Sample records for control system risk

  1. 17 CFR 1.73 - Clearing futures commission merchant risk management.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... maintain systems of risk controls reasonably designed to ensure compliance with the limits; (iii) When a... for clearing, it shall establish and maintain systems of risk management controls reasonably designed... maintain systems of risk management controls reasonably designed to ensure compliance with the limits. (v...

  2. 17 CFR 1.73 - Clearing futures commission merchant risk management.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... maintain systems of risk controls reasonably designed to ensure compliance with the limits; (iii) When a... for clearing, it shall establish and maintain systems of risk management controls reasonably designed... maintain systems of risk management controls reasonably designed to ensure compliance with the limits. (v...

  3. 17 CFR 240.15c3-1f - Optional market and credit risk requirements for OTC derivatives dealers (Appendix F to 17 CFR...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... would be determined. (iii) Internal risk management control systems. An OTC derivatives dealer shall provide a comprehensive description of its internal risk management control systems and how those systems... internal risk management control systems that meet the requirements set forth in § 240.15c3-4; and (ii) Has...

  4. 17 CFR 240.15c3-1f - Optional market and credit risk requirements for OTC derivatives dealers (Appendix F to 17 CFR...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... would be determined. (iii) Internal risk management control systems. An OTC derivatives dealer shall provide a comprehensive description of its internal risk management control systems and how those systems... internal risk management control systems that meet the requirements set forth in § 240.15c3-4; and (ii) Has...

  5. 17 CFR 240.17i-4 - Internal risk management control system requirements for supervised investment bank holding...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 17 Commodity and Securities Exchanges 3 2011-04-01 2011-04-01 false Internal risk management... Supervised Investment Bank Holding Company Rules § 240.17i-4 Internal risk management control system...) As part of its internal risk management control system, a supervised investment bank holding company...

  6. 17 CFR 240.17i-4 - Internal risk management control system requirements for supervised investment bank holding...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Internal risk management... Supervised Investment Bank Holding Company Rules § 240.17i-4 Internal risk management control system...) As part of its internal risk management control system, a supervised investment bank holding company...

  7. 75 FR 1002 - Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-07

    ... derivatives dealers to establish, document, and maintain a system of internal risk management controls. The... establishing, documenting, and reviewing its internal risk management control system, which are designed to... internal risk management control system) + (One new OTC derivatives dealer x 200 hours to maintain an...

  8. 78 FR 15056 - Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-08

    ... establish, document, and maintain a system of internal risk management controls. The Rule sets forth the..., documenting, and reviewing its internal risk management control system, which are designed to, among other... documenting its risk management control system is 2,000 hours and that, on average, a registered OTC...

  9. 78 FR 128 - Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-02

    ... derivatives dealer will spend establishing and documenting its risk management control system is 2,000 hours... to maintain (e.g., reviewing and updating) its risk management control system.\\1\\ Currently, four... registered with the Commission to maintain their risk management control systems,\\2\\ 2,666 hours for the four...

  10. 17 CFR 240.15c3-1e - Deductions for market and credit risk for certain brokers or dealers (Appendix E to 17 CFR 240...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... provisions of § 240.15c3-4 with respect to an internal risk management control system for the affiliate group... part of the internal risk management control system for the affiliate group, establish, document, and... risk management control system for the affiliate group that the ultimate holding company has...

  11. 17 CFR 240.15c3-1e - Deductions for market and credit risk for certain brokers or dealers (Appendix E to 17 CFR 240...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... provisions of § 240.15c3-4 with respect to an internal risk management control system for the affiliate group... part of the internal risk management control system for the affiliate group, establish, document, and... risk management control system for the affiliate group that the ultimate holding company has...

  12. 17 CFR 240.15c3-1e - Deductions for market and credit risk for certain brokers or dealers (Appendix E to 17 CFR 240...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... provisions of § 240.15c3-4 with respect to an internal risk management control system for the affiliate group... part of the internal risk management control system for the affiliate group, establish, document, and... risk management control system for the affiliate group that the ultimate holding company has...

  13. 17 CFR 240.15c3-1e - Deductions for market and credit risk for certain brokers or dealers (Appendix E to 17 CFR 240...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... provisions of § 240.15c3-4 with respect to an internal risk management control system for the affiliate group... part of the internal risk management control system for the affiliate group, establish, document, and... risk management control system for the affiliate group that the ultimate holding company has...

  14. 75 FR 1003 - Submission for OMB Review; Comment Request;

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-07

    ... internal risk management controls to assist it in managing the risks associated with its business... money laundering and terrorist financing as part of its internal risk management control system. Finally, Rule 17i-4 requires that an SIBHC periodically review its internal risk management control system for...

  15. 17 CFR 240.15c3-4 - Internal risk management control systems for OTC derivatives dealers.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Internal risk management...-Counter Markets § 240.15c3-4 Internal risk management control systems for OTC derivatives dealers. (a) An OTC derivatives dealer shall establish, document, and maintain a system of internal risk management...

  16. 17 CFR 240.15c3-1e - Deductions for market and credit risk for certain brokers or dealers (Appendix E to 17 CFR 240...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... apply; (D) As part of the internal risk management control system for the affiliate group, establish... risk management control system for the affiliate group that the ultimate holding company has... reports or to modify its group-wide internal risk management control procedures. If the Commission finds...

  17. A Model-based Framework for Risk Assessment in Human-Computer Controlled Systems

    NASA Technical Reports Server (NTRS)

    Hatanaka, Iwao

    2000-01-01

    The rapid growth of computer technology and innovation has played a significant role in the rise of computer automation of human tasks in modem production systems across all industries. Although the rationale for automation has been to eliminate "human error" or to relieve humans from manual repetitive tasks, various computer-related hazards and accidents have emerged as a direct result of increased system complexity attributed to computer automation. The risk assessment techniques utilized for electromechanical systems are not suitable for today's software-intensive systems or complex human-computer controlled systems. This thesis will propose a new systemic model-based framework for analyzing risk in safety-critical systems where both computers and humans are controlling safety-critical functions. A new systems accident model will be developed based upon modem systems theory and human cognitive processes to better characterize system accidents, the role of human operators, and the influence of software in its direct control of significant system functions. Better risk assessments will then be achievable through the application of this new framework to complex human-computer controlled systems.

  18. U.K. Foot and Mouth Disease: A Systemic Risk Assessment of Existing Controls.

    PubMed

    Delgado, João; Pollard, Simon; Pearn, Kerry; Snary, Emma L; Black, Edgar; Prpich, George; Longhurst, Phil

    2017-09-01

    This article details a systemic analysis of the controls in place and possible interventions available to further reduce the risk of a foot and mouth disease (FMD) outbreak in the United Kingdom. Using a research-based network analysis tool, we identify vulnerabilities within the multibarrier control system and their corresponding critical control points (CCPs). CCPs represent opportunities for active intervention that produce the greatest improvement to United Kingdom's resilience to future FMD outbreaks. Using an adapted 'features, events, and processes' (FEPs) methodology and network analysis, our results suggest that movements of animals and goods associated with legal activities significantly influence the system's behavior due to their higher frequency and ability to combine and create scenarios of exposure similar in origin to the U.K. FMD outbreaks of 1967/8 and 2001. The systemic risk assessment highlights areas outside of disease control that are relevant to disease spread. Further, it proves to be a powerful tool for demonstrating the need for implementing disease controls that have not previously been part of the system. © 2016 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

  19. Using a geographical information system to plan a malaria control programme in South Africa.

    PubMed Central

    Booman, M.; Durrheim, D. N.; La Grange, K.; Martin, C.; Mabuza, A. M.; Zitha, A.; Mbokazi, F. M.; Fraser, C.; Sharp, B. L.

    2000-01-01

    INTRODUCTION: Sustainable control of malaria in sub-Saharan Africa is jeopardized by dwindling public health resources resulting from competing health priorities that include an overwhelming acquired immunodeficiency syndrome (AIDS) epidemic. In Mpumalanga province, South Africa, rational planning has historically been hampered by a case surveillance system for malaria that only provided estimates of risk at the magisterial district level (a subdivision of a province). METHODS: To better map control programme activities to their geographical location, the malaria notification system was overhauled and a geographical information system implemented. The introduction of a simplified notification form used only for malaria and a carefully monitored notification system provided the good quality data necessary to support an effective geographical information system. RESULTS: The geographical information system displays data on malaria cases at a village or town level and has proved valuable in stratifying malaria risk within those magisterial districts at highest risk, Barberton and Nkomazi. The conspicuous west-to-east gradient, in which the risk rises sharply towards the Mozambican border (relative risk = 4.12, 95% confidence interval = 3.88-4.46 when the malaria risk within 5 km of the border was compared with the remaining areas in these two districts), allowed development of a targeted approach to control. DISCUSSION: The geographical information system for malaria was enormously valuable in enabling malaria risk at town and village level to be shown. Matching malaria control measures to specific strata of endemic malaria has provided the opportunity for more efficient malaria control in Mpumalanga province. PMID:11196490

  20. A Practical Risk Assessment Methodology for Safety-Critical Train Control Systems

    DOT National Transportation Integrated Search

    2009-07-01

    This project proposes a Practical Risk Assessment Methodology (PRAM) for analyzing railroad accident data and assessing the risk and benefit of safety-critical train control systems. This report documents in simple steps the algorithms and data input...

  1. A Framework for Context Sensitive Risk-Based Access Control in Medical Information Systems

    PubMed Central

    Choi, Donghee; Kim, Dohoon; Park, Seog

    2015-01-01

    Since the access control environment has changed and the threat of insider information leakage has come to the fore, studies on risk-based access control models that decide access permissions dynamically have been conducted vigorously. Medical information systems should protect sensitive data such as medical information from insider threat and enable dynamic access control depending on the context such as life-threatening emergencies. In this paper, we suggest an approach and framework for context sensitive risk-based access control suitable for medical information systems. This approach categorizes context information, estimating and applying risk through context- and treatment-based permission profiling and specifications by expanding the eXtensible Access Control Markup Language (XACML) to apply risk. The proposed framework supports quick responses to medical situations and prevents unnecessary insider data access through dynamic access authorization decisions in accordance with the severity of the context and treatment. PMID:26075013

  2. 77 FR 39302 - Self-Regulatory Organizations; EDGA Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-02

    ... Change Relating to New Market Access Risk Management Service, EdgeRisk Controls SM June 26, 2012... access risk management service, called EdgeRisk Controls\\SM\\ (the ``Service''). II. Self-Regulatory... and maintain a system of risk management controls and supervisory procedures that are reasonably...

  3. 12 CFR Appendix F to Part 225 - Interagency Guidelines Establishing Information Security Standards

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... arrangements in place to control risks. C. Manage and Control Risk. Each bank holding company shall: 1. Design... GOVERNORS OF THE FEDERAL RESERVE SYSTEM (CONTINUED) BANK HOLDING COMPANIES AND CHANGE IN BANK CONTROL.... Assess Risk C. Manage and Control Risk D. Oversee Service Provider Arrangements E. Adjust the Program F...

  4. 17 CFR 240.15c3-4 - Internal risk management control systems for OTC derivatives dealers.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... unenforceable; (6) Procedures are in place to identify and address any deficiencies in the operating systems and... control systems for OTC derivatives dealers. 240.15c3-4 Section 240.15c3-4 Commodity and Securities...-Counter Markets § 240.15c3-4 Internal risk management control systems for OTC derivatives dealers. (a) An...

  5. 17 CFR 240.15c3-4 - Internal risk management control systems for OTC derivatives dealers.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... unenforceable; (6) Procedures are in place to identify and address any deficiencies in the operating systems and... control systems for OTC derivatives dealers. 240.15c3-4 Section 240.15c3-4 Commodity and Securities...-Counter Markets § 240.15c3-4 Internal risk management control systems for OTC derivatives dealers. (a) An...

  6. 17 CFR 240.15c3-4 - Internal risk management control systems for OTC derivatives dealers.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... unenforceable; (6) Procedures are in place to identify and address any deficiencies in the operating systems and... control systems for OTC derivatives dealers. 240.15c3-4 Section 240.15c3-4 Commodity and Securities...-Counter Markets § 240.15c3-4 Internal risk management control systems for OTC derivatives dealers. (a) An...

  7. 17 CFR 240.15c3-5 - Risk management controls for brokers or dealers with market access.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 17 Commodity and Securities Exchanges 3 2013-04-01 2013-04-01 false Risk management controls for... Markets § 240.15c3-5 Risk management controls for brokers or dealers with market access. (a) For the... system provided by a broker-dealer operator of an alternative trading system to a non-broker-dealer. (2...

  8. 17 CFR 240.15c3-5 - Risk management controls for brokers or dealers with market access.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 17 Commodity and Securities Exchanges 4 2014-04-01 2014-04-01 false Risk management controls for... Markets § 240.15c3-5 Risk management controls for brokers or dealers with market access. (a) For the... system provided by a broker-dealer operator of an alternative trading system to a non-broker-dealer. (2...

  9. 77 FR 39300 - Self-Regulatory Organizations; EDGX Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-02

    ... Change Relating to New Market Access Risk Management Service, EdgeRisk Controls SM June 26, 2012... access risk management service, called EdgeRisk Controls SM (the ``Service''). II. Self-Regulatory..., document and maintain a system of risk management controls and supervisory procedures that are reasonably...

  10. 12 CFR Appendix F to Part 225 - Interagency Guidelines Establishing Information Security Standards

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... arrangements in place to control risks. C. Manage and Control Risk. Each bank holding company shall: 1. Design... GOVERNORS OF THE FEDERAL RESERVE SYSTEM BANK HOLDING COMPANIES AND CHANGE IN BANK CONTROL (REGULATION Y) Pt.... Assess Risk C. Manage and Control Risk D. Oversee Service Provider Arrangements E. Adjust the Program F...

  11. Problem of two-level hierarchical minimax program control the final state of regional social and economic system in the presence of risks

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

    Shorikov, A. F., E-mail: afshorikov@mail.ru

    This article discusses a discrete-time dynamical system consisting of a set a controllable objects (region and forming it municipalities). The dynamics each of these is described by the corresponding vector nonlinear discrete-time recurrent vector equations and its control system consist from two levels: basic (control level I) that is dominating and subordinate level (control level II). Both levels have different criterions of functioning and united a priori by determined informational and control connections defined in advance. In this paper we study the problem of optimization of guaranteed result for program control by the final state of regional social and economicmore » system in the presence of risks. For this problem we proposed in this work an economical and mathematical model of two-level hierarchical minimax program control the final state of regional social and economic system in the presence of risks and the general scheme for its solving.« less

  12. Overview of NASA's Thermal Control System Development for Exploration Project

    NASA Technical Reports Server (NTRS)

    Stephan, Ryan A.

    2010-01-01

    NASA's Constellation Program includes the Orion, Altair, and Lunar Surface Systems project offices. The first two elements, Orion and Altair, are manned space vehicles while the third element is broader and includes several sub-elements including Rovers and a Lunar Habitat. The upcoming planned missions involving these systems and vehicles include several risks and design challenges. Due to the unique thermal environment, many of these risks and challenges are associated with the vehicles' thermal control system. NASA's Exploration Systems Mission Directorate (ESMD) includes the Exploration Technology Development Program (ETDP). ETDP consists of several technology development projects. The project chartered with mitigating the aforementioned risks and design challenges is the Thermal Control System Development for Exploration Project. The risks and design challenges are addressed through a rigorous technology development process that culminates with an integrated thermal control system test. The resulting hardware typically has a Technology Readiness Level (TRL) of six. This paper summarizes the development efforts being performed by the technology development project. The development efforts involve heat acquisition and heat rejection hardware including radiators, heat exchangers, and evaporators. The project has also been developing advanced phase change material heat sinks and performing assessments for thermal control system fluids.

  13. Drinking Water Distribution Systems

    EPA Pesticide Factsheets

    Learn about an overview of drinking water distribution systems, the factors that degrade water quality in the distribution system, assessments of risk, future research about these risks, and how to reduce cross-connection control risk.

  14. Safety Metrics for Human-Computer Controlled Systems

    NASA Technical Reports Server (NTRS)

    Leveson, Nancy G; Hatanaka, Iwao

    2000-01-01

    The rapid growth of computer technology and innovation has played a significant role in the rise of computer automation of human tasks in modem production systems across all industries. Although the rationale for automation has been to eliminate "human error" or to relieve humans from manual repetitive tasks, various computer-related hazards and accidents have emerged as a direct result of increased system complexity attributed to computer automation. The risk assessment techniques utilized for electromechanical systems are not suitable for today's software-intensive systems or complex human-computer controlled systems.This thesis will propose a new systemic model-based framework for analyzing risk in safety-critical systems where both computers and humans are controlling safety-critical functions. A new systems accident model will be developed based upon modem systems theory and human cognitive processes to better characterize system accidents, the role of human operators, and the influence of software in its direct control of significant system functions Better risk assessments will then be achievable through the application of this new framework to complex human-computer controlled systems.

  15. 12 CFR 217.101 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... management and maintenance system; and control, oversight, and validation system for credit risk of wholesale... advanced IRB systems, operational risk management processes, operational risk data and assessment systems... the seller and the obligor (intercompany accounts receivable and receivables subject to contra...

  16. Cost Estimation and Control for Flight Systems

    NASA Technical Reports Server (NTRS)

    Hammond, Walter E.; Vanhook, Michael E. (Technical Monitor)

    2002-01-01

    Good program management practices, cost analysis, cost estimation, and cost control for aerospace flight systems are interrelated and depend upon each other. The best cost control process cannot overcome poor design or poor systems trades that lead to the wrong approach. The project needs robust Technical, Schedule, Cost, Risk, and Cost Risk practices before it can incorporate adequate Cost Control. Cost analysis both precedes and follows cost estimation -- the two are closely coupled with each other and with Risk analysis. Parametric cost estimating relationships and computerized models are most often used. NASA has learned some valuable lessons in controlling cost problems, and recommends use of a summary Project Manager's checklist as shown here.

  17. 78 FR 13917 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing Amendment No. 1 and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-01

    ... systemic risk since the reversals may override DTC's risk management controls such as the Collateral...\\ The stated purpose of Title VIII is to mitigate systemic risk in the financial system and promote... soundness; Reduce systemic risks; and Support the stability of the broader financial system. The Commission...

  18. Overview of NASA's Thermal Control System Development for Exploration Project

    NASA Technical Reports Server (NTRS)

    Stephan, Ryan A.

    2011-01-01

    The now-cancelled Constellation Program included the Orion, Altair, and Lunar Surface Systems project offices. The first two elements, Orion and Altair, were planned to be manned space vehicles while the third element was much more diverse and included several sub-elements. Among other things, these sub-elements were Rovers and a Lunar Habitat. The planned missions involving these systems and vehicles included several risks and design challenges. Due to the unique thermal operating environment, many of these risks and challenges were associated with the vehicles thermal control system. NASA s Exploration Technology Development Program (ETDP) consisted of various technology development projects. The project chartered with mitigating the aforementioned thermal risks and design challenges was the Thermal Control System Development for Exploration Project. These risks and design challenges were being addressed through a rigorous technology development process that was planned to culminate with an integrated thermal control system test. Although the technologies being developed were originally aimed towards mitigating specific Constellation risks, the technology development process is being continued within a new program. This continued effort is justified by the fact that many of the technologies are generically applicable to future spacecraft thermal control systems. The current paper summarizes the development efforts being performed by the technology development project. The development efforts involve heat acquisition and heat rejection hardware including radiators, heat exchangers, and evaporators. The project has also been developing advanced phase change material heat sinks and performing a material compatibility assessment for a promising thermal control system working fluid. The to-date progress and lessons-learned from these development efforts will be discussed throughout the paper.

  19. Security Risk Assessment Process for UAS in the NAS CNPC Architecture

    NASA Technical Reports Server (NTRS)

    Iannicca, Dennis C.; Young, Dennis P.; Thadani, Suresh K.; Winter, Gilbert A.

    2013-01-01

    This informational paper discusses the risk assessment process conducted to analyze Control and Non-Payload Communications (CNPC) architectures for integrating civil Unmanned Aircraft Systems (UAS) into the National Airspace System (NAS). The assessment employs the National Institute of Standards and Technology (NIST) Risk Management framework to identify threats, vulnerabilities, and risks to these architectures and recommends corresponding mitigating security controls. This process builds upon earlier work performed by RTCA Special Committee (SC) 203 and the Federal Aviation Administration (FAA) to roadmap the risk assessment methodology and to identify categories of information security risks that pose a significant impact to aeronautical communications systems. A description of the deviations from the typical process is described in regards to this aeronautical communications system. Due to the sensitive nature of the information, data resulting from the risk assessment pertaining to threats, vulnerabilities, and risks is beyond the scope of this paper.

  20. Security Risk Assessment Process for UAS in the NAS CNPC Architecture

    NASA Technical Reports Server (NTRS)

    Iannicca, Dennis Christopher; Young, Daniel Paul; Suresh, Thadhani; Winter, Gilbert A.

    2013-01-01

    This informational paper discusses the risk assessment process conducted to analyze Control and Non-Payload Communications (CNPC) architectures for integrating civil Unmanned Aircraft Systems (UAS) into the National Airspace System (NAS). The assessment employs the National Institute of Standards and Technology (NIST) Risk Management framework to identify threats, vulnerabilities, and risks to these architectures and recommends corresponding mitigating security controls. This process builds upon earlier work performed by RTCA Special Committee (SC) 203 and the Federal Aviation Administration (FAA) to roadmap the risk assessment methodology and to identify categories of information security risks that pose a significant impact to aeronautical communications systems. A description of the deviations from the typical process is described in regards to this aeronautical communications system. Due to the sensitive nature of the information, data resulting from the risk assessment pertaining to threats, vulnerabilities, and risks is beyond the scope of this paper

  1. Approaches to Quality Risk Management When Using Single-Use Systems in the Manufacture of Biologics.

    PubMed

    Ishii-Watabe, Akiko; Hirose, Akihiko; Katori, Noriko; Hashii, Norikata; Arai, Susumu; Awatsu, Hirotoshi; Eiza, Akira; Hara, Yoshiaki; Hattori, Hideshi; Inoue, Tomomi; Isono, Tetsuya; Iwakura, Masahiro; Kajihara, Daisuke; Kasahara, Nobuo; Matsuda, Hiroyuki; Murakami, Sei; Nakagawa, Taishiro; Okumura, Takehiro; Omasa, Takeshi; Takuma, Shinya; Terashima, Iyo; Tsukahara, Masayoshi; Tsutsui, Maiko; Yano, Takahiro; Kawasaki, Nana

    2015-10-01

    Biologics manufacturing technology has made great progress in the last decade. One of the most promising new technologies is the single-use system, which has improved the efficiency of biologics manufacturing processes. To ensure safety of biologics when employing such single-use systems in the manufacturing process, various issues need to be considered including possible extractables/leachables and particles arising from the components used in single-use systems. Japanese pharmaceutical manufacturers, together with single-use suppliers, members of the academia and regulatory authorities have discussed the risks of using single-use systems and established control strategies for the quality assurance of biologics. In this study, we describe approaches for quality risk management when employing single-use systems in the manufacturing of biologics. We consider the potential impact of impurities related to single-use components on drug safety and the potential impact of the single-use system on other critical quality attributes as well as the stable supply of biologics. We also suggest a risk-mitigating strategy combining multiple control methods which includes the selection of appropriate single-use components, their inspections upon receipt and before releasing for use and qualification of single-use systems. Communication between suppliers of single-use systems and the users, as well as change controls in the facilities both of suppliers and users, are also important in risk-mitigating strategies. Implementing these control strategies can mitigate the risks attributed to the use of single-use systems. This study will be useful in promoting the development of biologics as well as in ensuring their safety, quality and stable supply.

  2. Risk control and the minimum significant risk

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

    Seiler, F.A.; Alvarez, J.L.

    1996-06-01

    Risk management implies that the risk manager can, by his actions, exercise at least a modicum of control over the risk in question. In the terminology of control theory, a management action is a control signal imposed as feedback on the system to bring about a desired change in the state of the system. In the terminology of risk management, an action is taken to bring a predicted risk to lower values. Even if it is assumed that the management action taken is 100% effective and that the projected risk reduction is infinitely well known, there is a lower limitmore » to the desired effects that can be achieved. It is based on the fact that all risks, such as the incidence of cancer, exhibit a degree of variability due to a number of extraneous factors such as age at exposure, sex, location, and some lifestyle parameters such as smoking or the consumption of alcohol. If the control signal is much smaller than the variability of the risk, the signal is lost in the noise and control is lost. This defines a minimum controllable risk based on the variability of the risk over the population considered. This quantity is the counterpart of the minimum significant risk which is defined by the uncertainties of the risk model. Both the minimum controllable risk and the minimum significant risk are evaluated for radiation carcinogenesis and are shown to be of the same order of magnitude. For a realistic management action, the assumptions of perfectly effective action and perfect model prediction made above have to be dropped, resulting in an effective minimum controllable risk which is determined by both risk limits. Any action below that effective limit is futile, but it is also unethical due to the ethical requirement of doing more good than harm. Finally, some implications of the effective minimum controllable risk on the use of the ALARA principle and on the evaluation of remedial action goals are presented.« less

  3. Alternative Perspectives on Risk

    NASA Technical Reports Server (NTRS)

    Davison, Jeannie; Orasanu, J.; Connors, Mary M. (Technical Monitor)

    1997-01-01

    The goal of the commercial air transport system is to provide air transportation to the flying public at an acceptable cost with minimal risk. in an ideal situation these three goals would support each other. In fact, it is sometimes the case that the goals conflict: getting passengers to their destinations on time may conflict with fixing a minor mechanical malfunction that may or may not impact safety; flying a route that will avoid turbulence, thereby providing passengers with a more comfortable ride, may consume more fuel; managing traffic density may mean aircraft are delayed or must use an approach that will result in a long taxi to their gates, costing time and fuel. Various players in the system--pilots, dispatchers, controllers, as well as managers in the airline carriers and traffic management system--make decisions every day that involve trade-offs of benefits and costs. The prospect of revisions in the air traffic management system, with shifts in responsibilities from controllers to users, including airline operations center personnel and pilots, means that individuals may be performing either new jobs or old jobs under new guidance. It will be essential to know how the various players (a) perceive the risks and benefits associated with the decisions they will make under the old and new control structures, and (b) how much risk they are willing to accept in making decisions. Risk is here defined as the probability and magnitude of negative events (after Slovic, 1987). Of primary interest are risks associated with traffic, weather, and operational factors such as schedule, fuel consumption, and passenger service. Previous research has documented differences between groups in perceptions of risks associated with both everyday and aviation related situations. Risk perception varies as a function of familiarity with the situation, degree to which one is potentially affected by the risk, the level of control one has over the situation, and one's level of experience and responsibility in the situation. In our presentation we will consider several factors that may influence differences in risk perception, risk tolerance and risk management among the three major categories of participants in the aviation system (pilots, dispatchers, and controllers). Primary factors that may affect risk attitudes (the collective term we will use for the three components of risk) include: expertise or job-specific knowledge or training, personal involvement or vulnerability to consequences, goals, time horizon (imminence of consequences), span of control and type of control, and information or technology support. These will be considered in the context of five different types of risk (physical threat, economic, social, legal, and ethical). A study designed to study differences between pilots and controllers in their perceptions and responses to traffic risks under the present and a user-preferred control situation will be described. Future studies involving dispatchers' risk perceptions regarding various types of risk will be discussed.

