behaviour. The integration of meteo-oceanic + oil spill models with coastal vulnerability and AIS data in the quantification of risk enhances the maritime situational awareness and the decision support model, providing a more realistic approach in the assessment of shoreline impacts. The risk assessment from historical data can help finding typical risk patterns, "hot spots" or developing sensitivity analysis to specific conditions, whereas real time risk levels can be used in the prioritization of individual ships, geographical areas, strategic tug positioning and implementation of dynamic risk-based vessel traffic monitoring.

Women and heart disease: the role of diabetes and hyperglycemia.

PubMed

Barrett-Connor, Elizabeth; Giardina, Elsa-Grace V; Gitt, Anselm K; Gudat, Uwe; Steinberg, Helmut O; Tschoepe, Diethelm

2004-05-10

Cardiovascular disease (CVD) is the primary cause of death in women, and women with type 2 diabetes mellitus are at greater risk of CVD compared with nondiabetic women. The increment in risk attributable to diabetes is greater in women than in men. The extent to which hyperglycemia contributes to heart disease risk has been examined in observational studies and clinical trials, although most included only men or did not analyze sex differences. The probable adverse influence of hyperglycemia is potentially mediated by impaired endothelial function, and/or by other mechanisms. Beyond high blood glucose level, a number of other common risk factors for CVD, including hypertension, dyslipidemia, and cigarette smoking, are seen in women with diabetes and require special attention. Presentation and diagnosis of CVD may differ between women and men, regardless of the presence of diabetes. Recognizing the potential for atypical presentation of CVD in women and the limitations of common diagnostic tools are important in preventing unnecessary delay in initiating proper treatment. Based on what we know today, treatment of CVD should be at least as aggressive in women-and especially in those with diabetes-as it is in men. Future trials should generate specific data on CVD in women, either by design of female-only studies or by subgroup analysis by sex.

Evaluation of prevalence and risk factors of gestational diabetes in a tertiary care hospital in Kerala.

PubMed

Mohan, Manju A; Chandrakumar, Abin

2016-01-01

The prospective study was conducted with the aim to evaluate the prevalence and risk factors of gestational diabetes mellitus in a tertiary care referral hospital in Kerala. A prospective observational study was conducted with the aim to study the prevalence, risk factors, complications, treatment pattern and cost analysis of GDM. The study was carried out in the Obstetrics & Gynecology dDepartment of Al Shifa hHospital located in northern Kerala. Over an eight-month period, 201 patients who met the inclusion criteria were enrolled for study from which prevalence of GDM was estimated at 15.9%. The study revealed higher prevalence of risk factors and complications such as age >25 years, BMI >26kg/m(2), family history of DM, past history GDM, history of big baby, gestational hypertension, vaginal candidiasis, premature rupture of membranes and hyperbilirubinemia in GDM group as compared to non-GDM group. The study also demonstrated that modern life-style was a major influencing factor for development of diabetes in the study population. The study reveals the necessity of proper screening diagnosis and management of GDM in pregnant women by the clinicians so as to prevent the future burden of type 2 diabetes. Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Analyses in Support of Risk-Informed Natural Gas Vehicle Maintenance Facility Codes and Standards: Phase II.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Blaylock, Myra L.; LaFleur, Chris Bensdotter; Muna, Alice Baca

Safety standards development for maintenance facilities of liquid and compressed natural gas fueled vehicles is required to ensure proper facility design and operating procedures. Standard development organizations are utilizing risk-informed concepts to develop natural gas vehicle (NGV) codes and standards so that maintenance facilities meet acceptable risk levels. The present report summarizes Phase II work for existing NGV repair facility code requirements and highlights inconsistencies that need quantitative analysis into their effectiveness. A Hazardous and Operability study was performed to identify key scenarios of interest using risk ranking. Detailed simulations and modeling were performed to estimate the location and behaviormore » of natural gas releases based on these scenarios. Specific code conflicts were identified, and ineffective code requirements were highlighted and resolutions proposed. These include ventilation rate basis on area or volume, as well as a ceiling offset which seems ineffective at protecting against flammable gas concentrations. ACKNOWLEDGEMENTS The authors gratefully acknowledge Bill Houf (SNL -- Retired) for his assistance with the set-up and post-processing of the numerical simulations. The authors also acknowledge Doug Horne (retired) for his helpful discussions. We would also like to acknowledge the support from the Clean Cities program of DOE's Vehicle Technology Office.« less

Risk factors influencing morbidity and mortality in perforated peptic ulcer disease

PubMed Central

Taş, İlhan; Ülger, Burak Veli; Önder, Akın; Kapan, Murat; Bozdağ, Zübeyir

2015-01-01

Objective: Peptic ulcer perforation continues to be a major surgical problem. In this study, risk factors that influence morbidity and mortality in perforated peptic ulcer disease were examined. Material and Methods: Files of 148 patients who were included in the study due to peptic ulcer perforation between January 2006 and December 2010 were retrospectively analyzed. Data regarding age, gender, complaints, time elapsed between onset of symptoms and hospital admission, physical examination findings, co-morbid diseases, laboratory and imaging findings, length of hospital stay, morbidity and mortality were recorded. Results: The study group included 129 (87.2%) male and 19 (12.8%) female patients. The mean age was 51.7±20 (15-88) years. Forty five patients (30.4%) had at least one co-morbid disease. In the postoperative period, 30 patients (20.3%) had complications. The most common complication was wound infection. Mortality was observed in 27 patients (18.2%). The most common cause of mortality was sepsis. Multivariate analysis revealed age over 60 years, presence of co-morbidities and Mannheim peritonitis index as independent risk factors for morbidity. Age over 60 years, time to admission and Mannheim peritonitis index were detected as independent risk factors for mortality. Conclusion: Early diagnosis and proper treatment are important in patients presenting with peptic ulcer perforation. PMID:25931940

Risk factors influencing morbidity and mortality in perforated peptic ulcer disease.

PubMed

Taş, İlhan; Ülger, Burak Veli; Önder, Akın; Kapan, Murat; Bozdağ, Zübeyir

2015-01-01

Peptic ulcer perforation continues to be a major surgical problem. In this study, risk factors that influence morbidity and mortality in perforated peptic ulcer disease were examined. Files of 148 patients who were included in the study due to peptic ulcer perforation between January 2006 and December 2010 were retrospectively analyzed. Data regarding age, gender, complaints, time elapsed between onset of symptoms and hospital admission, physical examination findings, co-morbid diseases, laboratory and imaging findings, length of hospital stay, morbidity and mortality were recorded. The study group included 129 (87.2%) male and 19 (12.8%) female patients. The mean age was 51.7±20 (15-88) years. Forty five patients (30.4%) had at least one co-morbid disease. In the postoperative period, 30 patients (20.3%) had complications. The most common complication was wound infection. Mortality was observed in 27 patients (18.2%). The most common cause of mortality was sepsis. Multivariate analysis revealed age over 60 years, presence of co-morbidities and Mannheim peritonitis index as independent risk factors for morbidity. Age over 60 years, time to admission and Mannheim peritonitis index were detected as independent risk factors for mortality. Early diagnosis and proper treatment are important in patients presenting with peptic ulcer perforation.

Increased risk of comorbid rheumatic disorders in vitiligo patients: A nationwide population-based study.

PubMed

Choi, Chong Won; Eun, Sung Hye; Choi, Kwang Hyun; Bae, Jung Min

2017-08-01

Vitiligo is a common acquired depigmentation disorder. Previous studies have shown that vitiligo is associated with a variety of autoimmune disorders. However, a large-scale epidemiological study focused on comorbid rheumatic disorders has not been undertaken. To clarify the associations between vitiligo and various rheumatic disorders, we performed a cross-sectional study using data from the Korean National Health Insurance claims database. Between 2009 and 2013, totals of 86 210 patients with vitiligo and 172 420 age- and sex-matched controls without vitiligo were enrolled in this study. Vitiligo patients were found to be at increased risk of systemic lupus erythematosus, systemic sclerosis, Sjögren's syndrome and rheumatoid arthritis, but no significant association was found between vitiligo and dermatomyositis/polymyositis, Behçet's disease or ankylosing spondylitis. Subgroup analysis showed an increased risk of dermatomyositis/polymyositis in male and ankylosing spondylitis in female vitiligo patients. The risks of dermatomyositis/polymyositis or ankylosing spondylitis were higher in young vitiligo patients. Our study confirms a significant association between vitiligo and rheumatic disorders. Differences in comorbid rheumatic disorders by age group and sex suggest the need for patient-specific approaches. Careful consideration of rheumatic disorders is required for the proper management of comorbidities in vitiligo patients. © 2017 Japanese Dermatological Association.

Appearance of Abnormal Cardiothoracic Ratio of Fetuses with Hemoglobin Bart's Disease: Life Table Analysis.

PubMed

Wanapirak, Chanane; Sirichotiyakul, Supatra; Luewan, Suchaya; Srisupundit, Kasemsri; Tongprasert, Fuanglada; Tongsong, Theera

2017-10-01

Objective  To determine the timeline of the first appearance of an increased CT ratio of fetuses with hemoglobin (Hb) Bart's disease. Materials and Methods  A prospective longitudinal study was conducted on pregnancies at risk for fetal Hb Bart's disease. Sonographic markers including cardiothoracic (CT) ratio and middle cerebral artery peak systolic velocity (MCA-PSV) were serially assessed and recorded from the first trimester. The definite diagnosis of fetal Hb Bart's disease based on DNA analysis (CVS), or fetal Hb typing (HPLC; cordocentesis) was performed at the first appearance of an increased CT ratio. Results  Of 275 pregnancies at risk, 64 fetuses were finally proven to be affected and life table analysis was performed. Most affected fetuses showed an increased CT ratio in late first trimester and early second trimester, with median time of the first appearance at 13 weeks and all affected fetuses were detected at 23 weeks or less. The CT ratio yielded a sensitivity of 100 % at a gestational age of 23 weeks with a false-positive rate of 8 %. MCA-PSV appeared later than CT ratio. Only 9.4 % of affected cases developed abnormal MCA-PSV before an increased CT ratio. Conclusion  The timeline of the first appearance of an increased CT ratio of fetuses with Hb Bart's disease was established. This may help us identify Hb Bart's disease among fetuses at risk in earlier gestation and proper schedules for serial ultrasound could be made more effectively. © Georg Thieme Verlag KG Stuttgart · New York.

Importance of biometrics to addressing vulnerabilities of the U.S. infrastructure

NASA Astrophysics Data System (ADS)

Arndt, Craig M.; Hall, Nathaniel A.

2004-08-01

Human identification technologies are important threat countermeasures in minimizing select infrastructure vulnerabilities. Properly targeted countermeasures should be selected and integrated into an overall security solution based on disciplined analysis and modeling. Available data on infrastructure value, threat intelligence, and system vulnerabilities are carefully organized, analyzed and modeled. Prior to design and deployment of an effective countermeasure; the proper role and appropriateness of technology in addressing the overall set of vulnerabilities is established. Deployment of biometrics systems, as with other countermeasures, introduces potentially heightened vulnerabilities into the system. Heightened vulnerabilities may arise from both the newly introduced system complexities and an unfocused understanding of the set of vulnerabilities impacted by the new countermeasure. The countermeasure's own inherent vulnerabilities and those introduced by the system's integration with the existing system are analyzed and modeled to determine the overall vulnerability impact. The United States infrastructure is composed of government and private assets. The infrastructure is valued by their potential impact on several components: human physical safety, physical/information replacement/repair cost, potential contribution to future loss (criticality in weapons production), direct productivity output, national macro-economic output/productivity, and information integrity. These components must be considered in determining the overall impact of an infrastructure security breach. Cost/benefit analysis is then incorporated in the security technology deployment decision process. Overall security risks based on system vulnerabilities and threat intelligence determines areas of potential benefit. Biometric countermeasures are often considered when additional security at intended points of entry would minimize vulnerabilities.

The two-dimensional Monte Carlo: a new methodologic paradigm for dose reconstruction for epidemiological studies.

PubMed

Simon, Steven L; Hoffman, F Owen; Hofer, Eduard

2015-01-01

Retrospective dose estimation, particularly dose reconstruction that supports epidemiological investigations of health risk, relies on various strategies that include models of physical processes and exposure conditions with detail ranging from simple to complex. Quantification of dose uncertainty is an essential component of assessments for health risk studies since, as is well understood, it is impossible to retrospectively determine the true dose for each person. To address uncertainty in dose estimation, numerical simulation tools have become commonplace and there is now an increased understanding about the needs and what is required for models used to estimate cohort doses (in the absence of direct measurement) to evaluate dose response. It now appears that for dose-response algorithms to derive the best, unbiased estimate of health risk, we need to understand the type, magnitude and interrelationships of the uncertainties of model assumptions, parameters and input data used in the associated dose estimation models. Heretofore, uncertainty analysis of dose estimates did not always properly distinguish between categories of errors, e.g., uncertainty that is specific to each subject (i.e., unshared error), and uncertainty of doses from a lack of understanding and knowledge about parameter values that are shared to varying degrees by numbers of subsets of the cohort. While mathematical propagation of errors by Monte Carlo simulation methods has been used for years to estimate the uncertainty of an individual subject's dose, it was almost always conducted without consideration of dependencies between subjects. In retrospect, these types of simple analyses are not suitable for studies with complex dose models, particularly when important input data are missing or otherwise not available. The dose estimation strategy presented here is a simulation method that corrects the previous deficiencies of analytical or simple Monte Carlo error propagation methods and is termed, due to its capability to maintain separation between shared and unshared errors, the two-dimensional Monte Carlo (2DMC) procedure. Simply put, the 2DMC method simulates alternative, possibly true, sets (or vectors) of doses for an entire cohort rather than a single set that emerges when each individual's dose is estimated independently from other subjects. Moreover, estimated doses within each simulated vector maintain proper inter-relationships such that the estimated doses for members of a cohort subgroup that share common lifestyle attributes and sources of uncertainty are properly correlated. The 2DMC procedure simulates inter-individual variability of possibly true doses within each dose vector and captures the influence of uncertainty in the values of dosimetric parameters across multiple realizations of possibly true vectors of cohort doses. The primary characteristic of the 2DMC approach, as well as its strength, are defined by the proper separation between uncertainties shared by members of the entire cohort or members of defined cohort subsets, and uncertainties that are individual-specific and therefore unshared.

Personality patterns predict the risk of antisocial behavior in Spanish-speaking adolescents.

PubMed

Alcázar-Córcoles, Miguel A; Verdejo-García, Antonio; Bouso-Sáiz, José C; Revuelta-Menéndez, Javier; Ramírez-Lira, Ezequiel

2017-05-01

There is a renewed interest in incorporating personality variables in criminology theories in order to build models able to integrate personality variables and biological factors with psychosocial and sociocultural factors. The aim of this article is the assessment of personality dimensions that contribute to the prediction of antisocial behavior in adolescents. For this purpose, a sample of adolescents from El Salvador, Mexico, and Spain was obtained. The sample consisted of 1035 participants with a mean age of 16.2. There were 450 adolescents from a forensic population (those who committed a crime) and 585 adolescents from the normal population (no crime committed). All of participants answered personality tests about neuroticism, extraversion, psychoticism, sensation seeking, impulsivity, and violence risk. Principal component analysis of the data identified two independent factors: (i) the disinhibited behavior pattern (PDC), formed by the dimensions of neuroticism, psychoticism, impulsivity and risk of violence; and (ii) the extrovert behavior pattern (PEC), formed by the dimensions of sensation risk and extraversion. Both patterns significantly contributed to the prediction of adolescent antisocial behavior in a logistic regression model which properly classifies a global percentage of 81.9%, 86.8% for non-offense and 72.5% for offense behavior. The classification power of regression equations allows making very satisfactory predictions about adolescent offense commission. Educational level has been classified as a protective factor, while age and gender (male) have been classified as risk factors.

Direct and reverse pollen-mediated gene flow between GM rice and red rice weed

PubMed Central

Serrat, X.; Esteban, R.; Peñas, G.; Català, M. M.; Melé, E.; Messeguer, J.

2013-01-01

Potential risks of genetically modified (GM) crops must be identified before their commercialization, as happens with all new technologies. One of the major concerns is the proper risk assessment of adventitious presence of transgenic material in rice fields due to cross-pollination. Several studies have been conducted in order to quantify pollen-mediated gene flow from transgenic rice (Oryza sativa) to both conventional rice and red rice weed (O. sativa f. spontanea) under field conditions. Some of these studies reported GM pollen-donor rice transferring GM traits to red rice. However, gene flow also occurs in the opposite direction, in a phenomenon that we have called reverse gene flow, resulting in transgenic seeds that have incorporated the traits of wild red rice. We quantified reverse gene flow using material from two field trials. A molecular analysis based on amplified fragment length polymorphisms was carried out, being complemented with a phenotypic identification of red rice traits. In both field trials, the reverse gene flow detected was greater than the direct gene flow. The rate of direct gene flow varied according to the relative proportions of the donor (GM rice) and receptor (red rice) plants and was influenced by wind direction. The ecological impact of reverse gene flow is limited in comparison with that of direct gene flow because non-shattered and non-dormant seeds would be obtained in the first generation. Hybrid seed would remain in the spike and therefore most of it would be removed during harvesting. Nevertheless, this phenomenon must be considered in fields used for elite seed production and in developing countries where farmers often keep some seed for planting the following year. In these cases, there is a higher risk of GM red rice weed infestation increasing from year to year and therefore a proper monitoring plan needs to be established.

A Contemporary Medicolegal Analysis of Implanted Devices for Chronic Pain Management.

PubMed

Abrecht, Christopher R; Greenberg, Penny; Song, Ellen; Urman, Richard D; Rathmell, James P

2017-04-01

Analysis of closed malpractice claims allows the study of rare but serious complications and likely results in improved patient safety by raising awareness of such complications. Clinical studies and closed claims analyses have previously reported on the common complications associated with intrathecal drug delivery systems (IDDS) and spinal cord stimulators (SCS). This study provides a contemporary analysis of claims from within the past 10 years. We performed a closed claims analysis for a period January 1, 2009 to December 31, 2013 for cases with pain medicine as the primary service. These cases were identified using the Controlled Risk Insurance Company (CRICO) Comparative Benchmarking System (CBS), a database containing more than 300,000 malpractice claims from more than 400 academic and community institutions, representing approximately 30% of malpractice cases in the United States. The clinical narratives, which included medical files, claims files, depositions, and expert witness testimony, were reviewed by the authors, as were the CRICO coded variables, which included algorithmically determined contributing factors to the patient injury. Intrathecal drug delivery systems represented 17 of the closed claims; spinal cord stimulators represented 11 of the closed claims. The most common chronic pain diagnoses for which a device was implanted included failed back surgery syndrome and spasticity. The average total incurred for pain medicine claims was $166,028. Damaging events included IDDS refill errors (eg, subcutaneous administration of medication, reprogramming errors), intraoperative nerve damage, and postoperative infection (eg, epidural abscess, meningitis). High-severity outcomes included nerve damage (eg, paraplegia) and death. Medium-severity outcomes included drug reactions (eg, respiratory arrest from opioid overdose) and the need for reoperation. For both IDDS and SCS, deficits in technical skill were the most common contributing factor to injury, followed by deficits in clinical judgment, communication, and documentation. Implanted devices used for pain management involve a significant risk of morbidity and mortality. Proper education of providers and patients is essential. Providers must acquire the technical skills required for the implantation and refilling of these devices and the clinical skills required for the identification and management of complications such as intrathecal granuloma. Proper patient selection and clear communication between the provider and the patient about these possible complications are of paramount importance.

Neck keloids: evaluation of risk factors and recommendation for keloid staging system.

PubMed

Tirgan, Michael H

2016-01-01

Importance : Health care providers have long struggled with recurrent and hard to treat keloids. Advancing our understanding of natural history and risk factors for development of large, very large and massive neck keloids can lead to improved treatment outcomes. Clinical staging system for the categorization of keloid lesions, as well as grouping of keloid patients according to the extent of skin involvement is both fundamental for design and delivery of proper plan of care and an absolute necessity for methodical trial design and interpretation of the results thereof. Objective : To review clinical presentation and natural history of neck keloids; to explore risk factors for development of large, very large and massive neck keloids; and to propose a clinical staging system that allows for categorization of keloid lesions by their size and grouping of keloid patients by the extent of their skin involvement.  Setting:  This is a retrospective analysis of 82 consecutive patients with neck keloids who were seen by the author in his keloid specialty medical practice.    Intervention : Non-surgical treatment was offered to all patients.  Results : Neck-area keloids were found to have several unique characteristics. All 65 African Americans in this study had keloidal lesions elsewhere on their skin. Very large and massive neck keloids appear to be race-specific and almost exclusively seen among African Americans. Submandibular and submental skin was the most commonly involved area of the neck. Keloid removal surgery was found to be the main risk factor for development of very large and massive neck keloids.  Conclusions and relevance : Surgical removal of neck keloids results in wounding of the skin and triggering a pathological wound-healing response that often leads to formation of a much larger keloid.  Given the potential for greater harm from surgery, the author proposes non-surgical approach for treatment of all primary neck keloids. Author's attempts to properly categorize keloid lesions and to group the study subjects was hampered by the lack of a previously defined methodology. A clinical staging system is proposed to address the deficiency in grouping of keloid patients according to the size and extent of skin involvement with keloid lesions.

The natural history of Charcot's neuroarthropathy.

PubMed

Nielson, David L; Armstrong, David G

2008-01-01

The goal of this article is to outline the progression of Charcot's neuroarthropathy. A historical background is detailed, with an emphasis on the current trends in the literature. Acute Charcot's neuroarthropathy requires a prompt diagnosis with the proper practical offloading methods of the affected limb. This, coupled with directed medical and surgical approaches designed to prevent or mitigate deformities, may subsequently reduce the risk of amputation in this high-risk population.

Study on status quo of shipbreaking sector and strategies

NASA Astrophysics Data System (ADS)

Shen, Wei; Xing, Guojing

2017-11-01

In recent years, the quantity of broken obsolete vessels tends to rise year by year in the shipbreaking sector, but breaking down obsolete vessels is one of vessel operations with high pollution and high risk, involving proper disposal of hazardous substances, bulge discarded oils and other materials, and thus causing great danger and harm. In this paper the author investigates mainly the status quo of the shipbreaking sector, comes up with the “green-shipbreaking” concept, analyzes main problems currently present in the shipbreaking sector and presents proper strategies and recommendations to deal with them.

Intuition and logic in human evolution

PubMed Central

Campbell, Robert

2012-01-01

Modern science has come to be regarded as an exclusively objective endeavor employing explicit language that attempts to exclude subjective anthropomorphic biases. In doing so it has run the risk of becoming a purely materialistic bias itself, according no proper place to the human spirit or to intuitive insights that have guided the evolution of human cultures, even though this includes the guiding insights of the most important contributors to the sciences. Although this may have been necessary to exclude rampant superstition in the past, a summary overview of the historical evidence indicates a current pressing need to restore a proper balance. PMID:23181155

Providing the Fire Risk Map in Forest Area Using a Geographically Weighted Regression Model with Gaussin Kernel and Modis Images, a Case Study: Golestan Province

NASA Astrophysics Data System (ADS)

Shah-Heydari pour, A.; Pahlavani, P.; Bigdeli, B.

2017-09-01

According to the industrialization of cities and the apparent increase in pollutants and greenhouse gases, the importance of forests as the natural lungs of the earth is felt more than ever to clean these pollutants. Annually, a large part of the forests is destroyed due to the lack of timely action during the fire. Knowledge about areas with a high-risk of fire and equipping these areas by constructing access routes and allocating the fire-fighting equipment can help to eliminate the destruction of the forest. In this research, the fire risk of region was forecasted and the risk map of that was provided using MODIS images by applying geographically weighted regression model with Gaussian kernel and ordinary least squares over the effective parameters in forest fire including distance from residential areas, distance from the river, distance from the road, height, slope, aspect, soil type, land use, average temperature, wind speed, and rainfall. After the evaluation, it was found that the geographically weighted regression model with Gaussian kernel forecasted 93.4% of the all fire points properly, however the ordinary least squares method could forecast properly only 66% of the fire points.

Balancing cardiovascular and gastrointestinal risks in patients with osteoarthritis receiving nonsteroidal anti‑inflammatory drugs. A summary of guidelines from an international expert group.

PubMed

Mosleh, Wassim; Farkouh, Michael E

2016-01-01

Over the past 2 decades, extensive research has assessed the use of traditional nonsteroidal anti‑inflammatory drugs (NSAIDs), and the newer cyclooxygenase‑2 (COX-2) inhibitor drugs, in the treatment of chronic pain syndromes. The proper use of NSAIDs has been the subject of significant debate, bringing together multidisciplinary researchers and clinicians to discuss the risks and benefits of these therapies. Current guidelines discussing the proper use of NSAIDs do not address the issue of the risks of COX‑2‑selective NSAIDs and nonselective NSAIDs for both the gastrointestinal (GI) and cardiovascular (CV) systems in patients on low‑dose aspirin. Accordingly, a multidisciplinary expert group was organized to review the current evidence with the aim of developing statements devoted to guide clinicians in making evidence‑based and individualized selections of NSAIDs. This review will discuss and summarize the most recent evidence on this topic to give an insight into the most effective and safest therapeutic options, thus preventing serious adverse CV and GI events. NSAIDs should be used cautiously and as infrequently as possible, with nonpharmacological approaches prescribed first. If the use of NSAIDs is required, the choice should balance the possible CV and GI risks.

Dental Students' Perceptions of Risk Factors for Musculoskeletal Disorders: Adapting the Job Factors Questionnaire for Dentistry.

PubMed

Presoto, Cristina D; Wajngarten, Danielle; Domingos, Patrícia A S; Campos, Juliana A D B; Garcia, Patrícia P N S

2018-01-01

The aims of this study were to adapt the Job Factors Questionnaire to the field of dentistry, evaluate its psychometric properties, evaluate dental students' perceptions of work/study risk factors for musculoskeletal disorders, and determine the influence of gender and academic level on those perceptions. All 580 students enrolled in two Brazilian dental schools in 2015 were invited to participate in the study. A three-factor structure (Repetitiveness, Work Posture, and External Factors) was tested through confirmatory factor analysis. Convergent validity was estimated using the average variance extracted (AVE), discriminant validity was based on the correlational analysis of the factors, and reliability was assessed. A causal model was created using structural equation modeling to evaluate the influence of gender and academic level on students' perceptions. A total of 480 students completed the questionnaire for an 83% response rate. The responding students' average age was 21.6 years (SD=2.98), and 74.8% were women. Higher scores were observed on the Work Posture factor items. The refined model presented proper fit to the studied sample. Convergent validity was compromised only for External Factors (AVE=0.47), and discriminant validity was compromised for Work Posture and External Factors (r 2 =0.69). Reliability was adequate. Academic level did not have a significant impact on the factors, but the women students exhibited greater perception. Overall, the adaptation resulted in a useful instrument for assessing perceptions of risk factors for musculoskeletal disorders. Gender was found to significantly influence all three factors, with women showing greater perception of the risk factors.

The true meaning of 'exotic species' as a model for genetically engineered organisms.

PubMed

Regal, P J

1993-03-15

The exotic or non-indigenous species model for deliberately introduced genetically engineered organisms (GEOs) has often been misunderstood or misrepresented. Yet proper comparisons of of ecologically competent GEOs to the patterns of adaptation of introduced species have been highly useful among scientists in attempting to determine how to apply biological theory to specific GEO risk issues, and in attempting to define the probabilities and scale of ecological risks with GEOs. In truth, the model predicts that most projects may be environmentally safe, but a significant minority may be very risky. The model includes a history of institutional follies that also should remind workers of the danger of oversimplifying biological issues, and warn against repeating the sorts of professional misjudgements that have too often been made in introducing organisms to new settings. We once expected that the non-indigenous species model would be refined by more analysis of species eruptions, ecological genetics, and the biology of select GEOs themselves, as outlined. But there has been political resistance to the effective regulation of GEOs, and a bureaucratic tendency to focus research agendas on narrow data collection. Thus there has been too little promotion by responsible agencies of studies to provide the broad conceptual base for truly science-based regulation. In its presently unrefined state, the non-indigenous species comparison would overestimate the risks of GEOs if it were (mis)applied to genetically disrupted, ecologically crippled GEOs, but in some cases of wild-type organisms with novel engineered traits, it could greatly underestimate the risks. Further analysis is urgently needed.

Season and preterm birth in Norway: A cautionary tale.

PubMed

Weinberg, Clarice R; Shi, Min; DeRoo, Lisa A; Basso, Olga; Skjærven, Rolv

2015-06-01

Preterm birth is a common, costly and dangerous pregnancy complication. Seasonality of risk would suggest modifiable causes. We examine seasonal effects on preterm birth, using data from the Medical Birth Registry of Norway (2,321,652 births), and show that results based on births are misleading and a fetuses-at-risk approach is essential. In our harmonic-regression Cox proportional hazards model we consider fetal risk of birth between 22 and 37 completed weeks of gestation. We examine effects of both day of year of conception (for early effects) and day of ongoing gestation (for seasonal effects on labour onset) as modifiers of gestational-age-based risk. Naïve analysis of preterm rates across days of birth shows compelling evidence for seasonality (P < 10(-152)). However, the reconstructed numbers of conceptions also vary with season (P < 10(-307)), confounding results by inducing seasonal variation in the age distribution of the fetal population at risk. When we instead properly treat fetuses as the individuals at risk, restrict analysis to pregnancies with relatively accurate ultrasound-based assessment of gestational age (available since 1998) and adjust for socio-demographic factors and maternal smoking, we find modest effects of both time of year of conception and time of year at risk, with peaks for early preterm near early January and early July. Analyses of seasonal effects on preterm birth are demonstrably vulnerable to confounding by seasonality of conception, measurement error in conception dating, and socio-demographic factors. The seasonal variation based on fetuses reveals two peaks for early preterm, coinciding with New Year's Day and the early July beginning of Norway's summer break, and may simply reflect a holiday-related pattern of unintended conception. Published by Oxford University Press on behalf of the International Epidemiological Association 2015. This work is written by a US Government employee and is in the public domain in the US.

Priorities and prospect theory.