  4. Importance Of Quality Control in Reducing System Risk, a Lesson Learned From The Shuttle and a Recommendation for Future Launch Vehicles

    NASA Technical Reports Server (NTRS)

    Safie, Fayssal M.; Messer, Bradley P.

    2006-01-01

    This paper presents lessons learned from the Space Shuttle return to flight experience and the importance of these lessons learned in the development of new the NASA Crew Launch Vehicle (CLV). Specifically, the paper discusses the relationship between process control and system risk, and the importance of process control in improving space vehicle flight safety. It uses the External Tank (ET) Thermal Protection System (TPS) experience and lessons learned from the redesign and process enhancement activities performed in preparation for Return to Flight after the Columbia accident. The paper also, discusses in some details, the Probabilistic engineering physics based risk assessment performed by the Shuttle program to evaluate the impact of TPS failure on system risk and the application of the methodology to the CLV.

  5. Quality Audit in the Fastener Industry

    NASA Technical Reports Server (NTRS)

    Reagan, John R.

    1995-01-01

    Both the financial and quality communities rely on audits to verify customers records. The financial community is highly structured around three categories of risk, INHERENT RISK, CONTROL RISK, and DETECTION RISK. Combined, the product of these three categories constitute the AUDIT RISK. The financial community establishes CONTROL RISK based in large part on a systems level understanding of the process flow. This system level understanding is best expressed in a flowchart. The quality community may be able to adopt this structure and thereby reduce cost while maintaining and enhancing quality. The quality community should attempt to flowchart the systems level quality process before beginning substantive testing. This theory needs to be applied in several trial cases to prove or disprove this hypothesis

  6. Quality audit in the fastener industry

    NASA Astrophysics Data System (ADS)

    Reagan, John R.

    1995-09-01

    Both the financial and quality communities rely on audits to verify customers records. The financial community is highly structured around three categories of risk, INHERENT RISK, CONTROL RISK, and DETECTION RISK. Combined, the product of these three categories constitute the AUDIT RISK. The financial community establishes CONTROL RISK based in large part on a systems level understanding of the process flow. This system level understanding is best expressed in a flowchart. The quality community may be able to adopt this structure and thereby reduce cost while maintaining and enhancing quality. The quality community should attempt to flowchart the systems level quality process before beginning substantive testing. This theory needs to be applied in several trial cases to prove or disprove this hypothesis

  7. A Guide to the Application of Probability Risk Assessment Methodology and Hazard Risk Frequency Criteria as a Hazard Control for the Use of the Mobile Servicing System on the International Space Station

    NASA Astrophysics Data System (ADS)

    D'silva, Oneil; Kerrison, Roger

    2013-09-01

    A key feature for the increased utilization of space robotics is to automate Extra-Vehicular manned space activities and thus significantly reduce the potential for catastrophic hazards while simultaneously minimizing the overall costs associated with manned space. The principal scope of the paper is to evaluate the use of industry standard accepted Probability risk/safety assessment (PRA/PSA) methodologies and Hazard Risk frequency Criteria as a hazard control. This paper illustrates the applicability of combining the selected Probability risk assessment methodology and hazard risk frequency criteria, in order to apply the necessary safety controls that allow for the increased use of the Mobile Servicing system (MSS) robotic system on the International Space Station. This document will consider factors such as component failure rate reliability, software reliability, and periods of operation and dormancy, fault tree analyses and their effects on the probability risk assessments. The paper concludes with suggestions for the incorporation of existing industry Risk/Safety plans to create an applicable safety process for future activities/programs

  8. Risk Identification in a Smart Monitoring System Used to Preserve Artefacts Based on Textile Materials

    NASA Astrophysics Data System (ADS)

    Diaconescu, V. D.; Scripcariu, L.; Mătăsaru, P. D.; Diaconescu, M. R.; Ignat, C. A.

    2018-06-01

    Exhibited textile-materials-based artefacts can be affected by the environmental conditions. A smart monitoring system that commands an adaptive automatic environment control system is proposed for indoor exhibition spaces containing various textile artefacts. All exhibited objects are monitored by many multi-sensor nodes containing temperature, relative humidity and light sensors. Data collected periodically from the entire sensor network is stored in a database and statistically processed in order to identify and classify the environment risk. Risk consequences are analyzed depending on the risk class and the smart system commands different control measures in order to stabilize the indoor environment conditions to the recommended values and prevent material degradation.

  9. STAT4 and the Risk of Rheumatoid Arthritis and Systemic Lupus Erythematosus

    PubMed Central

    Remmers, Elaine F.; Plenge, Robert M.; Lee, Annette T.; Graham, Robert R.; Hom, Geoffrey; Behrens, Timothy W.; de Bakker, Paul I.W.; Le, Julie M.; Lee, Hye-Soon; Batliwalla, Franak; Li, Wentian; Masters, Seth L.; Booty, Matthew G.; Carulli, John P.; Padyukov, Leonid; Alfredsson, Lars; Klareskog, Lars; Chen, Wei V.; Amos, Christopher I.; Criswell, Lindsey A.; Seldin, Michael F.; Kastner, Daniel L.

    2009-01-01

    BACKGROUND Rheumatoid arthritis is a chronic inflammatory disease with a substantial genetic component. Susceptibility to disease has been linked with a region on chromosome 2q. METHODS We tested single-nucleotide polymorphisms (SNPs) in and around 13 candidate genes within the previously linked chromosome 2q region for association with rheumatoid arthritis. We then performed fine mapping of the STAT1-STAT4 region in a total of 1620 case patients with established rheumatoid arthritis and 2635 controls, all from North America. Implicated SNPs were further tested in an independent case-control series of 1529 patients with early rheumatoid arthritis and 881 controls, all from Sweden, and in a total of 1039 case patients and 1248 controls from three series of patients with systemic lupus erythematosus. RESULTS A SNP haplotype in the third intron of STAT4 was associated with susceptibility to both rheumatoid arthritis and systemic lupus erythematosus. The minor alleles of the haplotype-defining SNPs were present in 27% of chromosomes of patients with established rheumatoid arthritis, as compared with 22% of those of controls (for the SNP rs7574865, P = 2.81×10-7; odds ratio for having the risk allele in chromosomes of patients vs. those of controls, 1.32). The association was replicated in Swedish patients with recent-onset rheumatoid arthritis (P = 0.02) and matched controls. The haplotype marked by rs7574865 was strongly associated with lupus, being present on 31% of chromosomes of case patients and 22% of those of controls (P = 1.87×10-9; odds ratio for having the risk allele in chromosomes of patients vs. those of controls, 1.55). Homozygosity of the risk allele, as compared with absence of the allele, was associated with a more than doubled risk for lupus and a 60% increased risk for rheumatoid arthritis. CONCLUSIONS A haplotype of STAT4 is associated with increased risk for both rheumatoid arthritis and systemic lupus erythematosus, suggesting a shared pathway for these illnesses. PMID:17804842

  10. STAT4 and the risk of rheumatoid arthritis and systemic lupus erythematosus.

    PubMed

    Remmers, Elaine F; Plenge, Robert M; Lee, Annette T; Graham, Robert R; Hom, Geoffrey; Behrens, Timothy W; de Bakker, Paul I W; Le, Julie M; Lee, Hye-Soon; Batliwalla, Franak; Li, Wentian; Masters, Seth L; Booty, Matthew G; Carulli, John P; Padyukov, Leonid; Alfredsson, Lars; Klareskog, Lars; Chen, Wei V; Amos, Christopher I; Criswell, Lindsey A; Seldin, Michael F; Kastner, Daniel L; Gregersen, Peter K

    2007-09-06

    Rheumatoid arthritis is a chronic inflammatory disease with a substantial genetic component. Susceptibility to disease has been linked with a region on chromosome 2q. We tested single-nucleotide polymorphisms (SNPs) in and around 13 candidate genes within the previously linked chromosome 2q region for association with rheumatoid arthritis. We then performed fine mapping of the STAT1-STAT4 region in a total of 1620 case patients with established rheumatoid arthritis and 2635 controls, all from North America. Implicated SNPs were further tested in an independent case-control series of 1529 patients with early rheumatoid arthritis and 881 controls, all from Sweden, and in a total of 1039 case patients and 1248 controls from three series of patients with systemic lupus erythematosus. A SNP haplotype in the third intron of STAT4 was associated with susceptibility to both rheumatoid arthritis and systemic lupus erythematosus. The minor alleles of the haplotype-defining SNPs were present in 27% of chromosomes of patients with established rheumatoid arthritis, as compared with 22% of those of controls (for the SNP rs7574865, P=2.81x10(-7); odds ratio for having the risk allele in chromosomes of patients vs. those of controls, 1.32). The association was replicated in Swedish patients with recent-onset rheumatoid arthritis (P=0.02) and matched controls. The haplotype marked by rs7574865 was strongly associated with lupus, being present on 31% of chromosomes of case patients and 22% of those of controls (P=1.87x10(-9); odds ratio for having the risk allele in chromosomes of patients vs. those of controls, 1.55). Homozygosity of the risk allele, as compared with absence of the allele, was associated with a more than doubled risk for lupus and a 60% increased risk for rheumatoid arthritis. A haplotype of STAT4 is associated with increased risk for both rheumatoid arthritis and systemic lupus erythematosus, suggesting a shared pathway for these illnesses. Copyright 2007 Massachusetts Medical Society.

  11. Joint System Prognostics For Increased Efficiency And Risk Mitigation In Advanced Nuclear Reactor Instrumentation and Control

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

    Donald D. Dudenhoeffer; Tuan Q. Tran; Ronald L. Boring

    2006-08-01

    The science of prognostics is analogous to a doctor who, based on a set of symptoms and patient tests, assesses a probable cause, the risk to the patient, and a course of action for recovery. While traditional prognostics research has focused on the aspect of hydraulic and mechanical systems and associated failures, this project will take a joint view in focusing not only on the digital I&C aspect of reliability and risk, but also on the risks associated with the human element. Model development will not only include an approximation of the control system physical degradation but also on humanmore » performance degradation. Thus the goal of the prognostic system is to evaluate control room operation; to identify and potentially take action when performance degradation reduces plant efficiency, reliability or safety.« less

  12. [Development of whole process quality control and management system of traditional Chinese medicine decoction pieces based on traditional Chinese medicine quality tree].

    PubMed

    Yu, Wen-Kang; Dong, Ling; Pei, Wen-Xuan; Sun, Zhi-Rong; Dai, Jun-Dong; Wang, Yun

    2017-12-01

    The whole process quality control and management of traditional Chinese medicine (TCM) decoction pieces is a system engineering, involving the base environment, seeds and seedlings, harvesting, processing and other multiple steps, so the accurate identification of factors in TCM production process that may induce the quality risk, as well as reasonable quality control measures are very important. At present, the concept of quality risk is mainly concentrated in the aspects of management and regulations, etc. There is no comprehensive analysis on possible risks in the quality control process of TCM decoction pieces, or analysis summary of effective quality control schemes. A whole process quality control and management system for TCM decoction pieces based on TCM quality tree was proposed in this study. This system effectively combined the process analysis method of TCM quality tree with the quality risk management, and can help managers to make real-time decisions while realizing the whole process quality control of TCM. By providing personalized web interface, this system can realize user-oriented information feedback, and was convenient for users to predict, evaluate and control the quality of TCM. In the application process, the whole process quality control and management system of the TCM decoction pieces can identify the related quality factors such as base environment, cultivation and pieces processing, extend and modify the existing scientific workflow according to their own production conditions, and provide different enterprises with their own quality systems, to achieve the personalized service. As a new quality management model, this paper can provide reference for improving the quality of Chinese medicine production and quality standardization. Copyright© by the Chinese Pharmaceutical Association.

  13. 12 CFR 324.101 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... quantification system; data management and maintenance system; and control, oversight, and validation system for...-supervised institution's advanced IRB systems, operational risk management processes, operational risk data...-length basis between the seller and the obligor (intercompany accounts receivable and receivables subject...

  14. Operational Performance Risk Assessment in Support of A Supervisory Control System

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

    Denning, Richard S.; Muhlheim, Michael David; Cetiner, Sacit M.

    Supervisory control system (SCS) is developed for multi-unit advanced small modular reactors to minimize human interventions in both normal and abnormal operations. In SCS, control action decisions made based on probabilistic risk assessment approach via Event Trees/Fault Trees. Although traditional PRA tools are implemented, their scope is extended to normal operations and application is reversed; success of non-safety related system instead failure of safety systems this extended PRA approach called as operational performance risk assessment (OPRA). OPRA helps to identify success paths, combination of control actions for transients and to quantify these success paths to provide possible actions without activatingmore » plant protection system. In this paper, a case study of the OPRA in supervisory control system is demonstrated within the context of the ALMR PRISM design, specifically power conversion system. The scenario investigated involved a condition that the feed water control valve is observed to be drifting to the closed position. Alternative plant configurations were identified via OPRA that would allow the plant to continue to operate at full or reduced power. Dynamic analyses were performed with a thermal-hydraulic model of the ALMR PRISM system using Modelica to evaluate remained safety margins. Successful recovery paths for the selected scenario are identified and quantified via SCS.« less

  15. [Establishment and application effect of fall prevention and control information system in elderly community].

    PubMed

    Zhao, Ting; Pi, Hong-Ying; Ku, Hong-An; Pan, Li; Gong, Zhu-Yun

    2018-02-08

    To investigate establishing, applying and evaluating the fall prevention and control information system in elderly community. Relying on internet technology and informatization means, the fall comprehensive prevention and control strategy of elderly was guided into online from offline. The fall prevention and control information system which was a collection of risk assessment, remote education and feedback was established. One hundred and twenty-six elderly (over 60 years old) in community were screened in this study and 84 high-risk elders who were involved in the remote continuous comprehensive intervention were screened out. Intervening measures included distributing propaganda album, making mission slides and video used to play with the interpretation remotely. Then fall related situation before and after intervention was analyzed and the effectiveness of system evaluated. After remote intervention, the fall incidence of high-risk group decreased from 21.43% to 4.76%( P <0.01). The body balance and gait stability improved clearly( P <0. 01). The rate of taking proper prevention and control behavior significantly improved( P <0.01). They believed in themselves not to fall down with more confidence when taking complex behaviors( P <0.01). The security of environment at home significantly enhanced( P <0. 01). Fall prevention and control information system in elderly community was innovative and convenient. The system could roundly assess the status related to fall and accurately screen out high-risk group. The system could implement the remote continuous comprehensive intervention so that the incident of fall was decrease. In conclusion, the system is stable and effective, can be further popularization and application as a successful pilot.

  16. Controlling the self-organizing dynamics in a sandpile model on complex networks by failure tolerance

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

    Qi, Junjian; Pfenninger, Stefan

    In this paper, we propose a strategy to control the self-organizing dynamics of the Bak-Tang-Wiesenfeld (BTW) sandpile model on complex networks by allowing some degree of failure tolerance for the nodes and introducing additional active dissipation while taking the risk of possible node damage. We show that the probability for large cascades significantly increases or decreases respectively when the risk for node damage outweighs the active dissipation and when the active dissipation outweighs the risk for node damage. By considering the potential additional risk from node damage, a non-trivial optimal active dissipation control strategy which minimizes the total cost inmore » the system can be obtained. Under some conditions the introduced control strategy can decrease the total cost in the system compared to the uncontrolled model. Moreover, when the probability of damaging a node experiencing failure tolerance is greater than the critical value, then no matter how successful the active dissipation control is, the total cost of the system will have to increase. This critical damage probability can be used as an indicator of the robustness of a network or system. Copyright (C) EPLA, 2015« less

  17. The Rise of Risk Management in the Universities: A New Way to Understand Quality in University Management

    ERIC Educational Resources Information Center

    Yokoyama, Keiko

    2018-01-01

    This study aims to identify how uncertainty and insecurity in the post-2008 period have reshaped risk management in the university systems. The study scrutinises internal control in the contexts of the English university system and the State University of New York (SUNY) system. It utilises the concept of 'risk' by exploring 'risk society' theses.…

  18. Comparative Risk Analysis for Metropolitan Solid Waste Management Systems

    NASA Astrophysics Data System (ADS)

    Chang, Ni-Bin; Wang, S. F.

    1996-01-01

    Conventional solid waste management planning usually focuses on economic optimization, in which the related environmental impacts or risks are rarely considered. The purpose of this paper is to illustrate the methodology of how optimization concepts and techniques can be applied to structure and solve risk management problems such that the impacts of air pollution, leachate, traffic congestion, and noise increments can be regulated in the iong-term planning of metropolitan solid waste management systems. Management alternatives are sequentially evaluated by adding several environmental risk control constraints stepwise in an attempt to improve the management strategies and reduce the risk impacts in the long run. Statistics associated with those risk control mechanisms are presented as well. Siting, routing, and financial decision making in such solid waste management systems can also be achieved with respect to various resource limitations and disposal requirements.

  19. Sociodemographic Risk, Parenting, and Effortful Control: Relations to Salivary Alpha-amylase and Cortisol in Early Childhood

    PubMed Central

    Taylor, Zoe E.; Spinrad, Tracy L.; VanSchyndel, Sarah K.; Eisenberg, Nancy; Huynh, Jacqueline; Sulik, Michael J.; Granger, Douglas A.

    2012-01-01

    Early sociodemographic risk, parenting, and temperament were examined as predictors of the activity of children’s (N = 148; 81 boys, 67 girls) hypothalamic-pituitary-adrenal axis and autonomic nervous system. Demographic risk was assessed at 18 months (T1), intrusive-overcontrolling parenting and effortful control were assessed at 30 months (T2), and salivary cortisol and alpha-amylase were collected at 72 (T3) months of age. Demographic risk at T1 predicted lower levels of children’s effortful control and higher levels of mothers’ intrusive-overcontrolling parenting at T2. Intrusive-overcontrolling parenting at T2 predicted higher levels of children’s cortisol and alpha-amylase at T3, but effortful control did not uniquely predict children’s cortisol or alpha-amylase. Findings support the open nature of stress responsive physiological systems to influence by features of the early caregiving environment and underscore the utility of including measures of these systems in prevention trials designed to influence child outcomes by modifying parenting behavior. PMID:22949301

  20. Cascade reservoir flood control operation based on risk grading and warning in the Upper Yellow River

    NASA Astrophysics Data System (ADS)

    Xuejiao, M.; Chang, J.; Wang, Y.

    2017-12-01

    Flood risk reduction with non-engineering measures has become the main idea for flood management. It is more effective for flood risk management to take various non-engineering measures. In this paper, a flood control operation model for cascade reservoirs in the Upper Yellow River was proposed to lower the flood risk of the water system with multi-reservoir by combining the reservoir flood control operation (RFCO) and flood early warning together. Specifically, a discharge control chart was employed to build the joint RFCO simulation model for cascade reservoirs in the Upper Yellow River. And entropy-weighted fuzzy comprehensive evaluation method was adopted to establish a multi-factorial risk assessment model for flood warning grade. Furthermore, after determining the implementing mode of countermeasures with future inflow, an intelligent optimization algorithm was used to solve the optimization model for applicable water release scheme. In addition, another model without any countermeasure was set to be a comparative experiment. The results show that the model developed in this paper can further decrease the flood risk of water system with cascade reservoirs. It provides a new approach to flood risk management by coupling flood control operation and flood early warning of cascade reservoirs.

  1. Integrated Environmental Risk Assessment and Whole-Process Management System in Chemical Industry Parks

    PubMed Central

    Shao, Chaofeng; Yang, Juan; Tian, Xiaogang; Ju, Meiting; Huang, Lei

    2013-01-01

    Chemical industry parks in China are considered high-risk areas because they present numerous risks that can damage the environment, such as pollution incidents. In order to identify the environmental risks and the principal risk factors in these areas, we have developed a simple physical model of a regional environmental risk field (ERF) using existing dispersal patterns and migration models. The regional ERF zoning was also conducted and a reference value for diagnostic methods was developed to determine risk-acceptable, risk-warning, and risk-mitigation zones, which can provide a risk source layout for chemical industry parks. In accordance with the environmental risk control requirements, this study focused on the three stages of control and management of environmental risk and established an environmental risk management system including risk source identification and assessment, environmental safety planning, early risk warning, emergency management, assessment of environmental effects, and environmental remediation of pollution accidents. By using this model, the environmental risks in Tianjin Binhai New Area, the largest chemical industry park in China, were assessed and the environmental risk zoning map was drawn, which suggested the existence of many unacceptable environmental risks in this area. Thus, relevant suggestions have been proposed from the perspective of the adjustment of risk source layout, intensified management of environmental risk control and so on. PMID:23603866

  2. Integrated environmental risk assessment and whole-process management system in chemical industry parks.

    PubMed

    Shao, Chaofeng; Yang, Juan; Tian, Xiaogang; Ju, Meiting; Huang, Lei

    2013-04-19

    Chemical industry parks in China are considered high-risk areas because they present numerous risks that can damage the environment, such as pollution incidents. In order to identify the environmental risks and the principal risk factors in these areas, we have developed a simple physical model of a regional environmental risk field (ERF) using existing dispersal patterns and migration models. The regional ERF zoning was also conducted and a reference value for diagnostic methods was developed to determine risk-acceptable, risk-warning, and risk-mitigation zones, which can provide a risk source layout for chemical industry parks. In accordance with the environmental risk control requirements, this study focused on the three stages of control and management of environmental risk and established an environmental risk management system including risk source identification and assessment, environmental safety planning, early risk warning, emergency management, assessment of environmental effects, and environmental remediation of pollution accidents. By using this model, the environmental risks in Tianjin Binhai New Area, the largest chemical industry park in China, were assessed and the environmental risk zoning map was drawn, which suggested the existence of many unacceptable environmental risks in this area. Thus, relevant suggestions have been proposed from the perspective of the adjustment of risk source layout, intensified management of environmental risk control and so on.

  3. Cyber Security for Lighting Systems

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

    None

    Fact sheet discusses cyber threats unique to lighting control systems in buildings and helps facility managers identify the types of lighting control systems that could introduce cybersecurity risks. Download the fact sheet.

  4. Reducing Preconception Risks Among African American Women with Conversational Agent Technology.

    PubMed

    Jack, Brian; Bickmore, Timothy; Hempstead, Megan; Yinusa-Nyahkoon, Leanne; Sadikova, Ekaterina; Mitchell, Suzanne; Gardiner, Paula; Adigun, Fatima; Penti, Brian; Schulman, Daniel; Damus, Karla

    2015-01-01

    Systems and tools are needed to identify and mitigate preconception health (PCH) risks, particularly for African American (AA) women, given persistent health disparities. We developed and tested "Gabby," an online preconception conversational agent system. One hundred nongravid AA women 18-34 years of age were screened for over 100 PCH risks and randomized to the Gabby or control group. The Gabby group interacted with the system for up to six months; the control group received a letter indicating their health risks with a recommendation to talk with their clinician. The numbers, proportions, and types of risks were compared between groups. There were 23.7 (SD 5.9) risks identified per participant. Eighty-five percent (77 of 91) provided 6 month follow up data. The Gabby group had greater reductions in the number (8.3 vs. 5.5 risks, P < .05) and the proportion (27.8% vs 20.5%, P < 0.01) of risks compared to controls. The Gabby group averaged 63.7 minutes of interaction time. Seventy-eight percent reported that it "was easy to talk to Gabby" and 64% used information from Gabby to improve their health. Gabby was significantly associated with preconception risk reduction. More research is needed to determine if Gabby can benefit higher risk populations and if risk reduction is clinically significant. © Copyright 2015 by the American Board of Family Medicine.

  5. Risk management in fly-by-wire systems

    NASA Technical Reports Server (NTRS)

    Knoll, Karyn T.

    1993-01-01

    A general description of various types of fly-by-wire systems is provided. The risks inherent in digital flight control systems, like those used in the Space Shuttle, are identified. The results of a literature survey examining risk management methods in use throughout the aerospace industry are presented. The applicability of these methods to the Space Shuttle program is discussed.

  6. 76 FR 28855 - Defense Federal Acquisition Regulation Supplement; Business Systems-Definition and Administration

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-18

    ... business systems and internal controls are the first line of defense against waste, fraud, and abuse. Weak control systems increase the risk of unallowable and unreasonable costs on Government contracts. To...'s accounting system rather than the adequacy of the contractor's control environment and overall...

  7. SCI Hazard Report Methodology

    NASA Technical Reports Server (NTRS)

    Mitchell, Michael S.

    2010-01-01

    This slide presentation reviews the methodology in creating a Source Control Item (SCI) Hazard Report (HR). The SCI HR provides a system safety risk assessment for the following Ares I Upper Stage Production Contract (USPC) components (1) Pyro Separation Systems (2) Main Propulsion System (3) Reaction and Roll Control Systems (4) Thrust Vector Control System and (5) Ullage Settling Motor System components.

  8. Association between rs2431697 T allele on 5q33.3 and systemic lupus erythematosus: case-control study and meta-analysis.

    PubMed

    Tang, Zhao-Ming; Wang, Ping; Chang, Pan-Pan; Hasahya, Tony; Xing, Hui; Wang, Jin-Ping; Hu, Li-Hua

    2015-11-01

    rs2431697 is located on 5q33.3, between pituitary tumor-transforming gene 1 and miR-146a. Several studies have estimated the association between rs2431697 and systemic lupus erythematosus risk. However, the results were inconsistent. A case-control study was carried out to explore the association between rs2431697 and systemic lupus erythematosus risk in a central Chinese population. Meta-analyses combining present with previous studies were conducted to further explore the association. Our case-control study included 322 cases and 353 controls. rs2431697 T allele was associated with increased risk of systemic lupus erythematosus (odds ratios (ORs) = 1.461, 95% confidence intervals (CI) 1.091-1.957, P = 0.011). The association was stronger between T allele and the risk of anti-double-stranded DNA (dsDNA)-positive systemic lupus erythematosus (OR = 2.510, 95% CI 1.545-4.077, P < 0.001). The meta-analyses included 8648 systemic lupus erythematosus patients and 10947 controls. rs2431697 T allele had an overall OR of 1.262 (95% CI 1.205-1.323, P < 0.001) under fixed-effects model. After stratified by ethnicity, I (2) reduced from 24.3 to 0 %. T allele had an OR of 1.213 (95% CI 1.145-1.284, P < 0.001) in European descendant and 1.365 (95% CI 1.259-1.480, P < 0.001) in Asian under fixed-effects model. Data on women were also extracted, and T allele had an OR of 1.337 (95% CI 1.162-1.539, P < 0.001) under random-effects model. The pooled ORs were not influenced by each study in sensitivity analyses. There were no publication biases observed in these analyses. The results from our case-control study and the meta-analyses indicate that rs2431697 T allele significantly associates with the increased risk of systemic lupus erythematosus.

  9. 75 FR 77645 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Pregnancy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-13

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Pregnancy Risk Assessment... initial review, discussion, and evaluation of ``Pregnancy Risk Assessment Monitoring System (PRAMS), DP11...

  10. [Risks and control of complete market-oriented reforms of medical institutions].

    PubMed

    Ding, Jiannong; Tian, Yongquan

    2014-04-01

    Marketization has become the mainstream since the new public management emerges globally in second half of the 20th century. Some countries infuse private capital into medical institutions which used to be managed by the government originally, and cause the medical industry reforms to be market-oriented. Market-oriented reforms of medical institutions may have risks in the following aspects: the risk of uneven distribution of medical resources, the risk of market failure, the moral risk of government renting-seeking and corruption and the decay of social justice values. Measures of controlling these risks include defining the function orientation of the government, completing the institution-building of healthcare system, improving primary medical system and strengthening social consciousness of hospitals.

  11. 17 CFR 240.17i-4 - Internal risk management control system requirements for supervised investment bank holding...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 17 Commodity and Securities Exchanges 3 2013-04-01 2013-04-01 false Internal risk management control system requirements for supervised investment bank holding companies. 240.17i-4 Section 240.17i-4 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION (CONTINUED) GENERAL RULES AND REGULATIONS, SECURITIES EXCHANGE ACT OF 1934...

  12. 17 CFR 240.17i-4 - Internal risk management control system requirements for supervised investment bank holding...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 17 Commodity and Securities Exchanges 3 2012-04-01 2012-04-01 false Internal risk management control system requirements for supervised investment bank holding companies. 240.17i-4 Section 240.17i-4 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION (CONTINUED) GENERAL RULES AND REGULATIONS, SECURITIES EXCHANGE ACT OF 1934...

  13. Proactive Motor Control Reduces Monetary Risk Taking in Gambling

    PubMed Central

    Adams, Rachel; Chambers, Christopher D.

    2012-01-01

    Less supervision by the executive system after disruption of the right prefrontal cortex leads to increased risk taking in gambling because superficially attractive—but risky—choices are not suppressed. Similarly, people might gamble more in multitask situations than in single-task situations because concurrent executive processes usually interfere with each other. In the study reported here, we used a novel monetary decision-making paradigm to investigate whether multitasking could reduce rather than increase risk taking in gambling. We found that performing a task that induced cautious motor responding reduced gambling in a multitask situation (Experiment 1). We then found that a short period of inhibitory training lessened risk taking in gambling at least 2 hr later (Experiments 2 and 3). Our findings indicate that proactive motor control strongly affects monetary risk taking in gambling. The link between control systems at different cognitive levels might be exploited to develop new methods for rehabilitation of addiction and impulse-control disorders. PMID:22692336

  14. SECURE INTERNET OF THINGS-BASED CLOUD FRAMEWORK TO CONTROL ZIKA VIRUS OUTBREAK.

    PubMed

    Sareen, Sanjay; Sood, Sandeep K; Gupta, Sunil Kumar

    2017-01-01

    Zika virus (ZikaV) is currently one of the most important emerging viruses in the world which has caused outbreaks and epidemics and has also been associated with severe clinical manifestations and congenital malformations. Traditional approaches to combat the ZikaV outbreak are not effective for detection and control. The aim of this study is to propose a cloud-based system to prevent and control the spread of Zika virus disease using integration of mobile phones and Internet of Things (IoT). A Naive Bayesian Network (NBN) is used to diagnose the possibly infected users, and Google Maps Web service is used to provide the geographic positioning system (GPS)-based risk assessment to prevent the outbreak. It is used to represent each ZikaV infected user, mosquito-dense sites, and breeding sites on the Google map that helps the government healthcare authorities to control such risk-prone areas effectively and efficiently. The performance and accuracy of the proposed system are evaluated using dataset for 2 million users. Our system provides high accuracy for initial diagnosis of different users according to their symptoms and appropriate GPS-based risk assessment. The cloud-based proposed system contributed to the accurate NBN-based classification of infected users and accurate identification of risk-prone areas using Google Maps.

  15. Recent acute prerace systemic illness in runners increases the risk of not finishing the race: SAFER study V.

    PubMed

    Gordon, Leigh; Schwellnus, Martin; Swanevelder, Sonja; Jordaan, Esme; Derman, Wayne

    2017-09-01

    There are limited data on the negative effects of exercise in athletes with acute infective illness. The aim of this study was to determine whether a recently diagnosed prerace acute illness in runners affects the ability to finish a race. Runners were prospectively evaluated in the 3 days before the race for acute infective illness and then received participation advice using clinical criteria based on systemic or localised symptoms/signs. We compared the did-not-start and the did-not-finish frequencies of ill runners (Ill=172: localised=58.7%; systemic=41.3%) with that of a control group of runners (Con=53 734). Runners with a systemic illness were 10.4% more likely not to start compared with controls (29.6% vs 19.2%) (p=0.0073). The risk difference of not starting the race in runners who were advised not to run the race compared with controls was 37.3% (56.5% vs 19.2%, p<0.0001). Compared with controls, runners with illness had a significantly (p<0.05) greater risk (any illness (5.2% vs 1.6%), systemic illness (8.0% vs 1.6%), illness <24 hours before the race (11.1% vs 1.6%)) and relative risk (prevalence risk ratio) (any illness=3.4, systemic illness=4.9, systemic illness <24 hours before the race=7.0) of not finishing the race. Runners with prerace acute systemic illness, and particularly those diagnosed <24 hours before race day, are less likely to finish the race, indicating a reduction in race performance. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. NASA's human system risk management approach and its applicability to commercial spaceflight.

    PubMed

    Law, Jennifer; Mathers, Charles H; Fondy, Susan R E; Vanderploeg, James M; Kerstman, Eric L

    2013-01-01

    As planning continues for commercial spaceflight, attention is turned to NASA to assess whether its human system risk management approach can be applied to mitigate the risks associated with commercial suborbital and orbital flights. NASA uses a variety of methods to assess the risks to the human system based on their likelihood and consequences. In this article, we review these methods and categorize the risks in the system as "definite," "possible," or "least" concern for commercial spaceflight. As with career astronauts, these risks will be primarily mitigated by screening and environmental control. Despite its focus on long-duration exploration missions, NASA's human system risk management approach can serve as a preliminary knowledge base to help medical planners prepare for commercial spaceflights.

  17. Today's School Risk Manager

    ERIC Educational Resources Information Center

    Johnson, Cheryl P.; Levering, Steve

    2009-01-01

    School districts are held accountable not only for the monies that contribute to the education system but also for mitigating any issues that threaten student learning. Some school districts are fortunate to have professional risk managers on staff who can identify and control the many risks that are unique to school systems. Most schools,…

  18. 76 FR 5379 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Pregnancy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-31

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Pregnancy Risk Assessment..., discussion, and evaluation of ``Pregnancy Risk Assessment Monitoring System (PRAMS), DP11-001 Panels A, B...

  19. Modelling the ability of source control measures to reduce inundation risk in a community-scale urban drainage system

    NASA Astrophysics Data System (ADS)

    Mei, Chao; Liu, Jiahong; Wang, Hao; Shao, Weiwei; Xia, Lin; Xiang, Chenyao; Zhou, Jinjun

    2018-06-01

    Urban inundation is a serious challenge that increasingly confronts the residents of many cities, as well as policymakers, in the context of rapid urbanization and climate change worldwide. In recent years, source control measures (SCMs) such as green roofs, permeable pavements, rain gardens, and vegetative swales have been implemented to address flood inundation in urban settings, and proven to be cost-effective and sustainable. In order to investigate the ability of SCMs on reducing inundation in a community-scale urban drainage system, a dynamic rainfall-runoff model of a community-scale urban drainage system was developed based on SWMM. SCMs implementing scenarios were modelled under six design rainstorm events with return period ranging from 2 to 100 years, and inundation risks of the drainage system were evaluated before and after the proposed implementation of SCMs, with a risk-evaluation method based on SWMM and analytic hierarchy process (AHP). Results show that, SCMs implementation resulting in significantly reduction of hydrological indexes that related to inundation risks, range of reduction rates of average flow, peak flow, and total flooded volume of the drainage system were 28.1-72.1, 19.0-69.2, and 33.9-56.0 %, respectively, under six rainfall events with return periods ranging from 2 to 100 years. Corresponding, the inundation risks of the drainage system were significantly reduced after SCMs implementation, the risk values falling below 0.2 when the rainfall return period was less than 10 years. Simulation results confirm the effectiveness of SCMs on mitigating inundation, and quantified the potential of SCMs on reducing inundation risks in the urban drainage system, which provided scientific references for implementing SCMs for inundation control of the study area.

  20. Vehicle rollover risk and electronic stability control systems.

    PubMed

    MacLennan, P A; Marshall, T; Griffin, R; Purcell, M; McGwin, G; Rue, L W

    2008-06-01

    Electronic stability control (ESC) systems were developed to reduce motor vehicle collisions (MVCs) caused by loss of control. Introduced in Europe in 1995 and in the USA in 1996, ESC is designed to improve vehicle lateral stability by electronically detecting and automatically assisting drivers in unfavorable situations. To examine the relationship between vehicle rollover risk and presence of ESC using a large national database of MVCs. A retrospective cohort study for the period 1995 through 2006 was carried out using data obtained from the National Automotive Sampling System General Estimates System. All passenger cars and sport utility vehicles (SUVs)/vans of model year 1996 and later were eligible. Vehicle ESC (unavailable, optional, standard) was determined on the basis of make, model, and model year. Risk ratios (RRs) and 95% CIs were calculated to compare rollover risk by vehicle ESC group. For all crashes, vehicles equipped with standard ESC had decreased risk of rollover (RR = 0.62, 95% CI 0.50 to 0.77) compared with vehicles with ESC unavailable. The association was consistent for single-vehicle MVCs (RR = 0.61, 95% CI 0.46 to 0.82); passenger cars had decreased rollover risk (RR = 0.77, 95% CI 0.52 to 1.12), but SUVs/vans had a more dramatically decreased risk (RR = 0.40, 95% CI 0.26 to 0.61). This study supports previous results showing ESC to be effective in reducing the risk of rollover. ESC is more effective in SUVs/vans for rollovers related to single-vehicle MVCs.

  1. Risk Assessment and Control through Countermeasure System Iplementation for Long-term Crew Exposure to Microgravity

    NASA Technical Reports Server (NTRS)

    Gernand, Jeremy M.

    2004-01-01

    Experience with the International Space Station (ISS) program demonstrates the degree to which engineering design and operational solutions must protect crewmembers from health risks due to long-term exposure to the microgravity environment. Risks to safety and health due to degradation in the microgravity environment include crew inability to complete emergency or nominal activities, increased risk of injury, and inability to complete safe return to the ground due to reduced strength or embrittled bones. These risks without controls slowly increase in probability for the length of the mission and become more significant for increasing mission durations. Countermeasures to microgravity include hardware systems that place a crewmember s body under elevated stress to produce an effect similar to daily exposure to gravity. The ISS countermeasure system is predominately composed of customized exercise machines. Historical treatment of microgravity countermeasure systems as medical research experiments unintentionally reduced the foreseen importance and therefore the capability of the systems to function in a long-term operational role. Long-term hazardous effects and steadily increasing operational risks due to non-functional countermeasure equipment require a more rigorous design approach and incorporation of redundancy into seemingly non- mission-critical hardware systems. Variations in the rate of health degradation and responsiveness to countermeasures among the crew population drastically increase the challenge for design requirements development and verification of the appropriate risk control strategy. The long-term nature of the hazards and severe limits on logistical re-supply mass, volume and frequency complicates assessment of hardware availability and verification of an adequate maintenance and sparing plan. Design achievement of medically defined performance requirements by microgravity countermeasure systems and incorporation of adequate failure tolerance significantly reduces these risks. Future implementation of on-site monitoring hardware for critical health parameters such as bone mineral density would allow greater responsiveness, efficiency, and optimized design of the countermeasures system.

  2. Full-Scaled Advanced Systems Testbed: Ensuring Success of Adaptive Control Research Through Project Lifecycle Risk Mitigation

    NASA Technical Reports Server (NTRS)

    Pavlock, Kate M.

    2011-01-01

    The National Aeronautics and Space Administration's Dryden Flight Research Center completed flight testing of adaptive controls research on the Full-Scale Advance Systems Testbed (FAST) in January of 2011. The research addressed technical challenges involved with reducing risk in an increasingly complex and dynamic national airspace. Specific challenges lie with the development of validated, multidisciplinary, integrated aircraft control design tools and techniques to enable safe flight in the presence of adverse conditions such as structural damage, control surface failures, or aerodynamic upsets. The testbed is an F-18 aircraft serving as a full-scale vehicle to test and validate adaptive flight control research and lends a significant confidence to the development, maturation, and acceptance process of incorporating adaptive control laws into follow-on research and the operational environment. The experimental systems integrated into FAST were designed to allow for flexible yet safe flight test evaluation and validation of modern adaptive control technologies and revolve around two major hardware upgrades: the modification of Production Support Flight Control Computers (PSFCC) and integration of two, fourth-generation Airborne Research Test Systems (ARTS). Post-hardware integration verification and validation provided the foundation for safe flight test of Nonlinear Dynamic Inversion and Model Reference Aircraft Control adaptive control law experiments. To ensure success of flight in terms of cost, schedule, and test results, emphasis on risk management was incorporated into early stages of design and flight test planning and continued through the execution of each flight test mission. Specific consideration was made to incorporate safety features within the hardware and software to alleviate user demands as well as into test processes and training to reduce human factor impacts to safe and successful flight test. This paper describes the research configuration, experiment functionality, overall risk mitigation, flight test approach and results, and lessons learned of adaptive controls research of the Full-Scale Advanced Systems Testbed.

  3. Effect of balance training on postural balance control and risk of fall in children with diplegic cerebral palsy.

    PubMed

    El-Shamy, Shamekh Mohamed; Abd El Kafy, Ehab Mohamed

    2014-01-01

    The purpose of this study was to evaluate the effects of balance training on postural control and fall risk in children with diplegic cerebral palsy. Thirty spastic diplegic cerebral palsied children (10-12 years) were included in this study. Children were randomly assigned into two equal-sized groups: control and study groups. Participants in both groups received a traditional physical therapy exercise program. The study group additionally received balance training on the Biodex balance system. Treatment was provided 30 min/d, 3 d/week for 3 successive months. To evaluate the limit of stability and fall risk, participated children received baseline and post-treatment assessments using the Biodex balance system. Overall directional control, total time to complete the test, overall stability index of the fall risk test and total score of the pediatric balance scale were measured. Children in both groups showed significant improvements in the mean values of all measured variables post-treatment (p < 0.05). The results also showed significantly better improvement in the measured parameters for the study group, as compared to the control group (p < 0.05). Balance training on Biodex system is a useful tool that can be used in improving postural balance control in children with diplegic cerebral palsy.

  4. 17 CFR 240.15c3-4 - Internal risk management control systems for OTC derivatives dealers.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 17 Commodity and Securities Exchanges 4 2014-04-01 2014-04-01 false Internal risk management control systems for OTC derivatives dealers. 240.15c3-4 Section 240.15c3-4 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION (CONTINUED) GENERAL RULES AND REGULATIONS, SECURITIES EXCHANGE ACT OF 1934 Rules and Regulations Under the...

  5. Cyber security risk assessment for SCADA and DCS networks.

    PubMed

    Ralston, P A S; Graham, J H; Hieb, J L

    2007-10-01

    The growing dependence of critical infrastructures and industrial automation on interconnected physical and cyber-based control systems has resulted in a growing and previously unforeseen cyber security threat to supervisory control and data acquisition (SCADA) and distributed control systems (DCSs). It is critical that engineers and managers understand these issues and know how to locate the information they need. This paper provides a broad overview of cyber security and risk assessment for SCADA and DCS, introduces the main industry organizations and government groups working in this area, and gives a comprehensive review of the literature to date. Major concepts related to the risk assessment methods are introduced with references cited for more detail. Included are risk assessment methods such as HHM, IIM, and RFRM which have been applied successfully to SCADA systems with many interdependencies and have highlighted the need for quantifiable metrics. Presented in broad terms is probability risk analysis (PRA) which includes methods such as FTA, ETA, and FEMA. The paper concludes with a general discussion of two recent methods (one based on compromise graphs and one on augmented vulnerability trees) that quantitatively determine the probability of an attack, the impact of the attack, and the reduction in risk associated with a particular countermeasure.

  6. Does tight control of systemic factors help in the management of diabetic retinopathy?

    PubMed Central

    Rajalakshmi, Ramachandran; Prathiba, Vijayaraghavan; Mohan, Viswanathan

    2016-01-01

    Diabetic retinopathy (DR), one of the leading causes of preventable blindness, is associated with many systemic factors that contribute to the development and progression of this microvascular complication of diabetes. While the duration of diabetes is the major risk factor for the development of DR, the main modifiable systemic risk factors for development and progression of DR are hyperglycemia, hypertension, and dyslipidemia. This review article looks at the evidence that control of these systemic factors has significant benefits in delaying the onset and progression of DR. PMID:26953026

  7. Toward Automating Web Protocol Configuration for a Programmable Logic Controller Emulator

    DTIC Science & Technology

    2014-06-19

    Security Risks for Industrial Control Systems ,” VDE 2004 Congress, Berlin, Germany, October 2004, pp. 1-7. [Cis12] Cisco, NetFlow Configuration Guide...Date 29 May 2014 Date AFIT-ENG-T-14-J-4 Abstract Industrial Control Systems (ICS) remain vulnerable through attack vectors that exist within programmable...5 2.2 Industrial Control Systems

  8. Temperature diagnostic to identify high risk areas and optimize Legionella pneumophila surveillance in hot water distribution systems.

    PubMed

    Bédard, Emilie; Fey, Stéphanie; Charron, Dominique; Lalancette, Cindy; Cantin, Philippe; Dolcé, Patrick; Laferrière, Céline; Déziel, Eric; Prévost, Michèle

    2015-03-15

    Legionella pneumophila is frequently detected in hot water distribution systems and thermal control is a common measure implemented by health care facilities. A risk assessment based on water temperature profiling and temperature distribution within the network is proposed, to guide effective monitoring strategies and allow the identification of high risk areas. Temperature and heat loss at control points (water heater, recirculation, representative points-of-use) were monitored in various sections of five health care facilities hot water distribution systems and results used to develop a temperature-based risk assessment tool. Detailed investigations show that defective return valves in faucets can cause widespread temperature losses because of hot and cold water mixing. Systems in which water temperature coming out of the water heaters was kept consistently above 60 °C and maintained above 55 °C across the network were negative for Legionella by culture or qPCR. For systems not meeting these temperature criteria, risk areas for L. pneumophila were identified using temperature profiling and system's characterization; higher risk was confirmed by more frequent microbiological detection by culture and qPCR. Results confirmed that maintaining sufficiently high temperatures within hot water distribution systems suppressed L. pneumophila culturability. However, the risk remains as shown by the persistence of L. pneumophila by qPCR. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. In regulation we trust.

    PubMed

    Wiig, Siri; Tharaldsen, Jorunn Elise

    2012-01-01

    The role of trust has been argued to play an increasingly important role in modern, complex, and ambivalent risk societies. Trust within organizational research is anticipated to have a general strategic impact on aspects such as organizational performance, communication and knowledge exchange, and learning from accidents. Trust is also an important aspect related to regulation of risk. Diverse regulatory regimes, their contexts and risks influence regulators use of trust and distrust in regulatory practice. The aim of this paper is to discuss the relationship between risk regulation and trust across diverse risk regulation regimes. By drawing from studies of risk regulation, risk perception, and trust the purpose is to discuss how regulation and trust are linked and used in practice to control risk across system levels in socio-technical systems in high risk industries. This paper provides new knowledge on 1) how functional and dysfunctional trust and distrust are grounded in the empirical realities of high risk industries, 2) how different perspectives on trust and distrust act together and bring new knowledge on how society control risk.

  10. Application and Evaluation of Control Modes for Risk-Based Engine Performance Enhancements

    NASA Technical Reports Server (NTRS)

    Liu, Yuan; Litt, Jonathan S.; Sowers, T. Shane; Owen, A. Karl (Compiler); Guo, Ten-Huei

    2014-01-01

    The engine control system for civil transport aircraft imposes operational limits on the propulsion system to ensure compliance with safety standards. However, during certain emergency situations, aircraft survivability may benefit from engine performance beyond its normal limits despite the increased risk of failure. Accordingly, control modes were developed to improve the maximum thrust output and responsiveness of a generic high-bypass turbofan engine. The algorithms were designed such that the enhanced performance would always constitute an elevation in failure risk to a consistent predefined likelihood. This paper presents an application of these risk-based control modes to a combined engine/aircraft model. Through computer and piloted simulation tests, the aim is to present a notional implementation of these modes, evaluate their effects on a generic airframe, and demonstrate their usefulness during emergency flight situations. Results show that minimal control effort is required to compensate for the changes in flight dynamics due to control mode activation. The benefits gained from enhanced engine performance for various runway incursion scenarios are investigated. Finally, the control modes are shown to protect against potential instabilities during propulsion-only flight where all aircraft control surfaces are inoperable.

  11. Application and Evaluation of Control Modes for Risk-Based Engine Performance Enhancements

    NASA Technical Reports Server (NTRS)

    Liu, Yuan; Litt, Jonathan S.; Sowers, T. Shane; Owen, A. Karl; Guo, Ten-Huei

    2015-01-01

    The engine control system for civil transport aircraft imposes operational limits on the propulsion system to ensure compliance with safety standards. However, during certain emergency situations, aircraft survivability may benefit from engine performance beyond its normal limits despite the increased risk of failure. Accordingly, control modes were developed to improve the maximum thrust output and responsiveness of a generic high-bypass turbofan engine. The algorithms were designed such that the enhanced performance would always constitute an elevation in failure risk to a consistent predefined likelihood. This paper presents an application of these risk-based control modes to a combined engine/aircraft model. Through computer and piloted simulation tests, the aim is to present a notional implementation of these modes, evaluate their effects on a generic airframe, and demonstrate their usefulness during emergency flight situations. Results show that minimal control effort is required to compensate for the changes in flight dynamics due to control mode activation. The benefits gained from enhanced engine performance for various runway incursion scenarios are investigated. Finally, the control modes are shown to protect against potential instabilities during propulsion-only flight where all aircraft control surfaces are inoperable.

  12. Perceptions of risk, risk aversion, and barriers to adoption of decision support systems and integrated pest management: An introduction

    USDA-ARS?s Scientific Manuscript database

    Rational management of plant diseases, both economically and environmentally, involves assessing risks and the costs associated with both correct and incorrect management decisions to determine when control measures are warranted. Decision support systems can help to inform users of plant disease r...

  13. [Assessment of cardiovascular risk in population groups. Comparison of Score system and Framingham in hypertensive patients].

    PubMed

    Cosín Aguilar, J; Hernándiz Martínez, A; Rodríguez Padial, L; Zamorano Gómez, J L; Arístegui Urrestarazu, R; Armada Peláez, B; Aguilar Llopis, A; Masramon Morell, X

    2006-04-01

    Calculation of cardiovascular risk in populations allows for developing and assessing of intervention programs and adapting health resources. While the Framingham System has been used in the past, a group of European researchers have proposed a different method called the Score project. The purpose of this paper is to compare the value of both methods for assessing cardiovascular risk. In 6,775 evaluable hypertensive patients distributed over the 17 Spanish autonomous communities (ACs), the 10-year risk of experiencing a coronary event (CR) was calculated using the Framingham equation, while risk of coronary death (RCD) and vascular death (RVD) was calculated using the Score project system, both at baseline and after one year of blood pressure control with amlodipine at the required dose. A comparison was made of the capacity to detect risk differences by both methods between populations with known different risks, and in the same population as a result of blood pressure control. Both the Score and the Framingham systems detected the significant decrease in both CR and RCD or RVD at one year of application of the CORONARIA study protocol. Risk decrease measured by any of the two methods was significant (p < 0.05) overall, by genders, and by ACs. However, the Score System, unlike the Framingham system, could not detect the reported differences in the mortality risk for coronary and vascular disease between the ACs of the North and the South-East parts of Spain.

  14. Application of a risk management system to improve drinking water safety.

    PubMed

    Jayaratne, Asoka

    2008-12-01

    The use of a comprehensive risk management framework is considered a very effective means of managing water quality risks. There are many risk-based systems available to water utilities such as ISO 9001 and Hazard Analysis and Critical Control Point (HACCP). In 2004, the World Health Organization's (WHO) Guidelines for Drinking Water Quality recommended the use of preventive risk management approaches to manage water quality risks. This paper describes the framework adopted by Yarra Valley Water for the development of its Drinking Water Quality Risk Management Plan incorporating HACCP and ISO 9001 systems and demonstrates benefits of Water Safety Plans such as HACCP. Copyright IWA Publishing 2008.