PubMed

Happich, M; Mazurek, B

2002-01-01

Whose preferences are to be used for cost-effectiveness analysis? It has been recommended that community preferences for health states are the most appropriate ones for use in a reference case analysis. However, critics maintain that persons are not able properly to judge a health state if they have not experienced the condition themselves. This problem is analyzed here in the framework of Prospect Theory. It can be argued that the differing reference points of patients and the general public are responsible for deviating results. In addition, we argue that risk attitudes with respect to health-related quality of life are an indicator of reference points. If patients and the general public refer to the same reference point, i.e., they have the same risk attitude, the hypothesis is that deviations no longer significantly differ. Evaluations of the health condition of tinnitus by 210 patients and 210 unaffected persons were compared. The Time Tradeoff and Standard Gamble methods were applied to elicit preferences. Risk attitude was measured with the question of whether participants would undergo a treatment that could either improve or worsen their health condition, both with an equal chance (five possible answers between "in no case" and "in any case"). Affected persons indicated significantly higher values for tinnitus-related quality of life according to the Standard Gamble method. The difference between Time Tradeoff values was less dramatic but still significant. In addition, nonaffected persons are more risk-averse than affected persons. However, differences in evaluations are not significant considering single risk groups (e.g., those who answered "in no case"). Prospect Theory is a reasonable framework for considering the question of whose preferences count. If this result can be generalized for other diseases as well, it allows the mathematical combination of "objective" evaluations by the general public with the illness experience of patients. These evaluations should be weighted with patients' risk attitudes, i.e., community preferences can be used if they are corrected for risk attitudes.

Risk factors for hearing loss in infants under universal hearing screening program in Northern Thailand

PubMed Central

Poonual, Watcharapol; Navacharoen, Niramon; Kangsanarak, Jaran; Namwongprom, Sirianong

2016-01-01

Objective To define the risk factors for hearing loss in infants (aged 3 months) under universal hearing screening program. Materials and methods A total of 3,120 infants (aged 3 months) who underwent hearing screening using a universal hearing screening program using automated otoacoustic emission test between November 1, 2010 and May 31, 2012 in Uttaradit Hospital, Buddhachinaraj Hospital, and Sawanpracharuk Hospital (tertiary hospitals) located in Northern Thailand were included in this prospective cohort study. Results Of the 3,120 infants, 135 (4.3%) were confirmed to have hearing loss with the conventional otoacoustic emission test. Five of these 135 infants (3.7%) with hearing loss showed test results consistent with auditory brainstem responses. From the univariable analysis, there were eleven potential risk factors associated with hearing deterioration. On multivariable analysis, the risk factors independently associated with hearing loss at 3 months were birth weight 1,500–2,500 g (risk ratio [RR] 1.6, 95% confidence interval [CI] 1.1–2.6), APGAR score <6 at 5 minutes (RR 2.2, 95% CI 1.1–4.4), craniofacial anomalies (RR 2.5, 95% CI 1.6–4.2), sepsis (RR 1.8, 95% CI 1.0–3.2), and ototoxic exposure (RR 4.1, 95% CI 1.9–8.6). Conclusion This study concluded that low birth weight, APGAR score <6 at 5 minutes, craniofacial anomalies, sepsis, and ototoxic exposure are the risk factors for bilateral hearing loss in infants (aged 3 months) and proper tests should be performed to identify these risk factors. As an outcome, under the present circumstances, it is suggested that infirmary/physicians/general practitioners/health action centers/polyclinics should carry out universal hearing screening in all infants before 36 weeks. The public health policy of Thailand regarding a universal hearing screening program is important for the prevention of disability and to enhance people’s quality of life. PMID:26766912

ASSESSMENT OF DYNAMIC PRA TECHNIQUES WITH INDUSTRY AVERAGE COMPONENT PERFORMANCE DATA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yadav, Vaibhav; Agarwal, Vivek; Gribok, Andrei V.

In the nuclear industry, risk monitors are intended to provide a point-in-time estimate of the system risk given the current plant configuration. Current risk monitors are limited in that they do not properly take into account the deteriorating states of plant equipment, which are unit-specific. Current approaches to computing risk monitors use probabilistic risk assessment (PRA) techniques, but the assessment is typically a snapshot in time. Living PRA models attempt to address limitations of traditional PRA models in a limited sense by including temporary changes in plant and system configurations. However, information on plant component health are not considered. Thismore » often leaves risk monitors using living PRA models incapable of conducting evaluations with dynamic degradation scenarios evolving over time. There is a need to develop enabling approaches to solidify risk monitors to provide time and condition-dependent risk by integrating traditional PRA models with condition monitoring and prognostic techniques. This paper presents estimation of system risk evolution over time by integrating plant risk monitoring data with dynamic PRA methods incorporating aging and degradation. Several online, non-destructive approaches have been developed for diagnosing plant component conditions in nuclear industry, i.e., condition indication index, using vibration analysis, current signatures, and operational history [1]. In this work the component performance measures at U.S. commercial nuclear power plants (NPP) [2] are incorporated within the various dynamic PRA methodologies [3] to provide better estimates of probability of failures. Aging and degradation is modeled within the Level-1 PRA framework and is applied to several failure modes of pumps and can be extended to a range of components, viz. valves, generators, batteries, and pipes.« less

Evaluation of Levels, Sources and Health Hazards of Road-Dust Associated Toxic Metals in Jalalabad and Kabul Cities, Afghanistan.

PubMed

Jadoon, Waqar Azeem; Khpalwak, Wahdatullah; Chidya, Russel Chrispine Garven; Abdel-Dayem, Sherif Mohamed Mohamed Ali; Takeda, Kazuhiko; Makhdoom, Masood Arshad; Sakugawa, Hiroshi

2018-01-01

This study was designed to investigate selected road-dust associated heavy metals, their relations with natural and anthropogenic sources, and potential human and environmental health risks. For this purpose, 42 and 36 road-dusts samples were collected from Jalalabad and Kabul cities (Afghanistan), respectively. The following elements were found in descending concentrations: Mn, Zn, Pb, Ni, Cu, Cr, Co, and Cd in Jalalabad; and Mn, Zn, Ni, Cu, Cr, Pb, Co, and Cd in Kabul. Except for Ni, all the elemental contents were less than the Canadian permissible limits in residential/parkland soils. Principle Component Analysis and enrichment of Cd, Cu, Ni, Pb, and Zn pointed to anthropogenic sources, whereas Co, Cr, and Mn indicated crustal inputs. Broadly, Cd monomial risk index ([Formula: see text]) was considerable; however, one site each in both cities showed high risk ([Formula: see text] ≥ 350). The potential ecological risk (RI) is mostly low; however, at some sites, the risk was considerable. Ingestion appeared to be the main exposure route (99%) for heavy metals and contributed > 90% to noncancerous (all residents), as well as 92% (children) and 75-89% (adults) cancerous risks. The noncancerous risks of all metals and their integrated risks for all residents were within acceptable levels. Moreover, potential cancer risks in children from Ni and Cr were slightly higher than the US-EPA safe levels but were within acceptable levels for adults. This study found higher risks to children and therefore recommends proper management and ways to control metals pollution load in these areas to decrease human health and RIs.

Calcium intake: good for the bones but bad for the heart? An analysis of clinical studies.

PubMed

Lima, Guilherme Alcantara Cunha; Lima, Priscilla Damião Araújo; Barros, Maria da Glória Costa Reis Monteiro de; Vardiero, Lívia Paiva; Melo, Elisa Fernandes de; Paranhos-Neto, Francisco de Paula; Madeira, Miguel; Farias, Maria Lucia Fleiuss de

2016-06-01

The proper dietary calcium intake and calcium supplementation, when indicated, are important factors in the acquisition of peak bone mass during youth and in the prevention of fractures in old age. In addition to its deposition in bone, calcium confers an increase in its resistance and exhibits important activities in different enzymatic pathways in the body (e.g., neural, hormonal, muscle-related and blood clotting pathways). Thus, calcium supplementation can directly or indirectly affect important functions in the body, such as the control of blood pressure, plasma glucose, body weight, lipid profile and endothelial function. Since one publication reported increased cardiovascular risk due to calcium supplementation, many researchers have studied whether this risk actually exists; the results are conflicting, and the involved mechanisms are uncertain. However, studies that have evaluated the influence of the consumption of foods rich in calcium have reported no increase in the cardiovascular risk, which suggests that nutritional intake should be prioritized as a method for supplementation and that the use of calcium supplements should be reserved for patients who truly need supplementation and are unable to achieve the recommended daily nutritional intake of calcium.

Filaria monitoring visualization system: a geographical information system-based application to manage lymphatic filariasis in Andhra Pradesh, India.

PubMed

Upadhyayula, Suryanaryana Murty; Mutheneni, Srinivasa Rao; Kumaraswamy, Sriram; Kadiri, Madhusudhan Rao; Pabbisetty, Sampath Kumar; Yellepeddi, Venkata Suryanarayana Murthy

2012-05-01

Among various public health diseases, filariasis constitutes a major public health problem in India, wherein an estimated 553.7 million people are at risk of infection. The aim of this article is to present a spatial mapping and analysis of filariasis data over a 3-year period (2004-2007) from Karimnagar, Chittoor, East and West Godavari districts of Andhra Pradesh, India. The data include epidemiological and entomological studies (i.e., infection rate, infectivity rate, mosquito per man hour, and microfilaria rate). These parameters were customized on Geographical Information System (GIS) platform and developed filaria monitoring visualization system (FMVS) for identifying the endemic/risk areas of filariasis among these four districts. GIS map for filariasis transmission from the study areas was created and stratified into different spatial entities like low, medium, and high risk zones. On the basis of the data and FMVS maps, it was demonstrated that filariasis remained unevenly distributed within the districts. Balancing the intervention coverage in different villages with overall mass drug administration and continued promotion of the proper use of control measures are necessary for further reduction of filarial cases in these districts.

FINDING THE BALANCE - QUALITY ASSURANCE REQUIREMENTS VS. RESEARCH NEEDS

EPA Science Inventory

Investigators often misapply quality assurance (QA) procedures and may consider QA as a hindrance to developing test plans for sampling and analysis. If used properly, however, QA is the driving force for collecting the right kind and proper amount of data. Researchers must use Q...

FINDING THE BALANCE - QUALITY ASSURANCE REQUIREMENTS VS. RESEARCH NEEDS

EPA Science Inventory

Investigators often misapply quality assurance (QA) procedures and may consider QA as a hindrance to developing test plans for
sampling and analysis. If used properly, however, QA is the driving force for collecting the right kind and proper amount of data.
Researchers must...

Modelling recurrent events: comparison of statistical models with continuous and discontinuous risk intervals on recurrent malaria episodes data

PubMed Central

2014-01-01

Background Recurrent events data analysis is common in biomedicine. Literature review indicates that most statistical models used for such data are often based on time to the first event or consider events within a subject as independent. Even when taking into account the non-independence of recurrent events within subjects, data analyses are mostly done with continuous risk interval models, which may not be appropriate for treatments with sustained effects (e.g., drug treatments of malaria patients). Furthermore, results can be biased in cases of a confounding factor implying different risk exposure, e.g. in malaria transmission: if subjects are located at zones showing different environmental factors implying different risk exposures. Methods This work aimed to compare four different approaches by analysing recurrent malaria episodes from a clinical trial assessing the effectiveness of three malaria treatments [artesunate + amodiaquine (AS + AQ), artesunate + sulphadoxine-pyrimethamine (AS + SP) or artemether-lumefantrine (AL)], with continuous and discontinuous risk intervals: Andersen-Gill counting process (AG-CP), Prentice-Williams-Peterson counting process (PWP-CP), a shared gamma frailty model, and Generalized Estimating Equations model (GEE) using Poisson distribution. Simulations were also made to analyse the impact of the addition of a confounding factor on malaria recurrent episodes. Results Using the discontinuous interval analysis, AG-CP and Shared gamma frailty models provided similar estimations of treatment effect on malaria recurrent episodes when adjusted on age category. The patients had significant decreased risk of recurrent malaria episodes when treated with AS + AQ or AS + SP arms compared to AL arm; Relative Risks were: 0.75 (95% CI (Confidence Interval): 0.62-0.89), 0.74 (95% CI: 0.62-0.88) respectively for AG-CP model and 0.76 (95% CI: 0.64-0.89), 0.74 (95% CI: 0.62-0.87) for the Shared gamma frailty model. With both discontinuous and continuous risk intervals analysis, GEE Poisson distribution models failed to detect the effect of AS + AQ arm compared to AL arm when adjusted for age category. The discontinuous risk interval analysis was found to be the more appropriate approach. Conclusion Repeated event in infectious diseases such as malaria can be analysed with appropriate existing models that account for the correlation between multiple events within subjects with common statistical software packages, after properly setting up the data structures. PMID:25073652

Risk factors associated with infectious bursal disease vaccination failures in broiler farms in Kenya.

PubMed

Mutinda, Wanzila Usyu; Nyaga, Philip Njeru; Mbuthia, Paul Gichohi; Bebora, Lilly Caroline; Muchemi, Gerald

2014-04-01

Immunization together with application of biosecurity measures are the principal methods of preventing infectious bursal disease outbreaks in high-risk areas. However, outbreaks in vaccinated chicken flocks have been reported in many parts of the world as a result of factors of vaccine virus, animal, or vaccine handler. In Kenya, such outbreaks have been reported, but the causes have not been studied. This study aimed at determining the risk factors associated with vaccine handling leading to vaccine failure in broiler flocks in Kwale County, Kenya. Structured questionnaires and visual observations were used to collect data from 83 broiler farms, 6 breeding farms, and 17 vaccine outlets. Relative risk (RR) analysis was used to determine the association between identified potential risk factors and vaccination failure. Results show that vaccines were properly handled in all vaccine outlet shops. Breeding farms maintained high levels of biosecurity and employed standard vaccine handling practices. Basic biosecurity practices were poor in broiler farms. Broiler farms failed to meet all the recommended standard procedures for vaccine storage, reconstitution, and administration. Risk factors included poor vaccine storage (RR = 8.7) and use of few drinkers to administer vaccine (RR = 5.8); traces of disinfectants in drinkers used to administer live vaccine (RR = 2.8); use of wrong vaccine-infectious bronchitis instead of infectious bursal disease vaccine (RR = 2.1); and use of improper diluents (RR = 1.6). Broiler farmers need training on basic farm biosecurity measures and standard vaccine handling practices.

Sarcocystis in Biology of Foodborne Parasites CRC Press

USDA-ARS?s Scientific Manuscript database

People can contract infections by consuming beef infected with Sarcocystis hominis or pork infected with Sarcocystis suihominis. Proper cooking can eliminate this foodborne risk of infection. Here, the biology of such parasites is thoroughly reviewed, focusing on the epidemiology, diagnosis, treat...

Differential Decomposition of Bacterial and Viral Fecal Indicators in Common Human Pollution Types

EPA Science Inventory

Understanding the decomposition of microorganisms associated with different human fecal pollution types is necessary for proper implementation of many water qualitymanagement practices, as well as predicting associated public health risks. Here, thedecomposition of select cultiva...

Case Report-Inguinoscrotal ureteral hernia diagnosed on micturating cystourethrography.

PubMed

Sripathi, Smiti; Rajagopal, Kv; Kakkar, Chandan; Polnaya, Ashwin

2011-07-01

The presence of a ureter within an inguinal hernia is an extremely rare entity, usually discovered incidentally during herniorrhaphy and may pose a surgical risk. Early preoperative diagnosis is crucial to guide proper surgical approach and to preserve renal function.

SPARC GENERATED CHEMICAL PROPERTIES DATABASE FOR USE IN NATIONAL RISK ASSESSMENTS

EPA Science Inventory

The SPARC (Sparc Performs Automated Reasoning in Chemistry) Model was used to provide temperature dependent algorithms used to estimate chemical properties for approximately 200 chemicals of interest to the promulgation of the Hazardous Waste Identification Rule (HWIR) . Proper...

Multi-Unit Considerations for Human Reliability Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

St. Germain, S.; Boring, R.; Banaseanu, G.

This paper uses the insights from the Standardized Plant Analysis Risk-Human Reliability Analysis (SPAR-H) methodology to help identify human actions currently modeled in the single unit PSA that may need to be modified to account for additional challenges imposed by a multi-unit accident as well as identify possible new human actions that might be modeled to more accurately characterize multi-unit risk. In identifying these potential human action impacts, the use of the SPAR-H strategy to include both errors in diagnosis and errors in action is considered as well as identifying characteristics of a multi-unit accident scenario that may impact themore » selection of the performance shaping factors (PSFs) used in SPAR-H. The lessons learned from the Fukushima Daiichi reactor accident will be addressed to further help identify areas where improved modeling may be required. While these multi-unit impacts may require modifications to a Level 1 PSA model, it is expected to have much more importance for Level 2 modeling. There is little currently written specifically about multi-unit HRA issues. A review of related published research will be presented. While this paper cannot answer all issues related to multi-unit HRA, it will hopefully serve as a starting point to generate discussion and spark additional ideas towards the proper treatment of HRA in a multi-unit PSA.« less

The factors that have correlation with student behavior to dispose liquid waste

NASA Astrophysics Data System (ADS)

Kusmawaningtyas, Rieneke; Darmajanti, Linda; Soesilo, Tri Edhi Budhi

2017-03-01

Students majoring in chemistry could produce toxic liquid waste in their laboratory practices. They are not allowed to dispose of hazardous laboratory liquid into the environment. The formulation of problem in this study is that not all students have good behavior to dispose liquid waste properly according to their type and chemical properties while it is expected that all students have good behavior to dispose liquid waste with the type and chemical properties in container vessel, even though all students are expected to have behavior to dispose waste in the container vessel with the support of the predisposing factors, enabling factors, and driving factors. The aim of this study is to analyze the type and chemical properties of liquid waste and the relationship between three factors forming behavior with student behavior. The relationship between three factors forming behavior with student behavior was analyzed by correlative analysis. Type and chemical properties known through observation and qualitative analysis. The results of this research is found that enabling factors and driving behavior have a weak relation with student behavior. Nevertheless, predisposing factors has no relation with student behavior. The result of analysis of waste laboratory are known that laboratory liquid waste contains Cu, Fe, and methylene blue which potentially pollute the environment. The findings show that although generally the laboratory use chemicals in small quantities, but the total quantity of laboratory liquid waste produced from all laboratories in some regions must be considered. Moreover, the impact of the big quantity of liquid waste to environment must be taken into account. Thus, it is recommended that students should raise awareness of the risks associated with laboratory liquid waste and, we should provide proper management for a laboratory and policy makers.

Affect of Early Life Oxygen Exposure on Proper Lung Development and Response to Respiratory Viral Infections

PubMed Central

Domm, William; Misra, Ravi S.; O’Reilly, Michael A.

2015-01-01

Children born preterm often exhibit reduced lung function and increased severity of response to respiratory viruses, suggesting that premature birth has compromised proper development of the respiratory epithelium and innate immune defenses. Increasing evidence suggests that premature birth promotes aberrant lung development likely due to the neonatal oxygen transition occurring before pulmonary development has matured. Given that preterm infants are born at a point of time where their immune system is also still developing, early life oxygen exposure may also be disrupting proper development of innate immunity. Here, we review current literature in hopes of stimulating research that enhances understanding of how the oxygen environment at birth influences lung development and host defense. This knowledge may help identify those children at risk for disease and ideally culminate in the development of novel therapies that improve their health. PMID:26322310

Diagnosis and treatment of common metabolic spinal disorders in the geriatric population.

PubMed

Eck, J C; Humphreys, S C

1998-12-01

Bone is constantly resorbed and remodeled throughout life. After approximately age 30, there is a net loss of bone mass. This places the geriatric population at an increased risk of pathologic bone disorders that can lead to fractures and deformity. In this paper, we review bone metabolism and remodeling and introduce the proper diagnostic techniques. The most common pathologic spinal disorders are introduced, with emphasis on presentation and treatment options. To prevent excessive bone loss, patients should be educated on proper nutrition (calcium and vitamin D requirements) and lifestyle (avoiding alcohol and cigarette smoking). Sex hormone and drug therapies are available to reduce bone loss. New bisphosphonates such as alendronate sodium (Fosamax) have been effective in increasing bone mass. Early diagnosis and proper treatment of pathologic bone disorders can reduce the incidence of fracture and allow the patient a more productive and comfortable life.

Research on orbit prediction for solar-based calibration proper satellite

NASA Astrophysics Data System (ADS)

Chen, Xuan; Qi, Wenwen; Xu, Peng

2018-03-01

Utilizing the mathematical model of the orbit mechanics, the orbit prediction is to forecast the space target's orbit information of a certain time based on the orbit of the initial moment. The proper satellite radiometric calibration and calibration orbit prediction process are introduced briefly. On the basis of the research of the calibration space position design method and the radiative transfer model, an orbit prediction method for proper satellite radiometric calibration is proposed to select the appropriate calibration arc for the remote sensor and to predict the orbit information of the proper satellite and the remote sensor. By analyzing the orbit constraint of the proper satellite calibration, the GF-1solar synchronous orbit is chose as the proper satellite orbit in order to simulate the calibration visible durance for different satellites to be calibrated. The results of simulation and analysis provide the basis for the improvement of the radiometric calibration accuracy of the satellite remote sensor, which lays the foundation for the high precision and high frequency radiometric calibration.

A Nation-Wide Study of Prevalence and Risk Factors for Fecal Impaction in Nursing Homes

PubMed Central

Rey, Enrique; Barcelo, Marta; Jiménez Cebrián, Maria Jose; Alvarez-Sanchez, Angel; Diaz-Rubio, Manuel; Rocha, Alberto Lopez

2014-01-01

Background There are no existing studies that provide data regarding the epidemiology of, and risk factors for, fecal impaction, either in the general population or in any sub-group of people. Objective Estimate the prevalence of and factors associated with fecal impaction on a representative sample of the institutionalized elderly population. Design Two-phase study. Phase 1: pilot study validating the methodology in which all residents of a single nursing home participated. Phase 2: national multi-center cross-sectional study. Setting 34 randomly selected nursing homes. Measurements The presence of fecal impaction and associated factors were evaluated using three different tools: data collected from medical records; a self-completion questionnaire filled out by the subjects or a proxy; and a rectal examination. Subjects Older subjects living in nursing homes. Results The prevalence of chronic constipation was 70.7% (95%CI: 67.3–74.1%), of which 95.9% of patients were properly diagnosed and 43.1% were properly controlled. The prevalence of FI according to patient history was 47.3% (43.6–51.0%) and 6.6% (4.7–8.5%) according to rectal examination. Controlled constipation (OR: 9.8 [5.2–18.4]) and uncontrolled constipation (OR: 37.21 [19.7–70.1]), the number of medications (OR: 1.2 [1.1–1.3]), reduced functional capacity (OR: 0.98 [0.97–0.99]) and the occasional use of NSAIDs were independent risk factors for fecal impaction. Conclusions Constipation affects more than 70% of people living in nursing homes. Although it is properly diagnosed in more than 95% of cases, the disease is only controlled in less than 50%. Constipation, especially when not controlled, is the most significant risk factor leading to fecal impaction, which is prevalent in almost 50% of this population. PMID:25148393

Exploring Women’s Perceptions of Their Risk of Developing Breast Cancer

DTIC Science & Technology

2008-06-01

into thrce categories based on its underlying etiology. Hereditary breast cancer comprises 5%-10%1 of cases and is attributed to known genetic muta...iavwomen did not recognize aec as a breast cancer risk - - ft~ctur after receiving extensive education on the subject. Other studies have suggeskd that...this issue. Limitations The limitations ofthis study should be considered to properly temper any conclusions drawn. The results were based on a

Observations on the Concept of Risk and Arab Culture

DTIC Science & Technology

2011-11-30

earliest dilemmas with risk can be seen in confrontations between the mercantile (or merchant) class and the Church. To see this, we have to... dilemmas with the Church and with interpretations regarding what is proper for humans to profit from and what is not: essentially, what is divine...property? We can see a reflection of this dilemma in the relatively late arrival of life insurance. Although a predecessor of life insurance was

Hypogonadism: Therapeutic Risks, Benefits, and Outcomes.

PubMed

Sigalos, John T; Pastuszak, Alexander W; Khera, Mohit

2018-03-01

Hypogonadism is a common condition defined by the presence of low serum testosterone levels and hypogonadal symptoms, and most commonly treated using testosterone therapy (TTh). The accuracy of diagnosis and appropriateness of treatment, along with proper follow-up, are increasingly important given the large increase in testosterone prescriptions and the recent concern for cardiovascular (CV) risk associated with TTh. In March of 2015, the US Food and Drug Administration required that testosterone product labels disclose a potential CV risk, despite the evidence base for this association being weak and inconclusive. However, TTh may improve CV outcomes rather than increase risks. Copyright © 2017 Elsevier Inc. All rights reserved.

Likelihood ratio-based integrated personal risk assessment of type 2 diabetes.

PubMed

Sato, Noriko; Htun, Nay Chi; Daimon, Makoto; Tamiya, Gen; Kato, Takeo; Kubota, Isao; Ueno, Yoshiyuki; Yamashita, Hidetoshi; Fukao, Akira; Kayama, Takamasa; Muramatsu, Masaaki

2014-01-01

To facilitate personalized health care for multifactorial diseases, risks of genetic and clinical/environmental factors should be assessed together for each individual in an integrated fashion. This approach is possible with the likelihood ratio (LR)-based risk assessment system, as this system can incorporate manifold tests. We examined the usefulness of this system for assessing type 2 diabetes (T2D). Our system employed 29 genetic susceptibility variants, body mass index (BMI), and hypertension as risk factors whose LRs can be estimated from openly available T2D association data for the Japanese population. The pretest probability was set at a sex- and age-appropriate population average of diabetes prevalence. The classification performance of our LR-based risk assessment was compared to that of a non-invasive screening test for diabetes called TOPICS (with score based on age, sex, family history, smoking, BMI, and hypertension) using receiver operating characteristic analysis with a community cohort (n = 1263). The area under the receiver operating characteristic curve (AUC) for the LR-based assessment and TOPICS was 0.707 (95% CI 0.665-0.750) and 0.719 (0.675-0.762), respectively. These AUCs were much higher than that of a genetic risk score constructed using the same genetic susceptibility variants, 0.624 (0.574-0.674). The use of ethnically matched LRs is necessary for proper personal risk assessment. In conclusion, although LR-based integrated risk assessment for T2D still requires additional tests that evaluate other factors, such as risks involved in missing heritability, our results indicate the potential usability of LR-based assessment system and stress the importance of stratified epidemiological investigations in personalized medicine.

Nano-Evaluris: an inhalation and explosion risk evaluation method for nanoparticle use. Part I: description of the methodology

NASA Astrophysics Data System (ADS)

Bouillard, Jacques X.; Vignes, Alexis

2014-02-01

In this paper, an inhalation health and explosion safety risk assessment methodology for nanopowders is described. Since toxicological threshold limit values are still unknown for nanosized substances, detailed risk assessment on specific plants may not be carried out. A simple approach based on occupational hazard/exposure band expressed in mass concentrations is proposed for nanopowders. This approach is consolidated with an iso surface toxicological scaling method, which has the merit, although incomplete, to provide concentration threshold levels for which new metrological instruments should be developed for proper air monitoring in order to ensure safety. Whenever the processing or use of nanomaterials is introducing a risk to the worker, a specific nano pictogram is proposed to inform the worker. Examples of risk assessment of process equipment (i.e., containment valves) processing various nanomaterials are provided. Explosion risks related to very reactive nanomaterials such as aluminum nanopowders can be assessed using this new analysis methodology adapted to nanopowders. It is nevertheless found that to formalize and extend this approach, it is absolutely necessary to develop new relevant standard apparatuses and to qualify individual and collective safety barriers with respect to health and explosion risks. In spite of these uncertainties, it appears, as shown in the second paper (Part II) that health and explosion risks, evaluated for given MWCNTs and aluminum nanoparticles, remain manageable in their continuous fabrication mode, considering current individual and collective safety barriers that can be put in place. The authors would, however, underline that peculiar attention must be paid to non-continuous modes of operations, such as process equipment cleaning steps, that are often under-analyzed and are too often forgotten critical steps needing vigilance in order to minimize potential toxic and explosion risks.

Improvements in powered air purifying respirator protection in an ABSL-3E facility

USDA-ARS?s Scientific Manuscript database

The study of and experimentation with zoonotic pathogens such as highly pathogenic avian influenza (HPAI) requires risk mitigation strategies including laboratory engineering controls and safety equipment, personal protective equipment (PPE), and proper practices and techniques. Incidences of potent...

Report: EPA Needs to Improve Recording Information Technology Investments and Issue a Policy Covering All Investments

EPA Pesticide Factsheets

Report #15-P-0292, September 22, 2015. The EPA management of its $334 million in IT investments is noncompliant with its current policy. Thus, the EPA is at risk of not managing taxpayer dollars properly.

40 CFR 745.113 - Certification and acknowledgment of disclosure.

Code of Federal Regulations, 2011 CFR

2011-07-01

... that may place young children at risk of developing lead poisoning. Lead poisoning in young children may produce permanent neurological damage, including learning disabilities, reduced intelligence... properly. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978...

40 CFR 745.113 - Certification and acknowledgment of disclosure.

Code of Federal Regulations, 2010 CFR

2010-07-01

... that may place young children at risk of developing lead poisoning. Lead poisoning in young children may produce permanent neurological damage, including learning disabilities, reduced intelligence... properly. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978...

40 CFR 745.113 - Certification and acknowledgment of disclosure.

Code of Federal Regulations, 2012 CFR

2012-07-01

... that may place young children at risk of developing lead poisoning. Lead poisoning in young children may produce permanent neurological damage, including learning disabilities, reduced intelligence... properly. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978...

24 CFR 35.92 - Certification and acknowledgment of disclosure.

Code of Federal Regulations, 2010 CFR

2010-04-01

... that may place young children at risk of developing lead poisoning. Lead poisoning in young children may produce permanent neurological damage, including learning disabilities, reduced intelligence... properly. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978...

24 CFR 35.92 - Certification and acknowledgment of disclosure.

Code of Federal Regulations, 2012 CFR

2012-04-01

... that may place young children at risk of developing lead poisoning. Lead poisoning in young children may produce permanent neurological damage, including learning disabilities, reduced intelligence... properly. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978...

24 CFR 35.92 - Certification and acknowledgment of disclosure.

Code of Federal Regulations, 2013 CFR

2013-04-01

... that may place young children at risk of developing lead poisoning. Lead poisoning in young children may produce permanent neurological damage, including learning disabilities, reduced intelligence... properly. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978...

40 CFR 745.113 - Certification and acknowledgment of disclosure.

Code of Federal Regulations, 2014 CFR

2014-07-01

... that may place young children at risk of developing lead poisoning. Lead poisoning in young children may produce permanent neurological damage, including learning disabilities, reduced intelligence... properly. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978...

24 CFR 35.92 - Certification and acknowledgment of disclosure.

Code of Federal Regulations, 2014 CFR

2014-04-01

... that may place young children at risk of developing lead poisoning. Lead poisoning in young children may produce permanent neurological damage, including learning disabilities, reduced intelligence... properly. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978...

24 CFR 35.92 - Certification and acknowledgment of disclosure.

Code of Federal Regulations, 2011 CFR

2011-04-01

... that may place young children at risk of developing lead poisoning. Lead poisoning in young children may produce permanent neurological damage, including learning disabilities, reduced intelligence... properly. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978...

AUTOMATED LONG-TERM REMOTE MONITORING OF SEDIMENT-WATER INTERFACIAL FLUX

EPA Science Inventory

Advective flux across the sediment-water interface is temporally and spatially heterogeneous in nature. For contaminated sediment sites, monitoring spatial as well as temporal variation of advective flux is of importance to proper risk management. This project was conducted to ...

48 CFR 970.5245-1 - Property.

Code of Federal Regulations, 2010 CFR

2010-10-01

... termination of this contract, the Contractor shall render an accounting, as prescribed by the Contracting... handling, control and disposition of high-risk property and classified materials throughout the life cycle... establish, administer, and properly maintain an approved property management system of accounting for and...

The Benefits of Health Maintenance.

ERIC Educational Resources Information Center

Rosenstein, Alan H.

1987-01-01

The article focuses on the merits of a comprehensive, medically-oriented health maintenance/risk assessment program, and suggests that such conditions as heart disease, cancer, and arteriosclerosis can be prevented or postponed through proper nutrition, weight control, exercise, smoking cessation, and stress management. (Author/CB)

Case Report-Inguinoscrotal ureteral hernia diagnosed on micturating cystourethrography

PubMed Central

Sripathi, Smiti; Rajagopal, KV; Kakkar, Chandan; Polnaya, Ashwin

2011-01-01

The presence of a ureter within an inguinal hernia is an extremely rare entity, usually discovered incidentally during herniorrhaphy and may pose a surgical risk. Early preoperative diagnosis is crucial to guide proper surgical approach and to preserve renal function. PMID:22013295

Variation in asparagine concentration in Nebraska wheat

USDA-ARS?s Scientific Manuscript database

The concentration of asparagine in wheat grain depends on both genetics and environmental factors, therefore study of different wheat cultivars, growing locations and crops years is needed for proper evaluation of potential risks of acrylamide formation in baked products made from Nebraska wheats. T...

REGULATORY PERSPECTIVE ON MANAGING RISKS AT WOOD TREATING SITES

EPA Science Inventory

Over 700 sites in the United States have been identified where wood preserving operations have been conducted. The most common types of wood preservatives found at these sites are creosote, pentachlorophenol (PCP), and copper chromated arsenate (CCA). When properly used and dis...

Assessment of BTEX-induced health risk under multiple uncertainties at a petroleum-contaminated site: An integrated fuzzy stochastic approach

NASA Astrophysics Data System (ADS)

Zhang, Xiaodong; Huang, Guo H.

2011-12-01

Groundwater pollution has gathered more and more attention in the past decades. Conducting an assessment of groundwater contamination risk is desired to provide sound bases for supporting risk-based management decisions. Therefore, the objective of this study is to develop an integrated fuzzy stochastic approach to evaluate risks of BTEX-contaminated groundwater under multiple uncertainties. It consists of an integrated interval fuzzy subsurface modeling system (IIFMS) and an integrated fuzzy second-order stochastic risk assessment (IFSOSRA) model. The IIFMS is developed based on factorial design, interval analysis, and fuzzy sets approach to predict contaminant concentrations under hybrid uncertainties. Two input parameters (longitudinal dispersivity and porosity) are considered to be uncertain with known fuzzy membership functions, and intrinsic permeability is considered to be an interval number with unknown distribution information. A factorial design is conducted to evaluate interactive effects of the three uncertain factors on the modeling outputs through the developed IIFMS. The IFSOSRA model can systematically quantify variability and uncertainty, as well as their hybrids, presented as fuzzy, stochastic and second-order stochastic parameters in health risk assessment. The developed approach haw been applied to the management of a real-world petroleum-contaminated site within a western Canada context. The results indicate that multiple uncertainties, under a combination of information with various data-quality levels, can be effectively addressed to provide supports in identifying proper remedial efforts. A unique contribution of this research is the development of an integrated fuzzy stochastic approach for handling various forms of uncertainties associated with simulation and risk assessment efforts.

[The model of perioperative risk assessment in elderly patients - interim analysis].

PubMed

Grabowska, Izabela; Ścisło, Lucyna; Pietruszka, Szymon; Walewska, Elzbieta; Paszko, Agata; Siarkiewicz, Benita; Richter, Piotr; Budzyński, Andrzej; Szczepanik, Antoni M

2017-04-21

Demographic changes in contemporary society require implementation of proper perioperative care of elderly patients due to an increased risk of perioperative complications in this group. Preoperative assessment of health status identifies risks and enables preventive interventions, improving outcomes of surgical treatment. The Comprehensive Geriatric Assessment contains numerous diagnostic tests and consultations, which is expensive and difficult to use in everyday practice. The development of a simplified model of perioperative assessment of elderly patients will help identifying the group of patients who require further diagnostic workup. The aim of the study is to evaluate the usefulness of the tests used in a proposed model of perioperative risk assessment in elderly patients. In a group of 178 patients older than 64 years admitted for surgical procedures, a battery of tests was performed. The proposed model of perioperative risk assessment included: Charlson Comorbidity Index, ADL (activities of daily living), TUG test (timed "up and go" test), MNA (mini nutritional assessment), AMTS (abbreviated mental test score), spirometry measurement of respiratory muscle strength (Pimax, Pemax). Distribution of abnormal results of each test has been analysed. The Charlson Index over 6 points was recorded in 10.1% of patients (15.1% in cancer patients). Abnormal result of the TUG test was observed in 32.1%. The risk of malnutrition in MNA test has been identified in 29.7% (39.2% in cancer patients). Abnormal test results at the level of 10-30% indicate potential diagnostic value of Charlson Comorbidity Index, TUG test and MNA in the evaluation of perioperative risk in elderly patients.

Emergency Department Catheter-Associated Urinary Tract Infection Prevention: Multisite Qualitative Study of Perceived Risks and Implemented Strategies.

PubMed

Carter, Eileen J; Pallin, Daniel J; Mandel, Leslie; Sinnette, Corine; Schuur, Jeremiah D

2016-02-01

Existing knowledge of emergency department (ED) catheter-associated urinary tract infection (CAUTI) prevention is limited. We aimed to describe the motivations, perceived risks for CAUTI acquisition, and strategies used to address CAUTI risk among EDs that had existing CAUTI prevention programs. In this qualitative comparative case study, we enrolled early-adopting EDs, that is, those using criteria for urinary catheter placement and tracking the frequency of catheters placed in the ED. At 6 diverse facilities, we conducted 52 semistructured interviews and 9 focus groups with hospital and ED participants. All ED CAUTI programs originated from a hospitalwide focus on CAUTI prevention. Staff were motivated to address CAUTI because they believed program compliance improved patient care. ED CAUTI prevention was perceived to differ from CAUTI prevention in the inpatient setting. To identify areas of ED CAUTI prevention focus, programs examined ED workflow and identified 4 CAUTI risks: (1) inappropriate reasons for urinary catheter placement; (2) physicians' limited involvement in placement decisions; (3) patterns of urinary catheter overuse; and (4) poor insertion technique. Programs redesigned workflow to address risks by (1) requiring staff to specify the medical reason for catheter at the point of order entry and placement; (2) making physicians responsible for determining catheter use; (3) using catheter alternatives to address patterns of overuse; and (4) modifying urinary catheter insertion practices to ensure proper placement. Early-adopting EDs redesigned workflow to minimize catheter use and ensure proper insertion technique. Assessment of ED workflow is necessary to identify and modify local practices that may increase CAUTI risk.

DataUp: A tool to help researchers describe and share tabular data.

PubMed

Strasser, Carly; Kunze, John; Abrams, Stephen; Cruse, Patricia

2014-01-01

Scientific datasets have immeasurable value, but they lose their value over time without proper documentation, long-term storage, and easy discovery and access. Across disciplines as diverse as astronomy, demography, archeology, and ecology, large numbers of small heterogeneous datasets (i.e., the long tail of data) are especially at risk unless they are properly documented, saved, and shared. One unifying factor for many of these at-risk datasets is that they reside in spreadsheets. In response to this need, the California Digital Library (CDL) partnered with Microsoft Research Connections and the Gordon and Betty Moore Foundation to create the DataUp data management tool for Microsoft Excel. Many researchers creating these small, heterogeneous datasets use Excel at some point in their data collection and analysis workflow, so we were interested in developing a data management tool that fits easily into those work flows and minimizes the learning curve for researchers. The DataUp project began in August 2011. We first formally assessed the needs of researchers by conducting surveys and interviews of our target research groups: earth, environmental, and ecological scientists. We found that, on average, researchers had very poor data management practices, were not aware of data centers or metadata standards, and did not understand the benefits of data management or sharing. Based on our survey results, we composed a list of desirable components and requirements and solicited feedback from the community to prioritize potential features of the DataUp tool. These requirements were then relayed to the software developers, and DataUp was successfully launched in October 2012.

DataUp: A tool to help researchers describe and share tabular data

PubMed Central

Strasser, Carly; Kunze, John; Abrams, Stephen; Cruse, Patricia

2014-01-01

Scientific datasets have immeasurable value, but they lose their value over time without proper documentation, long-term storage, and easy discovery and access. Across disciplines as diverse as astronomy, demography, archeology, and ecology, large numbers of small heterogeneous datasets (i.e., the long tail of data) are especially at risk unless they are properly documented, saved, and shared. One unifying factor for many of these at-risk datasets is that they reside in spreadsheets. In response to this need, the California Digital Library (CDL) partnered with Microsoft Research Connections and the Gordon and Betty Moore Foundation to create the DataUp data management tool for Microsoft Excel. Many researchers creating these small, heterogeneous datasets use Excel at some point in their data collection and analysis workflow, so we were interested in developing a data management tool that fits easily into those work flows and minimizes the learning curve for researchers. The DataUp project began in August 2011. We first formally assessed the needs of researchers by conducting surveys and interviews of our target research groups: earth, environmental, and ecological scientists. We found that, on average, researchers had very poor data management practices, were not aware of data centers or metadata standards, and did not understand the benefits of data management or sharing. Based on our survey results, we composed a list of desirable components and requirements and solicited feedback from the community to prioritize potential features of the DataUp tool. These requirements were then relayed to the software developers, and DataUp was successfully launched in October 2012. PMID:25653834

[The Pharmaceuticals and Medical Devices Agency's Approach to Facilitate Risk Communication and Its Challenges].

PubMed

Kondo, Emiko; Torii, Mayumi; Oba, Izumi; Okamoto, Mai

2018-01-01

　The issue of drug lag in Japan has been rapidly reduced in recent years, and newly approved drugs now become available on Japanese and international markets at the same time. In this context, the risk management plan (RMP) system was introduced in 2012. RMPs describe important safety concerns recognized by Japan's Pharmaceuticals and Medical Devices Agency (PMDA) and marketing authorization holders (MAHs), as well as safety measures that MAHs request healthcare professionals (HCPs) to follow. The publication of RMPs is expected to support the sharing of drug risk management among HCPs during the postmarketing phase. In addition, to encourage risk communication between HCPs and patients, the PMDA website provides drug guides for patients and other information to promote proper understanding of drugs by patients and their families and enable them to identify serious adverse drug reactions at an early stage. However, the results of surveys conducted by the PMDA in FY2014 and FY2015 revealed low levels of awareness of RMPs and drug guides for patients in hospitals and other healthcare institutions. The surveys also showed that information regarding the proper use of drugs from MAHs and the PMDA was not incorporated into practice at healthcare institutions, resulting in the repeated release of identical safety alerts. To facilitate the increased utilization of risk communication tools, the PMDA has been providing and disseminating these tools through its website. This study addresses those efforts and the associated challenges.

Design, Analysis, and Reporting of Crossover Trials for Inclusion in a Meta-Analysis.

PubMed

Li, Tianjing; Yu, Tsung; Hawkins, Barbara S; Dickersin, Kay

2015-01-01

To evaluate the characteristics of the design, analysis, and reporting of crossover trials for inclusion in a meta-analysis of treatment for primary open-angle glaucoma and to provide empirical evidence to inform the development of tools to assess the validity of the results from crossover trials and reporting guidelines. We searched MEDLINE, EMBASE, and Cochrane's CENTRAL register for randomized crossover trials for a systematic review and network meta-analysis we are conducting. Two individuals independently screened the search results for eligibility and abstracted data from each included report. We identified 83 crossover trials eligible for inclusion. Issues affecting the risk of bias in crossover trials, such as carryover, period effects and missing data, were often ignored. Some trials failed to accommodate the within-individual differences in the analysis. For a large proportion of the trials, the authors tabulated the results as if they arose from a parallel design. Precision estimates properly accounting for the paired nature of the design were often unavailable from the study reports; consequently, to include trial findings in a meta-analysis would require further manipulation and assumptions. The high proportion of poorly reported analyses and results has the potential to affect whether crossover data should or can be included in a meta-analysis. There is pressing need for reporting guidelines for crossover trials.

Assessment of dietary habits, nutritional status and blood biochemical parameters in patients prepared for bariatric surgery: a preliminary study.

PubMed

Jastrzębska-Mierzyńska, Marta; Ostrowska, Lucyna; Hady, Hady Razak; Dadan, Jacek

2012-08-01

Morbid obesity needs to be treated by bariatric procedures. Proper dietary preparation of patients before surgery conditions their postoperative status. Assessment of dietary habits, nutritional status and biochemical parameters of the blood in patients being prepared for different bariatric procedures. The study involved a group of 27 obese adults: 19 women (mean age: 40.4 ±13.9 years) and 8 men (mean age: 39.6 ±12.7 years) qualified for bariatric procedures. Body composition, dietary habits and selected biochemical parameters of blood were assessed. Statistical analysis of the results was conducted using Statistica 9.0. Daily food rations consumed by women provided 1910.6 ±915.9 kcal/day, and by men 2631 ±1463.2 kcal/day on average. In both groups, the consumption of major nutrients was found to be inadequate. In both groups, deficiency was observed in the dietary intake of folic acid and potassium. Additionally, there was a decrease in the intake of vitamin D(3), calcium and iron in women and magnesium in men. In the two groups, disturbances were noted in lipid and carbohydrate metabolism. Our study indicates the necessity for dietary instructions in bariatric patients with regard to proper dietary habits and to reduce the risk of malnutrition before and after surgery.

Diarrhea Outbreak during U.S. Military Training in El Salvador

PubMed Central

Kasper, Matthew R.; Lescano, Andres G.; Lucas, Carmen; Gilles, Duncan; Biese, Brian J.; Stolovitz, Gary; Reaves, Erik J.

2012-01-01

Infectious diarrhea remains a major risk to deployed military units worldwide in addition to their impact on travelers and populations living in the developing world. This report describes an outbreak of diarrheal illness in the U.S. military’s 130th Maneuver Enhancement Brigade deployed in San Vicente, El Salvador during a training and humanitarian assistance mission. An outbreak investigation team from U.S. Naval Medical Research Unit – Six conducted an epidemiologic survey and environmental assessment, patient interviews, and collected stool samples for analysis in an at risk population of 287 personnel from May 31st to June 3rd, 2011. Personnel (n = 241) completed an epidemiological survey (87% response rate) and 67 (27%) reported diarrhea and/or vomiting during the past two weeks. The median duration of illness was reported to be 3 days (IQR 2–4 days) and abdominal pain was reported among 30 (49%) individuals. Presentation to the medical aid station was sought by (62%) individuals and 9 (15%) had to stop or significantly reduce work for at least one day. Microscopy and PCR analysis of 14 stool samples collected from previously symptomatic patients, Shigella (7), Cryptosporidium (5), and Cyclospora (4) were the most prevalent pathogens detected. Consumption of food from on-base local vendors (RR = 4.01, 95% CI = 1.53–10.5, p-value <0.001) and arriving on base within the past two weeks (RR = 2.79, 95% confidence [CI] = 1.35–5.76, p-value = 0.001) were associated with increased risk of developing diarrheal disease. The risk of infectious diarrhea is great among reserve military personnel during two week training exercises. The consumption of local food, prepared without proper monitoring, is a risk factor for deployed personnel developing diarrheal illness. Additional information is needed to better understand disease risks to personnel conducting humanitarian assistance activities in the Latin America Region. PMID:22815747

Spatial patterns of frequent floods in Switzerland

NASA Astrophysics Data System (ADS)

Schneeberger, Klaus; Rössler, Ole; Weingartner, Rolf

2017-04-01

Information about the spatial characteristics of high and extreme streamflow is often needed for an accurate analysis of flood risk and effective co-ordination of flood related activities, such as flood defence planning. In this study we analyse the spatial dependence of frequent floods in Switzerland across different scales. Firstly, we determine the average length of high and extreme flow events for 56 runoff time series of Swiss rivers. Secondly, a dependence measure expressing the probability that streamflow peaks are as high as peaks at a conditional site is used to describe and map the spatial extend of joint occurrence of frequent floods across Switzerland. Thirdly, we apply a cluster analysis to identify groups of sites that are likely to react similarly in terms of joint occurrence of high flow events. The results indicate that a time interval with a length of 3 days seems to be most appropriate to characterise the average length of high streamflow events across spatial scales. In the main Swiss basins, high and extreme streamflows were found to be asymptotically independent. In contrast, at the meso-scale distinct flood regions, which react similarly in terms of occurrence of frequent flood, were found. The knowledge about these regions can help to optimise flood defence planning or to estimate regional flood risk properly.

Osteodistraction With Dental Implant-Borne Devices for Bone Regeneration in Atrophied Premaxilla.

PubMed

Carlino, Francesco; Villani, Gian Piero; Berti, Andrea; Pantaleo, Giuseppe; Cortese, Antonio; Claudio, Pier Paolo

2016-11-01

Aim of this work is to present the evolution of an innovative technique for tooth/implant supported bone distraction, leading to proper oral rehabilitation in patients with atrophic alveolar bone, even when a complete premaxilla expansion is needed, or in patients in whom implants were already present, but inserted in wrong position.Distraction osteogenesis was selected because of its moderate invasiveness, the few surgical steps needed, and the proper cost/benefits balance. This procedure is particularly suited for young patients with remarkable aesthetic demands related to active social and working life, as for elderly patients expecting lower surgical stress and risks.

Gas analysis system for the Eight Foot High Temperature Tunnel

NASA Technical Reports Server (NTRS)

Leighty, Bradley D.; Davis, Patricia P.; Upchurch, Billy T.; Puster, Richard L.

1992-01-01

This paper describes the development of a gas collection and analysis system that is to be installed in the Eight-Foot High Temperature Tunnel (8' HTT) at NASA's Langley Research Center. This system will be used to analyze the test gas medium that results after burning a methane-air mixture to achieve the proper tunnel test parameters. The system consists of a sampling rake, a gas sample storage array, and a gas chromatographic system. Gas samples will be analyzed after each run to assure that proper combustion takes place in the tunnel resulting in a correctly balanced composition of the test gas medium. The proper ratio of gas species is critically necessary in order for the proper operation and testing of scramjet engines in the tunnel. After a variety of methane-air burn conditions have been analyzed, additional oxygen will be introduced into the combusted gas and the enriched test gas medium analyzed. The pre/post enrichment sets of data will be compared to verify that the gas species of the test gas medium is correctly balanced for testing of air-breathing engines.

Staff Perception on Biomedical or Health Care Waste Management: A Qualitative Study in a Rural Tertiary Care Hospital in India

PubMed Central

Joshi, Rita; Shah, Harshada; Sharma, Megha; Pathak, Ashish; Macaden, Ragini; Stålsby Lundborg, Cecilia

2015-01-01

Background Health care or biomedical waste, if not managed properly, can be of high risk to the hospital staff, the patients, the community, public health and the environment, especially in low and middle income settings where proper disposal norms are often not followed. Our aim was to explore perceptions of staff of an Indian rural tertiary care teaching hospital on hospital waste management. Method A qualitative study was conducted using 10 focus group discussions (FGDs), with different professional groups, cleaning staff, nurses, medical students, doctors and administrators. The FGD guide included the following topics: (i) role of Health Care Waste Management (HCWM) in prevention of health care associated infections, (ii) awareness of and views about HCWM-related guidelines/legislation, (iii) current HCWM practices, (iv) perception and preparedness related to improvements of the current practices, and (v) proper implementation of the available guidelines/legislation. The FGDs were recorded, transcribed verbatim, translated to English (when conducted in Hindi) and analysed using content analysis. Results Two themes were identified: Theme (A), ‘Challenges in integration of HCWM in organizational practice,’ with the categories (I) Awareness and views about HCWM, (II) Organizational practices regarding HCWM, and (III) Challenges in Implementation of HCWM; and Theme (B), ‘Interventions to improve HCWM,’ with three categories, (I) Educational and motivational interventions, (II) Organizational culture change, and (III) Policy-related interventions. Conclusion A gap between knowledge and actual practice regarding HCWM was highlighted in the perception of the hospital staff. The participants suggested organizational changes, training and monitoring to address this. The information generated is relevant not merely to the microsystem studied but to other institutions in similar settings. PMID:26023783

Differential Decay of Bacterial and Viral Fecal Indicators in Common Human Pollution Sources

EPA Science Inventory

Understanding the decomposition of different human fecal pollution sources is necessary for proper implementation of many water quality management practices, as well as predicting associated public health risks. Here, the decay of select cultivated and molecular indicators of fe...

76 FR 24089 - Credit Risk Retention

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-29

... Resecuritization Transactions D. Additional Exemptions E. Safe Harbor for Certain Foreign-Related Transactions VII..., when incentives are not properly aligned and there is a lack of discipline in the origination process... incentive problems among various parties involved in the process.\\8\\ \\7\\ Securitization may reduce the cost...

QUANTIFYING SUBGRID POLLUTANT VARIABILITY IN EULERIAN AIR QUALITY MODELS

EPA Science Inventory

In order to properly assess human risk due to exposure to hazardous air pollutants or air toxics, detailed information is needed on the location and magnitude of ambient air toxic concentrations. Regional scale Eulerian air quality models are typically limited to relatively coar...

Radiation exposure from fluoroscopy during orthopedic surgical procedures

DOE Office of Scientific and Technical Information (OSTI.GOV)

Riley, S.A.

1989-11-01

The use of fluoroscopy has enabled orthopedic surgeons to become technically more proficient. In addition, these surgical procedures tend to have less associated patient morbidity by decreasing operative time and minimizing the area of the operative field. The trade-off, however, may be an increased risk of radiation exposure to the surgeon on an annual or lifetime basis. The current study was designed to determine the amount of radiation received by the primary surgeon and the first assistant during selected surgical procedures involving the use of fluoroscopy. Five body sites exposed to radiation were monitored for dosage. The results of thismore » study indicate that with appropriate usage, (1) radiation exposure from fluoroscopy is relatively low; (2) the surgeon's dominant hand receives the most exposure per case; and (3) proper maintenance and calibration of fluoroscopic machines are important factors in reducing exposure risks. Therefore, with proper precautions, the use of fluoroscopy in orthopedic procedures can remain a safe practice.« less

Indian research on acute organic brain syndrome: Delirium.

PubMed

Pinto, Charles

2010-01-01

Delirium, though quite often referred to psychiatrists for management, does not find many takers for analysis, research and publications. Acute in onset, multiplicity of etiology and manifestations, high risk of mortality delirium is very rewarding in proper management and outcome. Delirium has a limited agenda on teaching programs, research protocols and therapeutic strategies. There is a dearth of Indian studies both in international and national scientific literature. This annotation is based on a Medline search for "delirium India" on Pubmed, which resulted in 54 articles. A search in Indian Journal of Psychiatry for "delirium" resulted in 38 published articles, "delirium tremens" showed up only five articles. The articles are primarily from the Indian Journal of Psychiatry with cross reference to articles on Pubmed or Google search on Indian studies and a few international studies.

Overview of the 2015 American Thyroid Association guidelines for managing thyroid nodules and differentiated thyroid cancer.

PubMed

Matti, Bashar; Cohen-Hallaleh, Ruben

2016-09-09

The last few years have witnessed numerous publications addressing the management of thyroid nodules and differentiated thyroid cancers. The purpose of this review is to provide a simplified summary of the newly released guidelines by the American Thyroid Association. A systematic approach has been recommended to evaluate a thyroid nodule through clinical assessment, measurement of serum Thyroid Stimulating Hormone, neck ultrasonography and Fine Needle Aspiration where appropriate. This is followed by cytology analysis using the Bethesda scoring system to detect malignancy. Once diagnosed, thyroid cancers need to be staged and risk stratification needs to be applied to develop further treatment plans. Lastly, several recommendations have been presented to assure proper follow-up and support for thyroid cancer patients regardless of the treatment received.

Preventing adolescent pregnancy and associated risks.

PubMed Central

Miller, R.

1995-01-01

Adolescent pregnancy is a complex and frustrating problem that exacts a large social and personal cost. This year approximately 40,000 Canadian teenagers will become pregnant. With proper prevention, this number could be reduced. Pregnant teenagers seem to be at increased risk for some obstetric complications and their children for some neonatal complications. Family physicians who see patients over the course of a lifetime are in a good position to prevent adolescent pregnancy and the associated complications. PMID:8520241

A case of taeniasis diagnosed postpartum.

PubMed

Noss, Matthew R; Gilmore, Katherine; Wittich, Arthur C

2013-04-01

A case of postpartum taeniasis will be discussed along with the pathophysiology, proper treatment, potential risks, and prevention of taeniasis infections to the pregnant mother, her infant, and her family members. Taenia spp. infections are relatively rare in developed societies. Increasing immigration to developed countries and an expanding role of medical aid in developing countries will lead to an increase in the number of taeniasis cases seen by medical providers. Taenia solium and T. saginata are the most common species and can be differentiated by proglottids (a segment of a tapeworm containing both male and female reproductive organs) or scolex (the head of a tapeworm which attaches to the intestine of the definitive host). Both carry different risks when considering autoinfection and transmission. Cystercercosis caused by T. solium is a risk for neonates and is cause for immediate treatment of the mother. A 23-year-old new mother, originally from Ethiopia, passed T. strobili shortly after giving birth. Her pregnancy was complicated by limited prenatal care. She did not experience any symptoms related to tapeworm infection. The patient received treatment with praziquantel. With a possible future increase in the number of cases seen by health care providers, understanding the risks of Taenia sp. infection is important as proper treatment and education are needed to halt the life cycle of the tapeworm before more serious infection ensues. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

National Athletic Trainers' Association Position Statement: Exertional Heat Illnesses.

PubMed

Casa, Douglas J; DeMartini, Julie K; Bergeron, Michael F; Csillan, Dave; Eichner, E Randy; Lopez, Rebecca M; Ferrara, Michael S; Miller, Kevin C; O'Connor, Francis; Sawka, Michael N; Yeargin, Susan W

2015-08-18

 To present best-practice recommendations for the prevention, recognition, and treatment of exertional heat illnesses (EHIs) and to describe the relevant physiology of thermoregulation.  Certified athletic trainers recognize and treat athletes with EHIs, often in high-risk environments. Although the proper recognition and successful treatment strategies are well documented, EHIs continue to plague athletes, and exertional heat stroke remains one of the leading causes of sudden death during sport. The recommendations presented in this document provide athletic trainers and allied health providers with an integrated scientific and clinically applicable approach to the prevention, recognition, treatment, and return-to-activity guidelines for EHIs. These recommendations are given so that proper recognition and treatment can be accomplished in order to maximize the safety and performance of athletes.  Athletic trainers and other allied health care professionals should use these recommendations to establish onsite emergency action plans for their venues and athletes. The primary goal of athlete safety is addressed through the appropriate prevention strategies, proper recognition tactics, and effective treatment plans for EHIs. Athletic trainers and other allied health care professionals must be properly educated and prepared to respond in an expedient manner to alleviate symptoms and minimize the morbidity and mortality associated with these illnesses.

National Athletic Trainers' Association Position Statement: Exertional Heat Illnesses.

PubMed

Casa, Douglas J; DeMartini, Julie K; Bergeron, Michael F; Csillan, Dave; Eichner, E Randy; Lopez, Rebecca M; Ferrara, Michael S; Miller, Kevin C; O'Connor, Francis; Sawka, Michael N; Yeargin, Susan W

2015-09-01

To present best-practice recommendations for the prevention, recognition, and treatment of exertional heat illnesses (EHIs) and to describe the relevant physiology of thermoregulation. Certified athletic trainers recognize and treat athletes with EHIs, often in high-risk environments. Although the proper recognition and successful treatment strategies are well documented, EHIs continue to plague athletes, and exertional heat stroke remains one of the leading causes of sudden death during sport. The recommendations presented in this document provide athletic trainers and allied health providers with an integrated scientific and clinically applicable approach to the prevention, recognition, treatment of, and return-to-activity guidelines for EHIs. These recommendations are given so that proper recognition and treatment can be accomplished in order to maximize the safety and performance of athletes. Athletic trainers and other allied health care professionals should use these recommendations to establish onsite emergency action plans for their venues and athletes. The primary goal of athlete safety is addressed through the appropriate prevention strategies, proper recognition tactics, and effective treatment plans for EHIs. Athletic trainers and other allied health care professionals must be properly educated and prepared to respond in an expedient manner to alleviate symptoms and minimize the morbidity and mortality associated with these illnesses.

Analysis of Plasma Albumin, Vitamin D, and Apolipoproteins A and B as Predictive Coronary Risk Biomarkers in the REGICOR Study.

PubMed

Vázquez-Oliva, Gabriel; Zamora, Alberto; Ramos, Rafel; Subirana, Isaac; Grau, María; Dégano, Irene R; Muñoz, Daniel; Fitó, Montserrat; Elosua, Roberto; Marrugat, Jaume

2018-05-12

New biomarkers could improve the predictive capacity of classic risk functions. The aims of this study were to determine the association between circulating levels of apolipoprotein A1 (apoA1), apolipoprotein B (apoB), albumin, and 25-OH-vitamin D and coronary events and to analyze whether these biomarkers improve the predictive capacity of the Framingham-REGICOR risk function. A case-cohort study was designed. From an initial cohort of 5404 individuals aged 35 to 74 years with a 5-year follow-up, all the participants who had a coronary event (n = 117) and a random group of the cohort (subcohort; n = 667) were selected. Finally, 105 cases and 651 individuals representative of the cohort with an available biological sample were included. The events of interest were angina, fatal and nonfatal myocardial infarction and coronary deaths. Case participants were older, had a higher proportion of men and cardiovascular risk factors, and showed higher levels of apoB and lower levels of apoA1, apoA1/apoB ratio, 25-OH-vitamin D and albumin than the subcohort. In multivariate analyses, plasma albumin concentration was the only biomarker independently associated with coronary events (HR, 0.73; P = .002). The inclusion of albumin in the risk function properly reclassified a significant proportion of individuals, especially in the intermediate risk group (net reclassification improvement, 32.3; P = .048). Plasma albumin levels are inversely associated with coronary risk and improve the predictive capacity of classic risk functions. Copyright © 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

A concept analysis of nurses' grief.