  15. Industrial Control Systems/SCADA systems risk assessment in the energy sector

    NASA Astrophysics Data System (ADS)

    Falodun, Babatunde

    The energy sector is one of the most critical components of our national infrastructure. It not only provides the electrical power and petroleum required to run day-to-day operations and mechanisms in society, it's also an important element that directly impacts the economy with regard to growth and stability. Industrial Control Systems (ICS) /Supervisory Control and Data Acquisition Systems (SCADA) are computerized mechanisms, they are both software and hardware that are used to control real time processes and operations in power plants and oil production facilities. A significant attack on these control systems that leads to widespread disruption of energy could result in catastrophic consequences for any major city and even the nation. This research paper explores cyber threats and vulnerabilities faced by ICS/SCADA systems in the energy sector and also highlights possible outcomes of a successful breach. Furthermore, the research underscores mitigation strategies that could be used to prevent and respond to an attack. Keywords: Cybersecurity, SCADA, Cyber Attacks, Threats, Vulnerabilities, Risk Assessment, Dr. Albert Orbinati.

  16. The Role and Quality of Software Safety in the NASA Constellation Program

    NASA Technical Reports Server (NTRS)

    Layman, Lucas; Basili, Victor R.; Zelkowitz, Marvin V.

    2010-01-01

    In this study, we examine software safety risk in the early design phase of the NASA Constellation spaceflight program. Obtaining an accurate, program-wide picture of software safety risk is difficult across multiple, independently-developing systems. We leverage one source of safety information, hazard analysis, to provide NASA quality assurance managers with information regarding the ongoing state of software safety across the program. The goal of this research is two-fold: 1) to quantify the relative importance of software with respect to system safety; and 2) to quantify the level of risk presented by software in the hazard analysis. We examined 154 hazard reports created during the preliminary design phase of three major flight hardware systems within the Constellation program. To quantify the importance of software, we collected metrics based on the number of software-related causes and controls of hazardous conditions. To quantify the level of risk presented by software, we created a metric scheme to measure the specificity of these software causes. We found that from 49-70% of hazardous conditions in the three systems could be caused by software or software was involved in the prevention of the hazardous condition. We also found that 12-17% of the 2013 hazard causes involved software, and that 23-29% of all causes had a software control. Furthermore, 10-12% of all controls were software-based. There is potential for inaccuracy in these counts, however, as software causes are not consistently scoped, and the presence of software in a cause or control is not always clear. The application of our software specificity metrics also identified risks in the hazard reporting process. In particular, we found a number of traceability risks in the hazard reports may impede verification of software and system safety.

  17. Montana Youth Risk Behavior Survey Report, 2005 for Alternative Schools Students: Statewide Analysis of Selected Behavior Risk Factors

    ERIC Educational Resources Information Center

    Montana Office of Public Instruction, 2005

    2005-01-01

    The Youth Risk Behavior Surveillance System is an epidemiologic surveillance system that was established by the U.S. Centers for Disease Control and Prevention (CDC) to help monitor the prevalence of behaviors that not only influence youth health, but also put youth at risk for the most significant health and social problems that can occur during…

  18. Montana Youth Risk Behavior Survey Report, 2005 for Students with Disabilities: Statewide Analysis of Selected Behavior Risk Factors

    ERIC Educational Resources Information Center

    Montana Office of Public Instruction, 2005

    2005-01-01

    The Youth Risk Behavior Surveillance System is an epidemiologic surveillance system that was established by the U.S. Centers for Disease Control and Prevention (CDC) to help monitor the prevalence of behaviors that not only influence youth health, but also put youth at risk for the most significant health and social problems that can occur during…

  19. Montana Youth Risk Behavior Survey Report, 2005 for Grades 7-8: Statewide Analysis of Selected Behavior Risk Factors

    ERIC Educational Resources Information Center

    Montana Office of Public Instruction, 2005

    2005-01-01

    The Youth Risk Behavior Surveillance System is an epidemiologic surveillance system that was established by the U.S. Centers for Disease Control and Prevention (CDC) to help monitor the prevalence of behaviors that not only influence youth health, but also put youth at risk for the most significant health and social problems that can occur during…

  20. Flood risk analysis for flood control and sediment transportation in sandy regions: A case study in the Loess Plateau, China

    NASA Astrophysics Data System (ADS)

    Guo, Aijun; Chang, Jianxia; Wang, Yimin; Huang, Qiang; Zhou, Shuai

    2018-05-01

    Traditional flood risk analysis focuses on the probability of flood events exceeding the design flood of downstream hydraulic structures while neglecting the influence of sedimentation in river channels on regional flood control systems. This work advances traditional flood risk analysis by proposing a univariate and copula-based bivariate hydrological risk framework which incorporates both flood control and sediment transport. In developing the framework, the conditional probabilities of different flood events under various extreme precipitation scenarios are estimated by exploiting the copula-based model. Moreover, a Monte Carlo-based algorithm is designed to quantify the sampling uncertainty associated with univariate and bivariate hydrological risk analyses. Two catchments located on the Loess plateau are selected as study regions: the upper catchments of the Xianyang and Huaxian stations (denoted as UCX and UCH, respectively). The univariate and bivariate return periods, risk and reliability in the context of uncertainty for the purposes of flood control and sediment transport are assessed for the study regions. The results indicate that sedimentation triggers higher risks of damaging the safety of local flood control systems compared with the event that AMF exceeds the design flood of downstream hydraulic structures in the UCX and UCH. Moreover, there is considerable sampling uncertainty affecting the univariate and bivariate hydrologic risk evaluation, which greatly challenges measures of future flood mitigation. In addition, results also confirm that the developed framework can estimate conditional probabilities associated with different flood events under various extreme precipitation scenarios aiming for flood control and sediment transport. The proposed hydrological risk framework offers a promising technical reference for flood risk analysis in sandy regions worldwide.

  1. Lack of any association between insertion/deletion (I/D) polymorphisms in the angiotensin-converting enzyme gene and digestive system cancer risk: a meta-analysis.

    PubMed

    Liu, Jin-Fei; Xie, Hao-Jun; Cheng, Tian-Ming

    2013-01-01

    To investigate the association between the gene polymorphisms of angiotensin-converting enzyme (ACE) and digestive system cancer risk. A search was performed in Pubmed, Medline, ISI Web of Science and Chinese Biomedical (CBM) databases, covering all studies until Sep 1st, 2013. Statistical analysis was performed by using Revman5.2 and STATA 12.0. A total of 15 case-control studies comprising 2,390 digestive system cancer patients and 9,706 controls were identified. No significant association was found between the I/D polymorphism and digestive cancer risk (OR =0.93, 95%CI = (0.75, 1.16), P =0.53 for DD+DI vs. II). In the subgroup analysis by ethnicity and cancer type, no significant associations were found for the comparison of DD+DI vs. II. Results from other comparative genetic models also indicated a lack of associations between this polymorphism and digestive system cancer risks. This meta-analysis suggested that the ACE D/I polymorphism might not contribute to the risk of digestive system cancer.

  2. Cost effective management of space venture risks

    NASA Technical Reports Server (NTRS)

    Giuntini, Ronald E.; Storm, Richard E.

    1986-01-01

    The development of a model for the cost-effective management of space venture risks is discussed. The risk assessment and control program of insurance companies is examined. A simplified system development cycle which consists of a conceptual design phase, a preliminary design phase, a final design phase, a construction phase, and a system operations and maintenance phase is described. The model incorporates insurance safety risk methods and reliability engineering, and testing practices used in the development of large aerospace and defense systems.

  3. Wallops Ship Surveillance System

    NASA Technical Reports Server (NTRS)

    Smith, Donna C.

    2011-01-01

    Approved as a Wallops control center backup system, the Wallops Ship Surveillance Software is a day-of-launch risk analysis tool for spaceport activities. The system calculates impact probabilities and displays ship locations relative to boundary lines. It enables rapid analysis of possible flight paths to preclude the need to cancel launches and allow execution of launches in a timely manner. Its design is based on low-cost, large-customer- base elements including personal computers, the Windows operating system, C/C++ object-oriented software, and network interfaces. In conformance with the NASA software safety standard, the system is designed to ensure that it does not falsely report a safe-for-launch condition. To improve the current ship surveillance method, the system is designed to prevent delay of launch under a safe-for-launch condition. A single workstation is designated the controller of the official ship information and the official risk analysis. Copies of this information are shared with other networked workstations. The program design is divided into five subsystems areas: 1. Communication Link -- threads that control the networking of workstations; 2. Contact List -- a thread that controls a list of protected item (ocean vessel) information; 3. Hazard List -- threads that control a list of hazardous item (debris) information and associated risk calculation information; 4. Display -- threads that control operator inputs and screen display outputs; and 5. Archive -- a thread that controls archive file read and write access. Currently, most of the hazard list thread and parts of other threads are being reused as part of a new ship surveillance system, under the SureTrak project.

  4. The -765G>C polymorphism in the cyclooxygenase-2 gene and digestive system cancer: a meta-analysis.

    PubMed

    Zhao, Fen; Cao, Yue; Zhu, Hong; Huang, Min; Yi, Cheng; Huang, Ying

    2014-01-01

    Published data regarding associations between the -765G>C polymorphism in cyclooxygenase-2 (COX-2) gene and digestive system cancer risk have been inconclusive. The aim of this study was to comprehensively evaluate the genetic risk of the -765G>C polymorphism in the COX-2 gene for digestive system cancer. A search was performed in Pubmed, Medline (Ovid), Embase, CNKI, Weipu, Wanfang and CBM databases, covering all studies until Feb 10, 2014. Statistical analysis was performed using Revman5.2. A total of 10,814 cases and 16,174 controls in 38 case-control studies were included in this meta-analysis. The results indicated that C allele carriers (GC+CC) had a 20% increased risk of digestive system cancer when compared with the homozygote GG (odds ratio (OR)=1.20, 95% confidence interval (CI), 1.00-1.44 for GC+CC vs GG). In the subgroup analysis by ethnicity, significant elevated risks were associated with C allele carriers (GC+CC) in Asians (OR = 1.46, 95% CI=1.07-2.01, and p=0.02) and Africans (OR=2.12, 95% CI=1.57-2.87, and p< 0.00001), but not among Caucasians, Americans and mixed groups. For subgroup analysis by cancer type (GC+CC vs GG), significant associations were found between the -765G>C polymorphism and higher risk for gastric cancer (OR=1.64, 95% CI=1.03-2.61, and p=0.04), but not for colorectal cancer, oral cancer, esophageal cancer, and others. Regarding study design (GC+CC vs GG), no significant associations were found in then population-based case-control (PCC), hospital-based case-control (HCC) and family-based case-control (FCC) studies. This meta-analysis suggested that the -765G>C polymorphism of the COX-2 gene is a potential risk factor for digestive system cancer in Asians and Africans and gastric cancer overall.

  5. 75 FR 30077 - Advisory Committee On Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee On Digital I&C...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-28

    ... Subcommittee On Digital I&C Systems The ACRS Subcommittee on Digital Instrumentation and Control (DI&C) Systems... the area of Digital Instrumentation and Control (DI&C) Probabilistic Risk Assessment (PRA). Topics... software reliability methods (QSRMs), NUREG/CR--6997, ``Modeling a Digital Feedwater Control System Using...

  6. 78 FR 53181 - Self-Regulatory Organizations; New York Stock Exchange LLC; Order Approving Proposed Rule Change...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-28

    ... process of upgrading their accounting systems and internal controls and hiring additional staff to meet... thereunder, that require registered companies to devise and maintain a system of internal accounting controls... company's risk management processes and system of internal control. A listed company may choose to...

  7. The Interaction Between Punishment Sensitivity and Effortful Control for Emerging Adults' Substance Use Behaviors.

    PubMed

    Kahn, Rachel E; Chiu, Pearl H; Deater-Deckard, Kirby; Hochgraf, Anna K; King-Casas, Brooks; Kim-Spoon, Jungmeen

    2018-01-08

    Within the dual systems perspective, high reward sensitivity and low punishment sensitivity in conjunction with deficits in cognitive control may contribute to high levels of risk taking, such as substance use. The current study examined whether the individual components of effortful control (inhibitory control, attentional control, and activation control) serve as regulators and moderate the association between reward or punishment sensitivity and substance use behaviors. A total of 1,808 emerging adults from a university setting (Mean age = 19.48; 72% female) completed self-report measures of reward and punishment sensitivity, effortful control, and substance use. Findings indicated significant two-way interactions for punishment sensitivity and inhibitory control for alcohol and marijuana use. The form of these interactions revealed a significant negative association between punishment sensitivity and alcohol and marijuana use at low levels of inhibitory control. No significant interactions emerged for reward sensitivity or other components of effortful control. The current findings provide preliminary evidence suggesting the dual systems theorized to influence risk taking behavior interact to make joint contributions to health risk behaviors such as substance use in emerging adults.

  8. Best Practices for Audit and Financial Advisory Committees Within the Department of Defense

    DTIC Science & Technology

    2007-12-06

    oversight of an organization’s annual financial statement audit, risk management plan, internal control framework, and compliance with external...is generally responsible for providing independent oversight of an organization’s annual financial statement audit, risk management plan, internal...achieving financial management objectives and identify areas of risk or concern. 40 11.2. Systems of Internal Controls

  9. Trends in the prevalence, awareness, treatment, and control of cardiovascular risk factors across educational level in the 1995-2005 period.

    PubMed

    Redondo, Ana; Benach, Joan; Subirana, Isaac; Martinez, José Miguel; Muñoz, Miguel Angel; Masiá, Rafel; Ramos, Rafael; Sala, Joan; Marrugat, Jaume; Elosua, Roberto

    2011-08-01

    To determine the differences and trends in the prevalence, awareness, treatment and control of cardiovascular risk factors and lifestyle variables across educational level in the 1995-2005 period in a country with a universal free health care system. Data from three consecutive independent population-based surveys were used. Cardiovascular risk factors, lifestyle variables, and self-reported educational level were collected in 9646 individuals ages 35-74 years throughout the decade. The prevalence of hypertension and diabetes was inversely associated with education. An increase in the proportion of hypertension and dyslipidemia awareness, treatment, and control in all educational level groups was observed. This increase was greater among the lowest education group, reducing the disparities between groups. The prevalence of lifestyle-related risk factors decreased in the greatest but increased in the lowest education group, widening the disparities between groups. A universal free health care system is effective in avoiding inequalities in the diagnosis, treatment, and control of cardiovascular risk factors. However, other social determinants seem to explain the social inequalities in the prevalence of these risk factors and in the adoption of healthy lifestyles. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. An integrated optimization method for river water quality management and risk analysis in a rural system.

    PubMed

    Liu, J; Li, Y P; Huang, G H; Zeng, X T; Nie, S

    2016-01-01

    In this study, an interval-stochastic-based risk analysis (RSRA) method is developed for supporting river water quality management in a rural system under uncertainty (i.e., uncertainties exist in a number of system components as well as their interrelationships). The RSRA method is effective in risk management and policy analysis, particularly when the inputs (such as allowable pollutant discharge and pollutant discharge rate) are expressed as probability distributions and interval values. Moreover, decision-makers' attitudes towards system risk can be reflected using a restricted resource measure by controlling the variability of the recourse cost. The RSRA method is then applied to a real case of water quality management in the Heshui River Basin (a rural area of China), where chemical oxygen demand (COD), total nitrogen (TN), total phosphorus (TP), and soil loss are selected as major indicators to identify the water pollution control strategies. Results reveal that uncertainties and risk attitudes have significant effects on both pollutant discharge and system benefit. A high risk measure level can lead to a reduced system benefit; however, this reduction also corresponds to raised system reliability. Results also disclose that (a) agriculture is the dominant contributor to soil loss, TN, and TP loads, and abatement actions should be mainly carried out for paddy and dry farms; (b) livestock husbandry is the main COD discharger, and abatement measures should be mainly conducted for poultry farm; (c) fishery accounts for a high percentage of TN, TP, and COD discharges but a has low percentage of overall net benefit, and it may be beneficial to cease fishery activities in the basin. The findings can facilitate the local authority in identifying desired pollution control strategies with the tradeoff between socioeconomic development and environmental sustainability.

  11. Inventory Control System for a Healthcare Apparel Service Centre with Stockout Risk: A Case Analysis

    PubMed Central

    Hui, Chi-Leung

    2017-01-01

    Based on the real-world inventory control problem of a capacitated healthcare apparel service centre in Hong Kong which provides tailor-made apparel-making services for the elderly and disabled people, this paper studies a partial backordered continuous review inventory control problem in which the product demand follows a Poisson process with a constant lead time. The system is controlled by an (Q,r) inventory policy which incorporate the stockout risk, storage capacity, and partial backlog. The healthcare apparel service centre, under the capacity constraint, aims to minimize the inventory cost and achieving a low stockout risk. To address this challenge, an optimization problem is constructed. A real case-based data analysis is conducted, and the result shows that the expected total cost on an order cycle is reduced substantially at around 20% with our proposed optimal inventory control policy. An extensive sensitivity analysis is conducted to generate additional insights. PMID:29527283

  12. Inventory Control System for a Healthcare Apparel Service Centre with Stockout Risk: A Case Analysis.

    PubMed

    Pan, An; Hui, Chi-Leung

    2017-01-01

    Based on the real-world inventory control problem of a capacitated healthcare apparel service centre in Hong Kong which provides tailor-made apparel-making services for the elderly and disabled people, this paper studies a partial backordered continuous review inventory control problem in which the product demand follows a Poisson process with a constant lead time. The system is controlled by an ( Q , r ) inventory policy which incorporate the stockout risk, storage capacity, and partial backlog. The healthcare apparel service centre, under the capacity constraint, aims to minimize the inventory cost and achieving a low stockout risk. To address this challenge, an optimization problem is constructed. A real case-based data analysis is conducted, and the result shows that the expected total cost on an order cycle is reduced substantially at around 20% with our proposed optimal inventory control policy. An extensive sensitivity analysis is conducted to generate additional insights.

  13. A Risk Management Architecture for Emergency Integrated Aircraft Control

    NASA Technical Reports Server (NTRS)

    McGlynn, Gregory E.; Litt, Jonathan S.; Lemon, Kimberly A.; Csank, Jeffrey T.

    2011-01-01

    Enhanced engine operation--operation that is beyond normal limits--has the potential to improve the adaptability and safety of aircraft in emergency situations. Intelligent use of enhanced engine operation to improve the handling qualities of the aircraft requires sophisticated risk estimation techniques and a risk management system that spans the flight and propulsion controllers. In this paper, an architecture that weighs the risks of the emergency and of possible engine performance enhancements to reduce overall risk to the aircraft is described. Two examples of emergency situations are presented to demonstrate the interaction between the flight and propulsion controllers to facilitate the enhanced operation.

  14. Research on Risk Management and Power Supplying Enterprise Control

    NASA Astrophysics Data System (ADS)

    Shen, Jianfei; Wang, Yige

    2017-09-01

    This paper derived from the background that electric power enterprises strengthen their risk management under requirements of the government. For the power industry, we explained the risk management theory, analysed current macro environment as well as basic situation, then classified and interpreted the main risks. In a case study on a power bureau, we established a risk management system based on deep understanding about the characteristics of its organization system and risk management function. Then, we focused on risks in operation as well as incorrupt government construction to give a more effective framework of the risk management system. Finally, we came up with the problems and specific countermeasures in risk management, which provided a reference for other electric power enterprises.

  15. Montana Youth Risk Behavior Survey Report, 2005 for American Indian Students in Urban Schools: Statewide Analysis of Selected Behavior Risk Factors

    ERIC Educational Resources Information Center

    Montana Office of Public Instruction, 2005

    2005-01-01

    The Youth Risk Behavior Surveillance System is an epidemiologic surveillance system that was established by the U.S. Centers for Disease Control and Prevention (CDC) to help monitor the prevalence of behaviors that not only influence youth health, but also put youth at risk for the most significant health and social problems that can occur during…

  16. Quality transitivity and traceability system of herbal medicine products based on quality markers.

    PubMed

    Liu, Changxiao; Guo, De-An; Liu, Liang

    2018-05-15

    Due to a variety of factors to affect the herb quality, the existing quality management model is unable to evaluate the process control. The development of the concept of "quality marker" (Q-marker) lays basis for establishing an independent process quality control system for herbal products. To ensure the highest degree of safety, effectiveness and quality process control of herbal products, it is aimed to establish a quality transitivity and traceability system of quality and process control from raw materials to finished herbal products. Based on the key issues and challenges of quality assessment, the current status of quality and process controls from raw materials to herbal medicinal products listed in Pharmacopoeia were analyzed and the research models including discovery and identification of Q-markers, analysis and quality management of risk evaluation were designed. Authors introduced a few new technologies and methodologies, such as DNA barcoding, chromatographic technologies, fingerprint analysis, chemical markers, bio-responses, risk management and solution for quality process control. The quality and process control models for herbal medicinal products were proposed and the transitivity and traceability system from raw materials to the finished products was constructed to improve the herbal quality from the entire supply and production chain. The transitivity and traceability system has been established based on quality markers, especially on how to control the production process under Good Engineering Practices, as well as to implement the risk management for quality and process control in herbal medicine production. Copyright © 2018 Elsevier GmbH. All rights reserved.

  17. STCA, TCAS, Airproxes and Collision Risk

    NASA Astrophysics Data System (ADS)

    Brooker, Peter

    2005-09-01

    The focus here is on the performance of and interaction between the Traffic Alert and Collision Avoidance System (TCAS) and the controller's short-term conflict alert (STCA) system. The data source used is UK Airprox Board Reports of close encounters between aircraft, and the focus is on commercial air transport aircraft using UK controlled airspace with a radar service. Do the systems work well together? Are controllers surprised when they find out that a pilot has received a TCAS resolution advisory? What do TCAS and STCA events say about collision risk? Generally, the systems seem to work together well. On most occasions, controllers are not surprised by TCAS advisories: either they have detected the problem themselves or STCA has alerted them to it. The statistically expected rate of future mid-air collisions is estimated by extrapolation of Airprox closest encounter distances.

  18. Flood risk analysis for flood control and sediment transportation: a case study in the catchments of the Loess Plateau, China

    NASA Astrophysics Data System (ADS)

    Wang, Y.; Chang, J.; Guo, A.

    2017-12-01

    Traditional flood risk analysis focuses on the probability of flood events exceeding the design flood of downstream hydraulic structures while neglecting the influence of sedimentation in river channels on flood control systems. Given this focus, a univariate and copula-based bivariate hydrological risk framework focusing on flood control and sediment transport is proposed in the current work. Additionally, the conditional probabilities of occurrence of different flood events under various extreme precipitation scenarios are estimated by exploiting the copula model. Moreover, a Monte Carlo-based algorithm is used to evaluate the uncertainties of univariate and bivariate hydrological risk. Two catchments located on the Loess plateau are selected as study regions: the upper catchments of the Xianyang and Huaxian stations (denoted as UCX and UCH, respectively). The results indicate that (1) 2-day and 3-day consecutive rainfall are highly correlated with the annual maximum flood discharge (AMF) in UCX and UCH, respectively; and (2) univariate and bivariate return periods, risk and reliability for the purposes of flood control and sediment transport are successfully estimated. Sedimentation triggers higher risks of damaging the safety of local flood control systems compared with the AMF, exceeding the design flood of downstream hydraulic structures in the UCX and UCH. Most importantly, there was considerable sampling uncertainty in the univariate and bivariate hydrologic risk analysis, which would greatly challenge measures of future flood mitigation. The proposed hydrological risk framework offers a promising technical reference for flood risk analysis in sandy regions worldwide.

  19. 75 FR 2457 - Defense Federal Acquisition Regulation Supplement; Business Systems-Definition and Administration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-15

    ... INFORMATION: A. Background Contractor business systems and internal controls are the first line of defense against waste, fraud, and abuse. Weak control systems increase the risk of unallowable and unreasonable... Office of Management and Budget (OMB) as follows: (1) Accounting Systems--OMB Clearance 9000-0011; (2...

  20. Integrated risk/cost planning models for the US Air Traffic system

    NASA Technical Reports Server (NTRS)

    Mulvey, J. M.; Zenios, S. A.

    1985-01-01

    A prototype network planning model for the U.S. Air Traffic control system is described. The model encompasses the dual objectives of managing collision risks and transportation costs where traffic flows can be related to these objectives. The underlying structure is a network graph with nonseparable convex costs; the model is solved efficiently by capitalizing on its intrinsic characteristics. Two specialized algorithms for solving the resulting problems are described: (1) truncated Newton, and (2) simplicial decomposition. The feasibility of the approach is demonstrated using data collected from a control center in the Midwest. Computational results with different computer systems are presented, including a vector supercomputer (CRAY-XMP). The risk/cost model has two primary uses: (1) as a strategic planning tool using aggregate flight information, and (2) as an integrated operational system for forecasting congestion and monitoring (controlling) flow throughout the U.S. In the latter case, access to a supercomputer is required due to the model's enormous size.

  1. Risk assessment for Industrial Control Systems quantifying availability using mean failure cost (MFC)

    DOE PAGES

    Chen, Qian; Abercrombie, Robert K; Sheldon, Frederick T.

    2015-09-23

    Industrial Control Systems (ICS) are commonly used in industries such as oil and natural gas, transportation, electric, water and wastewater, chemical, pharmaceutical, pulp and paper, food and beverage, as well as discrete manufacturing (e.g., automotive, aerospace, and durable goods.) SCADA systems are generally used to control dispersed assets using centralized data acquisition and supervisory control.Originally, ICS implementations were susceptible primarily to local threats because most of their components were located in physically secure areas (i.e., ICS components were not connected to IT networks or systems). The trend toward integrating ICS systems with IT networks (e.g., efficiency and the Internet ofmore » Things) provides significantly less isolation for ICS from the outside world thus creating greater risk due to external threats. Albeit, the availability of ICS/SCADA systems is critical to assuring safety, security and profitability. Such systems form the backbone of our national cyber-physical infrastructure.Herein, we extend the concept of mean failure cost (MFC) to address quantifying availability to harmonize well with ICS security risk assessment. This new measure is based on the classic formulation of Availability combined with Mean Failure Cost (MFC). Finally, the metric offers a computational basis to estimate the availability of a system in terms of the loss that each stakeholder stands to sustain as a result of security violations or breakdowns (e.g., deliberate malicious failures).« less

  2. Structural color changes in permanent enamel of patients with cleft lip and palate: a case-control study.

    PubMed

    Kulas, Antje; Illge, Christina; Bekes, Katrin; Eckert, Alexander W; Fuhrmann, Robert A W; Hirsch, Christian

    2016-01-01

    White spots are more common in patients with cleft lip and palate (CLP) than in the normal population. Whether these are due to the cleft itself or concomitant circumstances (e.g., surgical procedures, orthodontic treatments, systemic fluoridation, increased caries risk) remains unclear. This case-control study evaluated both their prevalence in CLP patients versus control subjects and associated risk factors. A total of 73 CLP patients (average age 8.7 years, range 6-18 years, 42 % male) and a control group of 73 age- and gender-matched non-CLP patients were included. Enamel color changes, subsuming mineralization defects (DDE index), mild dental fluorosis (Dean's index), and initial caries (ICDAS score 2), were recorded. Caries index (dmf-t/DMF-T) scores were also recorded to distinguish between high or low caries risk as defined by the Deutsche Arbeitsgemeinschaft für Jugendzahnpflege criteria. Histories of systemic fluoridation, trauma to primary teeth, surgery, and orthodontic treatment were obtained using a questionnaire. Statistical analysis included t test, χ (2) test, and multivariable logistic regression. Enamel color changes were observed three times more often in the CLP group than in the control group (39.7 vs. 12.3 %; p < 0.001). Significantly more patients in the CLP group had a history of orthodontic treatment (38.4 vs. 15.1 %; p < 0.05). An increased risk for enamel color changes was associated with CLP itself [OR (odds ratio) 3.6; 95 % confidence interval (CI) 1.3-9.9] and table salt plus tablets combined for systemic fluoridation (OR 2.7, 95 % CI 1.1-6.9). No increased risks were identified for increased caries risk, history of primary-tooth trauma, or history of orthodontic treatment. The higher prevalence of enamel color changes in the CLP group (more than threefold compared to the control group) was not related to previous orthodontic treatments; however, systemic fluoridation (table salt and tablets) constituted a risk factor for the enamel color changes seen in the CLP patients.