PubMed

Wisekal, Ashley E

2015-10-01

The psychological and personal well-being of nurses can change the way they care for patients. If nurses' grief is not properly managed, the nursing shortage will continue to grow. Consequently, a need exists for the identification of nurses' grief and effective interventions to manage grief to ensure the successful development and growth of the nursing profession. This concept analysis sought to properly define nurses' grief and the role it plays in the day-to-day requirements of nurses. A review of the literature was conducted using CINAHL®, BioMed, EBSCOhost, and MEDLINE® and the following key words. Nurses' grief must be incorporated into the nursing curriculum and addressed by employers. In particular, facility leaders should help promote a healthy work environment and address the need for proper grief management. Educators, managers, and nurses can benefit from acknowledging the current gap in managing nurses' grief.

On Dangerous Anthropogenic Interference and Climate Change Risk (Invited)

NASA Astrophysics Data System (ADS)

Mann, M. E.

2009-12-01

The United Nations Framework Convention on Climate Change (UNFCCC) commits signatory nations (which includes all major nations including the United States) to stabilizing greenhouse gas concentrations at levels short of Dangerous Anthropogenic Interference (“ DAI”) with the climate. To properly define DAI, one must take into account issues that are not only scientific, but, economic, political, and ethical in nature. Defining DAI is furthermore complicated by the inter-generational and regionally-disaggregated nature of the risks associated with climate change. In this talk, I will explore the nature of anthropogenic climate change risks and the notion of DAI.

PREDICTORS OF INFLAMMATORY LOCAL RECURRENCE AFTER BREAST-CONSERVING THERAPY FOR BREAST CANCER: MATCHED CASE-CONTROL STUDY.

PubMed

Akoum, Riad; Abdalla, Eddie K; Saade, Michel; Awdeh, Adnan; Abi-Aad, Fouad; Bejjani, Noha; Ghossain, Antoine; Brihi, Emile; Audi, Akram

2015-01-01

Inflammatory local recurrence (ILR) after breast-conserving surgery for noninflammatory breast cancer (BC) is associated with dismal prognosis. Risk factors for ILR are not well defined. Between 2001 and 2010, twelve patients at our hospital developed ILR after breast-conserving surgery, adjuvant chemotherapy, and radiotherapy for BC. We compared their clinico-pathological characteristics to those of 24 patients with noninflammatory local recurrence (non-ILR), 24 patients with distant metastases, and 48 disease-free controls, matched for age and observation period. The median time to ILR was 10 months. In univariate analysis, extent of lymph node involvement (p < 0.05), multifocality (p < 0.05), c-erbB2 overexpression (p < 0.05), and lymphovascular invasion (LVI) (p < 0.001) affected the risk of ILR. Conditional logistic regression analysis showed a significant association between ILR and combined LVI and high histopathological grade. The odds ratio (OR) for ILR versus non-ILR was 6.14 (95% confidence interval [CI] 1.48-25.38) and for ILR versus distant metastases it was 3.05 (95% CI 0.09-97.83) when both LVI and high histopathological grade were present. Patients with family history of BC were more likely to present with ILR than non-ILR (OR 5.47; 95% CI 1.55-19.31) or distant relapse (OR 5.62; 95% CI 0.26-119.95). Pre- and postmenopausal women with high-grade BC and LVI are at increased risk to develop ILR, especially in the presence of family history of BC. Identification of risk factors for this lethal form of recurrent BC may lead to more effective preventive treatment strategies in properly selected patients.

The lost value of groundwater and its influence on environmental decision making.

PubMed

Paleologos, Evan K

2008-08-01

A critical aspect in establishing environmental policies lies in the proper assessment of the value of the resource being affected. Standard risk assessment analyses calculate the cost of pollution as consisting, solely, of the cost to remediate a site. This traditional definition is extended here to include the lost value of groundwater. These concepts and their impact on decision-making analyses are illustrated through the case of municipal waste landfills. Based on data from existing polluting sites, a simple cost-benefit probabilistic analysis is conducted first, which equates, as is the practice, the cost of pollution to that of remediation. This leads rationally to selection of the lowest-protection technology. Using plausible arguments the reduction in value of groundwater from potable high-quality water to irrigation water, which is what is returned after remediation, is argued. The arguments consist of: (a) the ratio of the subsidized prices of drinking to irrigation water reflects the relative value of the use of water; (b) the amount paid for remediation, in each case, represents, at a minimum, the value of the water recovered; and (c) the lost value of groundwater equals the value of drinking water minus the value of irrigation water. Incorporation of this lost value of groundwater is sufficient to drastically alter the conclusions of the decision-making analysis and make the highest level technology the most rational and profitable alternative. The broader point of this article lies in that proper accounting of environmental costs is necessary in order to alter environmental policies and practices.

Using GRACE-Derived Water and Moisture Products as a Predictive Tool for Fire Response in the Contiguous United States

NASA Astrophysics Data System (ADS)

Rousseau, N. J.; Jensen, D.; Zajic, B.; Rodell, M.; Reager, J. T., II

2015-12-01

Understanding the relationship between wildfire activity and soil moisture in the United States has been difficult to assess, with limited ability to determine areas that are at high risk. This limitation is largely due to complex environmental factors at play, especially as they relate to alternating periods of wet and dry conditions, and the lack of remotely-sensed products. Recent drought conditions and accompanying low Fuel Moisture Content (FMC) have led to disastrous wildfire outbreaks causing economic loss, property damage, and environmental degradation. Thus, developing a programmed toolset to assess the relationship between soil moisture, which contributes greatly to FMC and fire severity, can establish the framework for determining overall wildfire risk. To properly evaluate these parameters, we used data assimilated from the Gravity Recovery and Climate Experiment (GRACE) and data from the Fire Program Analysis fire-occurrence database (FPA FOD) to determine the extent soil moisture affects fire activity. Through these datasets, we produced correlation and regression maps at a coarse resolution of 0.25 degrees for the contiguous United States. These fire-risk products and toolsets proved the viability of this methodology, allowing for the future incorporation of more GRACE-derived water parameters, MODIS vegetation indices, and other environmental datasets to refine the model for fire risk. Additionally, they will allow assessment to national-scale early fire management and provide responders with a predictive tool to better employ early decision-support to areas of high risk during regions' respective fire season(s).

The significance of the psychosocial factors influence in pathogenesis of cardiovascular disease.

PubMed

Masic, Izet; Alajbegovic, Jasmin

2013-11-01

Cardiovascular diseases (CVD) are the leading cause of death in the world today. Risk factors are those factors that influence the development of CVD. Risk factors can be divided into materialistic (genetic predisposition, smoking, alcohol) and non-materialistic (psychosocial factors). Our goal is to note the role of the health system, to emphasize the importance of psychosocial factors in the pathogenesis of CVD, explain the relationship between psychosocial factors and other risk factors, stress the importance of prevention through the provision of management of the cardiovascular system (CVS) diseases. A DESCRIPTIVE ANALYSIS WAS PERFORMED ON SCIENTIFIC STUDIES IN SEVERAL PUBLISHED ARTICLES IN JOURNALS ON CVS: Public Health Reviews, CVD, European Heart Journal, Materia Socio Medica and other indexed journals that publish articles on CVS. THE IMPORTANCE AND ROLE OF THE HEALTH SYSTEM IN THE EARLY DETECTION, DIAGNOSIS, THERAPY AND CVS DISEASE PREVENTION IS PRESENTED THROUGH THREE THEMATIC AREAS: (a) The incidence and prevalence of CVS diseases; (b) treatment of CVS diseases and (c) promotion of health in patients with CVS disease and those the risk of their occurrence. Health promotion is the most important aspect of the health system monitoring. Health promotion is adequately implemented ifthe management ofCVD is proper. The main objectives of CVD management are: Preventing or delaying the occurrence of CVD, reducing the number and severity of worsening and complications of CVD. Management Includes: Individual and family, the health system and the community. Materialistic and non-materialistic risk factors together contribute to the development of CVD.

Analysis of chats on French internet forums about drugs and pregnancy.

PubMed

Palosse-Cantaloube, Lucie; Lacroix, Isabelle; Rousseau, Vanessa; Bagheri, Haleh; Montastruc, Jean-Louis; Damase-Michel, Christine

2014-12-01

Some pregnant women use the internet to search for medical information. However, online information is not controlled. The objectives were to describe French online chats about drugs and pregnancy and evaluate the quality and reliability of information shared by internet users. This French descriptive study was performed in November 2012. In order to identify drugs and pregnancy-related forum websites, we used three French key words: forum, pregnancy and drug. We explored the first 10 websites from the search result. Diseases were described using the International Classification of Diseases and drugs classified with the Anatomical Therapeutic Chemical codes and the FDA risk classification. We selected 115 questions that were mainly posted by pregnant internet users in French forums. Drugs raising questions were mostly "nervous system," "anti-infective for systemic use" and "respiratory system" drugs. The risk during pregnancy for nearly half of these drugs had not been evaluated properly. Health professionals were only involved in 7% of the 214 answers. Internet users advised to take a drug in 21% of their answers. Thirty-four percent of those recommended drugs had not been well-evaluated or were potentially at risk during pregnancy. Finally, 12% of the answers could be at risk for pregnant woman. This study shows that information related to drugs and pregnancy in online chats could be at risk for pregnant women. Internet users must be aware that online forums are not reliable sources of information. Copyright © 2014 John Wiley & Sons, Ltd.

Noncommunicable Disease Risk Factors and Mobile Phones: A Proposed Research Agenda

PubMed Central

Wosu, Adaeze C; Gibson, Dustin G; Labrique, Alain B; Ali, Joseph; Pariyo, George W

2017-01-01

Noncommunicable diseases (NCDs) account for two-thirds of all deaths globally, with 75% of these occurring in low- and middle-income countries (LMICs). Many LMICs seek cost-effective methods to obtain timely and quality NCD risk factor data that could inform resource allocation, policy development, and assist evaluation of NCD trends over time. Over the last decade, there has been a proliferation of mobile phone ownership and access in LMICs, which, if properly harnessed, has great potential to support risk factor data collection. As a supplement to traditional face-to-face surveys, the ubiquity of phone ownership has made large proportions of most populations reachable through cellular networks. However, critical gaps remain in understanding the ways by which mobile phone surveys (MPS) could aid in collection of NCD data in LMICs. Specifically, limited information exists on the optimization of these surveys with regard to incentives and structure, comparative effectiveness of different MPS modalities, and key ethical, legal, and societal issues (ELSI) in the development, conduct, and analysis of these surveys in LMIC settings. We propose a research agenda that could address important knowledge gaps in optimizing MPS for the collection of NCD risk factor data in LMICs and provide an example of a multicountry project where elements of that agenda aim to be integrated over the next two years. PMID:28476722

Temporal Patterns of Exposure to Asbestos and Risk of Asbestosis: An Analysis of a Cohort of Asbestos Textile Workers.

PubMed

Farioli, Andrea; Violante, Francesco S; La Vecchia, Carlo; Negri, Eva; Pelucchi, Claudio; Spatari, Giovanna; Boffetta, Paolo; Pira, Enrico

2018-01-12

The aim of the study was to assess the risk of asbestosis death based on the temporal pattern of exposure to asbestos. We followed up a cohort of asbestos textile workers, employed in 1946 to 1984, until November 2013. We measured the duration of the employment, the time since last employment (TSLE), the age, and the year of first employment. Hazard ratios (HR) were estimated through multivariable Cox regression models. We observed 51 asbestosis deaths among 1823 workers. The HR of asbestosis death increased with exposure duration (HR 2.4 for ≥15 years compared with <5 years, P trend = 0.014) and declined with TSLE (HR 0.3 for ≥25 compared with <5 years, P = 0.004). The risk of asbestosis mortality strongly declined for exposure starting after 1968. The risk of asbestosis death strongly declines in the decades after cessation of the exposure.This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0.

Risk factors for prostate cancer in Universiti Kebangsaan Malaysia Medical Centre: a case-control study.

PubMed

Subahir, Mohd Nizam; Shah, Shamsul Azhar; Zainuddin, Zulkifli Md

2009-01-01

In Malaysia, prostate cancer is ranked 6th among male cancer and expected to increase in the future. Several factors have shown to be related to prostate cancer such as sociodemographic, lifestyle, diet, occupational exposure, medical and health status. This is the first time a similar study was conducted in Malaysia to recognize the risk factors for prostate cancer patients who came for treatment at University Kebangsaan Malaysia Medical Centre (UKMMC). Prostate cancer cases diagnosed between 2003 and 2008 which met with the inclusion criteria were included in the study. One hundred and twelfth (112) pairs of cases and controls matched by age and ethnicity were analysed. McNemar Odds Ratios (OR(M)) were calculated using McNemar Calculator software for univariate analysis while conditional logistic regression was used for multivariate analysis, both using SPSS version 12.0. Most of the prostate cancer patients (68.8%) that came for treatment in UKMMC were above 70 years old. The majority were Chinese (50.0%) followed by Malay (46.4%) and Indian (3.6%). Multivariate analysis showed cases were more likely to have a first-degree relative with a history of cancer (OR= 3.77, 95% CI= 1.19-11.85), to have been exposed to pesticides (OR= 5.57, 95% CI= 1.75-17.78) and consumed more meat (OR= 12.23, 95% CI= 3.89-39.01). Significantly reduced risks of prostate cancer were noted among those consuming more vegetables (OR= 0.12, 95% CI= 0.02-0.84), more tomatoes (OR= 0.35, 95% CI= 0.13-0.93) and those who had frequent sexual intercourse (OR= 0.44, 95% CI= 0.19-0.96). Some lifestyle and occupation factors are strong predictors of the occurrence of prostate cancer among patients in UKMMC. More importantly, with the identification of the potentially modifiable risk factors, proper public health intervention can be improved.

A Preliminary Tsunami Vulnerability Analysis for Yenikapi Region in Istanbul

NASA Astrophysics Data System (ADS)

Ceren Cankaya, Zeynep; Suzen, Lutfi; Cevdet Yalciner, Ahmet; Kolat, Cagil; Aytore, Betul; Zaytsev, Andrey

2015-04-01

One of the main requirements during post disaster recovery operations is to maintain proper transportation and fluent communication at the disaster areas. Ports and harbors are the main transportation hubs which must work with proper performance at all times especially after the disasters. Resilience of coastal utilities after earthquakes and tsunamis have major importance for efficient and proper rescue and recovery operations soon after the disasters. Istanbul is a mega city with its various coastal utilities located at the north coast of the Sea of Marmara. At Yenikapi region of Istanbul, there are critical coastal utilities and vulnerable coastal structures and critical activities occur daily. Fishery ports, commercial ports, small craft harbors, passenger terminals of intercity maritime transportation, water front commercial and/or recreational structures are some of the examples of coastal utilization which are vulnerable against marine disasters. Therefore their vulnerability under tsunami or any other marine hazard to Yenikapi region of Istanbul is an important issue. In this study, a methodology of vulnerability analysis under tsunami attack is proposed with the applications to Yenikapi region. In the study, high resolution (1m) GIS database of Istanbul Metropolitan Municipality (IMM) is used and analyzed by using GIS implementation. The bathymetry and topography database and the vector dataset containing all buildings/structures/infrastructures in the study area are obtained for tsunami numerical modeling for the study area. GIS based tsunami vulnerability assessment is conducted by applying the Multi-criteria Decision Making Analysis (MCDA). The tsunami parameters from deterministically defined worst case scenarios are computed from the simulations using tsunami numerical model NAMI DANCE. The vulnerability parameters in the region due to two different classifications i) vulnerability of buildings/structures and ii) vulnerability of (human) evacuation are defined and scored. The risk level is computed using tsunami intensity (level of flow depth from simulations) and vulnerability (structural and human-based) at each node in Yenikapi. The results are presented at high resolution (1m) and discussed. Acknowledgements: Partial support by EU 603839 ASTARTE Project, UDAP-C-12-14 of AFAD of Turkey, 108Y227 and 113M556 of TUBITAK Turkey, RAPSODI (CONCERT_Dis-021) of CONCERT-Japan Joint Call, 2011K140210 of DPT, Istanbul Metropolitan Municipality, Japan-Turkey Joint Research Project by JICA on earthquakes and tsunamis in Marmara Region by SATREPS are acknowledged.

Safety in Riding Programs: A Director's Guide.

ERIC Educational Resources Information Center

Kpachavi, Teresa

1996-01-01

Camp riding programs should be examined regularly for liability and risk management issues. Elements of a basic safety assessment include requiring proper safety apparel, removing obstructions from riding rings, ensuring doors and gates are closed, requiring use of lead ropes, securing equine medications, banning smoking, posting written…

14 CFR 23.1351 - General.

Code of Federal Regulations, 2013 CFR

2013-01-01

.../alternator. (5) Each generator/alternator must have an overvoltage control designed and installed to prevent... control and protective devices, must be able to furnish the required power at the proper voltage to each... detrimental substances, and mechanical damage; and (iii) So designed that the risk of electrical shock to crew...

14 CFR 23.1351 - General.

Code of Federal Regulations, 2011 CFR

2011-01-01

.../alternator. (5) Each generator/alternator must have an overvoltage control designed and installed to prevent... control and protective devices, must be able to furnish the required power at the proper voltage to each... detrimental substances, and mechanical damage; and (iii) So designed that the risk of electrical shock to crew...

14 CFR 23.1351 - General.

Code of Federal Regulations, 2014 CFR

2014-01-01

.../alternator. (5) Each generator/alternator must have an overvoltage control designed and installed to prevent... control and protective devices, must be able to furnish the required power at the proper voltage to each... detrimental substances, and mechanical damage; and (iii) So designed that the risk of electrical shock to crew...

14 CFR 23.1351 - General.

Code of Federal Regulations, 2012 CFR

2012-01-01

.../alternator. (5) Each generator/alternator must have an overvoltage control designed and installed to prevent... control and protective devices, must be able to furnish the required power at the proper voltage to each... detrimental substances, and mechanical damage; and (iii) So designed that the risk of electrical shock to crew...

14 CFR 23.1351 - General.

Code of Federal Regulations, 2010 CFR

2010-01-01

.../alternator. (5) Each generator/alternator must have an overvoltage control designed and installed to prevent... control and protective devices, must be able to furnish the required power at the proper voltage to each... detrimental substances, and mechanical damage; and (iii) So designed that the risk of electrical shock to crew...

Value and production of novel legume pulses-based snack foods

USDA-ARS?s Scientific Manuscript database

Healthy eating has always been important for proper growth and development, but more recently it has been accepted that healthy eating is a significant factor in reducing the risk of developing nutrition-related heath problems including obesity, heart disease, cancer, diabetes, hypertension (high bl...

Safer Soldering Guidelines and Instructional Resources

ERIC Educational Resources Information Center

Love, Tyler S.; Tomlinson, Joel

2018-01-01

Soldering is a useful and necessary process for many classroom, makerspace, Fab Lab, technology and engineering lab, and science lab activities. As described in this article, soldering can pose many safety risks without proper engineering controls, standard operating procedures, and direct instructor supervision. There are many safety hazards…

The Sign Told Me how to Play--A Lesson in Risk Reduction.

ERIC Educational Resources Information Center

Wallach, Frances

1988-01-01

Two constantly appearing claims in most playground accident suits are improper supervision and lack of warning to the users. This article discusses legal implications of improper signage, explains use of symbols, and presents general sign guidelines to ensure proper safety measures. (MLH)

Model of areas for identifying risks influencing the compliance of technological processes and products

NASA Astrophysics Data System (ADS)

Misztal, A.; Belu, N.

2016-08-01

Operation of every company is associated with the risk of interfering with proper performance of its fundamental processes. This risk is associated with various internal areas of the company, as well as the environment in which it operates. From the point of view of ensuring compliance of the course of specific technological processes and, consequently, product conformity with requirements, it is important to identify these threats and eliminate or reduce the risk of their occurrence. The purpose of this article is to present a model of areas of identifying risk affecting the compliance of processes and products, which is based on multiregional targeted monitoring of typical places of interference and risk management methods. The model is based on the verification of risk analyses carried out in small and medium-sized manufacturing companies in various industries..

Applying the Heuristic to the Risk Assessment within the Automotive Industry Supply Chain

NASA Astrophysics Data System (ADS)

Marasova, Daniela; Andrejiova, Miriam; Grincova, Anna

2017-03-01

Risk management facilitates risk identification, evaluation, control, and by means of appropriate set of measures, risk reduction or complete elimination. Therefore, the risk management becomes a strategic factor for a company's success. Properly implemented risk management system does not represent a tool to avoid the risk; it is used to understand the risk and provide the bases for strategic decision-making. Risk management represents a key factor for the supply chain operations. Managing the risks is crucial for achieving the customer satisfaction and thus also a company's success. The subject-matter of the article is the assessment of the supply chain in the automobile industry, in terms of risks. The topicality of this problem is even higher, as after the economic crisis it is necessary to revaluate the readiness of the supply chain for prospective risk conditions. One advantage of this article is the use of the Saaty method as a tool for the risk management within the supply chain.

Serum protein mediators of dementia and aging proper.

PubMed

Royall, Donald R; Al-Rubaye, Safa; Bishnoi, Ram; Palmer, Raymond F

2016-12-03

The latent variable "δ" (for "dementia") appears to be uniquely responsible for the dementing aspects of cognitive impairment. Age, depressive symptoms, gender and the apolipoprotein E (APOE) ε4 allele are independently associated with δ. In this analysis, we explore serum proteins as potential mediators of age's specific association with δ in a large, ethnically diverse longitudinal cohort, the Texas Alzheimer's Research and Care Consortium (TARCC). 22 serum proteins were recognized as partial mediators of age's association with δ. These include Insulin-like Growth Factor-Binding Protein 2 (IGF-BP2), which we had previously associated with age-specific cognitive change, and both Pancreatic Polypeptide (PP) and von Willebrand Factor (vWF), previously associated with δ. Nine other δ-related proteins were not confirmed by this ethnicity adjusted analysis. Our findings suggest that age's association with the disabling fraction of cognitive performance is partially mediated by serum proteins, somatomedins and hormones. Those proteins may offer targets for the specific treatment of age-related effects on dementia severity and conversion risk.

Attitudes, perceptions, and trust. Insights from a consumer survey regarding genetically modified banana in Uganda.

PubMed

Kikulwe, Enoch M; Wesseler, Justus; Falck-Zepeda, Jose

2011-10-01

Genetically modified (GM) crops and food are still controversial. This paper analyzes consumers' perceptions and institutional awareness and trust toward GM banana regulation in Uganda. Results are based on a study conducted among 421 banana-consuming households between July and August 2007. Results show a high willingness to purchase GM banana among consumers. An explanatory factor analysis is conducted to identify the perceptions toward genetic modification. The identified factors are used in a cluster analysis that grouped consumers into segments of GM skepticism, government trust, health safety concern, and food and environmental safety concern. Socioeconomic characteristics differed significantly across segments. Consumer characteristics and perception factors influence consumers' willingness to purchase GM banana. The institutional awareness and trust varied significantly across segments as well. The findings would be essential to policy makers when designing risk-communication strategies targeting different consumer segments to ensure proper discussion and addressing potential concerns about GM technology. Copyright © 2011 Elsevier Ltd. All rights reserved.

[Ergonomic analysis of the handle of manual instruments for dental hygiene].

PubMed

Migliario, Mario; Franchignoni, Marco; Soldati, Libero; Melle, Andrea; Carcieri, Paola; Ferriero, Giorgio

2012-01-01

Work-related musculoskeletal disorders of upper limbs are very common among dental hygienists. To minimize the risk of their occurrence, it is essential that attention be paid to proper ergonomics in the workplace, including the selection of instrumentation. At present there are no specific guidelines but only some indications for the selection of the different hand tools. The main purpose of this study was to make a comparative analysis of different types of handles of hand tools used for root planing (Gracey curettes). Nine dental hygienists were interviewed with a questionnaire aimed to assess three different types of curette handle. The results showed that lightness, being of solid steel, having a cylindrical non-uniform shape with full enlarged cross-section, and being silicon coated with non-slip ends are the preferred characteristics for a curette handle. These considerations may assist both manufacturers in designing new hand instruments and clinicians in selecting the most ergonomic ones to buy.

How Students Learn from Multiple Contexts and Definitions: Proper Time as a Coordination Class

ERIC Educational Resources Information Center

Levrini, Olivia; diSessa, Andrea A.

2008-01-01

This article provides an empirical analysis of a single classroom episode in which students reveal difficulties with the concept of proper time in special relativity but slowly make progress in improving their understanding. The theoretical framework used is "coordination class theory," which is an evolving model of concepts and conceptual change.…

Plant Nutrient Testing and Analysis in Forest and Conservation Nurseries

Treesearch

Thomas D. Landis; Diane L. Haase; R. Kasten Dumroese

2005-01-01

Supplying mineral nutrients at the proper rate and in the proper balance has a major effect on seedling growth rate but, more importantly, on seedling quality. In addition, mounting concerns about fertilizer pollution are increasing awareness of the benefits of precision fertilization. Because they reflect actual mineral nutrient uptake, plant tissue tests are the best...

Time to revisit arsenic regulations: comparing drinking water and rice.

PubMed

Sauvé, Sébastien

2014-05-17

Current arsenic regulations focus on drinking water without due consideration for dietary uptake and thus seem incoherent with respect to the risks arising from rice consumption. Existing arsenic guidelines are a cost-benefit compromise and, as such, they should be periodically re-evaluated. Literature data was used to compare arsenic exposure from rice consumption relative to exposure arising from drinking water. Standard risk assessment paradigms show that arsenic regulations for drinking water should target a maximum concentration of nearly zero to prevent excessive lung and bladder cancer risks (among others). A feasibility threshold of 3 μg As l(-1) was determined, but a cost-benefit analysis concluded that it would be too expensive to target a threshold below 10 μg As l(-1). Data from the literature was used to compare exposure to arsenic from rice and rice product consumption relative to drinking water consumption. The exposure to arsenic from rice consumption can easily be equivalent to or greater than drinking water exposure that already exceeds standard risks and is based on feasibility and cost-benefit compromises. It must also be emphasized that many may disagree with the implications for their own health given the abnormally high cancer odds expected at the cost-benefit arsenic threshold. Tighter drinking water quality criteria should be implemented to properly protect people from excessive cancer risks. Food safety regulations must be put in place to prevent higher concentrations of arsenic in various drinks than those allowed in drinking water. Arsenic concentrations in rice should be regulated so as to roughly equate the risks and exposure levels observed from drinking water.

Assessing Risks from Cyclones for Human Lives and Livelihoods in the Coastal Region of Bangladesh

PubMed Central

Khan, Amanat Ullah; Kervyn, Matthieu

2017-01-01

As a disaster prone country, Bangladesh is regularly hit by natural hazards, including devastating cyclones, such as in 1970, 1991 and 2007. Although the number of cyclones’ fatalities reduced from 0.3 million in 1970 to a few thousand or fewer in recent events, loss of lives and impact on livelihoods remains a concern. It depends on the meteorological characteristics of cyclone and the general vulnerability and capacity of the exposed population. In that perspective, a spatially explicit risk assessment is an essential step towards targeted disaster risk reduction. This study aims at analyzing the spatial variation of the different factors contributing to the risk for coastal communities at regional scale, including the distribution of the hazards, exposure, vulnerability and capacity. An exploratory factor analysis method is used to map vulnerability contrasts between local administrative units. Indexing and ranking using geospatial techniques are used to produce maps of exposure, hazard, vulnerability, capacities and risk. Results show that vulnerable populations and exposed areas are distributed along the land sea boundary, islands and major inland rivers. The hazard, assessed from the density of historical cyclone paths, is highest in the southwestern part of the coast. Whereas cyclones shelters are shown to properly serve the most vulnerable populations as priority evacuation centers, the overall pattern of capacity accounting for building quality and road network shows a more complex pattern. Resultant risk maps also provide a reasonable basis from which to take further structural measures to minimize loss of lives in the upcoming cyclones. PMID:28757550

Human exposure to chemical mixtures: Challenges for the integration of toxicology with epidemiology data in risk assessment.

PubMed

Hernández, Antonio F; Tsatsakis, Aristidis M

2017-05-01

Little is known about the potential adverse effects from longterm exposure to complex mixtures at low doses, close to health-based reference values. Traditional chemical-specific risk assessment based on animal testing may be insufficient and the lack of toxicological studies on chemical mixtures remains a major regulatory challenge. Hence, new methodologies on cumulative risk assessment are being developed but still present major limitations. Evaluation of chemical mixture effects requires an integrated and systematic approach and close collaboration across different scientific fields, particularly toxicology, epidemiology, exposure science, risk assessment and statistics for a proper integration of data from all these disciplines. Well designed and conducted epidemiological studies can take advantage of this new paradigm and can provide insight to support the correlation between humans low-dose exposures and diseases, thus avoiding the uncertainty associated with extrapolation across species. In this regard, human epidemiology studies may play a significant role in the new vision of toxicity testing. However, this type of information has not been fully considered in risk assessment, mainly due to the inherent limitations of epidemiologic studies. An integrated approach of in vivo, in vitro and in silico data, together with systematic reviews or meta-analysis of high quality epidemiological studies will improve the robustness of risk assessment of chemical mixtures and will provide a stronger basis for regulatory decisions. The ultimate goal is that experimental and mechanistic data can lend support and biological plausibility to the human epidemiological observations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Cleaning and disinfection of patient care items, in relation to small animals.

PubMed

Weese, J Scott

2015-03-01

Patient care involves several medical and surgical items, including those that come into contact with sterile or other high-risk body sites and items that have been used on other patients. These situations create a risk for infection if items are contaminated, and the implications can range from single infections to large outbreaks. To minimize the risk, proper equipment cleaning, disinfection/sterilization, storage, and monitoring practices are required. Risks posed by different items; the required level of cleaning, disinfection, or sterilization; the methods that are available and appropriate; and how to ensure efficacy, must be considered when designing and implementing an infection control program. Copyright © 2015 Elsevier Inc. All rights reserved.

Combining operational models and data into a dynamic vessel risk assessment tool for coastal regions

NASA Astrophysics Data System (ADS)

Fernandes, R.; Braunschweig, F.; Lourenço, F.; Neves, R.

2016-02-01

The technological evolution in terms of computational capacity, data acquisition systems, numerical modelling and operational oceanography is supplying opportunities for designing and building holistic approaches and complex tools for newer and more efficient management (planning, prevention and response) of coastal water pollution risk events. A combined methodology to dynamically estimate time and space variable individual vessel accident risk levels and shoreline contamination risk from ships has been developed, integrating numerical metocean forecasts and oil spill simulations with vessel tracking automatic identification systems (AIS). The risk rating combines the likelihood of an oil spill occurring from a vessel navigating in a study area - the Portuguese continental shelf - with the assessed consequences to the shoreline. The spill likelihood is based on dynamic marine weather conditions and statistical information from previous accidents. The shoreline consequences reflect the virtual spilled oil amount reaching shoreline and its environmental and socio-economic vulnerabilities. The oil reaching shoreline is quantified with an oil spill fate and behaviour model running multiple virtual spills from vessels along time, or as an alternative, a correction factor based on vessel distance from coast. Shoreline risks can be computed in real time or from previously obtained data. Results show the ability of the proposed methodology to estimate the risk properly sensitive to dynamic metocean conditions and to oil transport behaviour. The integration of meteo-oceanic + oil spill models with coastal vulnerability and AIS data in the quantification of risk enhances the maritime situational awareness and the decision support model, providing a more realistic approach in the assessment of shoreline impacts. The risk assessment from historical data can help finding typical risk patterns ("hot spots") or developing sensitivity analysis to specific conditions, whereas real-time risk levels can be used in the prioritization of individual ships, geographical areas, strategic tug positioning and implementation of dynamic risk-based vessel traffic monitoring.

[Establishment of response system to emergency parasitic disease affairs in China].

PubMed

Chun-Li, C; Le-Ping, S; Qing-Biao, H; Bian-Li, X U; Bo, Z; Jian-Bing, L; Dan-Dan, L; Shi-Zhu, L I; Oning, X; Xiao-Nong, Z

2017-08-14

China's prevention and control of parasitic diseases has made remarkable achievements. However, the prevalence and transmission of parasitic diseases is impacted by the complicated natural and social factors of environment, natural disasters, population movements, and so on. Therefore, there are still the risks of the outbreak of emergency parasitic diseases affairs, which may affect the control effectiveness of parasitic diseases and endanger the social stability seriously. In this article, we aim at the analysis of typical cases of emergency parasitic disease affairs and their impacts on public health security in China in recently years, and we also elaborate the disposal characteristics of emergency parasitic disease affairs, and propose the establishment of response system to emergency parasitic disease affairs in China, including the organizational structure and response flow path, and in addition, point out that, in the future, we should strengthen the system construction and measures of the response system to emergency parasitic disease affairs, so as to control the risk and harm of parasitic disease spread as much as possible and to realize the early intervention and proper disposal of emergency parasitic disease affairs.

Nonfatal residential fire-related injuries treated in emergency departments--United States, 2001.

PubMed

2003-09-26

During 2000, the most recent year for which national mortality data are available, 3,907 persons died in the United States from fire-related injuries; residential fires accounted for 2,955 (76%) of these deaths. The National Fire Protection Association (NFPA) reported that approximately 396,500 residential fires occurred in 2001. Injuries from residential fires are preventable by improving awareness of the common causes of fires and by using simple interventions (e.g., properly maintained smoke alarms and fire escape plans). Surveillance of fire-related injuries can aid prevention by increasing the understanding of these injuries and by identifying at-risk populations to target for interventions and education. To characterize nonfatal residential fire-related injuries treated in U.S. hospital emergency departments (EDs) during 2001, CDC analyzed data from the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP). This report summarizes the results of that analysis, which indicate that, in 2001, an estimated 25,717 nonfatal residential fire-related injuries were treated in U.S. hospital EDs. Fire prevention and safety interventions and education should target at-risk populations for fire-related injuries.

Applying causal mediation analysis to personality disorder research.

PubMed

Walters, Glenn D

2018-01-01

This article is designed to address fundamental issues in the application of causal mediation analysis to research on personality disorders. Causal mediation analysis is used to identify mechanisms of effect by testing variables as putative links between the independent and dependent variables. As such, it would appear to have relevance to personality disorder research. It is argued that proper implementation of causal mediation analysis requires that investigators take several factors into account. These factors are discussed under 5 headings: variable selection, model specification, significance evaluation, effect size estimation, and sensitivity testing. First, care must be taken when selecting the independent, dependent, mediator, and control variables for a mediation analysis. Some variables make better mediators than others and all variables should be based on reasonably reliable indicators. Second, the mediation model needs to be properly specified. This requires that the data for the analysis be prospectively or historically ordered and possess proper causal direction. Third, it is imperative that the significance of the identified pathways be established, preferably with a nonparametric bootstrap resampling approach. Fourth, effect size estimates should be computed or competing pathways compared. Finally, investigators employing the mediation method are advised to perform a sensitivity analysis. Additional topics covered in this article include parallel and serial multiple mediation designs, moderation, and the relationship between mediation and moderation. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Studies on the psychosomatic functioning of ill-health according to Eastern and Western medicine. 1. Visual observation of the sublingual vein for early detection of vital energy stagnation and blood stasis.

PubMed

Takeichi, M; Sato, T

1999-01-01

Computer-assisted image analyses were performed on the tongue color of 95 medical students without previous history of blood stasis-related condition to clarify the mutual relationship of the color of the tongue proper, the coating, and sublingual vein. The location of the measurement for the tongue proper was the underside of the tongue, and location of the measurement for the tongue coating was the upper surface of the tongue. A linear correlation analysis showed a correlation for each of the different positions for the non-normalized red value and normalized blue value. This analysis also demonstrated a statistically-significant relationship between the tongue proper and the sublingual vein using Red-Green-Blue components and normalized Red-Green-Blue components (r = +0.670 - 0.817, p < 0.0001). The most significant correlation between the tongue proper and the sublingual vein was the normalized red value and the normalized Red-Green-Blue values for minimizing the range of the standard error of the mean (r = +0.745, p < 0.0001), although non-normalized blue had the highest correlation coefficient. Therefore, it seems reasonable to select those normalized red values for the comparison in the tongue color analysis. Correlation of the color between the sublingual vein and the tongue proper strongly suggests that inspection with the naked eye of the sublingual vein is useful for the early detection of vital energy stagnation and blood stasis. Also, because of its close relation to sustained chronic stress, changes in the sublingual vein might be available as one physiological parameter of a stress reaction.

On the Occurrence of Wide Binaries in the Local Disk and Halo Populations

NASA Astrophysics Data System (ADS)

Hartman, Zachary; Lepine, Sebastien

2018-01-01

We present results from our search for wide binaries in the SUPERBLINK+GAIA all-sky catalog of 2.8 million high proper motion stars (μ>40 mas/yr). Through a Bayesian analysis of common proper motion pairs, we have identified highly probable wide binary/multiple systems based on statistics of their proper motion differences and angular separations. Using a reduced proper motion diagram, we determine whether these wide are part of the young disk, old disk, or Galactic halo population. We examine the relative occurrence rate for very wide companions in these respective populations. All groups are found to contain a significant number of wide binary systems, with about 1 percent of the stars in each group having pairs with separations >1,000 AU.

Air Force System Safety Handbook, Designing the Safest Possible Systems Consistent with Mission Requirements and Cost Effectiveness

DTIC Science & Technology

2000-07-01

acceptance is not as simple a matter as it may first appear. Several points must be kept in mind. (1) Risk is a fundamental reality . (2) Risk...1) Proper preparation of an SSPP requires coming to grips with the hard realities of program execution. It involves the exami- nation and...Interfaces. (32:48) Since the conduct of a system safety program will eventually touch on virtually every other element of a system devel- opment program, a

Strengthening the Security of ESA Ground Data Systems

NASA Astrophysics Data System (ADS)

Flentge, Felix; Eggleston, James; Garcia Mateos, Marc

2013-08-01

A common approach to address information security has been implemented in ESA's Mission Operations (MOI) Infrastructure during the last years. This paper reports on the specific challenges to the Data Systems domain within the MOI and how security can be properly managed with an Information Security Management System (ISMS) according to ISO 27001. Results of an initial security risk assessment are reported and the different types of security controls that are being implemented in order to reduce the risks are briefly described.

Asthma prevalence and severity in low-resource communities.

PubMed

Cruz, Álvaro A; Stelmach, Rafael; Ponte, Eduardo V

2017-06-01

The prevalence of asthma was thought to be low in most low-income countries, but several reports have indicated this is not always true. This is a narrative review of recent publications on the burden of asthma in low and middle-income countries (LMIC) and underprivileged communities from developed countries. Several studies have reported a low prevalence of asthma is LMIC, but indicate it is increasing. In the last few years, however, many surveys demonstrated this may not always be true. An analysis of the International Study for Asthma and Allergy in Childhood phase III database indicated although the prevalence of asthma among children and adolescents is higher in the developed countries, symptoms of asthma are often more severe in less affluent nations. The rate of uncontrolled asthma is also higher among underprivileged communities of developed countries. Secondary analysis of data generated by the WHO's world health survey performed among adults of 70 countries indicate symptoms of asthma are less frequent in middle-income countries and more frequent in the extremes, low income and high income. This sort of U shaped distribution suggests the disease (or syndrome) comprise more than one major phenotype related to diverse underlying mechanisms. In fact, recent reports show symptoms of asthma among the poor are associated with unhygienic living conditions, which may reduce the risk of atopy but increase the risk of nonatopic wheezing. Urbanization and exposure to air pollution also seem to contribute to an increasing prevalence severity of asthma in LMIC. Access to proper diagnosis and treatment with controller medications for asthma, specially with inhaled corticosteroids is feasible and cost-effective, reduce symptoms, health resource utilization, improves quality of life, and reduce mortality in low-resource settings. Prevalence of asthma was thought to be low in low-income countries, but several reports have indicated this is not always true. Under diagnosis, under treatment, exposure to air pollution, and unhygienic living conditions may contribute to a higher frequency and severity of symptoms of asthma among the poor. Proper diagnosis and treatment with controller medications for asthma is feasible and cost-effective in low-resource settings.

Aerosol, a health hazard during ultrasonic scaling: A clinico-microbiological study.

PubMed

Singh, Akanksha; Shiva Manjunath, R G; Singla, Deepak; Bhattacharya, Hirak S; Sarkar, Arijit; Chandra, Neeraj

2016-01-01

Ultrasonic scaling is a routinely used treatment to remove plaque and calculus from tooth surfaces. These scalers use water as a coolant which is splattered during the vibration of the tip. The splatter when mixed with saliva and plaque of the patients causes the aerosol highly infectious and acts as a major risk factor for transmission of the disease. In spite of necessary protection, sometimes, the operator might get infected because of the infectious nature of the splatter. To evaluate the aerosol contamination produced during ultrasonic scaling by the help of microbiological analysis. This clinico-microbiological study consisted of twenty patients. Two agar plates were used for each patient; the first was kept at the center of the operatory room 20 min before the treatment while the second agar plate was kept 40 cm away from the patient's chest during the treatment. Both the agar plates were sent for microbiological analysis. The statistical analysis was done with the help of STATA 11.0 (StataCorp. 2013. Stata Statistical Software, Release 13. College Station, TX: StataCorp LP, 4905 Lakeway Drive College Station, Texas, USA). Statistical software was used for data analysis and the P < 0.001 was considered to be statistically significant. The results for bacterial count were highly significant when compared before and during the treatment. The Gram staining showed the presence of Staphylococcus and Streptococcus species in high numbers. The aerosols and splatters produced during dental procedures have the potential to spread infection to dental personnel. Therefore, proper precautions should be taken to minimize the risk of infection to the operator.

Landslide risk analysis: a multi-disciplinary methodological approach

NASA Astrophysics Data System (ADS)

Sterlacchini, S.; Frigerio, S.; Giacomelli, P.; Brambilla, M.

2007-11-01

This study describes an analysis carried out within the European community project "ALARM" (Assessment of Landslide Risk and Mitigation in Mountain Areas, 2004) on landslide risk assessment in the municipality of Corvara in Badia, Italy. This mountainous area, located in the central Dolomites (Italian Alps), poses a significant landslide hazard to several man-made and natural objects. Three parameters for determining risk were analysed as an aid to preparedness and mitigation planning: event occurrence probability, elements at risk, and the vulnerability of these elements. Initially, a landslide hazard scenario was defined; this step was followed by the identification of the potential vulnerable elements, by the estimation of the expected physical effects, due to the occurrence of a damaging phenomenon, and by the analysis of social and economic features of the area. Finally, a potential risk scenario was defined, where the relationships between the event, its physical effects, and its economic consequences were investigated. People and public administrators with training and experience in local landsliding and slope processes were involved in each step of the analysis. A "cause-effect" correlation was applied, derived from the "dose-response" equation initially used in the biological sciences and then adapted by economists for the assessment of environmental risks. The relationship was analysed from a physical point of view and the cause (the natural event) was correlated to the physical effects, i.e. the aesthetic, functional, and structural damage. An economic evaluation of direct and indirect damage was carried out considering the assets in the affected area (i.e., tourist flows, goods, transport and the effect on other social and economic activities). This study shows the importance of indirect damage, which is as significant as direct damage. The total amount of direct damage was estimated in 8 913 000 €; on the contrary, indirect damage ranged considerably from 2 840 000 to 9 350 000 €, depending on the selected temporal scenario and the expected closing time of the potentially affected structures. The multi-disciplinary approach discussed in this study may assist local decision makers in determining the nature and magnitude of the expected losses due to a dangerous event, which can be anticipated in a given study area, during a specified time period. Besides, a preventive knowledge of the prospective physical effects and economic consequences may help local decision makers to choose the best prevention and mitigation options and to decide how to allocate resources properly, so that potential benefits are maximised at an acceptable cost.

Youth and Tattoos: What School Health Personnel Should Know.

ERIC Educational Resources Information Center

Brown, Kelli McCormack; Perlmutter, Paula; McDermott, Robert J.

2000-01-01

The recent proliferation of tattooing has prompted increased concern for safety and awareness of hazardous conditions. Transmission of infectious diseases can occur when proper sterilization and safety procedures are not followed. Adolescents are a critical high-risk group that need the attention of school health personnel to help them become…

77 FR 60615 - National Substance Abuse Prevention Month, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-04

... in our schools, to greater risks on our roads and in our communities, to the heartache of lives cut... approach that advances evidence-based public health and safety reforms. We have invested in outreach... tide of prescription drug abuse through education, monitoring, proper disposal, and enforcement. We...

[The caregiver's relationship with the sick body].

PubMed

Mercadier, Catherine

The patient-caregiver relationship is also a 'body-to-body' relationship. It brings into play sensory perceptions generating a cognitive and emotional interpretation. Maintaining the proper distance enables caregivers to remain professional while controlling the risk of 'symbolic contamination' and emotional overflow. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

METHODS DEVELOPMENT AT THE NEAR LAB ECOLOGICAL RESEARCH AREA (NLERA) LOCATED IN THE NEUSE RIVER BASIN.

EPA Science Inventory

This task supports the Agency's efforts on developing a proper risk assessment tools to address Ecological and eventually Human exposures. The Agency needs to be able to identify, measure and estimate ecosystem exposure to multiple stressors. The research under this task suppor...

Institutional Conflict.

ERIC Educational Resources Information Center

Ostar, Allan W.

1995-01-01

One way universities have served society since the Middle Ages is by providing an environment giving students and faculty freedom to explore new ideas without fear of retribution. Properly used, conflict can be the catalyst for advancing wisdom. However, the university is at risk when rational discourse is replaced by conflict as the means of…

Tourette Syndrome: A Case for Establishing the Individual Needs of Children at Risk.

ERIC Educational Resources Information Center

Wilson, Jeni; Shrimpton, Bradley

Tourette Syndrome (TS) is a neurological disorder characterized by multiple, involuntary, and repetitive motor and vocal tics. This paper addresses the educational needs of students with TS noting that, without proper intervention and appropriate learning experiences, these children often experience personal distress, reduced self-esteem, social…

76 FR 28917 - Medical Foster Homes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-19

... be safely and properly stored in either the original, labeled container, or in a safety can as defined by NPFA 30 (2008 edition). This is to ensure that dangerous materials are only kept in containers... containers which might increase fire risk associated with those materials. In proposed Sec. 17.74(p), we...

Proteomic Assessment of Biochemical Pathways That Are Critical to Nickel-Induced Toxicity Responses in Human Epithelial Cells

EPA Science Inventory

Understanding the mechanisms underlying toxicity initiated by nickel, a ubiquitous environmental contaminant and known human carcinogen is necessary for proper assessment of its risks to human and environment. Among a variety of toxic mechanisms, disruption of protein responses a...

Big assumptions for small samples in crop insurance

Treesearch

Ashley Elaine Hungerford; Barry Goodwin

2014-01-01

The purpose of this paper is to investigate the effects of crop insurance premiums being determined by small samples of yields that are spatially correlated. If spatial autocorrelation and small sample size are not properly accounted for in premium ratings, the premium rates may inaccurately reflect the risk of a loss.

Training to Increase Safe Tray Carrying among Cocktail Servers

ERIC Educational Resources Information Center

Scherrer, Megan D.; Wilder, David A.

2008-01-01

We evaluated the effects of training on proper carrying techniques among 3 cocktail servers to increase safe tray carrying on the job and reduce participants' risk of developing musculoskeletal disorders. As participants delivered drinks to their tables, their finger, arm, and neck positions were observed and recorded. Each participant received…

75 FR 31789 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-04

... necessity and utility of the proposed information collection for the proper performance of the Agency's... Performance Measures: Use: Part C Sponsors provide medical coverage through at-risk arrangements with CMS... Executive Order 13410, ``Promoting Quality and Efficient Health Care in Federal Government Administered or...

24 CFR 203.208 - Insurance backing criteria.

Code of Federal Regulations, 2010 CFR

2010-04-01

... market such insurance coverage by the proper regulatory agency in each State in which the Plan will operate. Any company operating under the Product Liability Risk Retention Act of 1981, as amended, will be regarded as having met licensing, filing, and approval requirements of all States, but must first...

7 CFR 407.15 - Group risk plan for sorghum.

Code of Federal Regulations, 2012 CFR

2012-01-01

... expected county yield and calculate indemnities. Planted acreage. Land in which the sorghum seed has been... subsequent mechanical incorporation of the sorghum seed is not allowed. 2. Crop Insured (a) The insured crop... application; (2) Properly planted and reported by the acreage reporting date; (3) Planted with the intent to...

7 CFR 407.15 - Group risk plan for sorghum.

Code of Federal Regulations, 2011 CFR

2011-01-01

... expected county yield and calculate indemnities. Planted acreage. Land in which the sorghum seed has been... subsequent mechanical incorporation of the sorghum seed is not allowed. 2. Crop Insured (a) The insured crop... application; (2) Properly planted and reported by the acreage reporting date; (3) Planted with the intent to...

78 FR 27117 - General and Plastic Surgery Devices: Reclassification of Ultraviolet Lamps for Tanning...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-09

... sunlamp products are mechanically safe to prevent user injury. Mechanical safety testing, such as cyclic... off) are in proper working order. This requirement would mitigate increased skin cancer risk from... that sunlamp products are electrically safe and electromagnetically compatible in their intended use...

Your Best Laid Plans for Disaster Recovery

ERIC Educational Resources Information Center

Shroads, David L.

2005-01-01

Most board members are aware of their fiduciary duty to oversee proper risk management of their institutions. Most boards are kept abreast of the various federal laws and the necessary insurance coverage, internal audits, and accreditation reviews that make modern-day governing boards increasingly more accountable. Given this combination of…

Bicycle Safety: A Balancing Act.

ERIC Educational Resources Information Center

Cinque, Chris

1989-01-01

In an effort to reduce deaths and serious injuries among bicyclists, physicians and bicycling organizations are promoting safety skill classes. Children are at especially high risk of accidents and need proper training and education. Helmets and other protective gear are considered crucial equipment, and common sense and alertness are important.…

A pilot exploratory investigation on pregnant women's views regarding STan fetal monitoring technology.

PubMed

Bryson, Kate; Wilkinson, Chris; Kuah, Sabrina; Matthews, Geoff; Turnbull, Deborah

2017-12-29

Women's views are critical for informing the planning and delivery of maternity care services. ST segment analysis (STan) is a promising method to more accurately detect when unborn babies are at risk of brain damage or death during labour that is being trialled for the first time in Australia. This is the first study to examine women's views about STan monitoring in this context. Semi-structured interviews were conducted with pregnant women recruited across a range of clinical locations at the study hospital. The interviews included hypothetical scenarios to assess women's prospective views about STan monitoring (as an adjunct to cardiotocography, (CTG)) compared to the existing fetal monitoring method of CTG alone. This article describes findings from an inductive and descriptive thematic analysis. Most women preferred the existing fetal monitoring method compared to STan monitoring; women's decision-making was multifaceted. Analysis yielded four themes relating to women's views towards fetal monitoring in labour: a) risk and labour b) mobility in labour c) autonomy and choice in labour d) trust in maternity care providers. Findings suggest that women's views towards CTG and STan monitoring are multifaceted, and appear to be influenced by individual labour preferences and the information being received and understood. This underlies the importance of clear communication between maternity care providers and women about technology use in intrapartum care. This research is now being used to inform the implementation of the first properly powered Australian randomised trial comparing STan and CTG monitoring.

Stability of tapered and parallel-walled dental implants: A systematic review and meta-analysis.

PubMed

Atieh, Momen A; Alsabeeha, Nabeel; Duncan, Warwick J

2018-05-15

Clinical trials have suggested that dental implants with a tapered configuration have improved stability at placement, allowing immediate placement and/or loading. The aim of this systematic review and meta-analysis was to evaluate the implant stability of tapered dental implants compared to standard parallel-walled dental implants. Applying the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement, randomized controlled trials (RCTs) were searched for in electronic databases and complemented by hand searching. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool and data were analyzed using statistical software. A total of 1199 studies were identified, of which, five trials were included with 336 dental implants in 303 participants. Overall meta-analysis showed that tapered dental implants had higher implant stability values than parallel-walled dental implants at insertion and 8 weeks but the difference was not statistically significant. Tapered dental implants had significantly less marginal bone loss compared to parallel-walled dental implants. No significant differences in implant failure rate were found between tapered and parallel-walled dental implants. There is limited evidence to demonstrate the effectiveness of tapered dental implants in achieving greater implant stability compared to parallel-walled dental implants. Superior short-term results in maintaining peri-implant marginal bone with tapered dental implants are possible. Further properly designed RCTs are required to endorse the supposed advantages of tapered dental implants in immediate loading protocol and other complex clinical scenarios. © 2018 Wiley Periodicals, Inc.

Audit Report on "Management Controls over the Department's Excess Weapons Inventories and Selected Sensitive Equipment used by Protective Forces"

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

2009-01-01

Since September 11, 2001, the Department of Energy has, on several occasions, revised its security posture based on identified threats and adversaries. These revisions in security posture have driven Departmental sites to upgrade their defensive and tactical equipment. Subsequent changes in the perceived threats have, in some cases, led to a reduction in the need for certain types of weapons, thus creating a pool of surplus equipment. These surplus weapons could potentially be used by other Department sites and Federal law enforcement agencies. Recent Office of Inspector General reports have raised concerns with the adequacy of controls related to defensivemore » and tactical equipment. For example, our report on Management Controls Over Defense Related High Risk Property (OAS-M-08-06, April 2008) found that administrative controls over certain defense related high risk property were not sufficient for providing accountability over these items. Because of prior reported weaknesses in controls over defensive and tactical equipment, we initiated this audit to determine whether the Department and its contractors were properly managing excess weapons inventories and selected sensitive equipment used by protective forces. Our review disclosed that the Department was not always properly managing its inventories of excess weapons and selected sensitive equipment. We identified issues with the retention of unneeded weapons at many locations and with the identification and tracking of sensitive items. More specifically: Sites maintained large inventories of weapons that were no longer needed but had not been made available for use by either other Departmental sites or other Federal law enforcement agencies. For instance, at six of the locations included in our review we identified a total of 2,635 unneeded weapons with a total acquisition value of over $2.8 million that had not been officially declared as excess - an action that would have made them available for others to use. In addition; Sites were not always identifying, tracking and properly disposing of potentially high risk and sensitive equipment. In particular, we identified control weaknesses in this area related to weapons sights and scopes. These issues occurred because the Department did not have processes in place to properly manage excess inventories of weapons. In particular, the Department does not have requirements for ensuring timely declaration of excess weapons. Additionally, certain sites indicated that they were unwilling to give up excess weapons because of the possibility that they may be needed in the future. However, other sites had a need for some of these weapons and could have avoided purchasing them had they been made available through the excess screening process. Also, we found that the Department lacks clear guidance on the identification of high risk/sensitive equipment. Except for immaterial differences, we were able to locate and verify accountability over the items of defensive and tactical equipment we selected for review. Specifically, we took statistical samples of weapons, ammunition, and other related equipment and were able to verify their existence. While these accountability measures were noteworthy, additional action is necessary to strengthen controls over weapon and sensitive equipment management. Untimely declaration of excess weapons may result in an inefficient use of scarce Government resources. Similarly, if selected high risk/sensitive equipment is not properly categorized and tracked, accountability issues may occur. To address these issues, we made recommendations aimed at improving the management of these categories of defensive and tactical equipment.« less

[Folate metabolism--epigenetic role of choline and vitamin B12 during pregnancy].

PubMed

Drews, Krzysztof

2015-12-01

Adequate choline intake during pregnancy is essential for proper fetal development. Nowadays studies suggest that even in high income countries regular pregnant women diet does not provide the satisfactory amount of choline. Choline demand during pregnancy is high and it seems to exceed present choline intake recommendations. Moreover lactation period also demands choline supplementation because of its high concentration in female milk. Numerous studies on animal model proved correlation between choline supplementation during pregnancy and proper fetal cognitive function development. Despite increased synthesis in maternal liver during pregnancy choline demand is much higher than common dietary uptake. Nowadays studies as to the nutritional recommendations during pregnancy concern also vitamin B12 supplementation. Vitamin B12 deficiency may be an important risk factor of neural tube defects development. Presented article contains a review of data on proper choline and vitamin B12 uptake during pregnancy and lactation and potential results of choline and vitamin B12 poor maternal status.

[Mobile phones and head tumours: it is time to read and highlight data in a proper way].

PubMed

Levis, Angelo G; Minicucci, Nadia; Ricci, Paolo; Gennaro, Valerio; Garbisa, Spiridione

2011-01-01

The uncertainty about the relationship between the use of mobile phones (MPs: analogue and digital cellulars, and cordless) and the increase of head tumour risk can be solved by a critical analysis of the methodological elements of both the positive and the negative studies. Results by Hardell indicate a cause/effect relationship: exposures for or latencies from ≥ 10 years to MPs increase by up to 100% the risk of tumour on the same side of the head preferred for phone use (ipsilateral tumours) - which is the only one significantly irradiated - with statistical significance for brain gliomas, meningiomas and acoustic neuromas. On the contrary, studies published under the Interphone project and others produced negative results and are characterised by the substantial underestimation of the risk of tumour. However, also in the Interphone studies a clear and statistically significant increase of ipsilateral head tumours (gliomas, neuromas and parotid gland tumours) is quite common in people having used MPs since or for ≥ 10 years. And also the metaanalyses by Hardell and other Authors, including only the literature data on ipsilateral tumours in people having used MPs since or for ≥ 10 years - and so also part of the Interphone data - still show statistically significant increases of head tumours.

Geostatistical approach for assessing soil volumes requiring remediation: validation using lead-polluted soils underlying a former smelting works.

PubMed

Demougeot-Renard, Helene; De Fouquet, Chantal

2004-10-01

Assessing the volume of soil requiring remediation and the accuracy of this assessment constitutes an essential step in polluted site management. If this remediation volume is not properly assessed, misclassification may lead both to environmental risks (polluted soils may not be remediated) and financial risks (unexpected discovery of polluted soils may generate additional remediation costs). To minimize such risks, this paper proposes a geostatistical methodology based on stochastic simulations that allows the remediation volume and the uncertainty to be assessed using investigation data. The methodology thoroughly reproduces the conditions in which the soils are classified and extracted at the remediation stage. The validity of the approach is tested by applying it on the data collected during the investigation phase of a former lead smelting works and by comparing the results with the volume that has actually been remediated. This real remediated volume was composed of all the remediation units that were classified as polluted after systematic sampling and analysis during clean-up stage. The volume estimated from the 75 samples collected during site investigation slightly overestimates (5.3% relative error) the remediated volume deduced from 212 remediation units. Furthermore, the real volume falls within the range of uncertainty predicted using the proposed methodology.

Factors that influence planning for physical activity among workers in small- and medium-sized enterprises.

PubMed

Kawahara, Sawako; Tadaka, Etsuko; Okochi, Ayako

2018-06-01

Physical activity (PA) is necessary for improving the health of workers in small- to medium-sized enterprises (SMEs). However, behavioral changes conducive to PA are often difficult to achieve despite intentions. Because intention to perform PA does not always translate to action, proper planning may be critical for achieving PA. In this study, we aimed to identify factors related to planning for PA among workers in SMEs because this is one population that has been identified as being at higher risk for lifestyle-related diseases in Japan. Participants completed a series of validated questionnaires. Of 353 valid responses, 226 individuals (149 men; aged 47.5 ± 8.7 years) stated their intention to perform PA. Multiple regression analysis indicated that a higher PA planning score was significantly associated with higher self-efficacy for PA ( p  < 0.001), higher risk perception regarding inactivity ( p  = 0.012), and greater knowledge of information about PA community services ( p  = 0.019). Therefore, we recommend that self-efficacy, risk perception, and information regarding PA community services are enhanced in the daily working lives of workers at their workplaces. In this manner, they can promote their planning of health behavioral changes in a supportive environment, drawing upon available services, supports, and other resources.

Risk factors of diarrhoea among flood victims: a controlled epidemiological study.

PubMed

Mondal, N C; Biswas, R; Manna, A

2001-01-01

The concept and practice of 'disaster preparedness and response', instead of traditional casualty relief, is relatively new. Vulnerability analysis and health risks assessment of disaster prone communities are important prerequisites of meaningful preparedness and effective response against any calamity. In this community based study, the risk of diarrhoeal disease and its related epidemiological factors were analysed by collecting data from two selected flood prone block of Midnapur district of West Bengal. The information was compared with that of another population living in two non-flood prone blocks of the same district. The study showed that diarrhoeal disease was the commonest morbidity in flood prone population. Some behaviours, like use of pond water for utensil wash and kitchen purpose, hand washing after defecation without soap, improper hand washing before eating, open field defecation, storage of drinking water in wide mouth vessels etc. were found to be associated with high attack rate of diarrhoea, in both study and control population during flood season compared to pre-flood season. Attack rates were also significantly higher in flood prone population than that of population in non-flood prone area during the same season. Necessity of both community education for proper water use behaviour and personal hygiene along with ensuring safe water and sanitation facilities of flood affected communities were emphasized.

Uses and misuses of statistics: the case of strontium ranelate and the number needed to treat.