  3. Enterprise Resource Planning Systems: Assessment of Risk Factors by California Community College Leaders

    ERIC Educational Resources Information Center

    Valente, Mario Manuel

    2011-01-01

    Most California Community Colleges have chosen to purchase and implement a Management Information Systems software solution also known as an Enterprise Resource Planning (ERP) system in order to monitor, control, and automate their administrative tasks. ERP implementations are complex, expensive, high profile, and therefore high risk. To reduce…

  4. Assessing risk factors in the organic control system: evidence from inspection data in Italy.

    PubMed

    Zanoli, Raffaele; Gambelli, Danilo; Solfanelli, Francesco

    2014-12-01

    Certification is an essential feature in organic farming, and it is based on inspections to verify compliance with respect to European Council Regulation-EC Reg. No 834/2007. A risk-based approach to noncompliance that alerts the control bodies to activate planning inspections would contribute to a more efficient and cost-effective certification system. An analysis of factors that can affect the probability of noncompliance in organic farming has thus been developed. This article examines the application of zero-inflated count data models to farm-level panel data from inspection results and sanctions obtained from the Ethical and Environmental Certification Institute, one of the main control bodies in Italy. We tested many a priori hypotheses related to the risk of noncompliance. We find evidence of an important role for past noncompliant behavior in predicting future noncompliance, while farm size and the occurrence of livestock also have roles in an increased probability of noncompliance. We conclude the article proposing that an efficient risk-based inspection system should be designed, weighting up the known probability of occurrence of a given noncompliance according to the severity of its impact. © 2014 Society for Risk Analysis.

  5. Controls on the Environmental Fate of Compounds Controlled by Coupled Hydrologic and Reactive Processes

    NASA Astrophysics Data System (ADS)

    Hixson, J.; Ward, A. S.; McConville, M.; Remucal, C.

    2017-12-01

    Current understanding of how compounds interact with hydrologic processes or reactive processes have been well established. However, the environmental fate for compounds that interact with hydrologic AND reactive processes is not well known, yet critical in evaluating environmental risk. Evaluations of risk are often simplified to homogenize processes in space and time and to assess processes independently of one another. However, we know spatial heterogeneity and time-variable reactivities complicate predictions of environmental transport and fate, and is further complicated by the interaction of these processes, limiting our ability to accurately predict risk. Compounds that interact with both systems, such as photolytic compounds, require that both components are fully understood in order to predict transport and fate. Release of photolytic compounds occurs through both unintentional releases and intentional loadings. Evaluating risks associated with unintentional releases and implementing best management practices for intentional releases requires an in-depth understanding of the sensitivity of photolytic compounds to external controls. Lampricides, such as 3-trifluoromethyl-4-nitrophenol (TFM), are broadly applied in the Great Lakes system to control the population of invasive sea lamprey. Over-dosing can yield fish kills and other detrimental impacts. Still, planning accounts for time of passage and dilution, but not the interaction of the physical and chemical systems (i.e., storage in the hyporheic zone and time-variable decay rates). In this study, we model a series of TFM applications to test the efficacy of dosing as a function of system characteristics. Overall, our results demonstrate the complexity associated with photo-sensitive compounds through stream-hyporheic systems, and highlight the need to better understand how physical and chemical systems interact to control transport and fate in the environment.

  6. Human Factors in Training

    NASA Technical Reports Server (NTRS)

    Barshi, Immanuel; Byrne, Vicky; Arsintescu, Lucia; Connell, Erin

    2010-01-01

    Future space missions will be significantly longer than current shuttle missions and new systems will be more complex than current systems. Increasing communication delays between crews and Earth-based support means that astronauts need to be prepared to handle the unexpected on their own. As crews become more autonomous, their potential span of control and required expertise must grow to match their autonomy. It is not possible to train for every eventuality ahead of time on the ground, or to maintain trained skills across long intervals of disuse. To adequately prepare NASA personnel for these challenges, new training approaches, methodologies, and tools are required. This research project aims at developing these training capabilities. By researching established training principles, examining future needs, and by using current practices in space flight training as test beds, both in Flight Controller and Crew Medical domains, this research project is mitigating program risks and generating templates and requirements to meet future training needs. Training efforts in Fiscal Year 09 (FY09) strongly focused on crew medical training, but also began exploring how Space Flight Resource Management training for Mission Operations Directorate (MOD) Flight Controllers could be integrated with systems training for optimal Mission Control Center (MCC) operations. The Training Task addresses Program risks that lie at the intersection of the following three risks identified by the Project: 1) Risk associated with poor task design; 2) Risk of error due to inadequate information; and 3) Risk associated with reduced safety and efficiency due to poor human factors design.

  7. Human Factors in Training

    NASA Technical Reports Server (NTRS)

    Barshi, Immanuel; Byrne, Vicky; Arsintescu, Lucia; Connell, Erin; Sandor, Aniko

    2009-01-01

    Future space missions will be significantly longer than current shuttle missions and new systems will be more complex than current systems. Increasing communication delays between crews and Earth-based support means that astronauts need to be prepared to handle the unexpected on their own. As crews become more autonomous, their potential span of control and required expertise must grow to match their autonomy. It is not possible to train for every eventuality ahead of time on the ground, or to maintain trained skills across long intervals of disuse. To adequately prepare NASA personnel for these challenges, new training approaches, methodologies, and tools are required. This research project aims at developing these training capabilities. By researching established training principles, examining future needs, and by using current practices in space flight training as test beds, both in Flight Controller and Crew Medical domains, this research project is mitigating program risks and generating templates and requirements to meet future training needs. Training efforts in Fiscal Year 08 (FY08) strongly focused on crew medical training, but also began exploring how Space Flight Resource Management training for Mission Operations Directorate (MOD) Flight Controllers could be integrated with systems training for optimal Mission Control Center (MCC) operations. The Training Task addresses Program risks that lie at the intersection of the following three risks identified by the Project: (1) Risk associated with poor task design (2) Risk of error due to inadequate information (3) Risk associated with reduced safety and efficiency due to poor human factors design

  8. Assessing reservoir operations risk under climate change

    USGS Publications Warehouse

    Brekke, L.D.; Maurer, E.P.; Anderson, J.D.; Dettinger, M.D.; Townsley, E.S.; Harrison, A.; Pruitt, T.

    2009-01-01

    Risk-based planning offers a robust way to identify strategies that permit adaptive water resources management under climate change. This paper presents a flexible methodology for conducting climate change risk assessments involving reservoir operations. Decision makers can apply this methodology to their systems by selecting future periods and risk metrics relevant to their planning questions and by collectively evaluating system impacts relative to an ensemble of climate projection scenarios (weighted or not). This paper shows multiple applications of this methodology in a case study involving California's Central Valley Project and State Water Project systems. Multiple applications were conducted to show how choices made in conducting the risk assessment, choices known as analytical design decisions, can affect assessed risk. Specifically, risk was reanalyzed for every choice combination of two design decisions: (1) whether to assume climate change will influence flood-control constraints on water supply operations (and how), and (2) whether to weight climate change scenarios (and how). Results show that assessed risk would motivate different planning pathways depending on decision-maker attitudes toward risk (e.g., risk neutral versus risk averse). Results also show that assessed risk at a given risk attitude is sensitive to the analytical design choices listed above, with the choice of whether to adjust flood-control rules under climate change having considerably more influence than the choice on whether to weight climate scenarios. Copyright 2009 by the American Geophysical Union.

  9. SU-E-I-54: Effective Dose and Radiation Cancer Risks for Scoliosis Patients Undergoing Full Spine Radiography

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

    Lin, Y; Hwang, Y; Tsai, H

    2015-06-15

    Purpose: Scoliotic patients underwent a lot of radiologic examinations during the control and treatment periods. This study used the PCXMC program to calculate the effective dose of the patients and assess the radiation cancer risks. Methods: Seventy five scoliotic patients were examined using CR or DR systems during the control and treatment periods in Chang Gung Memorial Hospital. The technical factors were recorded for each patient during his/her control and treatment period. The entrance surface dose was measured using thermoluminence dosimeters and derived from technical factors and irradiated geometry. The effective dose of patients and relative radiation cancer risks weremore » calculated by the PCXMC program. All required information regarding patient age and sex, the x-ray spectra, and the tube voltage and current were registered. The radiation risk were estimated using the model developed by the BEIR VII committee (2006). Results: The effective doses of full spine radiography with anteroposterior and lateral projections were 0.626 mSv for patients using DR systems, and 0.483mSv for patients using CR systems, respectively. The dose using DR system was 29.6% higher than those using CR system. The maximum organ dose was observed in the breast for both projections in all the systems. The risk of exposure—induced cancer death (REID) of patients for DR and CR systems were 0.009% and 0.007%, respectively. Conclusion: The risk estimates were regarded with healthy skepticism, placed more emphasis on the magnitude of the risk. The effective doses estimated in this study could be served as a reference for radiologists and technologists and demonstrate the necessity to optimize patient protection for full spine radiography though the effective doses are not at the level to induce deterministic effects and not significant in the stochastic effect. This study was supported by the grants from the Chang Gung Memorial Hospital (CMRPD1D0421)« less

  10. An Environmental Impact Assessment of Perfluorocarbon Thermal Working Fluid Use On Board Crewed Spacecraft

    NASA Technical Reports Server (NTRS)

    Perry, Jay L.; Arnold, William a.

    2006-01-01

    The design and operation of crewed spacecraft requires identifying and evaluating chemical compounds that may present reactivity and compatibility risks with the environmental control and life support (ECLS) system. Such risks must be understood so that appropriate design and operational controls, including specifying containment levels, can be instituted or an appropriate substitute material selected. Operational experience acquired during the International Space Station (ISS) program has found that understanding ECLS system and environmental impact presented by thermal control system working fluids is imperative to safely operating any crewed space exploration vehicle. Perfluorocarbon fluids are used as working fluids in thermal control fluid loops on board the ISS. Also, payload hardware developers have identified perfluorocarbon fluids as preferred thermal control working fluids. Interest in using perfluorocarbon fluids as thermal control system working fluids for future crewed space vehicles and outposts is high. Potential hazards associated with perfluorocarbon fluids are discussed with specific attention given to engineering assessment of ECLS system compatibility, compatibility testing results, and spacecraft environmental impact. Considerations for perfluorocarbon fluid use on crewed spacecraft and outposts are summarized.

  11. Injury risk in runners using standard or motion control shoes: a randomised controlled trial with participant and assessor blinding

    PubMed Central

    Malisoux, Laurent; Chambon, Nicolas; Delattre, Nicolas; Gueguen, Nils; Urhausen, Axel; Theisen, Daniel

    2016-01-01

    Background/aim This randomised controlled trial investigated if the usage of running shoes with a motion control system modifies injury risk in regular leisure-time runners compared to standard shoes, and if this influence depends on foot morphology. Methods Recreational runners (n=372) were given either the motion control or the standard version of a regular running shoe model and were followed up for 6 months regarding running activity and injury. Foot morphology was analysed using the Foot Posture Index method. Cox regression analyses were used to compare injury risk between the two groups, based on HRs and their 95% CIs, controlling for potential confounders. Stratified analyses were conducted to evaluate the effect of motion control system in runners with supinated, neutral and pronated feet. Results The overall injury risk was lower among the participants who had received motion control shoes (HR=0.55; 95% CI 0.36 to 0.85) compared to those receiving standard shoes. This positive effect was only observed in the stratum of runners with pronated feet (n=94; HR=0.34; 95% CI 0.13 to 0.84); there was no difference in runners with neutral (n=218; HR=0.78; 95% CI 0.44 to 1.37) or supinated feet (n=60; HR=0.59; 95% CI 0.20 to 1.73). Runners with pronated feet using standard shoes had a higher injury risk compared to those with neutral feet (HR=1.80; 95% CI 1.01 to 3.22). Conclusions The overall injury risk was lower in participants who had received motion control shoes. Based on secondary analysis, those with pronated feet may benefit most from this shoe type. PMID:26746907

  12. Are elements of the chronic care model associated with cardiovascular risk factor control in type 2 diabetes?

    PubMed

    Parchman, Michael; Kaissi, Amer A

    2009-03-01

    Control of modifiable risk factors for cardiovascular (CV) disease, the most common cause of morbidity and mortality among people with Type 2 diabetes is dependent on both patient self-care behaviors and the characteristics of the clinic in which care is delivered. The relationship between control of CV risk factors, patient self-care behaviors, and the presence of CCM (Chronic Care Model) components across multiple primary care clinic settings was examined. Thirty consecutive patients presenting with Type 2 diabetes were enrolled from each of 20 primary care clinics from across South Texas. Patients were asked about their stage of change for four self-care behaviors: diet, exercise, glucose monitoring, and medication adherence. CV risk factors included the most recent values of glycosolated hemoglobin (A1C), blood pressure, and (low-density lipoprotein) cholesterol. Clinicians in each clinic completed the Assessment of Chronic Illness Care (ACIC) survey, a validated measure of the CCM components. Hierarchical logistic regression models were used. Only 25 (13%) of the 618 patients had good control of all three CV risk factors. Good control of these risk factors was positively associated with community linkages and delivery system design but was inversely associated with clinical information systems. Patients who were in the maintenance stage of change for all four self-care behaviors were more likely to have all three risk factors well controlled. Risk factors for CV disease among patients with diabetes are associated with the structure and design of the clinical microsystem where care is delivered. In addition to focusing on clinician knowledge, future interventions should address the clinical microsystem's structure and design to reduce the burden of CV disease among patients with Type 2 diabetes.

  13. DebtRank-transparency: Controlling systemic risk in financial networks

    PubMed Central

    Thurner, Stefan; Poledna, Sebastian

    2013-01-01

    Nodes in a financial network, such as banks, cannot assess the true risks associated with lending to other nodes in the network, unless they have full information on the riskiness of all other nodes. These risks can be estimated by using network metrics (as DebtRank) of the interbank liability network. With a simple agent based model we show that systemic risk in financial networks can be drastically reduced by increasing transparency, i.e. making the DebtRank of individual banks visible to others, and by imposing a rule, that reduces interbank borrowing from systemically risky nodes. This scheme does not reduce the efficiency of the financial network, but fosters a more homogeneous risk-distribution within the system in a self-organized critical way. The reduction of systemic risk is due to a massive reduction of cascading failures in the transparent system. A regulation-policy implementation of the proposed scheme is discussed. PMID:23712454

  14. An outline of a risk assessment-based system of meat safety assurance and its future prospects.

    PubMed

    Berends, B R; van Knapen, F

    1999-10-01

    Discussed are the outlines of a risk assessment-based system of meat safety assurance to replace the current meat inspection. An example of a system that uses the Hazard Analysis of Critical Control Points (HACCP)-principles in the entire production chain from stable to table is also given. Continuous evaluation of risks is the main driving force of the new system. Only then the system has the means to remain flexible and provide for the data necessary to convince trade partners that the products they buy are safe. A monitoring system that keeps track of the important health hazards in the entire chain from stable to table is therefore necessary. This includes monitoring of cases of disease in the human population caused by the hazardous agents of concern. Coordination of the monitoring and control and processing of the information is done by an independent body. Furthermore, the system demands a production from stable to table that is based on the ideas of Integrated Quality Control (IQC), HACCP, and certification of production processes and quality control procedures. Clear legislation provides for criteria about acceptable or unacceptable health risks for the consumer and determines at what moments which risks should be controlled by the producers. Simultaneously, the legislation has to be flexible enough to be able to adapt quickly to any changes in risks, or in the way risks should be controlled. In the new system current meat inspection can easily be carried out by employees of the slaughter houses and is no longer a direct responsibility of the authorities. The authorities only demand certain safety levels and verify whether producers stick to these. Producers remain fully responsible for the safety and quality of their products, and fully liable in case of any damage to the consumers' health. However, it is to be expected that some EU Member-States miss the organizational and agricultural basis for a successful application of the new system. Consequences are that two parallel flows of meat and meat products may come to existence. One flow will exist of meat produced according to the new, and with respect to safety assurance, superior system. The other flow will consist of meat produced and inspected in the traditional way. However, this meat will contain all the flaws that required a revision of the system in the first place. This, and the fact that EU policy ordains that part-taking in an alternative meat inspection system should be voluntary, may very well result in a very slow start-up of the new system. One of the easiest solutions, however, would be to implement a decontamination step in the slaughtering process, provided that this is accompanied by strict codes of hygienic practices and good manufacturing practices. Not only would this lead to safer meat, but also result in the two separate flows of meat becoming one flow again as well as an easier to organize livestock production according to HACCP-principles.

  15. 76 FR 22662 - Notice of Intent To Apply Certain Supervisory Guidance to Savings and Loan Holding Companies

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-22

    ... information that is used to assess inherent risks and internal control processes. Such activities include... management and information systems; and internal controls. The financial condition rating is supported by... appropriate standards of capitalization, liquidity, and risk management consistent with the principles of...

  16. Integrated digital/electric aircraft concepts study

    NASA Technical Reports Server (NTRS)

    Cronin, M. J.; Hays, A. P.; Green, F. B.; Radovcich, N. A.; Helsley, C. W.; Rutchik, W. L.

    1985-01-01

    The integrated digital/electrical aircraft (IDEA) is an aircraft concept which employs all electric secondary power systems and advanced digital flight control systems. After trade analysis, preferred systems were applied to the baseline configuration. An additional configuration, the alternate IDEA, was also considered. For this concept the design ground rules were relaxed in order to quantify additional synergistic benefits. It was proposed that an IDEA configuration and technical risks associated with the IDEA systems concepts be defined and the research and development required activities to reduce these risks be identified. The selected subsystems include: power generation, power distribution, actuators, environmental control system and flight controls systems. When the aircraft was resized, block fuel was predicted to decrease by 11.3 percent, with 7.9 percent decrease in direct operating cost. The alternate IDEA shows a further 3.4 percent reduction in block fuel and 3.1 percent reduction in direct operating cost.

  17. Comparison of a Stratified Group Intervention (STarT Back) With Usual Group Care in Patients With Low Back Pain: A Nonrandomized Controlled Trial.

    PubMed

    Murphy, Susan E; Blake, Catherine; Power, Camillus K; Fullen, Brona M

    2016-04-01

    A nonrandomized controlled trial. This study aims to explore the effectiveness of group-based stratified care in primary care. Stratified care based on psychosocial screening (STarT Back) has demonstrated greater clinical and cost-effectiveness in patients with low back pain. However, low back pain interventions are often delivered in groups and evaluating this system of care in a group setting is important. Patients were recruited from 60 general practices and linked physiotherapy services. A new group stratified intervention was compared with a historical nonstratified control group. Patients stratified as low, medium and high risk were offered risk-matched group care. Consenting participants completed self-report measures of functional disability (primary outcome measure), pain, psychological distress, and beliefs. The historical control received a generic group intervention. Analysis was by intention to treat. In total, 251 patients in the new stratified intervention and 332 in the historical control were included in the primary analysis at 12 weeks. The mean age of patients was 43 ± 10.98 years. Overall adjusted mean changes in the RMDQ scores were higher in the stratified intervention than in the control arm at 12-week follow-up (P = 0.028). Exploring the risk groups, individually the high-risk stratified group, demonstrated better outcome over the controls (P = 0.031). The medium-risk stratified intervention demonstrated equally good outcomes (P = 0.125), and low-risk stratified patients, despite less intervention, did as well as the historical controls (P = 0.993). Stratified care delivered in a group setting demonstrated superior outcomes in the high-risk patients, and equally good outcomes for the medium and low-risk groups. This model, embedded in primary care, provides an early and effective model of chronic disease management and adds another dimension to the utility of the STarT Back system of care. 2.

  18. 12 CFR 225.24 - Procedures for other nonbanking proposals.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., internal controls and risk management systems that will be utilized in the conduct of the proposed... FEDERAL RESERVE SYSTEM BANK HOLDING COMPANIES AND CHANGE IN BANK CONTROL (REGULATION Y) Regulations... listed activities. A bank holding company seeking to acquire or control voting securities or assets of a...

  19. Real-Time Optimal Flood Control Decision Making and Risk Propagation Under Multiple Uncertainties

    NASA Astrophysics Data System (ADS)

    Zhu, Feilin; Zhong, Ping-An; Sun, Yimeng; Yeh, William W.-G.

    2017-12-01

    Multiple uncertainties exist in the optimal flood control decision-making process, presenting risks involving flood control decisions. This paper defines the main steps in optimal flood control decision making that constitute the Forecast-Optimization-Decision Making (FODM) chain. We propose a framework for supporting optimal flood control decision making under multiple uncertainties and evaluate risk propagation along the FODM chain from a holistic perspective. To deal with uncertainties, we employ stochastic models at each link of the FODM chain. We generate synthetic ensemble flood forecasts via the martingale model of forecast evolution. We then establish a multiobjective stochastic programming with recourse model for optimal flood control operation. The Pareto front under uncertainty is derived via the constraint method coupled with a two-step process. We propose a novel SMAA-TOPSIS model for stochastic multicriteria decision making. Then we propose the risk assessment model, the risk of decision-making errors and rank uncertainty degree to quantify the risk propagation process along the FODM chain. We conduct numerical experiments to investigate the effects of flood forecast uncertainty on optimal flood control decision making and risk propagation. We apply the proposed methodology to a flood control system in the Daduhe River basin in China. The results indicate that the proposed method can provide valuable risk information in each link of the FODM chain and enable risk-informed decisions with higher reliability.

  20. Reducing The Risk Of Fires In Conveyor Transport

    NASA Astrophysics Data System (ADS)

    Cheremushkina, M. S.; Poddubniy, D. A.

    2017-01-01

    The paper deals with the actual problem of increasing the safety of operation of belt conveyors in mines. Was developed the control algorithm that meets the technical requirements of the mine belt conveyors, reduces the risk of fires of conveyors belt, and enables energy and resource savings taking into account random sort of traffic. The most effective method of decision such tasks is the construction of control systems with the use of variable speed drives for asynchronous motors. Was designed the mathematical model of the system "variable speed multiengine drive - conveyor - control system of conveyors", that takes into account the dynamic processes occurring in the elements of the transport system, provides an assessment of the energy efficiency of application the developed algorithms, which allows to reduce the dynamic overload in the belt to (15-20)%.

  1. Algorithm for solving of two-level hierarchical minimax program control problem of final state the regional socio-economic system in the presence of risks

    NASA Astrophysics Data System (ADS)

    Shorikov, A. F.

    2017-10-01

    In this paper we study the problem of optimization of guaranteed result for program control by the final state of regional social and economic system in the presence of risks. For this problem we propose a mathematical model in the form of two-level hierarchical minimax program control problem of the final state of this process with incomplete information. For solving of its problem we constructed the common algorithm that has a form of a recurrent procedure of solving a linear programming and a finite optimization problems.

  2. Summary

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

    Powell, Danny H; Elwood Jr, Robert H

    2011-01-01

    An effective risk assessment system is needed to address the threat posed by an active or passive insider who, acting alone or in collusion, could attempt diversion or theft of nuclear material. The material control and accountability (MC&A) system effectiveness tool (MSET) is a self-assessment or inspection tool utilizing probabilistic risk assessment (PRA) methodology to calculate the system effectiveness of a nuclear facility's material protection, control, and accountability (MPC&A) system. The MSET process is divided into four distinct and separate parts: (1) Completion of the questionnaire that assembles information about the operations of every aspect of the MPC&A system; (2)more » Conversion of questionnaire data into numeric values associated with risk; (3) Analysis of the numeric data utilizing the MPC&A fault tree and the SAPHIRE computer software; and (4) Self-assessment using the MSET reports to perform the effectiveness evaluation of the facility's MPC&A system. The process should lead to confirmation that mitigating features of the system effectively minimize the threat, or it could lead to the conclusion that system improvements or upgrades are necessary to achieve acceptable protection against the threat. If the need for system improvements or upgrades is indicated when the system is analyzed, MSET provides the capability to evaluate potential or actual system improvements or upgrades. A facility's MC&A system can be evaluated at a point in time. The system can be reevaluated after upgrades are implemented or after other system changes occur. The total system or specific subareas within the system can be evaluated. Areas of potential system improvement can be assessed to determine where the most beneficial and cost-effective improvements should be made. Analyses of risk importance factors show that sustainability is essential for optimal performance and reveals where performance degradation has the greatest impact on total system risk. The risk importance factors show the amount of risk reduction achievable with potential upgrades and the amount of risk reduction achieved after upgrades are completed. Applying the risk assessment tool gives support to budget prioritization by showing where budget support levels must be sustained for MC&A functions most important to risk. Results of the risk assessment are also useful in supporting funding justifications for system improvements that significantly reduce system risk. The functional model, the system risk assessment tool, and the facility evaluation questionnaire are valuable educational tools for MPC&A personnel. These educational tools provide a framework for ongoing dialogue between organizations regarding the design, development, implementation, operation, assessment, and sustainability of MPC&A systems. An organization considering the use of MSET as an analytical tool for evaluating the effectiveness of its MPC&A system will benefit from conducting a complete MSET exercise at an existing nuclear facility.« less

  3. [Materials and articles intended to come into contact with food: evaluation of the rapid alert system for food and feed (RASFF) 2008-2010].