PubMed

Pedrazzoni, M; Giusti, A; Pioli, G

2011-09-01

In the last 15 years, several pharmacological agents for the prevention of fractures have been developed and commercialized. Most of them showed to be effective in reducing fracture risk. The enhanced availability of drugs to prevent fractures has generated a fierce competition among pharmaceutical companies to conquer a share of the potential market, often with claims of superiority of a drug over another without direct comparisons. The definitive way to compare different treatments would require randomized head to head trials. These trials are expensive, need large samples and are unlikely to be ever performed. Therefore, it has become a common practice to compare pharmacological agents through observational studies on administrative databases or by the indirect comparison of the results of individual randomised-controlled trials (RCT) and their meta-analyses. These studies may produce evidence of clinical value, complementary to that given by RCT. However, without a proper and complete analysis, they may result in a biased picture of effectiveness and be completely misleading. In this article, we critically disclose how such competition may produce biased and misleading picture of evidence, by reviewing the significance of the number needed to treat, absolute risk reduction and relative risk reduction in relation to vertebral fractures prevention with available drugs.

Factors affecting the retrieval of famous names.

PubMed

Martins, Isabel Pavão; Loureiro, Clara; Rodrigues, Susana; Dias, Beatriz; Slade, Peter

2010-06-01

Tests of famous faces are used to study language and memory. Yet, the effect of stimulus properties on performance has not been fully investigated. To identify factors influencing proper name retrieval and to probe stimulus-specific parameters within proper name lexicon, we analysed the results obtained by 300 healthy participants on a test of famous faces that includes 74 personalities. A factor analysis yielded five main factors that were characterized by language (national or foreign names), epoch of peak popularity (current, recent or past) and occupation (politicians, entertainment and sports) of the personalities. Multiple regression analysis showed that participants' education, age and gender accounted for 10-32% of the variance in factor scores. These results indicate that there are variables of the stimulus and participants' that must be taken into account in proper name testing and in designing tests aimed to differentiate age-associated difficulties from cognitive decline.

Identifying desertification risk areas using fuzzy membership and geospatial technique - A case study, Kota District, Rajasthan

NASA Astrophysics Data System (ADS)

Dasgupta, Arunima; Sastry, K. L. N.; Dhinwa, P. S.; Rathore, V. S.; Nathawat, M. S.

2013-08-01

Desertification risk assessment is important in order to take proper measures for its prevention. Present research intends to identify the areas under risk of desertification along with their severity in terms of degradation in natural parameters. An integrated model with fuzzy membership analysis, fuzzy rule-based inference system and geospatial techniques was adopted, including five specific natural parameters namely slope, soil pH, soil depth, soil texture and NDVI. Individual parameters were classified according to their deviation from mean. Membership of each individual values to be in a certain class was derived using the normal probability density function of that class. Thus if a single class of a single parameter is with mean μ and standard deviation σ, the values falling beyond μ + 2 σ and μ - 2 σ are not representing that class, but a transitional zone between two subsequent classes. These are the most important areas in terms of degradation, as they have the lowest probability to be in a certain class, hence highest probability to be extended or narrowed down in next or previous class respectively. Eventually, these are the values which can be easily altered, under extrogenic influences, hence are identified as risk areas. The overall desertification risk is derived by incorporating the different risk severity of each parameter using fuzzy rule-based interference system in GIS environment. Multicriteria based geo-statistics are applied to locate the areas under different severity of desertification risk. The study revealed that in Kota, various anthropogenic pressures are accelerating land deterioration, coupled with natural erosive forces. Four major sources of desertification in Kota are, namely Gully and Ravine erosion, inappropriate mining practices, growing urbanization and random deforestation.

Evaluation of Angiographic and Technical Aspects of Carotid Stenting with Diffusion-Weighted Magnetic Resonance Imaging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Blasel, Stella, E-mail: Stella.Blasel@kgu.de; Hattingen, Elke; Berkefeld, Joachim

2009-07-15

The detection of clinically silent ischemic lesions on postprocedural diffusion-weighted magnetic resonance images has become a preferred method for the description of embolic risks. The purpose of this single-center study was to evaluate whether diffusion-weighted imaging (DWI) could determine material related or technical risk factors of filter-protected carotid stenting. Eighty-four patients with symptomatic severe ({>=}60%) carotid artery stenoses received filter-protected carotid stenting. Standard DWI (b = 1000) was performed within 48 h before and after carotid stenting. The occurrence and load of new postinterventional DWI lesions were assessed. Multivariate analysis was performed to determine risk factors associated with DWI lesions,more » with emphasis on technical factors such as use of different access devices (guiding catheter method vs. long carotid sheath method), type of stent (open-cell nitinol stent vs. closed-cell Wallstent), and protective device (filters with 80-{mu}m vs. 110-120-{mu}m pore size). Markers for generalized atherosclerosis and for degree and site of stenosis were assessed to allow comparison of adequate risk profiles. Access, protective device, and stent type were not significantly associated with new embolic DWI lesions when we compared patients with equivalent risk profiles (long carotid sheath method 48% [11 of 23] vs. guiding catheter method 44% [27 of 61], Wallstent 47% [15 of 32] vs. nitinol stent 44% [23 of 52], and small pore size filter 61% [11 of 18] vs. large pore size filter 41% [27 of 66]). Single-center DWI studies with a moderate number of cases are inadequate for proper assessment of the embolic risk of technical- or material-related risk factors in carotid stenting. Larger multicenter studies with more cases are needed.« less

Department of Defense Energy and Logistics: Implications of Historic and Future Cost, Risk, and Capability Analysis

NASA Astrophysics Data System (ADS)

Tisa, Paul C.

Every year the DoD spends billions satisfying its large petroleum demand. This spending is highly sensitive to uncontrollable and poorly understood market forces. Additionally, while some stakeholders may not prioritize its monetary cost and risk, energy is fundamentally coupled to other critical factors. Energy, operational capability, and logistics are heavily intertwined and dependent on uncertain security environment and technology futures. These components and their relationships are less understood. Without better characterization, future capabilities may be significantly limited by present-day acquisition decisions. One attempt to demonstrate these costs and risks to decision makers has been through a metric known as the Fully Burdened Cost of Energy (FBCE). FBCE is defined as the commodity price for fuel plus many of these hidden costs. The metric encouraged a valuable conversation and is still required by law. However, most FBCE development stopped before the lessons from that conversation were incorporated. Current implementation is easy to employ but creates little value. Properly characterizing the costs and risks of energy and putting them in a useful tradespace requires a new framework. This research aims to highlight energy's complex role in many aspects of military operations, the critical need to incorporate it in decisions, and a novel framework to do so. It is broken into five parts. The first describes the motivation behind FBCE, the limits of current implementation, and outlines a new framework that aids decisions. Respectively, the second, third, and fourth present a historic analysis of the connections between military capabilities and energy, analyze the recent evolution of this conversation within the DoD, and pull the historic analysis into a revised framework. The final part quantifies the potential impacts of deeply uncertain futures and technological development and introduces an expanded framework that brings capability, energy, and their uncertainty into the same tradespace. The work presented is intended to inform better policies and investment decisions for military acquisitions. The discussion highlights areas within the DoD's understanding of energy that could improve or whose development has faltered. The new metric discussed allows the DoD to better manage and plan for long-term energy-related costs and risk.

Investigations of Crashes Involving Pregnant Occupants

PubMed Central

Klinich, Kathleen DeSantis; Schneider, Lawrence W.; Moore, Jamie L.; Pearlman, Mark D.

2000-01-01

Case reports of 16 crashes involving pregnant occupants are presented that illustrate the main conclusions of a crash-investigation program that includes 42 crashes investigated to date. Some unusual cases that are exceptions to the overall trends are also described. The study indicates a strong association between adverse fetal outcome and both crash severity and maternal injury. Proper restraint use, with and without airbag deployment, generally leads to acceptable fetal outcomes in lower severity crashes, while it does not affect fetal outcome in high-severity crashes. Compared to properly restrained pregnant occupants, improperly restrained occupants have a higher risk of adverse fetal outcome in lower severity crashes, which comprise the majority of all motor-vehicle collisions. PMID:11558095

Football injuries: current concepts.

PubMed

Olson, David E; Sikka, Robby Singh; Hamilton, Abigail; Krohn, Austin

2011-01-01

Football is one of the most popular sports in the United States and is the leading cause of sports-related injury. A large focus in recent years has been on concussions, sudden cardiac death, and heat illness, all thought to be largely preventable health issues in the young athlete. Injury prevention through better understanding of injury mechanisms, education, proper equipment, and practice techniques and preseason screening may aid in reducing the number of injuries. Proper management of on-field injuries and health emergencies can reduce the morbidity associated with these injuries and may lead to faster return to play and reduced risk of future injury. This article reviews current concepts surrounding frequently seen football-related injuries.

Ares I Integrated Vehicle System Safety Team

NASA Technical Reports Server (NTRS)

Wetherholt, Jon; McNairy, Lisa; Shackelford, Carla

2009-01-01

Complex systems require integrated analysis teams which sometimes are divided into subsystem teams. Proper division of the analysis in to subsystem teams is important. Safety analysis is one of the most difficult aspects of integration.

Risk perception as a driver for risk management policies

NASA Astrophysics Data System (ADS)

Carmona, María; Mañez, María

2016-04-01

Risk is generally defined as the "combination of the probability of the occurrence of an event and its negative consequences" ( UNISDR, 2009). However, the perception of a risk differs among cultures regarding different features such as the context,causes, benefits or damage. Risk perception is the subjective valuation of the probability of an event happening and how concerned individuals or groups are with the consequences (Sjöberg, 2004). Our study is based on an existing framework for risk perception (Rehn and Rohrmann, 2000). We analyse the characteristics of the risk perception regarding extreme events (e.g.droughts) and how the perception of the group drives the action to manage the risk. We do this to achieve an overview of the conditions that let stakeholders join each other to improve risk management especially when governments are not reacting properly. For our research, attention is paid on risk perception of Multi-Sector Partnerships not taking into account the individual level of risk perception. We focus on those factors that make risk management effective and increase resilience. Multi-Sector Partnerships, considered as significant governance structures for risk management, might contribute to reduce vulnerability in prone areas to natural hazards and disasters. The Multi-Sector Partnerships used for our research are existing partnerships identified in the cases studies of the European project ENHANCE. We implement a survey to analyse the perception of risk in the case studies. That survey is based on the Cultural Theory (Douglas and Wildavsky, 1982)and the Protection Motivation Theory (Rogers, 1975). We analyse the results using the Qualitative-Comparative Analysis proposed by Ragin in 1987. The results show the main characteristics of a risk culture that are beneficial to manage a risk. Those characteristics are shaped by the perception of risk of the people involved in the partnership, which in turn shapes their risk management. Nevertheless, we have to recognise that there is no "one-size-fit-all" solution and that Multi-Sector Partnerships are shape by the hazard they face and also by the social, political and historical background of the area where they are.

Testing stellar proper motions of TGAS stars using data from the HSOY, UCAC5 and PMA catalogues

NASA Astrophysics Data System (ADS)

Fedorov, P. N.; Akhmetov, V. S.; Velichko, A. B.

2018-05-01

We analyse the stellar proper motions from the Tycho-Gaia Astrometric Solution (TGAS) and those from the ground-based HSOY, UCAC5 and PMA catalogues derived by combining them with Gaia DR1 space data. Assuming that systematic differences in stellar proper motions of the two catalogues are caused by a mutual rigid-body rotation of the reference catalogue systems, we analyse components of the rotation vector between the systems. We found that the ωy component of the rotation vector is ˜1.5 mas yr-1 and it depends non-linearly on stellar magnitude for the objects of 9.5-11.5 mag used in all three comparisons of the catalogues HSOY, UCAC5 and PMA with respect to TGAS. We found that the Tycho-2 stars in TGAS appeared to have an inexplicable dependence of proper motion on stellar magnitude. We showed that the proper motions of the TGAS stars derived using AGIS differ from those obtained by the conventional (classical) method. Moreover, the application of both methods has not revealed such a difference between the proper motions of the Hipparcos and TGAS stars. An analysis of the systematic differences between the proper motions of the TGAS stars derived by the classical method and the proper motions of the HSOY, UCAC5 and PMA stars shows that the ωy component here does not depend on the magnitude. This indicates unambiguously that there is a magnitude error in the proper motions of the Tycho-2 stars derived with the AGIS.

Regulatory forum opinion piece*: immunotoxicology assessments in nonhuman primates--challenges and opportunities.

PubMed

Lebrec, Hervé N

2013-01-01

The immune system has been recognized for decades as a potential "target organ" of toxicity. Immune system activation can result in cytokine release resulting in severe systemic toxicity. Immunosuppression can result in impaired host defense and an increase in opportunistic infection, reemergence of latent infection, poor responses to vaccination, or increased risk of certain cancers. Several regulatory documents have addressed various aspects of immunotoxicity assessments. Nonhuman primates (NHPs) and in particular macaques are often the only relevant species for biotechnology-derived investigational new drugs based on cross-reactivity with human and NHP targets. This article reviews the challenges and opportunities associated with monitoring immune function in NHPs in the context of regulatory expectations. The article emphasizes how a comprehensive assessment of immunotoxicity remains a challenge due to interanimal variability associated with certain parameters (e.g., T-dependent antibody response)and it identifies gaps, such as the stage of development of certain assays (e.g., cytotoxic T-cell function). Despite these challenges, a thorough assessment of target biology-driven theoretical risks, in combination with proper integration of all information from the standard toxicology studies, and the refinement of certain assays should enable proper risk assessment. To this effect, emphasis should be placed on leveraging predictive in vitro assays using human cells.

Prevalence and Associated Risk Factors of Giardia Infection among Indigenous Communities in Rural Malaysia

PubMed Central

Choy, Seow Huey; Al-Mekhlafi, Hesham M.; Mahdy, Mohammed A. K.; Nasr, Nabil N.; Sulaiman, Maria; Lim, Yvonne A. L.; Surin, Johari

2014-01-01

This study was carried out to investigate the prevalence and risk factors of Giardia infection among indigenous people in rural Malaysia. Faecal samples were collected from 1,330 participants from seven states of Malaysia and examined by wet mount and formalin-ether sedimentation methods while demographic, socioeconomic and environmental information was collected using a pre-tested questionnaire. The overall prevalence of Giardia infection was 11.6% and was significantly higher among those aged ≤ 12 years compared to their older counterparts. Multivariate logistic regression identified age of ≤12 years, lacking of toilet at household, not washing hands before eating, not washing hands after playing with animals, not boiling water before consumption, bathing in the river, and not wearing shoes when outside as the significant risk factors of Giardia infection among these communities. Based on a multilocus genotyping approach (including tpi, gdh and bg gene sequences), 69 isolates were identified as assemblage A, and 69 as assemblage B. No association between the assemblages and presence of symptoms was found. Providing proper sanitation, as well as provision of clean drinking water and proper health education regarding good personal hygiene practices will help significantly in reducing the prevalence and burden of Giardia infection in these communities. PMID:25366301

Design and analysis of group-randomized trials in cancer: A review of current practices.

PubMed

Murray, David M; Pals, Sherri L; George, Stephanie M; Kuzmichev, Andrey; Lai, Gabriel Y; Lee, Jocelyn A; Myles, Ranell L; Nelson, Shakira M

2018-06-01

The purpose of this paper is to summarize current practices for the design and analysis of group-randomized trials involving cancer-related risk factors or outcomes and to offer recommendations to improve future trials. We searched for group-randomized trials involving cancer-related risk factors or outcomes that were published or online in peer-reviewed journals in 2011-15. During 2016-17, in Bethesda MD, we reviewed 123 articles from 76 journals to characterize their design and their methods for sample size estimation and data analysis. Only 66 (53.7%) of the articles reported appropriate methods for sample size estimation. Only 63 (51.2%) reported exclusively appropriate methods for analysis. These findings suggest that many investigators do not adequately attend to the methodological challenges inherent in group-randomized trials. These practices can lead to underpowered studies, to an inflated type 1 error rate, and to inferences that mislead readers. Investigators should work with biostatisticians or other methodologists familiar with these issues. Funders and editors should ensure careful methodological review of applications and manuscripts. Reviewers should ensure that studies are properly planned and analyzed. These steps are needed to improve the rigor and reproducibility of group-randomized trials. The Office of Disease Prevention (ODP) at the National Institutes of Health (NIH) has taken several steps to address these issues. ODP offers an online course on the design and analysis of group-randomized trials. ODP is working to increase the number of methodologists who serve on grant review panels. ODP has developed standard language for the Application Guide and the Review Criteria to draw investigators' attention to these issues. Finally, ODP has created a new Research Methods Resources website to help investigators, reviewers, and NIH staff better understand these issues. Published by Elsevier Inc.

Promoting the management and protection of private water wells.

PubMed

Simpson, Hugh

Rural families in Ontario depend almost entirely on groundwater from private wells for their potable water supply. In many cases, groundwater may be the only feasible water supply source and it requires management and protection. A significant potential source of ground water contamination is the movement of contaminated surface water through water wells that are improperly constructed, maintained, or should be decommissioned. Therefore, proper water well construction and maintenance, and eventual decommissioning, are critical for managing and protecting the quantity and quality of groundwater, as well as ensuring the integrity of rural drinking-water supplies. These actions are important for protecting private water supplies from both potential human and natural contamination. Individual well owners each have a personal interest and valuable role in ensuring the integrity of their water supplies. The following information is required to help well owners ensure the integrity of their water supply: different types of wells, why some wells are at greater risk of contamination than others, and sources of groundwater contaminants; groundwater contaminants, how they can move through soil and water, and potential risks to human health; benefits of ensuring that wells are properly maintained and operate efficiently; and importance of a regular well water quality testing program. This paper summarizes the technical information that should be provided to rural well owners concerning proper water well and groundwater management and protection, and provides an example of how this information can be promoted in an effective manner.

Extended robust support vector machine based on financial risk minimization.

PubMed

Takeda, Akiko; Fujiwara, Shuhei; Kanamori, Takafumi

2014-11-01

Financial risk measures have been used recently in machine learning. For example, ν-support vector machine ν-SVM) minimizes the conditional value at risk (CVaR) of margin distribution. The measure is popular in finance because of the subadditivity property, but it is very sensitive to a few outliers in the tail of the distribution. We propose a new classification method, extended robust SVM (ER-SVM), which minimizes an intermediate risk measure between the CVaR and value at risk (VaR) by expecting that the resulting model becomes less sensitive than ν-SVM to outliers. We can regard ER-SVM as an extension of robust SVM, which uses a truncated hinge loss. Numerical experiments imply the ER-SVM's possibility of achieving a better prediction performance with proper parameter setting.

Towards a Framework for Managing Risk Associated with Technology-Induced Error.

PubMed

Borycki, Elizabeth M; Kushniruk, Andre W

2017-01-01

Health information technologies (HIT) promised to streamline and modernize healthcare processes. However, a growing body of research has indicated that if such technologies are not designed, implemented or maintained properly this may lead to an increased incidence of new types of errors which the authors have referred to as "technology-induced errors". In this paper, framework is presented that can be used to manage HIT risk. The framework considers the reduction of technology-induced errors at different stages by managing risks associated with the implementation of HIT. Frameworks that allow health information technology managers to employ proactive and preventative approaches that can be used to manage the risks associated with technology-induced errors are critical to improving HIT safety and managing risk associated with implementing new technologies.

Is food allergen analysis flawed? Health and supply chain risks and a proposed framework to address urgent analytical needs.

PubMed

Walker, M J; Burns, D T; Elliott, C T; Gowland, M H; Mills, E N Clare

2016-01-07

Food allergy is an increasing problem for those affected, their families or carers, the food industry and for regulators. The food supply chain is highly vulnerable to fraud involving food allergens, risking fatalities and severe reputational damage to the food industry. Many facets are being pursued to ameliorate the difficulties including better food labelling and the concept of thresholds of elicitation of allergy symptoms as risk management tools. These efforts depend to a high degree on the ability reliably to detect and quantify food allergens; yet all current analytical approaches exhibit severe deficiencies that jeopardise accurate results being produced particularly in terms of the risks of false positive and false negative reporting. If we fail to realise the promise of current risk assessment and risk management of food allergens through lack of the ability to measure food allergens reproducibly and with traceability to an international unit of measurement, the analytical community will have failed a significant societal challenge. Three distinct but interrelated areas of analytical work are urgently needed to address the substantial gaps identified: (a) a coordinated international programme for the production of properly characterised clinically relevant reference materials and calibrants for food allergen analysis; (b) an international programme to widen the scope of proteomics and genomics bioinformatics for the genera containing the major allergens to address problems in ELISA, MS and DNA methods; (c) the initiation of a coordinated international programme leading to reference methods for allergen proteins that provide results traceable to the SI. This article describes in more detail food allergy, the risks of inapplicable or flawed allergen analyses with examples and a proposed framework, including clinically relevant incurred allergen concentrations, to address the currently unmet and urgently required analytical requirements. Support for the above recommendations from food authorities, business organisations and National Measurement Institutes is important; however transparent international coordination is essential. Thus our recommendations are primarily addressed to the European Commission, the Health and Food Safety Directorate, DG Santé. A global multidisciplinary consortium is required to provide a curated suite of data including genomic and proteomic data on key allergenic food sources, made publically available on line.

Elective induction of labor: part 2.

PubMed

Crosby, Warren

2008-12-01

The elective induction of labor has become commonplace, and many are concerned that the practice introduces risks for the woman and the fetus that would not be incurred if labor had been allowed to begin spontaneously. This second paper of a two-part communication reviews the risks and benefits of the elective induction of labor, and concludes that the risks of the induction of labor are few when the patient is properly screened medically and appropriately informed. The principal worry is a doubled risk of Cesarean delivery among primigravidas (not multiparas) in whom labor is electively induced. The benefits of selecting the date of delivery are powerful incentives for busy working women. But the benefits are primarily social, and add to the convenience of both the patient and her doctor. The risks, however, are medical, and are not confined to the pregnancy at risk. Appropriately informed consent is the key to balance the risks and benefits.

Impact of Physical Activity on Glycemic Control and Prevalence of Cardiovascular Risk Factors in Adults With Type 1 Diabetes: A Cross-sectional Multicenter Study of 18,028 Patients.

PubMed

Bohn, Barbara; Herbst, Antje; Pfeifer, Martin; Krakow, Dietmar; Zimny, Stefan; Kopp, Florian; Melmer, Andreas; Steinacker, Jürgen M; Holl, Reinhard W

2015-08-01

Physical activity (PA) can improve cardiovascular risk in the general population and in patients with type 2 diabetes. Studies also indicate an HbA(1c)-lowering effect in patients with type 2 diabetes. Since reports in patients with type 1 diabetes are scarce, this analysis aimed to investigate whether there is an association between PA and glycemic control or cardiovascular risk in subjects with type 1 diabetes. A total of 18,028 adults (≥18 to <80 years of age) from Germany and Austria with type 1 diabetes from the Diabetes-Patienten-Verlaufsdokumentation (DPV) database were included. Patients were stratified according to their self-reported frequency of PA (PA0, inactive; PA1, one to two times per week; PA2, more than two times per week). Multivariable regression models were applied for glycemic control, diabetes-related comorbidities, and cardiovascular risk factors. Data were adjusted for sex, age, and diabetes duration. P values for trend were given. SAS 9.4 was used for statistical analysis. An inverse association between PA and HbA(1c), diabetic ketoacidosis, BMI, dyslipidemia (all P < 0.0001), and hypertension (P = 0.0150), as well as between PA and retinopathy or microalbuminuria (both P < 0.0001), was present. Severe hypoglycemia (assistance required) did not differ in PA groups (P = 0.8989), whereas severe hypoglycemia with coma was inversely associated with PA (P < 0.0001). PA seemed to be beneficial with respect to glycemic control, diabetes-related comorbidities, and cardiovascular risk factors without an increase of adverse events. Hence, our data underscore the recommendation for subjects with type 1 diabetes to perform regular PA. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Lessons learned from Khartoum flash flood impacts: An integrated assessment.

PubMed

Mahmood, Mohamad Ibrahim; Elagib, Nadir Ahmed; Horn, Finlay; Saad, Suhair A G

2017-12-01

This study aims at enabling the compilation of key lessons for decision makers and urban planners in rapidly urbanizing cities regarding the identification of representative, chief causal natural and human factors for the increased level of flash flood risk. To achieve this, the impacts of flash flood events of 2013 and 2014 in the capital of Sudan, Khartoum, were assessed using seven integrated approaches, i.e. rainfall data analysis, document analysis of affected people and houses, observational fieldwork in the worst flood affected areas, people's perception of causes and mitigation measures through household interviews, reported drinking water quality, reported water-related diseases and social risk assessment. Several lessons have been developed as follows. Urban planners must recognize the devastating risks of building within natural pathways of ephemeral watercourses. They must also ensure effective drainage infrastructures and physio-geographical investigations prior to developing urban areas. The existing urban drainage systems become ineffective due to blockage by urban waste. Building of unauthorized drainage and embankment structures by locals often cause greater flood problems than normal. The urban runoff is especially problematic for residential areas built within low-lying areas having naturally low infiltration capacity, as surface water can rapidly collect within hollows and depressions, or beside elevated roads that preclude the free flow of floodwater. Weak housing and infrastructure quality are especially vulnerable to flash flooding and even to rainfall directly. Establishment of services infrastructure is imperative for flash flood disaster risk reduction. Water supply should be from lower aquifers to avoid contaminant groundwater. Regular monitoring of water quality and archiving of its indicators help identify water-related diseases and sources of water contamination in the event of environmental disasters such as floods. Though the understanding of risk perception by the locals is an important aspect of the decision making and planning processes, it should be advanced enough for proper awareness. Copyright © 2017 Elsevier B.V. All rights reserved.

SIS and SIR epidemic models under virtual dispersal

PubMed Central

Bichara, Derdei; Kang, Yun; Castillo-Chavez, Carlos; Horan, Richard; Perrings, Charles

2015-01-01

We develop a multi-group epidemic framework via virtual dispersal where the risk of infection is a function of the residence time and local environmental risk. This novel approach eliminates the need to define and measure contact rates that are used in the traditional multi-group epidemic models with heterogeneous mixing. We apply this approach to a general n-patch SIS model whose basic reproduction number R0 is computed as a function of a patch residence-times matrix ℙ. Our analysis implies that the resulting n-patch SIS model has robust dynamics when patches are strongly connected: there is a unique globally stable endemic equilibrium when R0 > 1 while the disease free equilibrium is globally stable when R0 ≤ 1. Our further analysis indicates that the dispersal behavior described by the residence-times matrix ℙ has profound effects on the disease dynamics at the single patch level with consequences that proper dispersal behavior along with the local environmental risk can either promote or eliminate the endemic in particular patches. Our work highlights the impact of residence times matrix if the patches are not strongly connected. Our framework can be generalized in other endemic and disease outbreak models. As an illustration, we apply our framework to a two-patch SIR single outbreak epidemic model where the process of disease invasion is connected to the final epidemic size relationship. We also explore the impact of disease prevalence driven decision using a phenomenological modeling approach in order to contrast the role of constant versus state dependent ℙ on disease dynamics. PMID:26489419

Polio vaccines, Simian Virus 40, and human cancer: the epidemiologic evidence for a causal association.

PubMed

Dang-Tan, Tam; Mahmud, Salaheddin M; Puntoni, Riccardo; Franco, Eduardo L

2004-08-23

In 1960, it was discovered that Simian Virus 40 (SV40) contaminated up to 30% of the poliovirus vaccines in the US. This contamination arose because the vaccines were produced in monkey kidney cell cultures harboring SV40 between 1955 and 1963. During this period, approximately 90% of children and 60% of adults in the USA were inoculated for polio and possibly exposed to SV40. Many epidemiologic and molecular pathogenesis studies have been conducted in order to identify potential cancer risks since this 'natural' experiment began. Productive SV40 infection has the potential to initiate malignancy in a variety of target tissues. Epidemiological studies that investigated the relationship between SV40 infection and cancer risks have yielded mixed results. Studies can be grouped into three categories based on their exposure definition of SV40 infection: (1) use of vaccination or birth cohorts as proxy variables for infection, (2) follow-up of children of pregnant women who received polio vaccines, and (3) direct molecular detection of the virus or serologic detection of anti-SV40 antibody responses. A meta-analysis of five published studies did not support the hypothesis that SV40 exposure increases the overall risk of cancer incidence or cancer mortality. The analysis of specific cancer sites is largely inconclusive because of substantial problems that most studies have had in reliably defining exposure, defining latency effects, or dealing with confounding and other biases. A new generation of molecular epidemiologic studies is necessary to properly address these issues.

The European flood risk directive: challenges for research

NASA Astrophysics Data System (ADS)

Mostert, E.; Junier, S. J.

2009-07-01

In recent years, flood management has shifted from protection against floods to managing the risks of floods. In Europe, this shift is reflected in the Flood risk directive of October 2007 (2007/60/EC; FRD). The FRD requires EU Member States to undertake a preliminary assessment of flood risks and, for areas with a significant flood risk, to prepare flood hazard and flood risk maps and flood risk management plans. The purpose of this paper is to introduce the FRD and discuss the challenges that the FRD poses to research. These challenges include the issue how to define and measure ''flood risk'', the selection of alternatives to be assessed, coping with uncertainty, risk communication, nurturing trust and promoting collaboration. These research challenges cannot be addressed properly within any single discipline and without involving the flood risk managers and other stakeholders. The paper therefore concludes that there is a large need for interdisciplinary and participatory research. This constitutes in fact the biggest research challenge.

Method for Assessing the Integrated Risk of Soil Pollution in Industrial and Mining Gathering Areas

PubMed Central

Guan, Yang; Shao, Chaofeng; Gu, Qingbao; Ju, Meiting; Zhang, Qian

2015-01-01

Industrial and mining activities are recognized as major sources of soil pollution. This study proposes an index system for evaluating the inherent risk level of polluting factories and introduces an integrated risk assessment method based on human health risk. As a case study, the health risk, polluting factories and integrated risks were analyzed in a typical industrial and mining gathering area in China, namely, Binhai New Area. The spatial distribution of the risk level was determined using a Geographic Information System. The results confirmed the following: (1) Human health risk in the study area is moderate to extreme, with heavy metals posing the greatest threat; (2) Polluting factories pose a moderate to extreme inherent risk in the study area. Such factories are concentrated in industrial and urban areas, but are irregularly distributed and also occupy agricultural land, showing a lack of proper planning and management; (3) The integrated risks of soil are moderate to high in the study area. PMID:26580644

Proton Pump Inhibitor use in Hospitalized Patients: Is Overutilization Becoming a Problem?

PubMed Central

Durand, Cheryl; Willett, Kristine C.; Desilets, Alicia R.

2012-01-01

Proton pump inhibitors (PPIs) are among the most common classes of medications prescribed. Though they were previously thought of as safe, recent literature has shown risks associated with their use including increased risk for Clostridium difficile infection, pneumonia, and fractures. Due to these risks, it is important to determine if PPIs are being used appropriately. This review evaluates seven studies in hospitalized patients. Additionally, this review evaluates literature pertaining to recently discovered adverse reactions; all studies found PPIs are being overutilized. Findings highlight the importance of evaluating appropriate therapy with these agents and recommending discontinuation if a proper indication does not exist. PMID:24833936

Method for minimizing the radiation exposure from scoliosis radiographs. [X ray

DOE Office of Scientific and Technical Information (OSTI.GOV)

De Smet, A.A.; Fritz, S.L.; Asher, M.A.

1981-01-01

The radiation exposure resulting from standard scoliosis radiographs was determined for eighteen adolescent girls. The risk of inducing breast cancer was estimated from the skin-exposure doses. The average skin exposure to the breasts was 59.6 millirads (0.59 mGy) for the anteroposterior radiograph. Assuming a total of twenty-two anteroposterior radiographs during a course of treatment, the cumulative exposure would result in a 1.35% relative increase in the risk of development of breast cancer. By utilizing collimation of the x-ray beam and proper selection of grids, films, and screens, the radiation risk of scoliosis radiographs is minimized.

Probabilistic risk assessment of the Space Shuttle. Phase 3: A study of the potential of losing the vehicle during nominal operation. Volume 2: Integrated loss of vehicle model

NASA Technical Reports Server (NTRS)

Fragola, Joseph R.; Maggio, Gaspare; Frank, Michael V.; Gerez, Luis; Mcfadden, Richard H.; Collins, Erin P.; Ballesio, Jorge; Appignani, Peter L.; Karns, James J.

1995-01-01

The application of the probabilistic risk assessment methodology to a Space Shuttle environment, particularly to the potential of losing the Shuttle during nominal operation is addressed. The different related concerns are identified and combined to determine overall program risks. A fault tree model is used to allocate system probabilities to the subsystem level. The loss of the vehicle due to failure to contain energetic gas and debris, to maintain proper propulsion and configuration is analyzed, along with the loss due to Orbiter, external tank failure, and landing failure or error.

Indian research on acute organic brain syndrome: Delirium

PubMed Central

Pinto, Charles

2010-01-01

Delirium, though quite often referred to psychiatrists for management, does not find many takers for analysis, research and publications. Acute in onset, multiplicity of etiology and manifestations, high risk of mortality delirium is very rewarding in proper management and outcome. Delirium has a limited agenda on teaching programs, research protocols and therapeutic strategies. There is a dearth of Indian studies both in international and national scientific literature. This annotation is based on a Medline search for “delirium India” on Pubmed, which resulted in 54 articles. A search in Indian Journal of Psychiatry for “delirium” resulted in 38 published articles, “delirium tremens” showed up only five articles. The articles are primarily from the Indian Journal of Psychiatry with cross reference to articles on Pubmed or Google search on Indian studies and a few international studies PMID:21836671

The opto-mechanical design process: from vision to reality

NASA Astrophysics Data System (ADS)

Kvamme, E. Todd; Stubbs, David M.; Jacoby, Michael S.

2017-08-01

The design process for an opto-mechanical sub-system is discussed from requirements development through test. The process begins with a proper mission understanding and the development of requirements for the system. Preliminary design activities are then discussed with iterative analysis and design work being shared between the design, thermal, and structural engineering personnel. Readiness for preliminary review and the path to a final design review are considered. The value of prototyping and risk mitigation testing is examined with a focus on when it makes sense to execute a prototype test program. System level margin is discussed in general terms, and the practice of trading margin in one area of performance to meet another area is reviewed. Requirements verification and validation is briefly considered. Testing and its relationship to requirements verification concludes the design process.

Measuring the Carotid to Femoral Pulse Wave Velocity (Cf-PWV) to Evaluate Arterial Stiffness.

PubMed

Ji, Hongwei; Xiong, Jing; Yu, Shikai; Chi, Chen; Bai, Bin; Teliewubai, Jiadela; Lu, Yuyan; Zhang, Yi; Xu, Yawei

2018-05-03

For the elderly, arterial stiffening is a good marker for aging evaluation and it is recommended that the arterial stiffness be determined noninvasively by the measurement of carotid to femoral pulse wave velocity (cf-PWV) (Class I; Level of Evidence A). In literature, numerous community-based or disease-specific studies have reported that higher cf-PWV is associated with increased cardiovascular risk. Here, we discuss strategies to evaluate arterial stiffness with cf-PWV. Following the well-defined steps detailed here, e.g., proper position operator, distance measurement, and tonometer position, we will obtain a standard cf-PWV value to evaluate arterial stiffness. In this paper, a detailed stepwise method to record a good quality PWV and pulse wave analysis (PWA) using a non-invasive tonometry-based device will be discussed.

Numerical FEM modeling in dental implantology

NASA Astrophysics Data System (ADS)

Roateşi, Iulia; Roateşi, Simona

2016-06-01

This paper is devoted to a numerical approach of the stress and displacement calculation of a system made up of dental implant, ceramic crown and surrounding bone. This is the simulation of a clinical situation involving both biological - the bone tissue, and non-biological - the implant and the crown, materials. On the other hand this problem deals with quite fine technical structure details - the threads, tapers, etc with a great impact in masticatory force transmission. Modeling the contact between the implant and the bone tissue is important to a proper bone-implant interface model and implant design. The authors proposed a three-dimensional numerical model to assess the biomechanical behaviour of this complex structure in order to evaluate its stability by determining the risk zones. A comparison between this numerical analysis and clinical cases is performed and a good agreement is obtained.

Designing trials for pressure ulcer risk assessment research: methodological challenges.

PubMed

Balzer, K; Köpke, S; Lühmann, D; Haastert, B; Kottner, J; Meyer, G

2013-08-01

For decades various pressure ulcer risk assessment scales (PURAS) have been developed and implemented into nursing practice despite uncertainty whether use of these tools helps to prevent pressure ulcers. According to current methodological standards, randomised controlled trials (RCTs) are required to conclusively determine the clinical efficacy and safety of this risk assessment strategy. In these trials, PURAS-aided risk assessment has to be compared to nurses' clinical judgment alone in terms of its impact on pressure ulcer incidence and adverse outcomes. However, RCTs evaluating diagnostic procedures are prone to specific risks of bias and threats to the statistical power which may challenge their validity and feasibility. This discussion paper critically reflects on the rigour and feasibility of experimental research needed to substantiate the clinical efficacy of PURAS-aided risk assessment. Based on reflections of the methodological literature, a critical appraisal of available trials on this subject and an analysis of a protocol developed for a methodologically robust cluster-RCT, this paper arrives at the following conclusions: First, available trials do not provide reliable estimates of the impact of PURAS-aided risk assessment on pressure ulcer incidence compared to nurses' clinical judgement alone due to serious risks of bias and insufficient sample size. Second, it seems infeasible to assess this impact by means of rigorous experimental studies since sample size would become extremely high if likely threats to validity and power are properly taken into account. Third, means of evidence linkages seem to currently be the most promising approaches for evaluating the clinical efficacy and safety of PURAS-aided risk assessment. With this kind of secondary research, the downstream effect of use of PURAS on pressure ulcer incidence could be modelled by combining best available evidence for single parts of this pathway. However, to yield reliable modelling results, more robust experimental research evaluating specific parts of the pressure ulcer risk assessment-prevention pathway is needed. Copyright © 2013 Elsevier Ltd. All rights reserved.

The role of GIS in urban seismic risk studies: application to the city of Almería (southern Spain)

NASA Astrophysics Data System (ADS)

Rivas-Medina, A.; Gaspar-Escribano, J. M.; Benito, B.; Bernabé, M. A.

2013-11-01

This work describes the structure and characteristics of the geographic information system (GIS) developed for the urban seismic risk study of the city of Almería (southern Spain), identifying the stages in which the use of this tool proved to be very beneficial for adopting informed decisions throughout the execution of the work. After the completion of the regional emergency plans for seismic risk in Spain and its subsequent approval by the National Civil Defence Commission, the municipalities that need to develop specific local seismic risk plans have been identified. Hence, the next action is to develop urban seismic risk analyses at a proper scale (Urban Seismic Risk Evaluation - Risk-UR). For this evaluation, different factors influencing seismic risk such as seismic hazard, geotechnical soil characteristics, vulnerability of structures of the region, reparation costs of damaged buildings and exposed population are combined. All these variables are gathered and analysed within a GIS and subsequently used for seismic risk estimation. The GIS constitutes a highly useful working tool because it facilitates data interoperability, making the great volume of information required and the numerous processes that take part in the calculations easier to handle, speeding up the analysis and the interpretation and presentation of the results of the different working phases. The result of this study is based on a great set of variables that provide a comprehensive view of the urban seismic risk, such as the damage distribution of buildings and dwellings of different typologies, the mean damage and the number of uninhabitable buildings for the expected seismic motion, the number of dead and injured at different times of the day, the cost of reconstruction and repair of buildings, among others. These results are intended for interpretation and decision making in emergency management by unspecialised users (Civil Defence technicians and managers).

Design and implementation of visualization methods for the CHANGES Spatial Decision Support System

NASA Astrophysics Data System (ADS)

Cristal, Irina; van Westen, Cees; Bakker, Wim; Greiving, Stefan

2014-05-01

The CHANGES Spatial Decision Support System (SDSS) is a web-based system aimed for risk assessment and the evaluation of optimal risk reduction alternatives at local level as a decision support tool in long-term natural risk management. The SDSS use multidimensional information, integrating thematic, spatial, temporal and documentary data. The role of visualization in this context becomes of vital importance for efficiently representing each dimension. This multidimensional aspect of the required for the system risk information, combined with the diversity of the end-users imposes the use of sophisticated visualization methods and tools. The key goal of the present work is to exploit efficiently the large amount of data in relation to the needs of the end-user, utilizing proper visualization techniques. Three main tasks have been accomplished for this purpose: categorization of the end-users, the definition of system's modules and the data definition. The graphical representation of the data and the visualization tools were designed to be relevant to the data type and the purpose of the analysis. Depending on the end-users category, each user should have access to different modules of the system and thus, to the proper visualization environment. The technologies used for the development of the visualization component combine the latest and most innovative open source JavaScript frameworks, such as OpenLayers 2.13.1, ExtJS 4 and GeoExt 2. Moreover, the model-view-controller (MVC) pattern is used in order to ensure flexibility of the system at the implementation level. Using the above technologies, the visualization techniques implemented so far offer interactive map navigation, querying and comparison tools. The map comparison tools are of great importance within the SDSS and include the following: swiping tool for comparison of different data of the same location; raster subtraction for comparison of the same phenomena varying in time; linked views for comparison of data from different locations and a time slider tool for monitoring changes in spatio-temporal data. All these techniques are part of the interactive interface of the system and make use of spatial and spatio-temporal data. Further significant aspects of the visualization component include conventional cartographic techniques and visualization of non-spatial data. The main expectation from the present work is to offer efficient visualization of risk-related data in order to facilitate the decision making process, which is the final purpose of the CHANGES SDSS. This work is part of the "CHANGES" project, funded by the European Community's 7th Framework Programme.

National Athletic Trainers' Association Position Statement: Exertional Heat Illnesses

PubMed Central

Casa, Douglas J.; DeMartini, Julie K.; Bergeron, Michael F.; Csillan, Dave; Eichner, E. Randy; Lopez, Rebecca M.; Ferrara, Michael S.; Miller, Kevin C.; O'Connor, Francis; Sawka, Michael N.; Yeargin, Susan W.

2015-01-01

Objective  To present best-practice recommendations for the prevention, recognition, and treatment of exertional heat illnesses (EHIs) and to describe the relevant physiology of thermoregulation. Background  Certified athletic trainers recognize and treat athletes with EHIs, often in high-risk environments. Although the proper recognition and successful treatment strategies are well documented, EHIs continue to plague athletes, and exertional heat stroke remains one of the leading causes of sudden death during sport. The recommendations presented in this document provide athletic trainers and allied health providers with an integrated scientific and clinically applicable approach to the prevention, recognition, treatment of, and return-to-activity guidelines for EHIs. These recommendations are given so that proper recognition and treatment can be accomplished in order to maximize the safety and performance of athletes. Recommendations  Athletic trainers and other allied health care professionals should use these recommendations to establish onsite emergency action plans for their venues and athletes. The primary goal of athlete safety is addressed through the appropriate prevention strategies, proper recognition tactics, and effective treatment plans for EHIs. Athletic trainers and other allied health care professionals must be properly educated and prepared to respond in an expedient manner to alleviate symptoms and minimize the morbidity and mortality associated with these illnesses. PMID:26381473

Evaluating the Impact of Contaminant Dilution and Biodegradation in Uncertainty Quantification of Human Health Risk

NASA Astrophysics Data System (ADS)

Zarlenga, Antonio; de Barros, Felipe; Fiori, Aldo

2016-04-01

We present a probabilistic framework for assessing human health risk due to groundwater contamination. Our goal is to quantify how physical hydrogeological and biochemical parameters control the magnitude and uncertainty of human health risk. Our methodology captures the whole risk chain from the aquifer contamination to the tap water assumption by human population. The contaminant concentration, the key parameter for the risk estimation, is governed by the interplay between the large-scale advection, caused by heterogeneity and the degradation processes strictly related to the local scale dispersion processes. The core of the hazard identification and of the methodology is the reactive transport model: erratic displacement of contaminant in groundwater, due to the spatial variability of hydraulic conductivity (K), is characterized by a first-order Lagrangian stochastic model; different dynamics are considered as possible ways of biodegradation in aerobic and anaerobic conditions. With the goal of quantifying uncertainty, the Beta distribution is assumed for the concentration probability density function (pdf) model, while different levels of approximation are explored for the estimation of the one-point concentration moments. The information pertaining the flow and transport is connected with a proper dose response assessment which generally involves the estimation of physiological parameters of the exposed population. Human health response depends on the exposed individual metabolism (e.g. variability) and is subject to uncertainty. Therefore, the health parameters are intrinsically a stochastic. As a consequence, we provide an integrated in a global probabilistic human health risk framework which allows the propagation of the uncertainty from multiple sources. The final result, the health risk pdf, is expressed as function of a few relevant, physically-based parameters such as the size of the injection area, the Péclet number, the K structure metrics and covariance shape, reaction parameters pertaining to aerobic and anaerobic degradation processes respectively as well as the dose response parameters. Even though the final result assumes a relatively simple form, few numerical quadratures are required in order to evaluate the trajectory moments of the solute plume. In order to perform a sensitivity analysis we apply the methodology to a hypothetical case study. The scenario investigated is made by an aquifer which constitutes a water supply for a population where a continuous source of NAPL contaminant feeds a steady plume. The risk analysis is limited to carcinogenic compounds for which the well-known linear relation for human risk is assumed. Analysis performed shows few interesting findings: the risk distribution is strictly dependent on the pore scale dynamics that trigger dilution and mixing; biodegradation may involve a significant reduction of the risk.

Clinical care of adult Turner syndrome--new aspects.

PubMed

Trolle, Christian; Mortensen, Kristian Havmand; Hjerrild, Britta E; Cleemann, Line; Gravholt, Claus H

2012-05-01

Turner syndrome (TS) is characterized by numerous medical challenges during adolescence and adulthood. Puberty has to be induced in most cases, and female sex hormone replacement therapy (HRT) should continue during adult years. These issues are normally dealt with by the paediatrician, but once a TS female enters adulthood it is less clear who should be the primary care giver. Morbidity and mortality is increased, especially due to the risk of dissection of the aorta and other cardiovascular diseases, as well as the risk of type 2 diabetes, hypertension, osteoporosis, thyroid disease and other diseases. The proper dose of HRT with female sex steroids has not been established, and, likewise, benefits and/or drawbacks from HRT have not been thoroughly evaluated. The transition period from paediatric to adult care seems to be especially vulnerable and the proper framework for transition has not yet been established. Likewise, no framework is in place for continuous follow-up during adult years in many countries. Today, most treatment recommendations are based on expert opinion and are unfortunately not evidence based, although more areas, such as growth hormone and oxandrolone treatment for increasing height, are becoming well founded. Osteoporosis, diabetes, both type 1 and 2, hypothyroidism, obesity and a host of other endocrine diseases and conditions are seen more frequently in TS. Prevention, intervention and proper treatment is only just being recognized. Hypertension is frequent and can be a forerunner of cardiovascular disease. The description of adult life with TS has been broadened and medical, social and psychological aspects are being added at a compelling pace. Proper care during adulthood should be studied and a framework for care should be in place, since most morbidity potentially is amenable to intervention. In summary, TS is a condition associated with a number of diseases and conditions which need the attention of a multi-disciplinary team during adulthood.

AIDS awareness and attitudes among Yemeni young people living in high-risk areas.

PubMed

Al-Serouri, A W; Anaam, M; Al-Iryani, B; Al Deram, A; Ramaroson, S

2010-03-01

Despite te low rate of infection in Yemen, there are concerns about the possible spread of HIV among high-risk and vulnerable groups. A community-based study was made in 2005 of AIDS awareness and attitudes among 601 young people aged 15-24 years from low-income, high-risk neighbourhoods in Aden. Young people lacked proper information about HIV/AIDS. Although 89% had heard of AIDS, fewer (46%) could name 3 ways of transmission or 3 ways to avoid infection (28%). Misconceptions about modes of transmissions were prevalent and many young people believed that they faced little or no risk. There were intolerant attitudes towards AIDS patients. About half the young people knew that prostitution and homosexuality existed in their area.

Optimizing human factors in dentistry.

PubMed

Gupta, Arpit; Ankola, Anil V; Hebbal, Mamata

2013-03-01

Occupational health hazards among dental professionals are on a continuous rise and they have a significant negative overall impact on daily life. This review is intended to provide the information regarding risk factors and to highlight the prevention strategies for optimizing human factors in dentistry. Risk factors among dentists are multifactorial, which can be categorized into biomechanical and psychosocial. To achieve a realistic target of safety and health at work, prevention is clearly the best approach; therefore, musculoskeletal disorders can be reduced through proper positioning of dental worker and patient, regular rest breaks, general good health, using ergonomic equipment, and exercises designed to counteract the particular risk factors for the dental occupation. However, substantial evidences are still required to elucidate the potential risk factors and to formulate effective prevention programs.

Risk and safety analysis for Florida commercial aerial application operations

NASA Astrophysics Data System (ADS)

Robbins, John Michael

The purpose of this study was to determine self-reported perceptions in the areas of agroterrorism, bioterrorism, chemical exposure and Federal Aviation Administration (FAA) oversight. The aerial application industry has been in existence since the 1920's with a gamut of issues ranging from pesticide drift to counterterrorism. The attacks of September 11th, 2001, caused a paradigm shift in the way the United States views security and, more importantly, the prevention of malicious activity. Through the proper implementation and dissemination of educational materials dealing with industry specific concerns, it is imperative that everyone has the proper level of resources and training to effectively manage terrorist threats. This research study was designed to interpret how aerial applicators view these topics of concern and how they perceive the current threat level of terrorism in the industry. Research results were consistent, indicating that a high number of aerial applicators in the state of Florida are concerned with these topics. As a result, modifications need to be made with respect to certain variables. The aerial application industry works day in and day out to provide a professional service that helps maintain the integrity of the food and commodities that we need to survive. They are a small percentage of the aviation community that we all owe a great deal for the vital and necessary services they provide.

Possibilities and pitfalls of outsourcing.

PubMed

Hazelwood, Sarah E; Hazelwood, Anita C; Cook, Ellen D

2005-10-01

Outsourcing can save healthcare organizations costs related to staffing and training. Organizations should ensure that a vendor's staff is credentialed, knowledgeable, and properly trained. Outsourcing firms should ensure the confidentiality and security of the information they will handle. Outsourcing carries risks for providers, including potentially negative impact on tax-exempt status and loss of control over business processes.

76 FR 38997 - Approval and Promulgation of Implementation Plans; State of Oregon; Regional Haze State...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-05

... economic blow that would result from an earlier closure and is an appropriate balance of environmental and... BART rules for the Boardman facility achieve the proper balance of environmental benefits, the cost to... secure greater environmental benefits with a better balance of cost and risk by transitioning the...

Metabolite Profiling and a Transcriptional Activation Assay Provide Direct Evidence of Androgen Receptor Antagonism by Bisphenol A in Fish.

EPA Science Inventory

Widespread environmental contamination by bisphenol A (BPA) has created the need to fully define its potential toxic mechanisms of action (MOA) to properly assess human health and ecological risks from exposure. Although long recognized as an estrogen receptor (ER) agonist, some ...

Preparticipation Screening for Sudden Cardiac Death in High School and College Athletes.

ERIC Educational Resources Information Center

Braden, David S.; Strong, William B.

1988-01-01

A properly performed screening history and cardiovascular examination can identify most young athletes at risk for sudden death from heart abnormalities. Warning signs and examiner response are discussed as well as appropriate use of echocardiography. Included is a sample preparticipation examination form recommended by the American Academy of…

49 CFR 236.1015 - PTC Safety Plan content requirements and PTC System Certification.

Code of Federal Regulations, 2010 CFR

2010-10-01

... established and can maintain a quality control system for PTC system design and manufacturing acceptable to... an explanation of the design principles and assumptions; (3) A risk assessment of the as-built PTC... the specific procedures and test equipment necessary to ensure the safe and proper installation...

Republication of "A Simple--But Powerful--Power Simulation"

ERIC Educational Resources Information Center

Bolman, Lee; Deal, Terrence E.

2017-01-01

The authors write that the longer they study and work in organizations, the more they discover power to be one of the central issues which researchers and students must understand. Researchers who ignore power run the risk of spurious, irrelevant findings. Students who assume administrative positions without a proper understanding of power and how…

Gray water recycle: Effect of pretreatment technologies on low pressure reverse osmosis treatment

USDA-ARS?s Scientific Manuscript database

Gray water can be a valuable source of water when properly treated to reduce the risks associated with chemical and microbial contamination to acceptable levels for the intended reuse application. In this study, the treatment of gray water using low pressure reverse osmosis (RO) filtration after pre...

Forest insurance

Treesearch

Ellis T. Williams

1949-01-01

Standing timber is one of the few important kinds of property that are not generally covered by insurance. Studies made by the Forest Service and other agencies have indicated that the risks involved in the insurance of timber are not unduly great, provided they can be properly distributed. Such studies, however, have thus far failed to induce any notable development...

Removal of EDB and 1,2-DCA by Abiotic Reaction with Iron (II) Sulfide

EPA Science Inventory

To properly evaluate the risk associated with exposure to EDB and 1,2-DCA in ground water from old spills of leaded gasoline, it is necessary to understand the mechanisms that may attenuate concentrations of these compounds in ground water. TCE reacts rapidly with iron (II) sulf...

12 CFR 563b.105 - What information must I include in my business plan?

Code of Federal Regulations, 2010 CFR

2010-01-01

... achieve your planned deployment of conversion proceeds in your proposed market areas, and how your... lending needs in your proposed market areas. OTS strongly discourages business plans that provide for a... properly managed leverage strategy. (3) The risks associated with your plan for deployment of conversion...

Understanding cardiovascular risk in hemophilia: A step towards prevention and management.

PubMed

Sousos, Nikolaos; Gavriilaki, Eleni; Vakalopoulou, Sofia; Garipidou, Vasileia

2016-04-01

Advances in hemophilia care have led to increased life expectancy and new challenges in the management of the aging hemophilia population, including cardiovascular risk. Despite the deep knowledge into cardiovascular disease in terms of pathophysiology, risk prediction, prevention, early detection and management gained over the last decades, studies in hemophiliacs are scarce and mainly descriptive. As a growing amount of evidence points towards a similar or increased prevalence of traditional cardiovascular risk factors in hemophilia compared to the general population, the role of non-traditional, disease-related and treatment-related cardiovascular risk factors remains under investigation. Better understanding of cardiovascular risk in hemophilia is mandatory for proper cardiovascular risk prevention and management. Therefore, this review aims to summarize current knowledge on cardiovascular risk in hemophilia patients focusing on a) cardiovascular risk factors (traditional, non-traditional, disease-related and treatment-related), b) cardiovascular morbidity and mortality and c) cardiovascular prevention and management. Copyright © 2016 Elsevier Ltd. All rights reserved.

High energy injury is a risk factor for preoperative venous thromboembolism in the patients with hip fractures: A prospective observational study.

PubMed

Park, Jin Sup; Jang, Jae Hoon; Park, Ki Young; Moon, Nam Hoon

2018-06-01

The purpose of this study was to identify the incidence of preoperative venous thromboembolism (VTE), and determine if high energy hip fracture affects preoperative VTE occurrence. Three-hundred nine patients (244 low and 61 high energy injuries) treated between March 2015 and March 2017 were included in this study. Indirect multidetector computed tomographic venography for the detection of preoperative VTE was performed at admission. The incidence of preoperative VTE was compared between high and low energy injury hip fractures. Logistic regression analysis was used to identify independent risk factors for preoperative VTE. The overall incidence of preoperative VTE was 18.4% (56 of 305 patients). Preoperative VTE was identified in 17 (27.9%) and 39 (16.0%) patients in the high and low energy injury groups, respectively (p = 0.034). Multivariate logistic regression analysis showed that high energy injury, history of VTE, and myeloproliferative disease were significant predictive factors of preoperative VTE (OR = 2.451; 95% CI = 1.227-4.896, OR = 11.174; 95% CI = 3.500-35.673, OR = 6.936; 95% CI = 1.641-29.321, respectively) CONCLUSION: Because high energy hip fracture is significantly associated with preoperative VTE occurrence, preoperative evaluation and proper thromboprophylaxis should be performed for patients with a high-energy hip fracture. Copyright © 2018 Elsevier Ltd. All rights reserved.

Mapping supply chain risk by network analysis of product platforms

DOE PAGES

Nuss, Philip; Graedel, T. E.; Alonso, Elisa; ...

2016-10-15

Modern technology makes use of a variety of materials to allow for its proper functioning. Here, to explore in detail the relationships connecting materials to the products that require them, we map supply chains for five product platforms (a cadmium telluride solar cell, a germanium solar cell, a turbine blade, a lead acid battery, and a hard drive (HD) magnet) using a data ontology that specifies the supply chain actors (nodes) and linkages (e.g., material exchange and contractual relationships) among them. We then propose a set of network indicators (product complexity, producer diversity, supply chain length, and potential bottlenecks) tomore » assess the situation for each platform in the overall supply chain networks. Among the results of interest are the following: (1) the turbine blade displays a high product complexity, defined by the material linkages to the platform; (2) the germanium solar cell is produced by only a few manufacturers globally and requires more physical transformation steps than do the other project platforms; (3) including production quantity and sourcing countries in the assessment shows that a large portion of nodes of the supply chain of the hard-drive magnet are located in potentially unreliable countries. Finally, we conclude by discussing how the network analysis of supply chains could be combined with criticality and scenario analyses of abiotic raw materials to comprise a comprehensive picture of product platform risk.« less

Integrate genome-based assessment of safety for probiotic strains: Bacillus coagulans GBI-30, 6086 as a case study.

PubMed

Salvetti, Elisa; Orrù, Luigi; Capozzi, Vittorio; Martina, Alessia; Lamontanara, Antonella; Keller, David; Cash, Howard; Felis, Giovanna E; Cattivelli, Luigi; Torriani, Sandra; Spano, Giuseppe

2016-05-01

Probiotics are microorganisms that confer beneficial effects on the host; nevertheless, before being allowed for human consumption, their safety must be verified with accurate protocols. In the genomic era, such procedures should take into account the genomic-based approaches. This study aims at assessing the safety traits of Bacillus coagulans GBI-30, 6086 integrating the most updated genomics-based procedures and conventional phenotypic assays. Special attention was paid to putative virulence factors (VF), antibiotic resistance (AR) genes and genes encoding enzymes responsible for harmful metabolites (i.e. biogenic amines, BAs). This probiotic strain was phenotypically resistant to streptomycin and kanamycin, although the genome analysis suggested that the AR-related genes were not easily transferrable to other bacteria, and no other genes with potential safety risks, such as those related to VF or BA production, were retrieved. Furthermore, no unstable elements that could potentially lead to genomic rearrangements were detected. Moreover, a workflow is proposed to allow the proper taxonomic identification of a microbial strain and the accurate evaluation of risk-related gene traits, combining whole genome sequencing analysis with updated bioinformatics tools and standard phenotypic assays. The workflow presented can be generalized as a guideline for the safety investigation of novel probiotic strains to help stakeholders (from scientists to manufacturers and consumers) to meet regulatory requirements and avoid misleading information.

Mapping supply chain risk by network analysis of product platforms

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nuss, Philip; Graedel, T. E.; Alonso, Elisa

Modern technology makes use of a variety of materials to allow for its proper functioning. Here, to explore in detail the relationships connecting materials to the products that require them, we map supply chains for five product platforms (a cadmium telluride solar cell, a germanium solar cell, a turbine blade, a lead acid battery, and a hard drive (HD) magnet) using a data ontology that specifies the supply chain actors (nodes) and linkages (e.g., material exchange and contractual relationships) among them. We then propose a set of network indicators (product complexity, producer diversity, supply chain length, and potential bottlenecks) tomore » assess the situation for each platform in the overall supply chain networks. Among the results of interest are the following: (1) the turbine blade displays a high product complexity, defined by the material linkages to the platform; (2) the germanium solar cell is produced by only a few manufacturers globally and requires more physical transformation steps than do the other project platforms; (3) including production quantity and sourcing countries in the assessment shows that a large portion of nodes of the supply chain of the hard-drive magnet are located in potentially unreliable countries. Finally, we conclude by discussing how the network analysis of supply chains could be combined with criticality and scenario analyses of abiotic raw materials to comprise a comprehensive picture of product platform risk.« less

Two unconventional risk factors for major adverse cardiovascular events in subjects with sexual dysfunction: low education and reported partner's hypoactive sexual desire in comparison with conventional risk factors.

PubMed

Rastrelli, Giulia; Corona, Giovanni; Fisher, Alessandra D; Silverii, Antonio; Mannucci, Edoardo; Maggi, Mario

2012-12-01

The classification of subjects as low or high cardiovascular (CV) risk is usually performed by risk engines, based upon multivariate prediction algorithms. However, their accuracy in predicting major adverse CV events (MACEs) is lower in high-risk populations as they take into account only conventional risk factors. To evaluate the accuracy of Progetto Cuore risk engine in predicting MACE in subjects with erectile dysfunction (ED) and to test the role of unconventional CV risk factors, specifically identified for ED. A consecutive series of 1,233 men (mean age 53.33 ± 9.08 years) attending our outpatient clinic for sexual dysfunction was longitudinally studied for a mean period of 4.4 ± 2.6 years. Several clinical, biochemical, and instrumental parameters were evaluated. Subjects were classified as high or low risk, according to previously reported ED-specific risk factors. In the overall population, Progetto Cuore-predicted population survival was not significantly different from the observed one (P = 0.545). Accordingly, receiver operating characteristic (ROC) analysis shows that Progetto Cuore has an accuracy of 0.697 ± 0.037 (P < 0.001) in predicting MACE. Considering subjects at high risk according to ED-specific risk factors, the observed incidence of MACE was significantly higher than the expected for both low educated and patients reporting partner's hypoactive sexual desire (HSD, both <0.05), but not for other described factors. The area under ROC curves of Progetto Cuore for MACE in subjects with low education and reported partner's HSD were 0.659 ± 0.053 (P = 0.008) and 0.550 ± 0.076 (P = 0.570), respectively. Overall, Progetto Cuore is a proper instrument for evaluating CV risk in ED subjects. However, in ED, other factors such as low education and partner's HSD concur to risk profile. At variance with low education, Progetto Cuore is not accurate enough to predict MACE in subjects with partner's HSD, suggesting that the latter effect is not mediated by conventional risk factors included in the algorithm. © 2012 International Society for Sexual Medicine.