    PubMed

    Baiguini, Alessandro; Colletta, Stefano; Rebella, Valentina

    2011-01-01

    For some time, packaging materials and articles intended to come into contact with food are included in the system of controls, early warnings and risk communication provided by the European Commission (EU) regulation 178/2002. Data analysis of the EU rapid alert system for food allows one to define a specific risk profile and to establish an effective plan for official control of materials intended to come into contact with food. In the 2008-2010 period the rapid alert system has ratified alert notifications, mostly related to plastic materials of Chinese origin.

  4. Factors influencing wound dehiscence.

    PubMed

    Riou, J P; Cohen, J R; Johnson, H

    1992-03-01

    Thirty-one abdominal fascial wound dehiscences occurred in 2,761 patients undergoing major abdominal surgery during a 5-year period (1%). Twenty-two specific local and systemic risk factors were analyzed and compared with the risk factors of a control group of 38 patients undergoing similar procedures without dehiscence. Through multivariate analysis, each factor was assessed as an independent statistical variable. Significant factors (p less than 0.05) were found to include age over 65, wound infection, pulmonary disease, hemodynamic instability, and ostomies in the incision. Additional systemic risk factors that were found to be significant included hypoproteinemia, systemic infection, obesity, uremia, hyperalimentation, malignancy, ascites, steroid use, and hypertension. Risk factors not found to be important independent variables included sex, type of incision, type of closure, foreign body in the wound, anemia, jaundice, and diabetes. When dehiscence and control groups were combined, 30% of patients with at least five significant risk factors developed dehiscence, and all the patients with more than eight risk factors developed a wound dehiscence. There was an overall mortality of 29%, which was directly related to the number of significant risk factors. The co-existence of 9 risk factors portended death in one third of the patients, and all the patients with more than 10 risk factors died.

  5. Decision-Making for Systemic Water Risks: Insights From a Participatory Risk Assessment Process in Vietnam

    NASA Astrophysics Data System (ADS)

    Wyrwoll, Paul R.; Grafton, R. Quentin; Daniell, Katherine A.; Chu, Hoang Long; Ringler, Claudia; Lien, Le Thi Ha; Khoi, Dang Kim; Do, Thang Nam; Tuan, Nguyen Do Anh

    2018-03-01

    Systemic threats to food-energy-environment-water systems require national policy responses. Yet complete control of these complex systems is impossible and attempts to mitigate systemic risks can generate unexpected feedback effects. Perverse outcomes from national policy can emerge from the diverse responses of decision-makers across different levels and scales of resource governance. Participatory risk assessment processes can help planners to understand subnational dynamics and ensure that policies do not undermine the resilience of social-ecological systems and infrastructure networks. Researchers can play an important role in participatory processes as both technical specialists and brokers of stakeholder knowledge on the feedbacks generated by systemic risks and policy decisions. Here, we evaluate the use of causal modeling and participatory risk assessment to develop national policy on systemic water risks. We present an application of the Risks and Options Assessment for Decision-Making (ROAD) process to a district of Vietnam where national agricultural water reforms are being piloted. The methods and results of this project provide general insights about how to support resilient decision-making, including the transfer of knowledge across administrative levels, identification of feedback effects, and the effective implementation of risk assessment processes.

  6. Flexing dual-systems models: How variable cognitive control in children informs our understanding of risk-taking across development.

    PubMed

    Li, Rosa

    2017-10-01

    Prevailing models of the development of decision-making propose that peak risk-taking occurs in adolescence due to a neural imbalance between two processes: gradual, linearly developing cognitive control and rapid, non-linearly developing reward-processing. Though many studies have found neural evidence supporting this dual-systems imbalance model, its behavioral predictions have been surprisingly difficult to document. Most laboratory studies have not found adolescents to exhibit greater risk-taking than children, and public health data show everyday risk-taking to peak in late adolescence/early adulthood. Moreover, when adolescents are provided detailed information about decision options and consequences, they evince similar behavior to adults. Such findings point to a critical feature of the development of decision-making that is missed by imbalance models. Specifically, the engagement of cognitive control is context dependent, such that cognitive control and therefore advantageous decision-making increases when available information is high and decreases when available information is low. Furthermore, the context dependence of cognitive control varies across development, such that increased information availability benefits children more than adolescents, who benefit more than adults. This review advances a flexible dual-systems model that is only imbalanced under certain conditions; explains disparities between neural, behavioral, and public health findings; and provides testable hypotheses for future research. Copyright © 2017 The Author. Published by Elsevier Ltd.. All rights reserved.

  7. Cyber Incidents Involving Control Systems

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

    Robert J. Turk

    2005-10-01

    The Analysis Function of the US-CERT Control Systems Security Center (CSSC) at the Idaho National Laboratory (INL) has prepared this report to document cyber security incidents for use by the CSSC. The description and analysis of incidents reported herein support three CSSC tasks: establishing a business case; increasing security awareness and private and corporate participation related to enhanced cyber security of control systems; and providing informational material to support model development and prioritize activities for CSSC. The stated mission of CSSC is to reduce vulnerability of critical infrastructure to cyber attack on control systems. As stated in the Incident Managementmore » Tool Requirements (August 2005) ''Vulnerability reduction is promoted by risk analysis that tracks actual risk, emphasizes high risk, determines risk reduction as a function of countermeasures, tracks increase of risk due to external influence, and measures success of the vulnerability reduction program''. Process control and Supervisory Control and Data Acquisition (SCADA) systems, with their reliance on proprietary networks and hardware, have long been considered immune to the network attacks that have wreaked so much havoc on corporate information systems. New research indicates this confidence is misplaced--the move to open standards such as Ethernet, Transmission Control Protocol/Internet Protocol, and Web technologies is allowing hackers to take advantage of the control industry's unawareness. Much of the available information about cyber incidents represents a characterization as opposed to an analysis of events. The lack of good analyses reflects an overall weakness in reporting requirements as well as the fact that to date there have been very few serious cyber attacks on control systems. Most companies prefer not to share cyber attack incident data because of potential financial repercussions. Uniform reporting requirements will do much to make this information available to Department of Homeland Security (DHS) and others who require it. This report summarizes the rise in frequency of cyber attacks, describes the perpetrators, and identifies the means of attack. This type of analysis, when used in conjunction with vulnerability analyses, can be used to support a proactive approach to prevent cyber attacks. CSSC will use this document to evolve a standardized approach to incident reporting and analysis. This document will be updated as needed to record additional event analyses and insights regarding incident reporting. This report represents 120 cyber security incidents documented in a number of sources, including: the British Columbia Institute of Technology (BCIT) Industrial Security Incident Database, the 2003 CSI/FBI Computer Crime and Security Survey, the KEMA, Inc., Database, Lawrence Livermore National Laboratory, the Energy Incident Database, the INL Cyber Incident Database, and other open-source data. The National Memorial Institute for the Prevention of Terrorism (MIPT) database was also interrogated but, interestingly, failed to yield any cyber attack incidents. The results of this evaluation indicate that historical evidence provides insight into control system related incidents or failures; however, that the limited available information provides little support to future risk estimates. The documented case history shows that activity has increased significantly since 1988. The majority of incidents come from the Internet by way of opportunistic viruses, Trojans, and worms, but a surprisingly large number are directed acts of sabotage. A substantial number of confirmed, unconfirmed, and potential events that directly or potentially impact control systems worldwide are also identified. Twelve selected cyber incidents are presented at the end of this report as examples of the documented case studies (see Appendix B).« less

  8. 12 CFR 225.26 - Factors considered in acting on nonbanking proposals.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... control and risk-management systems, and capital of the entity conducting the activity. (c) Competitive... proposals. 225.26 Section 225.26 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM BANK HOLDING COMPANIES AND CHANGE IN BANK CONTROL (REGULATION Y...

  9. 77 FR 33950 - Prudential Management and Operations Standards

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-08

    ... by guideline. 12 U.S.C. 4513b. Those 10 areas relate to: Adequacy of internal controls and information systems; adequacy and independence of the internal audit systems; management of interest rate risk... Join Bank Letter at 7-8. 4. Standard 1 (Internal Controls and Information Systems) \\22\\ \\22\\ The Joint...

  10. Programmable Logic Controller Modification Attacks for use in Detection Analysis

    DTIC Science & Technology

    2014-03-27

    and J. Lowe, “The Myths and Facts Behind Cyber Security Risks for Industrial Control Systems ,” in Proceedings of the VDE Kongress, vol. 116, 2004. [13...Feb 2014 Date 20 Feb 2014 Date 20 Feb 2014 Date AFIT-ENG-14-M-66 Abstract Unprotected Supervisory Control and Data Acquisition (SCADA) systems offer...control and monitor physical industrial processes. Although attacks targeting SCADA systems have increased, there has been little work exploring the

  11. Interaction of Physical and Chemical Processes Controlling the Environmental Fate and Transport of Lampricides Through Stream-Hyporheic Systems

    NASA Astrophysics Data System (ADS)

    Hixson, J.; Ward, A. S.; Schmadel, N.; McConville, M.; Remucal, C.

    2016-12-01

    The transport and fate of contaminants of emerging concern through the environment is complicated by the heterogeneity of natural systems and the unique reaction pathways of individual compounds. Our current evaluation of risk is often simplified to controls assumed to be homogeneous in space and time. However, we know spatial heterogeneity and time-variable reaction rates complicate predictions of environmental transport and fate, and therefore risk. These complications are the result of the interactions between the physical and chemical systems and the time-variable equilibrium that exists between the two. Compounds that interact with both systems, such as photolytic compounds, require that both components are fully understood in order to predict transport and fate. Release of photolytic compounds occurs through both unintentional releases and intentional loadings. Evaluating risks associated with unintentional releases and implementing best management practices for intentional releases requires an in-depth understanding of the sensitivity of photolytic compounds to external controls. Lampricides, such as 3-trifluoromethyl-4-nitrophenol (TFM), are broadly applied in the Great Lakes system to control the population of invasive sea lamprey. Over-dosing can yield fish kills and other detrimental impacts. Still, planning accounts for time of passage and dilution, but not the interaction of the physical and chemical systems (i.e., storage in the hyporheic zone and time-variable decay rates). In this study, we model a series of TFM applications to test the efficacy of dosing as a function of system characteristics. Overall, our results demonstrate the complexity associated with photo-sensitive compounds through stream-hyporheic systems, and highlight the need to better understand how physical and chemical systems interact to control transport and fate in the environment.

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

    Witzke, Edward L.

    In 2014, the United States Department of Defense started tra nsitioning the way it performs risk management and accreditation of informatio n systems to a process entitled Risk Management Framework for DoD Information Technology or RMF for DoD IT. There are many more security and privacy contro ls (and control enhancements) from which to select in RMF, than there w ere in the previous Information Assurance process. This report is an attempt t o clarify the way security controls and enhancements are selected. After a brief overview and comparison of RMF for DoD I T with the previously used process,more » this report looks at the determination of systems as National Security Systems (NSS). Once deemed to be an NSS, this report addr esses the categorization of the information system with respect to impact level s of the various security objectives and the selection of an initial baseline o f controls. Next, the report describes tailoring the controls through the use of overl ays and scoping considerations. Finally, the report discusses organizatio n-defined values for tuning the security controls to the needs of the information system.« less

  13. Making partnerships work: issues of risk, trust and control for managers and service providers.

    PubMed

    Walker, Rae; Smith, Penny; Adam, Jenny

    2009-03-01

    Trust is widely recognised is a core feature of partnership relationships and one that facilitates joint work. It is an issue that must be addressed if partnerships are to enhance service system integration. In recent literature trust has been linked to concepts of risk and control. In this study of trust within a Primary Care Partnership (PCP) in Australia the experiences of risk and uncertainty, and control, of participants in different structural positions, were explored in detail. The data used in this paper was qualitative, derived from 63 interviews with managers and service providers participating in committees of the PCP. This paper reports on the differences in the experience of risk and uncertainty, trust and control, of managers and service providers working as boundary spanners through the committees of a PCP. For managers there were significant risks and uncertainties, and trust and control were important. For service providers there were few risks and uncertainties, and trust and control were of much less importance. Some policy implications of the differences in perspective are discussed, as are important areas for further research.

  14. Antenatal Ultrasound and Risk of Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Grether, Judith K.; Li, Sherian Xu; Yoshida, Cathleen K.; Croen, Lisa A.

    2010-01-01

    We evaluated antenatal ultrasound (U/S) exposure as a risk factor for autism spectrum disorders (ASD), comparing affected singleton children and control children born 1995-1999 and enrolled in the Kaiser Permanente health care system. Among children with ASD (n = 362) and controls (n = 393), 13% had no antenatal exposure to U/S examinations;…

  15. [Correlation analysis of G870A CCND1 gene polymorphism with digestive system tumors].

    PubMed

    Yang, Shu-Min; Shi, Ya-Lin

    2016-11-20

    To study the correlation of G870A CCND1 gene polymorphism and digestive system tumors. From August 2010 to August 2014, 164 digestive system cancer patients (including 82 patients with gastric cancer and 82 with colorectal cancer) and 82 healthy subjects (control group) were examined with PCR-restriction fragment length polymorphism (PCR-RFLP). The distribution of CCND1 gene G870A frequency in the 3 groups and its association with tumor staging and grading were analyzed. The frequencies of the GG, GA and AA genotypes in G870A CCND1 gene loci in patients with gastric cancer and colorectal cancer differed significantly from those in the control group (P<0.05). G870A CCND1 gene polymorphism was closely associated with an increased risk of digestive system tumors (P<0.05). The GA and AA genotypes were associated with a significantly higher risk of digestive system cancer risk than the GG genotype (P<0.05), and their frequencies were significantly higher in patients with tumors of higher pathological grade and in those in advanced tumor stages (P<0.05). G870A CCND1 gene polymorphism is associated with the risk of digestive system tumors. The allele A is associated with an increased risk of digestive system tumors and correlated with the tumor differentiation and staging of the tumor.

  16. Human Factors in Training

    NASA Technical Reports Server (NTRS)

    Barshi, Immanuel; Byme, Vicky; Arsintescu, Lucia

    2008-01-01

    Future space missions will be significantly longer than current Shuttle missions and new systems will be more complex than current systems. Increasing communication delays between crews and Earth-based support means that astronauts need to be prepared to handle the unexpected on their own. As crews become more autonomous, their potential span of control and required expertise must grow to match their autonomy. It is not possible to train for every eventuality ahead of time on the ground, or to maintain trained skills across long intervals of disuse. To adequately prepare NASA personnel for these challenges, new training approaches, methodologies, and tools are required. This research project aims at developing these training capabilities. Training efforts in FY07 strongly focused on crew medical training, but also began exploring how Space Flight Resource Management training for Mission Operations Directorate (MOD) Flight Controllers could be integrated with systems training for optimal Mission Control Center operations. Beginning in January 2008, the training research effort will include team training prototypes and tools. The Training Task addresses Program risks that lie at the intersection of the following three risks identified by the Project: 1) Risk associated with poor task design; 2) Risk of error due to inadequate information; 3) Risk associated with reduced safety and efficiency due to poor human factors design.

  17. Federal Family Education Loan Information System. Weak Computer Controls Increase Risk of Unauthorized Access to Sensitive Data. Report to the Secretary of Education.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC. Accounting and Information Management Div.

    This report presents an evaluation of the general controls over the Federal Family Education Loan Program (FFELP) information system maintained and operated by a contractor for the U.S. Department of Education (ED), which administers FFELP. The evaluation found that ED's general controls over the FFELP information system did not adequately protect…

  18. Evaluating Information Assurance Control Effectiveness on an Air Force Supervisory Control and Data Acquisition (SCADA) System

    DTIC Science & Technology

    2011-03-01

    Byres, E. J., Lowe, J. (2004). The Myths and facts behind cyber security risks for industrial control systems . Berlin, Germany: VDE 2004 Congress...ACQUISITION (SCADA) SYSTEM THESIS Jason R. Nielsen, Major, USAF AFIT/GCO/ENG/11-10 DEPARTMENT OF THE AIR FORCE AIR UNIVERSITY AIR FORCE...DATA ACQUISITION (SCADA) SYSTEM THESIS Presented to the Faculty Department of Electrical and Computer Engineering Graduate School of

  19. Learning from high risk industries may not be straightforward: a qualitative study of the hierarchy of risk controls approach in healthcare.

    PubMed

    Liberati, Elisa G; Peerally, Mohammad Farhad; Dixon-Woods, Mary

    2018-02-01

    Though healthcare is often exhorted to learn from 'high-reliability' industries, adopting tools and techniques from those sectors may not be straightforward. We sought to examine the hierarchies of risk controls approach, used in high-risk industries to rank interventions according to supposed effectiveness in reducing risk, and widely advocated as appropriate for healthcare. Classification of risk controls proposed by clinical teams following proactive detection of hazards in their clinical systems. Classification was based on a widely used hierarchy of controls developed by the US National Institute for Occupational Safety and Health (NIOSH). A range of clinical settings in four English NHS hospitals. The four clinical teams in our study planned a total of 42 risk controls aimed at addressing safety hazards. Most (n = 35) could be classed as administrative controls, thus qualifying among the weakest type of interventions according to the HoC approach. Six risk controls qualified as 'engineering' controls, i.e. the intermediate level of the hierarchy. Only risk control qualified as 'substitution', classified as the strongest type of intervention by the HoC. Many risk controls introduced by clinical teams may cluster towards the apparently weaker end of an established hierarchy of controls. Less clear is whether the HoC approach as currently formulated is useful for the specifics of healthcare. Valuable opportunities for safety improvement may be lost if inappropriate hierarchical models are used to guide the selection of patient safety improvement interventions. Though learning from other industries may be useful, caution is needed. © The Author(s) 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care.

  20. Legionella Risk Management and Control in Potable Water Systems: Argument for the Abolishment of Routine Testing.

    PubMed

    Whiley, Harriet

    2016-12-24

    Legionella is an opportunistic pathogen of public health significance. One of the main sources of Legionella is potable water systems. As a consequence of aging populations there is an increasing demographic considered at high risk for Legionellosis and, as such, a review of the guidelines is required. Worldwide, Legionella has been detected from many potable water sources, suggesting it is ubiquitous in this environment. Previous studies have identified the limitations of the current standard method for Legionella detection and the high possibility of it returning both false negative and false positive results. There is also huge variability in Legionella test results for the same water sample when conducted at different laboratories. However, many guidelines still recommend the testing of water systems. This commentary argues for the removal of routine Legionella monitoring from all water distribution guidelines. This procedure is financially consuming and false negatives may result in managers being over-confident with a system or a control mechanism. Instead, the presence of the pathogen should be assumed and focus spent on managing appropriate control measures and protecting high-risk population groups.

  1. Legionella Risk Management and Control in Potable Water Systems: Argument for the Abolishment of Routine Testing

    PubMed Central

    Whiley, Harriet

    2016-01-01

    Legionella is an opportunistic pathogen of public health significance. One of the main sources of Legionella is potable water systems. As a consequence of aging populations there is an increasing demographic considered at high risk for Legionellosis and, as such, a review of the guidelines is required. Worldwide, Legionella has been detected from many potable water sources, suggesting it is ubiquitous in this environment. Previous studies have identified the limitations of the current standard method for Legionella detection and the high possibility of it returning both false negative and false positive results. There is also huge variability in Legionella test results for the same water sample when conducted at different laboratories. However, many guidelines still recommend the testing of water systems. This commentary argues for the removal of routine Legionella monitoring from all water distribution guidelines. This procedure is financially consuming and false negatives may result in managers being over-confident with a system or a control mechanism. Instead, the presence of the pathogen should be assumed and focus spent on managing appropriate control measures and protecting high-risk population groups. PMID:28029126

  2. The significance of OLGA and OLGIM staging systems in the risk assessment of gastric cancer: a systematic review and meta-analysis.

    PubMed

    Yue, Hu; Shan, Liu; Bin, Lv

    2018-02-19

    Despite extensive research on the criteria for the assessment of gastric cancer risk using the Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastritis/Intestinal-Metaplasia Assessment (OLGIM) systems, no comprehensive overview or systematic summary on their use is currently available. To perform a systematic review and meta-analysis to assess the efficacy of the OLGA and OLGIM staging systems in evaluating gastric cancer risk. We searched various databases, including PubMed, EMBASE, Medline, and Cochrane's library, for articles published before March 2017 on the association between OLGA/OLGIM stages and risk of gastric cancer. Statistical analysis was performed using RevMan 5.30 and Stata 14.0, with the odds ratio, risk ratio, and 95% confidence interval as the effect measures. A meta-analysis of six case-control studies and two cohort studies, comprising 2700 subjects, was performed. The meta-analysis of prospective case-control studies demonstrated a significant association between the OLGA/OLGIM stages III/IV and gastric cancer. The Newcastle-Ottawa Scale (NOS) score reflected heterogeneity in the case-control studies on OLGA. Subgroup analysis of high-quality (NOS score ≥ 5) studies showed an association between OLGA stage III/IV and increased risk of gastric cancer; the association was also high in the remaining study with low NOS score. The association between higher stages of gastritis defined by OLGA and risk of gastric cancer was significant. This correlation implies that close and frequent monitoring of such high-risk patients is necessary to facilitate timely diagnosis of gastric cancer.

  3. Amoeba-related health risk in drinking water systems: could monitoring of amoebae be a complementary approach to current quality control strategies?

    PubMed

    Codony, Francesc; Pérez, Leonardo Martín; Adrados, Bárbara; Agustí, Gemma; Fittipaldi, Mariana; Morató, Jordi

    2012-01-01

    Culture-based methods for fecal indicator microorganisms are the standard protocol to assess potential health risk from drinking water systems. However, these traditional fecal indicators are inappropriate surrogates for disinfection-resistant fecal pathogens and the indigenous pathogens that grow in drinking water systems. There is now a range of molecular-based methods, such as quantitative PCR, which allow detection of a variety of pathogens and alternative indicators. Hence, in addition to targeting total Escherichia coli (i.e., dead and alive) for the detection of fecal pollution, various amoebae may be suitable to indicate the potential presence of pathogenic amoeba-resisting microorganisms, such as Legionellae. Therefore, monitoring amoeba levels by quantitative PCR could be a useful tool for directly and indirectly evaluating health risk and could also be a complementary approach to current microbial quality control strategies for drinking water systems.

  4. Innovative neuro-fuzzy system of smart transport infrastructure for road traffic safety

    NASA Astrophysics Data System (ADS)

    Beinarovica, Anna; Gorobetz, Mikhail; Levchenkov, Anatoly

    2017-09-01

    The proposed study describes applying of neural network and fuzzy logic in transport control for safety improvement by evaluation of accidents’ risk by intelligent infrastructure devices. Risk evaluation is made by following multiple-criteria: danger, changeability and influence of changes for risk increasing. Neuro-fuzzy algorithms are described and proposed for task solution. The novelty of the proposed system is proved by deep analysis of known studies in the field. The structure of neuro-fuzzy system for risk evaluation and mathematical model is described in the paper. The simulation model of the intelligent devices for transport infrastructure is proposed to simulate different situations, assess the risks and propose the possible actions for infrastructure or vehicles to minimize the risk of possible accidents.

  5. Potential of household environmental resources and practices in eliminating residual malaria transmission: a case study of Tanzania, Burundi, Malawi and Liberia.

    PubMed

    Semakula, Henry M; Song, Guobao; Zhang, Shushen; Achuu, Simon P

    2015-09-01

    The increasing protection gaps of insecticide-treated nets and indoor-residual spraying methods against malaria have led to an emergence of residual transmission in sub-Saharan Africa and thus, supplementary strategies to control mosquitoes are urgently required. To assess household environmental resources and practices that increase or reduce malaria risk among children under-five years of age in order to identify those aspects that can be adopted to control residual transmission. Household environmental resources, practices and malaria test results were extracted from Malaria Indicators Survey datasets for Tanzania, Burundi, Malawi and Liberia with 16,747 children from 11,469 households utilised in the analysis. Logistic regressions were performed to quantify the contribution of each factor to malaria occurrence. Cattle rearing reduced malaria risk between 26%-49% while rearing goats increased the risk between 26%-32%. All piped-water systems reduced malaria risk between 30%-87% (Tanzania), 48%-95% (Burundi), 67%-77% (Malawi) and 58%-73 (Liberia). Flush toilets reduced malaria risk between 47%-96%. Protected-wells increased malaria risk between 19%-44%. Interestingly, boreholes increased malaria risk between 19%-75%. Charcoal use reduced malaria risk between 11%-49%. Vector control options for tackling mosquitoes were revealed based on their risk levels. These included cattle rearing, installation of piped-water systems and flush toilets as well as use of smokeless fuels.

  6. Risk of infective endocarditis in patients with systemic lupus erythematosus in Taiwan: a nationwide population-based study.

    PubMed

    Chang, Y S; Chang, C C; Chen, Y H; Chen, W S; Chen, J H

    2017-10-01

    Objectives Patients with systemic lupus erythematosus are considered vulnerable to infective endocarditis and prophylactic antibiotics are recommended before an invasive dental procedure. However, the evidence is insufficient. This nationwide population-based study evaluated the risk and related factors of infective endocarditis in systemic lupus erythematosus. Methods We identified 12,102 systemic lupus erythematosus patients from the National Health Insurance research-oriented database, and compared the incidence rate of infective endocarditis with that among 48,408 non-systemic lupus erythematosus controls. A Cox multivariable proportional hazards model was employed to evaluate the risk of infective endocarditis in the systemic lupus erythematosus cohort. Results After a mean follow-up of more than six years, the systemic lupus erythematosus cohort had a significantly higher incidence rate of infective endocarditis (42.58 vs 4.32 per 100,000 person-years, incidence rate ratio = 9.86, p < 0.001) than that of the control cohort. By contrast, the older systemic lupus erythematosus cohort had lower risk (adjusted hazard ratio 11.64) than that of the younger-than-60-years systemic lupus erythematosus cohort (adjusted hazard ratio 15.82). Cox multivariate proportional hazards analysis revealed heart disease (hazard ratio = 5.71, p < 0.001), chronic kidney disease (hazard ratio = 2.98, p = 0.034), receiving a dental procedure within 30 days (hazard ratio = 36.80, p < 0.001), and intravenous steroid therapy within 30 days (hazard ratio = 39.59, p < 0.001) were independent risk factors for infective endocarditis in systemic lupus erythematosus patients. Conclusions A higher risk of infective endocarditis was observed in systemic lupus erythematosus patients. Risk factors for infective endocarditis in the systemic lupus erythematosus cohort included heart disease, chronic kidney disease, steroid pulse therapy within 30 days, and a recent invasive dental procedure within 30 days.