Survey on food hygiene knowledge on board ships.

PubMed

Grappasonni, Iolanda; Marconi, Donatella; Mazzucchi, Fabrizio; Petrelli, Fabio; Scuri, Stefania; Amenta, Francesco

2013-01-01

The aim of the study was to evaluate the knowledge and attitudes on food hygiene in seafarers. The study was conducted using an anonymous questionnaire presented to the workers of 7 tankers of an Italian shipping company (Finaval S.p.A.). As a reference, the analysis was extended to office employees of the same firm. Data were divided according to the rank of seafarers to assess possible differences in perceiving the risk. Overall knowledge on food safety concept was not high among seafarers. In general, galley and catering workers group provided a lower percentage of correct answers than other crew members. Foodservices staff revealed little awareness of the risks linked with handling food and their perception of risk of disease transmission through food was low. Answers about risk related to specific food (eggs and fish) showed that knowledge about these problems was less than satisfactory. Moreover, the percentage of 'I don't know' answers was high. These findings suggest that this personnel is aware of the right stepsof health protection in terms of food hygiene, but does not understand why it is necessary. Galley and catering group workers were not the most informed about food hygiene problems.This highlights the need to hire qualified personnel of the food industry on board ships. All those working inthe food service area should be properly trained on food hygiene. Seafarers should be the target of specificinformative campaigns about health risks linked with aliments, possible consequences of it and also oneson how to minimise the exposure to potentially dangerous agents/behaviours during travel/life at sea.

Karate injuries in children and adolescents.

PubMed

Zetaruk, M N; Violan, M A; Zurakowski, D; Micheli, L J

2000-05-01

To identify risk factors for injury and to establish safety guidelines for children in Uechi-Ryu karate. A 1-year retrospective survey of injuries. A private karate school (Uechi-Ryu style) in Plymouth, MA. A total of 68 athletes (age 6-16 years; mean age 10 years) who participated in karate during the 1995-1996 season. None. The presence or absence of injury, with grading of injuries as major, moderate or minor. The types of injuries and body region involved were also analyzed. Twenty eight percent of athletes sustained at least one injury. All injuries were minor, with no time off from training required. The injuries consisted primarily of bruises (11 of 19). Other injuries included mild sprains or strains (5 of 19) and having their 'wind knocked out' (3 of 19). Most injuries were localized to the extremities. Logistic regression analysis identified risk factors for injury. Risk of injury increased with number of years of training (odds ratio 2.95; 95% confidence interval 1.81-4.82; P<0.0001), number of hours per week (odds ratio 2.12; CI 1.15-4.21; P = 0.016) and rank, specifically brown belt versus lower belts (odds ratio 6.56; CI 2.02-21.26; P = 0.006). Karate is a relatively safe sport for children and adolescents when properly taught. Risk of injury increases with experience; therefore, greater supervision is required of higher ranks. Injury increases with weekly training; however, 3 h a week or less appears to be associated with a low risk of significant injury in this age group.

Effectiveness and risks of combining antipsychotic drugs with electroconvulsive treatment.

PubMed

Sanz-Fuentenebro, Francisco Javier; Vidal Navarro, Ignacio; Ballesteros Sanz, Daniel; Verdura Vizcaíno, Ernesto

2011-01-01

The simultaneous application of electroconvulsive therapy (ECT) and psychotropic drugs is based on sparse data. Despite this, and the restrictive approach of the Guidelines and Consensus is widespread in the usual care, it is widely practiced in routine clinical. We reviewed the results of search on the topic in MEDLINE, PsychINFO, EMBASE and Cochrane, and the main guidelines on the subject and analyzed for drug groups. Except some reservation with regard to classical MAOIs, antidepressants are safe and effective enhancers of the TEC. It is desirable to discontinuation of BZD whenever clinically possible before the course of ECT for risk of interference, if not possible will have to use proper technique to ensure effective incentives. It is advisable to stop or reduce the dose of lithium prior to ECT based on a cost-benefit analysis of the risk of relapse, if maintained will be adjusted lower levels and cognitive effects minimizing techniques. The combination with "classic" and "atypical" antipsychotics power positive clinical effects and the risk of combined use is low. The positive data are collected with clozapine and ECT-resistant psychosis, with little presence of effects of the decrease of seizure threshold by clozapine, and important effect of empowerment, but of limited duration. Although it is strictly necessary to identify situations in terms of drugs, patient and ECT technique, and care necessary to develop tests that provide methodologically sound data, the combined use of ECT and psychotropic drugs in general presents an acceptable risk level and efficacy data by encouraging empowerment. Copyright © 2010 SEP y SEPB. Published by Elsevier Espana. All rights reserved.

Health risk assessment of drinking arsenic-containing groundwater in Hasilpur, Pakistan: effect of sampling area, depth, and source.

PubMed

Tabassum, Riaz Ahmad; Shahid, Muhammad; Dumat, Camille; Niazi, Nabeel Khan; Khalid, Sana; Shah, Noor Samad; Imran, Muhammad; Khalid, Samina

2018-02-10

Currently, several news channels and research publications have highlighted the dilemma of arsenic (As)-contaminated groundwater in Pakistan. However, there is lack of data regarding groundwater As content of various areas in Pakistan. The present study evaluated As contamination and associated health risks in previously unexplored groundwater of Hasilpur-Pakistan. Total of 61 groundwater samples were collected from different areas (rural and urban), sources (electric pump, hand pump, and tubewell) and depths (35-430 ft or 11-131 m). The water samples were analyzed for As level and other parameters such as pH, electrical conductivity, total dissolved solids, cations, and anions. It was found that 41% (25 out of 61) water samples contained As (≥ 5 μg/L). Out of 25 As-contaminated water samples, 13 water samples exceeded the permissible level of WHO (10 μg/L). High As contents have been found in tubewell samples and at high sampling depths (> 300 ft). The major As-contaminated groundwater in Hasilpur is found in urban areas. Furthermore, health risk and cancer risk due to As contamination were also assessed with respect to average daily dose (ADD), hazard quotient (HQ), and carcinogenic risk (CR). The values of HQ and CR of As in Hasilpur were up to 58 and 0.00231, respectively. Multivariate analysis revealed a positive correlation between groundwater As contents, pH, and depth in Hasilpur. The current study proposed the proper monitoring and management of well water in Hasilpur to minimize the As-associated health hazards.

The Significance of the Psychosocial Factors Influence in Pathogenesis of Cardiovascular Disease

PubMed Central

Masic, Izet; Alajbegovic, Jasmin

2013-01-01

Background: Cardiovascular diseases (CVD) are the leading cause of death in the world today. Risk factors are those factors that influence the development of CVD. Risk factors can be divided into materialistic (genetic predisposition, smoking, alcohol) and non-materialistic (psychosocial factors). Our goal is to note the role of the health system, to emphasize the importance of psychosocial factors in the pathogenesis of CVD, explain the relationship between psychosocial factors and other risk factors, stress the importance of prevention through the provision of management of the cardiovascular system (CVS) diseases. Methods: A descriptive analysis was performed on scientific studies in several published articles in journals on CVS: Public Health Reviews, CVD, European Heart Journal, Materia Socio Medica and other indexed journals that publish articles on CVS. Results and Conclusions: The importance and role of the health system in the early detection, diagnosis, therapy and CVS disease prevention is presented through three thematic areas: (a) The incidence and prevalence of CVS diseases; (b) treatment of CVS diseases and (c) promotion of health in patients with CVS disease and those the risk of their occurrence. Health promotion is the most important aspect of the health system monitoring. Health promotion is adequately implemented ifthe management ofCVD is proper. The main objectives of CVD management are: Preventing or delaying the occurrence of CVD, reducing the number and severity of worsening and complications of CVD. Management Includes: Individual and family, the health system and the community. Materialistic and non-materialistic risk factors together contribute to the development of CVD. PMID:24404370

Determination of priority among air pollution factors in preventing COPD in residents of Shanghai City proper

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xuguang, Tao; Chuan-jie, Hong; Shun-zhang, Yu

The purpose of our study is to determine the priority among ambient sulphur dioxide (SO{sub 2}), inhalable particulates (IP), and indoor use of coal for cooking or heating to prevent COPD in residents of Shanghai city proper. We describe spatial and temporal distribution of the concentration of ambient SO{sub 2}, IP, and the proportion of families who use coal (1980-1985) by the trend surface simulating method and other statistics. Stratified by two sets of extreme levels of ambient SO{sub 2}, IP, and the proportion of coal-using families, we selected eight groups with different combinations of exposure levels. We analyzed themore » relationship between air pollution factors and their health effects at levels of mortality (1978-1987, 232,459 person years), prevalence (1987, 12,037 persons), lung function and local immunologic function (1987, 514 women) with logistic and stepwise regression, and ridit analysis. After controlling for possible confounders, e.g., tobacco smoking and occupational exposure, we found that indoor use of coal is a more important risk factor than ambient SO{sub 2} and IP. We then used canonical correlation analysis to evaluate the overall exposure-effect relationship between one set of air pollution and confounding factors and the other set of health effect indices. High correlation is found between the two. The indoor use of coal is more important for the overall health effects than the ambient SO{sub 2} and IP, to change from coal to gas could reduce the environmental exposure canonical variable more readily, with an effect equivalent to a reduction of 0.1839 mg/m{sup 3} for ambient SO{sub 2}, or 0.2806 mg/m{sup 3} for ambient IP in concentration.« less

Time to revisit arsenic regulations: comparing drinking water and rice

PubMed Central

2014-01-01

Background Current arsenic regulations focus on drinking water without due consideration for dietary uptake and thus seem incoherent with respect to the risks arising from rice consumption. Existing arsenic guidelines are a cost-benefit compromise and, as such, they should be periodically re-evaluated. Discussion Literature data was used to compare arsenic exposure from rice consumption relative to exposure arising from drinking water. Standard risk assessment paradigms show that arsenic regulations for drinking water should target a maximum concentration of nearly zero to prevent excessive lung and bladder cancer risks (among others). A feasibility threshold of 3 μg As l-1 was determined, but a cost-benefit analysis concluded that it would be too expensive to target a threshold below 10 μg As l-1. Data from the literature was used to compare exposure to arsenic from rice and rice product consumption relative to drinking water consumption. The exposure to arsenic from rice consumption can easily be equivalent to or greater than drinking water exposure that already exceeds standard risks and is based on feasibility and cost-benefit compromises. It must also be emphasized that many may disagree with the implications for their own health given the abnormally high cancer odds expected at the cost-benefit arsenic threshold. Summary Tighter drinking water quality criteria should be implemented to properly protect people from excessive cancer risks. Food safety regulations must be put in place to prevent higher concentrations of arsenic in various drinks than those allowed in drinking water. Arsenic concentrations in rice should be regulated so as to roughly equate the risks and exposure levels observed from drinking water. PMID:24884827

Prevalence and risk factors of adhesive capsulitis of the shoulder after breast cancer treatment.

PubMed

Yang, Seoyon; Park, Dae Hwan; Ahn, Sei Hyun; Kim, Jisun; Lee, Jong Won; Han, Jun Young; Kim, Dong Kyu; Jeon, Jae Yong; Choi, Kyoung Hyo; Kim, Won

2017-04-01

The present study investigated the prevalence and risk factors of adhesive capsulitis of the shoulder in breast cancer patients between 13 and 18 months after surgery. This study included 271 women who underwent surgery for breast cancer with a postoperative period of 13-18 months. Current adhesive capsulitis was defined as restriction of external rotation and one or more additional directional restrictions with history of shoulder pain. Cumulative adhesive capsulitis was defined as current adhesive capsulitis or a previous history of adhesive capsulitis after breast cancer surgery. Multivariate logistic regression analysis was performed to examine associations between current or cumulative adhesive capsulitis and potential risk factors. Among the 271 study patients, 28 (10.3%) and 21 (7.7%) had cumulative or current adhesive capsulitis, respectively. The incidences of cumulative and current adhesive capsulitis were higher in those aged 50-59 years (odds ratio [OR], 9.912; 95% confidence interval [CI], 1.790-54.880; and OR, 12.395; 95% CI, 1.187-129.444, respectively) and those who underwent mastectomy (OR, 6.805; 95% CI, 1.800-25.733; and OR, 9.645; 95% CI, 2.075-44.829, respectively) or mastectomy with reconstruction (OR, 13.122; 95% CI, 2.488-69.218; and OR, 20.075; 95% CI, 2.873-140.261, respectively). Adhesive capsulitis of the shoulder is a common problem after breast cancer treatment. An age of 50-59 years and mastectomy are major risk factors for adhesive capsulitis, and breast reconstruction additionally increases the risk. Patients with these risk factors require greater attention for early diagnosis and proper treatment.

Seroprevalence and diagnosis of HIV, HBV, HCV and syphilis infections among blood donors.

PubMed

Tafesse, Tadesse Bekele; Gebru, Addis Adera; Gobalee, Semgne; Belay, Gosaye Degu; Belew, Molla Teferi; Ataro, Demelash; Ebrahim, Belay Ali; Shebeshi, Getachew Mekonnon; Yimam, Yonas

2017-01-01

Blood transfusion is one of the most important therapeutic options of life-saving intervention for recipients who are in diseased or non-diseased conditions with severe blood loss. However, it is associated with certain risks which can lead to adverse consequences that may cause acute or delayed complications and bring the risk of transfusion-transmissible infections including HIV, Hepatitis B & C and Syphilis. So, there might be a fatal risk instead of life saving. This paper aims to provide a comprehensive and reliable tabulation of available data on seroprevalence and diagnosis of HIV, HBV, HCV and Syphilis infections among blood donors. We searched studies reporting the prevalence rate of HIV, HBV, HCV and Syphilis infections among blood donors that were published between October 2009 and June 2016, using databases of PubMed, Scopus, MEDLINE, Elsevier, ScienceDirect, EBSCO, Google Scholar, EMBASE, and Web of Science with keywords: ``Hepatitis C Virus'', ``Hepatitis B Virus'', ``HIV'', ``Syphilis'', ``Seroprevalence'', and ``blood donor''. The seroprevalence of HBV and HCV was highest in African countries as compared to others continents, predominantly the West African region with a range of 10.0% to 14.96% and 1.5% to 8.69%, respectively, while the overall seropositivity of HIV and syphilis infection show a significant declining pattern through successive years globally, even though relatively higher prevalence rate was observed among older age and those with low level of education. There is a problem during selection, diagnoses and screening process in developing nations primarily due to shortage of sensitive screening test kits, highly qualified human resource and lack of proper standard operating procedures and hence, the safety of blood and blood products are the primary threats in the region. Proper clinical diagnosis and screening method should be applied during blood donation and therefore, all the donated blood should be screened properly for transfusion-transmitted infections.

Misperception among physicians and patients regarding the risks and benefits of statin treatment: the potential role of direct-to-consumer advertising.

PubMed

Kon, Rachel H; Russo, Mark W; Ory, Bridget; Mendys, Phil; Simpson, Ross J

2008-02-01

Statins are commonly used to reduce the risk of heart attacks and strokes. Despite the benefit and limited risks in properly identified patients, clinicians are often challenged by patient acceptance and adherence to these medications. To assess if patients and physicians may have unfounded safety concerns about hepatotoxicity from these medications, we surveyed physicians and patients. We found inconsistent liver function-monitoring practices as well as exaggerated fears of statin-induced hepatotoxicity. Patients who received risk information from their physician were more likely to accurately estimate hepatotoxic risk than patients receiving such information from other sources. We believe these misperceptions about the relative risk and benefits of statin therapy are propagated by direct-to-consumer advertising, which may emphasize potential adverse events relative to treatment benefits. These perceptions are likely to adversely affect statin adherence, and may be addressed by patient education.

Risk factors for otolaryngological foreign bodies in Eastern Poland.

PubMed

Rybojad, Beata; Niedzielski, Artur; Niedzielska, Grazyna; Rybojad, Pawel

2012-11-01

To identify the sociodemographic characteristics and risk factors associated with suspected foreign bodies in the ear, nose, throat, airway, and esophagus among Polish children. Case series with chart review. Setting Tertiary care medical center. A retrospective analysis of the medical records of patients hospitalized for a suspected foreign body (FB) between 1998 and 2008 was conducted. Data regarding place of residence, presence of siblings, parents' educational status, seasonality, psychomotor development, age, and sex were collected and statistically analyzed. Of the 1011 patients with suspected foreign body insertion, 849 (84%) had a positive diagnosis. Of the confirmed foreign bodies, 96 were found in the tracheobronchial tree, 142 were found in the esophagus, and 611 were located in the external auditory canals, nasopharyngeal passage, tonsils, auricles, or lips. Sociodemographically, 596 of the children came from urban areas, with a preponderance of males (55%). Objects were removed more frequently in summer and autumn (60%). Children with siblings (53%) predominated. The majority of patients (52%) had parents with an elementary education. Food was the most frequent foreign body in children under 3 years of age. Patients with delayed psychomotor development constituted 1.6% of the analyzed population. Being male, 1 to 3 years of age, belonging to an urban family with siblings, and having parents with an elementary education increased the risk of foreign body insertion. Training caregivers about proper nutrition and safety rules when playing with children can reduce the risk of accidents related to foreign body insertion.

Principle considerations for the risk assessment of sprayed consumer products.

PubMed

Steiling, W; Bascompta, M; Carthew, P; Catalano, G; Corea, N; D'Haese, A; Jackson, P; Kromidas, L; Meurice, P; Rothe, H; Singal, M

2014-05-16

In recent years, the official regulation of chemicals and chemical products has been intensified. Explicitly for spray products enhanced requirements to assess the consumers'/professionals' exposure to such product type have been introduced. In this regard the Aerosol-Dispensers-Directive (75/324/EEC) with obligation for marketing aerosol dispensers, and the Cosmetic-Products-Regulation (1223/2009/EC) which obliges the insurance of a safety assessment, have to be mentioned. Both enactments, similar to the REACH regulation (1907/2006/EC), require a robust chemical safety assessment. From such assessment, appropriate risk management measures may be identified to adequately control the risk of these chemicals/products to human health and the environment when used. Currently, the above-mentioned regulations lack the guidance on which data are needed for preparing a proper hazard analysis and safety assessment of spray products. Mandatory in the process of inhalation risk and safety assessment is the determination and quantification of the actual exposure to the spray product and more specifically, its ingredients. In this respect the current article, prepared by the European Aerosol Federation (FEA, Brussels) task force "Inhalation Toxicology", intends to introduce toxicological principles and the state of the art in currently available exposure models adapted for typical application scenarios. This review on current methodologies is intended to guide safety assessors to better estimate inhalation exposure by using the most relevant data. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Distribution and potential health risk of groundwater uranium in Korea.

PubMed

Shin, Woosik; Oh, Jungsun; Choung, Sungwook; Cho, Byong-Wook; Lee, Kwang-Sik; Yun, Uk; Woo, Nam-Chil; Kim, Hyun Koo

2016-11-01

Chronic exposure even to extremely low specific radioactivity of natural uranium in groundwater results in kidney problems and potential toxicity in bones. This study was conducted to assess the potential health risk via intake of the groundwater containing uranium, based on the determination of the uranium occurrence in groundwater. The groundwater was investigated from a total of 4140 wells in Korea. Most of the groundwater samples showed neutral pH and (sub-)oxic condition that was influenced by the mixing with shallow groundwater due to long-screened (open) wells. High uranium contents exceeding the WHO guideline level of 30 μg L(-1) were observed in the 160 wells located mainly in the plutonic bedrock regions. The statistical analysis suggested that the uranium component was present in groundwater by desorption and re-dissolution processes. Predominant uranium phases were estimated to uranyl carbonates under the Korean groundwater circumstances. These mobile forms of uranium and oxic condition facilitate the increase of potential health risk downgradient. In particular, long-term intake of groundwater containing >200 μg U L(-1) may induce internal exposure to radiation as well as the effects of chemical toxicity. These high uranium concentrations were found in twenty four sampling wells of rural areas in this study, and they were mainly used for drinking. Therefore, the high-level uranium wells and neighboring areas must be properly managed and monitored to reduce the exposure risk for the residents by drinking groundwater. Copyright © 2016 Elsevier Ltd. All rights reserved.

Stochastic empirical loading and dilution model for analysis of flows, concentrations, and loads of highway runoff constituents

USGS Publications Warehouse

Granato, Gregory E.; Jones, Susan C.

2014-01-01

In cooperation with FHWA, the U.S. Geological Survey developed the stochastic empirical loading and dilution model (SELDM) to supersede the 1990 FHWA runoff quality model. The SELDM tool is designed to transform disparate and complex scientific data into meaningful information about the adverse risks of runoff on receiving waters, the potential need for mitigation measures, and the potential effectiveness of such measures for reducing such risks. The SELDM tool is easy to use because much of the information and data needed to run it are embedded in the model and obtained by defining the site location and five simple basin properties. Information and data from thousands of sites across the country were compiled to facilitate the use of the SELDM tool. A case study illustrates how to use the SELDM tool for conducting the types of sensitivity analyses needed to properly assess water quality risks. For example, the use of deterministic values to model upstream stormflows instead of representative variations in prestorm flow and runoff may substantially overestimate the proportion of highway runoff in downstream flows. Also, the risks for total phosphorus excursions are substantially affected by the selected criteria and the modeling methods used. For example, if a single deterministic concentration is used rather than a stochastic population of values to model upstream concentrations, then the percentage of water quality excursions in the downstream receiving waters may depend entirely on the selected upstream concentration.

Basic overview towards the assessment of landslide and subsidence risks along a geothermal pipeline network

NASA Astrophysics Data System (ADS)

Astisiasari; Van Westen, Cees; Jetten, Victor; van der Meer, Freek; Rahmawati Hizbaron, Dyah

2017-12-01

An operating geothermal power plant consists of installation units that work systematically in a network. The pipeline network connects various engineering structures, e.g. well pads, separator, scrubber, and power station, in the process of transferring geothermal fluids to generate electricity. Besides, a pipeline infrastructure also delivers the brine back to earth, through the injection well-pads. Despite of its important functions, a geothermal pipeline may bear a threat to its vicinity through a pipeline failure. The pipeline can be impacted by perilous events like landslides, earthquakes, and subsidence. The pipeline failure itself may relate to physical deterioration over time, e.g. due to corrosion and fatigue. The geothermal reservoirs are usually located in mountainous areas that are associated with steep slopes, complex geology, and weathered soil. Geothermal areas record a noteworthy number of disasters, especially due to landslide and subsidence. Therefore, a proper multi-risk assessment along the geothermal pipeline is required, particularly for these two types of hazard. This is also to mention that the impact on human fatality and injury is not presently discussed here. This paper aims to give a basic overview on the existing approaches for the assessment of multi-risk assessment along geothermal pipelines. It delivers basic principles on the analysis of risks and its contributing variables, in order to model the loss consequences. By considering the loss consequences, as well as the alternatives for mitigation measures, the environmental safety in geothermal working area could be enforced.

Prediabetes in patients receiving tacrolimus in the first year after kidney transplantation: a prospective and multicenter study.

PubMed

Porrini, Esteban; Moreno, Jose Manuel; Osuna, Antonio; Benitez, Rocio; Lampreabe, Ildefonso; Diaz, Juan Manuel; Silva, Irene; Domínguez, Rosa; Gonzalez-Cotorruelo, Julio; Bayes, Beatriz; Lauzurica, Ricardo; Ibernon, Meritxell; Moreso, Francisco; Delgado, Patricia; Torres, Armando

2008-04-27

Tacrolimus-based immunosuppression, the most widely used regimen in kidney transplantation, increases the risk of new onset diabetes after transplantation (NODAT). However, the prevalence, evolution and risk factors of different prediabetic alterations: impaired fasting glucose, impaired glucose tolerance, and provisional diabetes, have not been established. In this multicenter and prospective study we evaluated 154 nondiabetic kidney transplant recipients receiving tacrolimus, mycophenolate mofetil and low dose steroids. An oral glucose tolerance test was performed 3 and 12 months after transplantation and prediabetes was defined by American Diabetes Association criteria. Prediabetes was highly prevalent and showed little variation between 3 and 12 months (36% and 33%, respectively). Impaired glucose tolerance was the most frequent abnormality observed (23% and 25%, respectively) observed. In addition, 20% of recipients showed NODAT by 1 year. Multivariate analysis showed that age (odds ratio [OR]: 1.07, 95% confidence interval [CI]: 1.004-1.14), pretransplant body mass index (OR: 1.3, CI: 1.09-1.6) and triglyceride/high density lipoprotein-cholesterol ratio, a marker of insulin resistance, (OR: 1.4, CI: 1.05-1.9) were independent risk factors for prediabetes. One in two recipients with tacrolimus-based immunosuppresion showed prediabetes or NODAT by 1 year posttransplantation when properly investigated. Older age and high pretransplant body mass index and triglyceride/high density lipoprotein-cholesterol ratio were risk factors for prediabetes. These findings may help applying early interventions to prevent the disorder.

Analysis of clinical observation on acute psychiatric wards.

PubMed

Najim, Hellme; Saleem, Khalid; Al Shirbiny, Basil; Ezeasor, Nebo

2013-09-01

Clinical observation is very important to manage risk of people who are acutely ill on psychiatric wards. It is always an area of dispute between different specialities and disciplines in serious untoward incidents (SUI). Three levels of observations have been applied on acute psychiatric words. Assessing practice is important to help to identify any area needs improving. A questionnaire was developed by HN to collect demographics. Medical notes on Westley and Grangewater wards were reviewed. Excel Microsoft Office World Computer Programme was used to analyse the results. 57% were men. 62% were above 41 years of age. Majority were suffering from schizophrenia and schizoaffective disorders 61%. 64.28% were admitted as formal patients. 31.42% were on level I observation.62.53 were informal. 54.76% were risk to themselves, 28.57% risk to others. 82.3% were on level II observation, 31.42% formal and 68.50% informal. 21.32% were on level III observation. 66.66% were formal and 66.66% had an incident before this level. This study have shown that patients are assessed properly before they go on any level of care. Some patients need to go on level III as they pose a risk mainly to other people. Regular reviews of patients, especially on high level of observation should be done more promptly, as being on observation is not a comfortable experience to go through and applying the least restrictive practice should always be sought and adopted.

Simulation and Shoulder Dystocia.

PubMed

Shaddeau, Angela K; Deering, Shad

2016-12-01

Shoulder dystocia is an unpredictable obstetric emergency that requires prompt interventions to ensure optimal outcomes. Proper technique is important but difficult to train given the urgent and critical clinical situation. Simulation training for shoulder dystocia allows providers at all levels to practice technical and teamwork skills in a no-risk environment. Programs utilizing simulation training for this emergency have consistently demonstrated improved performance both during practice drills and in actual patients with significantly decreased risks of fetal injury. Given the evidence, simulation training for shoulder dystocia should be conducted at all institutions that provide delivery services.

Severe hypertriglyceridemia in Puerto Rico blood donors: a population study 2009-2011.

PubMed

Morales-Borges, Raúl H; Merced, Carmen

2012-01-01

Puerto Rico blood donor issues has been identified in cases of severe hypertriglyceridemia presenting as turbid. Blood donations resulting in milky serum must be discarded. They are discarded because we cannot properly test the donation. This is the first report where we correlate turbidity and cardiovascular risk factors in the Puerto Rico population as well as blood types O and A, Rh (+) with dyslipidemia. Blood donors should be screened in more details regarding cardiovascular and metabolic risks to avoid problems with recruitment and retention strategies.

Implementing AORN recommended practices for minimally invasive surgery: part I.

PubMed

Morton, Paula J

2012-09-01

This article focuses on the patient safety aspects of the revised AORN "Recommended practices for minimally invasive surgery" (MIS). Key considerations include ensuring proper fluid management practices, assessing patients for risk factors related to MIS, implementing precautions for electrosurgery, planning for risks related to MIS, and assessing patients postoperatively for potential complications related to MIS. Collaboration and collegiality among members of the surgical team are essential for ensuring all pertinent aspects of care are recognized and considered. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.

An Attempt at Quantifying Factors that Affect Efficiency in the Management of Solid Waste Produced by Commercial Businesses in the City of Tshwane, South Africa

PubMed Central

Worku, Yohannes; Muchie, Mammo

2012-01-01

Objective. The objective was to investigate factors that affect the efficient management of solid waste produced by commercial businesses operating in the city of Pretoria, South Africa. Methods. Data was gathered from 1,034 businesses. Efficiency in solid waste management was assessed by using a structural time-based model designed for evaluating efficiency as a function of the length of time required to manage waste. Data analysis was performed using statistical procedures such as frequency tables, Pearson's chi-square tests of association, and binary logistic regression analysis. Odds ratios estimated from logistic regression analysis were used for identifying key factors that affect efficiency in the proper disposal of waste. Results. The study showed that 857 of the 1,034 businesses selected for the study (83%) were found to be efficient enough with regards to the proper collection and disposal of solid waste. Based on odds ratios estimated from binary logistic regression analysis, efficiency in the proper management of solid waste was significantly influenced by 4 predictor variables. These 4 influential predictor variables are lack of adherence to waste management regulations, wrong perception, failure to provide customers with enough trash cans, and operation of businesses by employed managers, in a decreasing order of importance. PMID:23209483

Automatic Implementation of Prony Analysis for Electromechanical Mode Identification from Phasor Measurements

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhou, Ning; Huang, Zhenyu; Tuffner, Francis K.

2010-07-31

Small signal stability problems are one of the major threats to grid stability and reliability. Prony analysis has been successfully applied on ringdown data to monitor electromechanical modes of a power system using phasor measurement unit (PMU) data. To facilitate an on-line application of mode estimation, this paper developed a recursive algorithm for implementing Prony analysis and proposed an oscillation detection method to detect ringdown data in real time. By automatically detect ringdown data, the proposed method helps guarantee that Prony analysis is applied properly and timely on the ringdown data. Thus, the mode estimation results can be performed reliablymore » and timely. The proposed method is tested using Monte Carlo simulations based on a 17-machine model and is shown to be able to properly identify the oscillation data for on-line application of Prony analysis.« less