  7. Implementation of Enhanced Propulsion Control Modes for Emergency Flight Operation

    NASA Technical Reports Server (NTRS)

    Csank, Jeffrey T.; Chin, Jeffrey C.; May, Ryan D.; Litt, Jonathan S.; Guo, Ten-Huei

    2011-01-01

    Aircraft engines can be effective actuators to help pilots avert or recover from emergency situations. Emergency control modes are being developed to enhance the engines performance to increase the probability of recovery under these circumstances. This paper discusses a proposed implementation of an architecture that requests emergency propulsion control modes, allowing the engines to deliver additional performance in emergency situations while still ensuring a specified safety level. In order to determine the appropriate level of engine performance enhancement, information regarding the current emergency scenario (including severity) and current engine health must be known. This enables the engine to operate beyond its nominal range while minimizing overall risk to the aircraft. In this architecture, the flight controller is responsible for determining the severity of the event and the level of engine risk that is acceptable, while the engine controller is responsible for delivering the desired performance within the specified risk range. A control mode selector specifies an appropriate situation-specific enhanced mode, which the engine controller then implements. The enhanced control modes described in this paper provide additional engine thrust or response capabilities through the modification of gains, limits, and the control algorithm, but increase the risk of engine failure. The modifications made to the engine controller to enable the use of the enhanced control modes are described, as are the interaction between the various subsystems and importantly, the interaction between the flight controller/pilot and the propulsion control system. Simulation results demonstrate how the system responds to requests for enhanced operation and the corresponding increase in performance.

  8. NASA System Safety Handbook. Volume 1; System Safety Framework and Concepts for Implementation

    NASA Technical Reports Server (NTRS)

    Dezfuli, Homayoon; Benjamin, Allan; Everett, Christopher; Smith, Curtis; Stamatelatos, Michael; Youngblood, Robert

    2011-01-01

    System safety assessment is defined in NPR 8715.3C, NASA General Safety Program Requirements as a disciplined, systematic approach to the analysis of risks resulting from hazards that can affect humans, the environment, and mission assets. Achievement of the highest practicable degree of system safety is one of NASA's highest priorities. Traditionally, system safety assessment at NASA and elsewhere has focused on the application of a set of safety analysis tools to identify safety risks and formulate effective controls.1 Familiar tools used for this purpose include various forms of hazard analyses, failure modes and effects analyses, and probabilistic safety assessment (commonly also referred to as probabilistic risk assessment (PRA)). In the past, it has been assumed that to show that a system is safe, it is sufficient to provide assurance that the process for identifying the hazards has been as comprehensive as possible and that each identified hazard has one or more associated controls. The NASA Aerospace Safety Advisory Panel (ASAP) has made several statements in its annual reports supporting a more holistic approach. In 2006, it recommended that "... a comprehensive risk assessment, communication and acceptance process be implemented to ensure that overall launch risk is considered in an integrated and consistent manner." In 2009, it advocated for "... a process for using a risk-informed design approach to produce a design that is optimally and sufficiently safe." As a rationale for the latter advocacy, it stated that "... the ASAP applauds switching to a performance-based approach because it emphasizes early risk identification to guide designs, thus enabling creative design approaches that might be more efficient, safer, or both." For purposes of this preface, it is worth mentioning three areas where the handbook emphasizes a more holistic type of thinking. First, the handbook takes the position that it is important to not just focus on risk on an individual basis but to consider measures of aggregate safety risk and to ensure wherever possible that there be quantitative measures for evaluating how effective the controls are in reducing these aggregate risks. The term aggregate risk, when used in this handbook, refers to the accumulation of risks from individual scenarios that lead to a shortfall in safety performance at a high level: e.g., an excessively high probability of loss of crew, loss of mission, planetary contamination, etc. Without aggregated quantitative measures such as these, it is not reasonable to expect that safety has been optimized with respect to other technical and programmatic objectives. At the same time, it is fully recognized that not all sources of risk are amenable to precise quantitative analysis and that the use of qualitative approaches and bounding estimates may be appropriate for those risk sources. Second, the handbook stresses the necessity of developing confidence that the controls derived for the purpose of achieving system safety not only handle risks that have been identified and properly characterized but also provide a general, more holistic means for protecting against unidentified or uncharacterized risks. For example, while it is not possible to be assured that all credible causes of risk have been identified, there are defenses that can provide protection against broad categories of risks and thereby increase the chances that individual causes are contained. Third, the handbook strives at all times to treat uncertainties as an integral aspect of risk and as a part of making decisions. The term "uncertainty" here does not refer to an actuarial type of data analysis, but rather to a characterization of our state of knowledge regarding results from logical and physical models that approximate reality. Uncertainty analysis finds how the output parameters of the models are related to plausible variations in the input parameters and in the modeling assumptions. The evaluation of unrtainties represents a method of probabilistic thinking wherein the analyst and decision makers recognize possible outcomes other than the outcome perceived to be "most likely." Without this type of analysis, it is not possible to determine the worth of an analysis product as a basis for making decisions related to safety and mission success. In line with these considerations the handbook does not take a hazard-analysis-centric approach to system safety. Hazard analysis remains a useful tool to facilitate brainstorming but does not substitute for a more holistic approach geared to a comprehensive identification and understanding of individual risk issues and their contributions to aggregate safety risks. The handbook strives to emphasize the importance of identifying the most critical scenarios that contribute to the risk of not meeting the agreed-upon safety objectives and requirements using all appropriate tools (including but not limited to hazard analysis). Thereafter, emphasis shifts to identifying the risk drivers that cause these scenarios to be critical and ensuring that there are controls directed toward preventing or mitigating the risk drivers. To address these and other areas, the handbook advocates a proactive, analytic-deliberative, risk-informed approach to system safety, enabling the integration of system safety activities with systems engineering and risk management processes. It emphasizes how one can systematically provide the necessary evidence to substantiate the claim that a system is safe to within an acceptable risk tolerance, and that safety has been achieved in a cost-effective manner. The methodology discussed in this handbook is part of a systems engineering process and is intended to be integral to the system safety practices being conducted by the NASA safety and mission assurance and systems engineering organizations. The handbook posits that to conclude that a system is adequately safe, it is necessary to consider a set of safety claims that derive from the safety objectives of the organization. The safety claims are developed from a hierarchy of safety objectives and are therefore hierarchical themselves. Assurance that all the claims are true within acceptable risk tolerance limits implies that all of the safety objectives have been satisfied, and therefore that the system is safe. The acceptable risk tolerance limits are provided by the authority who must make the decision whether or not to proceed to the next step in the life cycle. These tolerances are therefore referred to as the decision maker's risk tolerances. In general, the safety claims address two fundamental facets of safety: 1) whether required safety thresholds or goals have been achieved, and 2) whether the safety risk is as low as possible within reasonable impacts on cost, schedule, and performance. The latter facet includes consideration of controls that are collective in nature (i.e., apply generically to broad categories of risks) and thereby provide protection against unidentified or uncharacterized risks.

  9. Research on Occupational Safety, Health Management and Risk Control Technology in Coal Mines.

    PubMed

    Zhou, Lu-Jie; Cao, Qing-Gui; Yu, Kai; Wang, Lin-Lin; Wang, Hai-Bin

    2018-04-26

    This paper studies the occupational safety and health management methods as well as risk control technology associated with the coal mining industry, including daily management of occupational safety and health, identification and assessment of risks, early warning and dynamic monitoring of risks, etc.; also, a B/S mode software (Geting Coal Mine, Jining, Shandong, China), i.e., Coal Mine Occupational Safety and Health Management and Risk Control System, is developed to attain the aforementioned objectives, namely promoting the coal mine occupational safety and health management based on early warning and dynamic monitoring of risks. Furthermore, the practical effectiveness and the associated pattern for applying this software package to coal mining is analyzed. The study indicates that the presently developed coal mine occupational safety and health management and risk control technology and the associated software can support the occupational safety and health management efforts in coal mines in a standardized and effective manner. It can also control the accident risks scientifically and effectively; its effective implementation can further improve the coal mine occupational safety and health management mechanism, and further enhance the risk management approaches. Besides, its implementation indicates that the occupational safety and health management and risk control technology has been established based on a benign cycle involving dynamic feedback and scientific development, which can provide a reliable assurance to the safe operation of coal mines.

  10. Research on Occupational Safety, Health Management and Risk Control Technology in Coal Mines

    PubMed Central

    Zhou, Lu-jie; Cao, Qing-gui; Yu, Kai; Wang, Lin-lin; Wang, Hai-bin

    2018-01-01

    This paper studies the occupational safety and health management methods as well as risk control technology associated with the coal mining industry, including daily management of occupational safety and health, identification and assessment of risks, early warning and dynamic monitoring of risks, etc.; also, a B/S mode software (Geting Coal Mine, Jining, Shandong, China), i.e., Coal Mine Occupational Safety and Health Management and Risk Control System, is developed to attain the aforementioned objectives, namely promoting the coal mine occupational safety and health management based on early warning and dynamic monitoring of risks. Furthermore, the practical effectiveness and the associated pattern for applying this software package to coal mining is analyzed. The study indicates that the presently developed coal mine occupational safety and health management and risk control technology and the associated software can support the occupational safety and health management efforts in coal mines in a standardized and effective manner. It can also control the accident risks scientifically and effectively; its effective implementation can further improve the coal mine occupational safety and health management mechanism, and further enhance the risk management approaches. Besides, its implementation indicates that the occupational safety and health management and risk control technology has been established based on a benign cycle involving dynamic feedback and scientific development, which can provide a reliable assurance to the safe operation of coal mines. PMID:29701715

  11. Integration and Assessment of Component Health Prognostics in Supervisory Control Systems

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

    Ramuhalli, Pradeep; Bonebrake, Christopher A.; Dib, Gerges

    Enhanced risk monitors (ERMs) for active components in advanced reactor concepts use predictive estimates of component failure to update, in real time, predictive safety and economic risk metrics. These metrics have been shown to be capable of use in optimizing maintenance scheduling and managing plant maintenance costs. Integrating this information with plant supervisory control systems increases the potential for making control decisions that utilize real-time information on component conditions. Such decision making would limit the possibility of plant operations that increase the likelihood of degrading the functionality of one or more components while maintaining the overall functionality of the plant.more » ERM uses sensor data for providing real-time information about equipment condition for deriving risk monitors. This information is used to estimate the remaining useful life and probability of failure of these components. By combining this information with plant probabilistic risk assessment models, predictive estimates of risk posed by continued plant operation in the presence of detected degradation may be estimated. In this paper, we describe this methodology in greater detail, and discuss its integration with a prototypic software-based plant supervisory control platform. In order to integrate these two technologies and evaluate the integrated system, software to simulate the sensor data was developed, prognostic models for feedwater valves were developed, and several use cases defined. The full paper will describe these use cases, and the results of the initial evaluation.« less

  12. Neuromuscular Control Deficits and the Risk of Subsequent Injury after a Concussion: A Scoping Review.

    PubMed

    Howell, David R; Lynall, Robert C; Buckley, Thomas A; Herman, Daniel C

    2018-05-01

    An emerging area of research has identified that an increased risk of musculoskeletal injury may exist upon returning to sports after a sport-related concussion. The mechanisms underlying this recently discovered phenomenon, however, remain unknown. One theorized reason for this increased injury risk includes residual neuromuscular control deficits that remain impaired despite clinical recovery. Thus, the objectives of this review were: (1) to summarize the literature examining the relationship between concussion and risk of subsequent injury and (2) to summarize the literature for one mechanism with a theorized association with this increased injury risk, i.e., neuromuscular control deficits observed during gait after concussion under dual-task conditions. Two separate reviews were conducted consistent with both specified objectives. Studies published before 9 December, 2016 were identified using PubMed, Web of Science, and Academic Search Premier (EBSCOhost). Inclusion for the objective 1 search included dependent variables of quantitative measurements of musculoskeletal injury after concussion. Inclusion criteria for the objective 2 search included dependent variables pertaining to gait, dynamic balance control, and dual-task function. A total of 32 studies were included in the two reviews (objective 1 n = 10, objective 2 n = 22). According to a variety of study designs, athletes appear to have an increased risk of sustaining a musculoskeletal injury following a concussion. Furthermore, dual-task neuromuscular control deficits may continue to exist after patients report resolution of concussion symptoms, or perform normally on other clinical concussion tests. Therefore, musculoskeletal injury risk appears to increase following a concussion and persistent motor system and attentional deficits also seem to exist after a concussion. While not yet experimentally tested, these motor system and attentional deficits may contribute to the risk of sustaining a musculoskeletal injury upon returning to full athletic participation.

  13. Staging of intestinal- and diffuse-type gastric cancers with the OLGA and OLGIM staging systems.

    PubMed

    Cho, S-J; Choi, I J; Kook, M-C; Nam, B-H; Kim, C G; Lee, J Y; Ryu, K W; Kim, Y-W

    2013-11-01

    Operative link on gastritis assessment (OLGA) and Operative link on gastric intestinal metaplasia assessment (OLGIM) staging systems have been proposed for gastric cancer (GC) risk estimation. To validate the OLGA and OLGIM staging systems in a region with high risk of GC. This retrospective study included 474 GC patients and age- and sex-matched health screening control persons in a cancer centre hospital. We classified gastritis patterns according to the OLGA and OLGIM systems using the histological database that a pathologist prospectively evaluated using the updated Sydney system. GC risk according to the OLGA and OLGIM stages was evaluated using logistic regression analysis. More GC patients had OLGA stages III-IV (46.2%) than controls (26.6%, P < 0.001), particularly among patients with intestinal-type GCs (62.2%) compared with diffuse-type GCs (30.9%). OLGA stages III and IV were significantly associated with increased risk of GC [odds ratios (ORs), 2.09; P = 0.008 and 2.04; P = 0.014 respectively] in multivariate analysis. The association was more significant for intestinal-type (ORs, 4.76; P = 0.001 and 4.19; P = 0.002 respectively), but not diffuse-type GC. OLGIM stages from I to IV were significantly associated with increased risk of both intestinal-type (ORs, 3.64, 5.15, 7.89 and 13.20 respectively) and diffuse-type GC (ORs, 1.84, 2.59, 5.08 and 6.32 respectively) with a significantly increasing trend. As high OLGA and OLGIM stages are independent risk factors for gastric cancer, the staging systems may be useful for risk assessment in high-risk regions, especially for intestinal-type gastric cancer. © 2013 John Wiley & Sons Ltd.

  14. Study of Systemic Risk Involved in Mutual Funds

    NASA Astrophysics Data System (ADS)

    Dash, Kishore C.; Dash, Monika

    Systemic risk, may be defined as the risk that contaminates to the whole system, consisting of many interacting agents that fail one after another. These agents, in an economic context, could be firms, banks, funds, or other financial institutions. Systemic risk is a macroscopic property of a system which emerges due to the nonlinear interaction of agents on a microscopic level. A stock market itself is a system in which there are many sub-systems, like Dowjones, Nifty, Sensex, Nasdaq, Nikkei and other market indices in global perspective. In Indian market, subsystems may be like Sensex, Nifty, BSE200, Bankex, smallcap index, midcap index, S&P CNX 500 and many others. Similarly there are many mutual funds, which have their own portfolio of different stocks, bonds etc. We have attempted to study the systemic risk involved in a fund as a macroscopic object with regard to its microscopic components as different stocks in its portfolio. It is observed that fund managers do manage to reduce the systemic risk just like we take precautions to control the spread of an epidemic.

  15. A Framework for Flood Risk Analysis and Benefit Assessment of Flood Control Measures in Urban Areas

    PubMed Central

    Li, Chaochao; Cheng, Xiaotao; Li, Na; Du, Xiaohe; Yu, Qian; Kan, Guangyuan

    2016-01-01

    Flood risk analysis is more complex in urban areas than that in rural areas because of their closely packed buildings, different kinds of land uses, and large number of flood control works and drainage systems. The purpose of this paper is to propose a practical framework for flood risk analysis and benefit assessment of flood control measures in urban areas. Based on the concept of disaster risk triangle (hazard, vulnerability and exposure), a comprehensive analysis method and a general procedure were proposed for urban flood risk analysis. Urban Flood Simulation Model (UFSM) and Urban Flood Damage Assessment Model (UFDAM) were integrated to estimate the flood risk in the Pudong flood protection area (Shanghai, China). S-shaped functions were adopted to represent flood return period and damage (R-D) curves. The study results show that flood control works could significantly reduce the flood risk within the 66-year flood return period and the flood risk was reduced by 15.59%. However, the flood risk was only reduced by 7.06% when the flood return period exceeded 66-years. Hence, it is difficult to meet the increasing demands for flood control solely relying on structural measures. The R-D function is suitable to describe the changes of flood control capacity. This frame work can assess the flood risk reduction due to flood control measures, and provide crucial information for strategy development and planning adaptation. PMID:27527202

  16. 78 FR 64735 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-29

    ...The Food and Drug Administration (FDA) is proposing regulations for domestic and foreign facilities that are required to register under the Federal Food, Drug, and Cosmetic Act (the FD&C Act) to establish requirements for current good manufacturing practice in manufacturing, processing, packing, and holding of animal food. FDA also is proposing regulations to require that certain facilities establish and implement hazard analysis and risk-based preventive controls for food for animals. FDA is taking this action to provide greater assurance that animal food is safe and will not cause illness or injury to animals or humans and is intended to build an animal food safety system for the future that makes modern, science and risk-based preventive controls the norm across all sectors of the animal food system.

  17. Behavioral and Neurodevelopmental Precursors to Binge-Type Eating Disorders: Support for the Role of Negative Valence Systems

    PubMed Central

    Vannucci, Anna; Nelson, Eric E.; Bongiorno, Diana M.; Pine, Daniel S.; Yanovski, Jack A.; Tanofsky-Kraff, Marian

    2015-01-01

    Background Pediatric loss-of-control eating is a robust behavioral precursor to binge-type eating disorders. Elucidating precursors to loss-of-control eating and binge-type eating disorders may refine developmental risk models of eating disorders and inform interventions. Method We review evidence within constructs of the Negative Valence Systems (NVS)-domain, as specified by the Research Domain Criteria framework. Based on published studies, we propose an integrated NVS model of binge-type eating disorder risk. Results Data implicate altered corticolimbic functioning, neuroendocrine dysregulation, and self-reported negative affect as possible risk-factors. However, neuroimaging and physiological data in children and adolescents are sparse, and most prospective studies are limited to self-report measures. Conclusions We discuss a broad NVS framework for conceptualizing early risk for binge-type eating disorders. Future neural and behavioral research on the developmental trajectory of loss-of-control and binge-type eating disorders is required. PMID:26040923

  18. [Contribution of remote sensing to malaria control].

    PubMed

    Machault, V; Pages, F; Rogier, C

    2009-04-01

    Despite national and international efforts, malaria remains a major public health problem and the fight to control the disease is confronted by numerous hurdles. Study of space and time dynamics of malaria is necessary as a basis for making appropriate decision and prioritizing intervention including in areas where field data are rare and sanitary information systems are inadequate. Evaluation of malarial risk should also help anticipate the risk of epidemics as a basis for early warning systems. Since 1960-70 civilian satellites launched for earth observation have been providing information for the measuring or evaluating geo-climatic and anthropogenic factors related to malaria transmission and burden. Remotely sensed data gathered for several civilian or military studies have allowed setup of entomological, parasitological, and epidemiological risk models and maps for rural and urban areas. Mapping of human populations at risk has also benefited from remotely sensing. The results of the published studies show that remote sensing is a suitable tool for optimizing planning, efficacy and efficiency of malaria control.

  19. The solution of the problem of oil spill risk control in the Baltic Sea taking into account the processes of oil propagation and degradation

    NASA Astrophysics Data System (ADS)

    Aseev, Nikita; Agoshkov, Valery

    2015-04-01

    The report is devoted to the one approach to the problem of oil spill risk control of protected areas in the Baltic Sea (Aseev et al., 2014). By the problem of risk control is meant a problem of determination of optimal resources quantity which are necessary for decreasing the risk to some acceptable value. It is supposed that only moment of accident is a random variable. Mass of oil slick is chosen as a function of control. For the realization of the random variable the quadratic 'functional of cost' is introduced. It comprises cleaning costs and deviation of damage of oil pollution from its acceptable value. The problem of minimization of this functional is solved based on the methods of optimal control and the theory of adjoint equations (Agoshkov, 2003, Agoshkov et al., 2012). The solution of this problem is explicitly found. In order to solve the realistic problem of oil spill risk control in the Baltic Sea the 2d model of oil spill propagation on the sea surface based on the Seatrack Web model (Liungman, Mattson, 2011) is developed. The model takes into account such processes as oil transportation by sea currents and wind, turbulent diffusion, spreading, evaporation from sea surface, dispersion and formation of emulsion 'water-in-oil'. The model allows to calculate basic oil slick parameters: localization, mass, volume, thickness, density of oil, water content and viscosity of emulsion. The results of several numerical experiments in the Baltic Sea using the model and the methodology of oil spill risk control are presented. Along with moment of accident other parameters of oil spill and environment could be chosen as a random variables. The methodology of solution of oil spill risk control problem will remain the same but the computational complexity will increase. Conversion of the function of control to quantity of resources with a glance to methods of pollution removal should be processed. As a result, the developed 2d model of oil spill propagation combined with the methodology of solution of oil spill risk control problem could provide the basis for oil spill simulation systems, systems of evaluation and control of oil spill risk and damage in seas or decision support systems. References V.I. Agoshkov. The methods of optimal control and adjoint equations in problems of mathematical physics. // Moscow: INM RAS, 2003, 256 p. (in Russian). V.I. Agoshkov, N.A. Aseev, I.S. Novikov. The methods of investigation and solution of the problems of local sources and local or integral observations. // Moscow: INM RAS, 2012. 151 p. (in Russian). N.A. Aseev, V.I. Agoshkov, V.B. Zalesny, R. Aps, P. Kujala, and J. Rytkonen. The problem of control of oil pollution risk in the Baltic Sea // Russ. J. Numer. Analysis and Math. Modelling, 2014, V 29, No. 2, 93-105. O. Liungman, J. Mattson. Scientific documentation of Seatrack Web; physical processes, algorithms and references, 2011. // https://stw-helcom.smhi.se/

  20. [Pregnancy in systemic autoimmune diseases: Myths, certainties and doubts].

    PubMed

    Danza, Álvaro; Ruiz-Irastorza, Guillermo; Khamashta, Munther

    2016-10-07

    Systemic autoimmune diseases especially affect young women during childbearing age. The aim of this review is to update systemic lupus erythematosus, antiphospholipid syndrome and systemic sclerosis management during pregnancy. These diseases present variable maternal and fetal risks. Studies show that an appropriate disease control and a reasonable remission period prior to pregnancy are associated with satisfactory obstetric outcomes. Antiphospholipid autoantibodies profile, anti-Ro/anti-La antibodies, pulmonary pressure and activity evaluation are crucial to assess the pregnancy risk. Monitoring requires a multidisciplinary team, serial analytic controls and Doppler ultrasound of maternal and fetal circulation. Evaluation of the activity of the disease is essential. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  1. Modeling Finite-Time Failure Probabilities in Risk Analysis Applications.

    PubMed

    Dimitrova, Dimitrina S; Kaishev, Vladimir K; Zhao, Shouqi

    2015-10-01

    In this article, we introduce a framework for analyzing the risk of systems failure based on estimating the failure probability. The latter is defined as the probability that a certain risk process, characterizing the operations of a system, reaches a possibly time-dependent critical risk level within a finite-time interval. Under general assumptions, we define two dually connected models for the risk process and derive explicit expressions for the failure probability and also the joint probability of the time of the occurrence of failure and the excess of the risk process over the risk level. We illustrate how these probabilistic models and results can be successfully applied in several important areas of risk analysis, among which are systems reliability, inventory management, flood control via dam management, infectious disease spread, and financial insolvency. Numerical illustrations are also presented. © 2015 Society for Risk Analysis.

  2. Game theory and risk-based leveed river system planning with noncooperation

    NASA Astrophysics Data System (ADS)

    Hui, Rui; Lund, Jay R.; Madani, Kaveh

    2016-01-01

    Optimal risk-based levee designs are usually developed for economic efficiency. However, in river systems with multiple levees, the planning and maintenance of different levees are controlled by different agencies or groups. For example, along many rivers, levees on opposite riverbanks constitute a simple leveed river system with each levee designed and controlled separately. Collaborative planning of the two levees can be economically optimal for the whole system. Independent and self-interested landholders on opposite riversides often are willing to separately determine their individual optimal levee plans, resulting in a less efficient leveed river system from an overall society-wide perspective (the tragedy of commons). We apply game theory to simple leveed river system planning where landholders on each riverside independently determine their optimal risk-based levee plans. Outcomes from noncooperative games are analyzed and compared with the overall economically optimal outcome, which minimizes net flood cost system-wide. The system-wide economically optimal solution generally transfers residual flood risk to the lower-valued side of the river, but is often impractical without compensating for flood risk transfer to improve outcomes for all individuals involved. Such compensation can be determined and implemented with landholders' agreements on collaboration to develop an economically optimal plan. By examining iterative multiple-shot noncooperative games with reversible and irreversible decisions, the costs of myopia for the future in making levee planning decisions show the significance of considering the externalities and evolution path of dynamic water resource problems to improve decision-making.

  3. 76 FR 51457 - Order Temporarily Exempting the Floor Broker Operations of Broker-Dealers With Market Access That...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-18

    ... applicable in connection with market access.\\9\\ The required financial risk management controls and... Act of 1934 August 15, 2011. I. Introduction Pursuant to Rule 15c3-5(f) under the Securities Exchange... maintain a system of risk management controls and supervisory procedures that, among other things, is...

  4. 49 CFR Appendix D to Part 172 - Rail Risk Analysis Factors

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... nature of the rail system, each carrier must select and document the analysis method/model used and identify the routes to be analyzed. D. The safety and security risk analysis must consider current data and... curvature; 7. Presence or absence of signals and train control systems along the route (“dark” versus...

  5. Impact of particles on sediment accumulation in a drinking water distribution system.

    PubMed

    Vreeburg, J H G; Schippers, D; Verberk, J Q J C; van Dijk, J C

    2008-10-01

    Discolouration of drinking water is one of the main reasons customers complain to their water company. Though corrosion of cast iron is often seen as the main source for this problem, the particles originating from the treatment plant play an important and potentially dominant role in the generation of a discolouration risk in drinking water distribution systems. To investigate this thesis a study was performed in a drinking water distribution system. In two similar isolated network areas the effect of particles on discolouration risk was studied with particle counting, the Resuspension Potential Method (RPM) and assessment of the total accumulated sediment. In the 'Control Area', supplied with normal drinking water, the discolouration risk was regenerated within 1.5 year. In the 'Research Area', supplied with particle-free water, this will take 10-15 years. An obvious remedy for controlling the discolouration risk is to improve the treatment with respect to the short peaks that are caused by particle breakthrough.

  6. CXCL4 in undifferentiated connective tissue disease at risk for systemic sclerosis (SSc) (previously referred to as very early SSc).

    PubMed

    Valentini, Gabriele; Riccardi, Antonella; Vettori, Serena; Irace, Rosaria; Iudici, Michele; Tolone, Salvatore; Docimo, Ludovico; Bocchino, Marialuisa; Sanduzzi, Alessandro; Cozzolino, Domenico

    2017-08-01

    The aim of the study was to evaluate CXCL4 levels in undifferentiated connective tissue disease at risk for SSc (UCTD-SSc-risk) and confirm its increase and investigate its prognostic value. Serum CXCL4 levels were measured in 45 patients and 24 controls. CXCL4 was significantly higher in UCTD-SSc-risk patients than in controls. It resulted higher in patients with a shorter disease duration and in those lacking capillaroscopic alterations. We confirm that CXCL4 levels are increased in UCTD-risk-SSc patients. Further studies are needed to investigate the role of CXCL4 assessment in UCTD-risk-SSc.

  7. Aviation Safety Risk Modeling: Lessons Learned From Multiple Knowledge Elicitation Sessions

    NASA Technical Reports Server (NTRS)

    Luxhoj, J. T.; Ancel, E.; Green, L. L.; Shih, A. T.; Jones, S. M.; Reveley, M. S.

    2014-01-01

    Aviation safety risk modeling has elements of both art and science. In a complex domain, such as the National Airspace System (NAS), it is essential that knowledge elicitation (KE) sessions with domain experts be performed to facilitate the making of plausible inferences about the possible impacts of future technologies and procedures. This study discusses lessons learned throughout the multiple KE sessions held with domain experts to construct probabilistic safety risk models for a Loss of Control Accident Framework (LOCAF), FLightdeck Automation Problems (FLAP), and Runway Incursion (RI) mishap scenarios. The intent of these safety risk models is to support a portfolio analysis of NASA's Aviation Safety Program (AvSP). These models use the flexible, probabilistic approach of Bayesian Belief Networks (BBNs) and influence diagrams to model the complex interactions of aviation system risk factors. Each KE session had a different set of experts with diverse expertise, such as pilot, air traffic controller, certification, and/or human factors knowledge that was elicited to construct a composite, systems-level risk model. There were numerous "lessons learned" from these KE sessions that deal with behavioral aggregation, conditional probability modeling, object-oriented construction, interpretation of the safety risk results, and model verification/validation that are presented in this paper.

  8. Injury risk in runners using standard or motion control shoes: a randomised controlled trial with participant and assessor blinding.

    PubMed

    Malisoux, Laurent; Chambon, Nicolas; Delattre, Nicolas; Gueguen, Nils; Urhausen, Axel; Theisen, Daniel

    2016-04-01

    This randomised controlled trial investigated if the usage of running shoes with a motion control system modifies injury risk in regular leisure-time runners compared to standard shoes, and if this influence depends on foot morphology. Recreational runners (n=372) were given either the motion control or the standard version of a regular running shoe model and were followed up for 6 months regarding running activity and injury. Foot morphology was analysed using the Foot Posture Index method. Cox regression analyses were used to compare injury risk between the two groups, based on HRs and their 95% CIs, controlling for potential confounders. Stratified analyses were conducted to evaluate the effect of motion control system in runners with supinated, neutral and pronated feet. The overall injury risk was lower among the participants who had received motion control shoes (HR=0.55; 95% CI 0.36 to 0.85) compared to those receiving standard shoes. This positive effect was only observed in the stratum of runners with pronated feet (n=94; HR=0.34; 95% CI 0.13 to 0.84); there was no difference in runners with neutral (n=218; HR=0.78; 95% CI 0.44 to 1.37) or supinated feet (n=60; HR=0.59; 95% CI 0.20 to 1.73). Runners with pronated feet using standard shoes had a higher injury risk compared to those with neutral feet (HR=1.80; 95% CI 1.01 to 3.22). The overall injury risk was lower in participants who had received motion control shoes. Based on secondary analysis, those with pronated feet may benefit most from this shoe type. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. Adolescent Neurodevelopment of Cognitive Control and Risk-taking in Negative Family Contexts

    PubMed Central

    McCormick, Ethan M.; Qu, Yang; Telzer, Eva H.

    2015-01-01

    Adolescents have an increased need to regulate their behavior as they gain access to opportunities for risky behavior; however, cognitive control systems necessary for this regulation remain relatively immature. Parents can impact their adolescent child's abilities to regulate their behavior and engagement in risk taking. Since adolescents undergo significant neural change, negative parent-child relationship quality may impede or alter development in prefrontal regions subserving cognitive control. To test this hypothesis, 20 adolescents completed a go/nogo task during two fMRI scans occurring 1 year apart. Adolescents reporting greater family conflict and lower family cohesion showed longitudinal increases in risk-taking behavior, which was mediated by longitudinal increases in left VLPFC activation during cognitive control. These results underscore the importance of parent-child relationships during early adolescence, and the neural processes by which cognitive control may be derailed and lead to increased risk taking. PMID:26434803

  10. Adolescent neurodevelopment of cognitive control and risk-taking in negative family contexts.

    PubMed

    McCormick, Ethan M; Qu, Yang; Telzer, Eva H

    2016-01-01

    Adolescents have an increased need to regulate their behavior as they gain access to opportunities for risky behavior; however, cognitive control systems necessary for this regulation remain relatively immature. Parents can impact their adolescent child's abilities to regulate their behavior and engagement in risk taking. Since adolescents undergo significant neural change, negative parent-child relationship quality may impede or alter development in prefrontal regions subserving cognitive control. To test this hypothesis, 20 adolescents completed a Go/NoGo task during two fMRI scans occurring 1year apart. Adolescents reporting greater family conflict and lower family cohesion showed longitudinal increases in risk-taking behavior, which was mediated by longitudinal increases in left VLPFC activation during cognitive control. These results underscore the importance of parent-child relationships during early adolescence, and the neural processes by which cognitive control may be derailed and may lead to increased risk taking. Published by Elsevier Inc.

  11. Functional dysconnectivity of corticostriatal circuitry as a risk phenotype for psychosis.

    PubMed

    Fornito, Alex; Harrison, Ben J; Goodby, Emmeline; Dean, Anna; Ooi, Cinly; Nathan, Pradeep J; Lennox, Belinda R; Jones, Peter B; Suckling, John; Bullmore, Edward T

    2013-11-01

    Dysregulation of corticostriatal circuitry has long been thought to be critical in the etiology of psychotic disorders, although the differential roles played by dorsal and ventral systems in mediating risk for psychosis have been contentious. To use resting-state functional magnetic resonance imaging to characterize disease-related, risk-related, and symptom-related changes of corticostriatal functional circuitry in patients with first-episode psychosis and their unaffected first-degree relatives. This case-control cross-sectional study was conducted at a specialist early psychosis clinic, GlaxoSmithKline Clinical Unit, and magnetic resonance imaging facility. Nineteen patients with first-episode psychosis, 25 of their unaffected first-degree relatives, and 26 healthy control subjects were included in this study. Voxelwise statistical parametric maps testing differences in the strength of functional connectivity between 6 striatal seed regions of interest (3 caudate and 3 putamen) per hemisphere and all other brain regions. Disease-related changes, reflecting differences between patients and control subjects, involved widespread dysregulation of corticostriatal systems characterized most prominently by a dorsal-to-ventral gradient of hypoconnectivity to hyperconnectivity between striatal and prefrontal regions. A similar gradient was evident in comparisons between relatives and control subjects, identifying it as a genetically inherited risk phenotype. In patients, functional connectivity in risk-affected and disease-affected dorsal frontostriatal circuitry correlated with the severity of both positive and negative symptoms. First-episode psychosis is associated with pronounced dysregulation of corticostriatal systems, characterized most prominently by hypoconnectivity of dorsal and hyperconnectivity of ventral frontostriatal circuits. These changes correlate with symptom severity and are also apparent in unaffected first-degree relatives, suggesting that they represent a putative risk phenotype for psychotic illness.

  12. Risk of malignancy with systemic psoriasis treatment in the Psoriasis Longitudinal Assessment Registry.

    PubMed

    Fiorentino, David; Ho, Vincent; Lebwohl, Mark G; Leite, Luiz; Hopkins, Lori; Galindo, Claudia; Goyal, Kavitha; Langholff, Wayne; Fakharzadeh, Steven; Srivastava, Bhaskar; Langley, Richard G

    2017-11-01

    The effect of systemic therapy on malignancy risk among patients with psoriasis is not fully understood. Evaluate the impact of systemic treatment on malignancy risk among patients with psoriasis in the Psoriasis Longitudinal Assessment and Registry (PSOLAR). Nested case-control analyses were performed among patients with no history of malignancy. Cases were defined as first malignancy (other than nonmelanoma skin cancer) in the Psoriasis Longitudinal Assessment and Registry, and controls were matched by age, sex, geographic region, and time on registry. Study therapies included methotrexate, ustekinumab, and tumor necrosis factor-α (TNF-α) inhibitors. Exposure was defined as 1 or more doses of study therapy within 12 months of malignancy onset and further stratified by duration of therapy. Multivariate conditional logistic regression, adjusted for potential confounders, was used to estimate odds ratios of malignancies associated with therapy. Among 12,090 patients, 252 malignancy cases were identified and 1008 controls were matched. Treatment with methotrexate or ustekinumab for more than 0 months to less than 3 months, 3 months to less than 12 months, or 12 months or longer was not associated with increased malignancy risk versus no exposure. Longer-term (≥12 months) (odds ratio, 1.54; 95% confidence interval, 1.10-2.15; P = .01), but not shorter-term treatment, with a TNF-α inhibitor was associated with increased malignancy risk. Cases and controls could belong to 1 or more therapy categories. Long-term (≥12 months) treatment with a TNF-α inhibitor, but not methotrexate and ustekinumab, may increase risk for malignancy in patients with psoriasis. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  13. Current food safety management systems in fish-exporting companies require further improvements to adequately cope with contextual pressure: case study.

    PubMed

    Onjong, Hillary Adawo; Wangoh, John; Njage, Patrick Murigu Kamau

    2014-10-01

    Fish-processing plants still face food safety (FS) challenges worldwide despite the existence of several quality assurance standards and food safety management systems/s (FSMSs). This study assessed performance of FSMS in fish exporting sector considering pressure from the context in which they operate. A FSMS diagnostic tool with checklist was used to assess the context, FSMS, and FS output in 9 Kenyan fish exporting companies. Majority (67%) companies operated at moderate- to high-risk context but with an average performance in control and assurance activities. This situation could be insufficient to deal with ambiguity, uncertainty, and vulnerability issues in the context characteristics. Contextual risk posed by product characteristics (nature of raw materials) and chain environment characteristics was high. Risk posed by the chain environment characteristics, low power in supplier relationships, and low degree of authority in customer relationships was high. Lack of authority in relationship with suppliers would lead to high raw material risk situation. Even though cooling facilities, a key control activity, was at an advanced level, there was inadequate packaging intervention equipment which coupled with inadequate physical intervention equipment could lead to further weakened FSMS performance. For the fish companies to improve their FSMS to higher level and enhance predictability, they should base their FSMS on scientific information sources, historical results, and own experimental trials in their preventive, intervention, and monitoring systems. Specific suggestions are derived for improvements toward higher FSMS activity levels or lower risk levels in context characteristics. Weak areas in performance of control and assurance activities in export fish-processing sector already implementing current quality assurance guidelines and standards were studied taking into consideration contextual pressure wherein the companies operate. Important mitigation measures toward improved contextual risk, core assurance, and control activities irrespective of applied food safety management systems in fish industries were suggested. © 2014 Institute of Food Technologists®

  14. [Clinical risk management in german hospitals - does size really matter?].

    PubMed

    Bohnet-Joschko, S; Jandeck, L M; Zippel, C; Andersen, M; Krummenauer, F

    2011-06-01

    In the last years, German hospitals have implemented different measures to increase patient safety. Special importance has been attached to near miss reporting systems (critical incident reporting system, CIRS) as instruments for risk identification in health care, instruments that promise high potential for organisational learning. To gain insight into the current status of critical incident reporting systems and other instruments for clinical risk management, a survey among 341 hospitals was carried out in 2009. Questions covered a process of six steps: from risk strategy to methods for risk identification, to risk analysis and risk assessment, to risk controlling and risk monitoring. Structured telephone interviews were conducted with 341 German hospitals, featuring in their statutory quality reports certain predefined key terms that indicated the concluded or planned implementation of clinical risk management. The main objective of those interviews was to check the relation between status/organisation of self-reported risk management and both operator (private, public, NPO) and size of hospital. The implementation of near miss reporting systems (CIRS) in German hospitals has been constantly rising since 2004: in 2009, 54 % of the interviewed hospitals reported an implemented CIRS; of these, 72 % reported the system to be hospital-wide. An association between CIRS and private, public or NPO-operator could not be detected (Fisher p = 1.000); however, the degree of CIRS implementation was significantly increasing with the size of the hospital, i.e., the number of beds (Fisher p = 0.008): only 38 % of the hospitals with less than 100 beds reported CIRS implementation against 52 % of those between 100 to 500 beds, and 67 % of those with more than 500 beds. While 62 % of the hospitals interviewed reported the maintenance of a risk management committee, only 14 % reported the implementation of risk analysing techniques. As to clinical risk management, 92 % of the hospitals see potential for internal improvement; 44 % have already communicated with external consultants. While identification of clinical risks with near miss and other incident reporting systems meets increasing acceptance, the learning potential based on incident reporting is not yet appropriately being used. There is a deficit regarding systematic and comprehensive risk assessment and controlling; this will have to be met by improving the organisational framework for clinical risk management. © Georg Thieme Verlag KG Stuttgart · New York.

  15. TOXPERT: An Expert System for Risk Assessment

    PubMed Central

    Soto, R. J.; Osimitz, T. G.; Oleson, A.

    1988-01-01

    TOXPERT is an artificial intelligence based system used to model product safety, toxicology (TOX) and regulatory (REG) decision processes. An expert system shell uses backward chaining rule control to link “marketing approval” goals to the type of product, REG agency, exposure conditions and TOX. Marketing risks are primarily a function of the TOX, hazards and exposure potential. The method employed differentiates between REG requirements in goal seeking control for various types of products. This is accomplished by controlling rule execution by defining frames for each REG agency. In addition, TOXPERT produces classifications of TOX ratings and suggested product labeling. This production rule system uses principles of TOX, REGs, corporate guidelines and internal “rules of thumb.” TOXPERT acts as an advisor for this narrow domain. Advantages are that it can make routine decisions freeing professional's time for more complex problem solving, provide backup and training.

  16. System Risk Balancing Profiles: Software Component

    NASA Technical Reports Server (NTRS)

    Kelly, John C.; Sigal, Burton C.; Gindorf, Tom

    2000-01-01

    The Software QA / V&V guide will be reviewed and updated based on feedback from NASA organizations and others with a vested interest in this area. Hardware, EEE Parts, Reliability, and Systems Safety are a sample of the future guides that will be developed. Cost Estimates, Lessons Learned, Probability of Failure and PACTS (Prevention, Avoidance, Control or Test) are needed to provide a more complete risk management strategy. This approach to risk management is designed to help balance the resources and program content for risk reduction for NASA's changing environment.

  17. Remote Sensing and Geographic Information Systems as Decision Support Tools for Malaria Control in the Republic of Korea

    DTIC Science & Technology

    2001-05-30

    larviciding due to the larger number of at- risk personnel and the smaller size of the vector habitats. This study demonstrates the usefulness of remote sensing...climate and demonstrates both short and long incubation periods. Long incubation periods increase the risk of re-introducing malaria to the continental...United States, making malaria control in the ROK even more important (Walter Reed Army Institute of Research 1998). This increased risk is from U.S

  18. 12 CFR 225.26 - Factors considered in acting on nonbanking proposals.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... acquired, the effect of the proposed transaction on those resources, and the management expertise, internal control and risk-management systems, and capital of the entity conducting the activity. (c) Competitive... THE FEDERAL RESERVE SYSTEM BANK HOLDING COMPANIES AND CHANGE IN BANK CONTROL (REGULATION Y...

  19. Prevention and control of food safety risks: the role of governments, food producers, marketers, and academia.

    PubMed

    Lupien, John R

    2007-01-01

    Food systems are rapidly changing as world population grows, increasing urbanization occurs, consumer tastes and preferences change and differ in various countries and cultures, large scale food production increases, and food imports and exports grow in volume and value. Consumers in all countries have become more insistent that foods available in the marketplace are of good quality and safe, and do not pose risks to them and their families. Publicity about food risk problems and related risks, including chemical and microbiological contamination of foods, mad-cow disease, avian flu, industrial chemical contamination all have made consumers and policy makers more aware of the need of the control of food safety risk factors in all countries. To discuss changes in food systems, and in consumer expectations, that have placed additional stress on the need for better control of food safety risks. Food producers, processors, and marketers have additional food law and regulations to meet; government agencies must increase monitoring and enforcement of adequate food quality and safety legislation and coordinate efforts between agriculture, health, trade, justice and customs agencies; and academia must take action to strengthen the education of competent food legislation administrators, inspectorate, and laboratory personnel for work in government and industry, including related food and food safety research . Both Government and the food industry must assure that adequate control programs are in place to control the quality and safety of all foods, raw or processed, throughout the food chain from production to final consumption. This includes appropriate laboratory facilities to perform necessary analysis of foods for risk and quality factors, and to carry out a wide range of food science, toxicological and related research.

  20. Work-system risk factors for permanent work disability among home-care workers: a case-control study.

    PubMed

    Dellve, Lotta; Lagerström, Monica; Hagberg, Mats

    2003-04-01

    There is a growing need for home-care services in western societies. As home-care workers show high levels of absence related to poor health it is important that we broaden our knowledge about what factors in the work system contribute to this. The aim of this study was to explore and estimate the impact of the work system on permanent work disability and its relative importance compared with home-life risks among home-care workers. The cases (617 subjects) were all home-care workers in Sweden, whose disability pension was approved in 1997 or 1998. The controls (771 subjects) were home-care workers still working. We used a questionnaire to gain situation-specific information on working life and home life 5 and 15 years before disability pension entitlement. The most important risk factors in the work system were poor ergonomic/lifting conditions, time pressure and lack of professional caring technique. Fifteen years prior to disability pension entitlement, insufficient management (odds ratio (OR) 95%, CI 2.6[1.6;4.2]) and relational problems at work were also risk factors. Five years before disability pension entitlement, poor organisational support (4.1 [2.5;6.7]), opportunities for co-working and working climate (3.5 [2.4;5.2]) were also strongly related to a persisting work ability. The magnitude of exposure to a number of risk factors had an increased effect (highest 13.8 [5.6-33.8]). The strongest risk factor in home life was little opportunity to rest from work (4.9 [3.0;8.0]). The risk factors in working life were robust to the inclusion of the grouped risk factors of home life. The conclusion was that risk factors related to the work system are, alone, strongly related to permanent work disability among home-care workers. Also, exposure to several of the risk factors constitutes a notably strong risk for permanent work disability.

  1. 17 CFR 240.15c3-1g - Conditions for ultimate holding companies of certain brokers or dealers (Appendix G to 17 CFR 240...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Commission determines, based on a review of the group-wide internal risk management control system and... regulator, all written policies and procedures concerning the group-wide internal risk management control... (as defined in 12 CFR 225, appendix A); (ii) Cumulative and non-cumulative preferred stock, except...

  2. 17 CFR 240.15c3-1g - Conditions for ultimate holding companies of certain brokers or dealers (Appendix G to 17 CFR 240...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Commission determines, based on a review of the group-wide internal risk management control system and... regulator, all written policies and procedures concerning the group-wide internal risk management control... (as defined in 12 CFR 225, appendix A); (ii) Cumulative and non-cumulative preferred stock, except...

  3. Health-care process improvement decisions: a systems perspective.

    PubMed

    Walley, Paul; Silvester, Kate; Mountford, Shaun

    2006-01-01

    The paper seeks to investigate decision-making processes within hospital improvement activity, to understand how performance measurement systems influence decisions and potentially lead to unsuccessful or unsustainable process changes. A longitudinal study over a 33-month period investigates key events, decisions and outcomes at one medium-sized hospital in the UK. Process improvement events are monitored using process control methods and by direct observation. The authors took a systems perspective of the health-care processes, ensuring that the impacts of decisions across the health-care supply chain were appropriately interpreted. The research uncovers the ways in which measurement systems disguise failed decisions and encourage managers to take a low-risk approach of "symptomatic relief" when trying to improve performance metrics. This prevents many managers from trying higher risk, sustainable process improvement changes. The behaviour of the health-care system is not understood by many managers and this leads to poor analysis of problem situations. Measurement using time-series methodologies, such as statistical process control are vital for a better understanding of the systems impact of changes. Senior managers must also be aware of the behavioural influence of similar performance measurement systems that discourage sustainable improvement. There is a risk that such experiences will tarnish the reputation of performance management as a discipline. Recommends process control measures as a way of creating an organization memory of how decisions affect performance--something that is currently lacking.

  4. 17 CFR 240.17i-6 - Reporting requirements for supervised investment bank holding companies.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... condition, risk management system, and transactions and relationships among members of the affiliate group... Oversight Board; and (ii) A supplemental report entitled “Accountant's Report on Internal Risk Management.... 7201(a)(12)) indicating the results of the accountant's review of the internal risk management control...

  5. The Troll HSE Risk Management System

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

    Wiig, E.; Berthelsen, I.; Donovan, K.

    1996-12-31

    The Petroleum Act and Internal Control regulations in Norway lay down requirements for how HSE shall be Managed and documented. To comply with the Norwegian legislation the Troll Project has developed an HSE Risk Management System (RMS) structured around Hazards and Effects Management. The resulting quality, technical and operating integrity, and HSE performance are an endorsement of the power of RMS.

  6. The Effect of Balance Training on Postural Control in Patients with Parkinson's Disease Using a Virtual Rehabilitation System.

    PubMed

    Albiol-Pérez, Sergio; Gil-Gómez, José-Antonio; Muñoz-Tomás, María-Teresa; Gil-Gómez, Hermenegildo; Vial-Escolano, Raquel; Lozano-Quilis, José-Antonio

    2017-03-23

    Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor clinical alterations among others. Postural problems have serious consequences for patients, not only limiting their daily life but also increasing some risks, like the risk of fall. Inadequate postural control and postural instability is a major problem in PD patients. A Virtual Motor Rehabilitation System (VMR) has been tested in patients with PD in the intervention period. Our purpose was to analyze the evolution of the spatial postural control during the intervention period, to see if there are any changes caused precisely by this intervention. Ten people with PD carried out 15 virtual rehabilitation sessions. We tested a groundbreaking system based on Virtual Motor Rehabilitation in two periods of time (baseline evaluation and final evaluation). In the training sessions, the participants performed a customizable treatment using a low-cost system, the Active Balance Rehabilitation system (ABAR). We stored the pressure performed by the participants every five hundredths of a second, and we analyzed the patients' pressure when they maintained their body on the left, on the right, and in the center in sitting position. Our system was able to measure postural control in every patient in each of the virtual rehabilitation sessions. There are no significant differences in the performance of postural control in any of the positions evaluated throughout the sessions. Moreover, the results show a trend to an improvement in all positions. This improvement is especially remarkable in the left/right positions, which are the most important positions in order to avoid problems such as the risk of fall. With regard to the suitability of the ABAR system, we have found outstanding results in enjoyment, success, clarity, and helpfulness. Although PD is a progressive neurodegenerative disorder, the results demonstrate that patients with PD maintain or even improve their postural control in all positions. We think that the main factor influencing these results is that patients use more of their available cognitive processing to improve their postural control. The ABAR system allows us to make this assumption because the system requires the continuous attention of patients, promoting cognitive processing.

  7. Strategies to Mitigate Ammonia Release on the International Space Station

    NASA Technical Reports Server (NTRS)

    Macatangay, Ariel V.; Prokhorov, Kimberlee S.; Sweterlitsch, Jeffrey J.

    2007-01-01

    International Space Station (ISS) is crucial to its continuous operation. Off-nominal situations can arise from virtually any aspect of ISS operations. One situation of particular concern is the inadvertent release of a chemical into the ISS atmosphere. In sufficient quantities, a chemical release can render the ISS uninhabitable regardless of the chemical s toxicity as a result of its effect on the hardware used to maintain the environment. This is certainly true with system chemicals which are integral components to the function and purpose of the system. Safeguards, such as design for minimum risk, multiple containment, hazard assessments, rigorous safety reviews, and others, are in place to minimize the probability of a chemical release to the ISS environment thereby allowing the benefits of system chemicals to outweigh the risks associated with them. The thermal control system is an example of such a system. Heat generated within the ISS is transferred from the internal thermal control system (ITCS) to the external thermal control system (ETCS) via two, single-barrier interface heat exchangers (IFHX). The ITCS and ETCS are closed-loop systems which utilize water and anhydrous ammonia, respectively, as heat-transfer fluids. There is approximately 1200 lbs. (208 gallons) of anhydrous ammonia in the ETCS circulating through the two heat exchangers, transferring heat from the ITCS water lines. At the amounts present in the ETCS, anhydrous ammonia is one system chemical that can easily overwhelm the station atmosphere scrubbing capabilities and render the ISS uninhabitable in the event of a catastrophic rupture. Although safeguards have certainly minimized the risk of an ammonia release into the Station atmosphere, credible release scenarios and controls to manage these scenarios are examined.

  8. Serine/threonine kinase 15 gene polymorphism and risk of digestive system cancers: A meta-analysis.

    PubMed

    Luo, Jianfei; Yan, Ruicheng; Zou, Li

    2015-01-01

    Previous studies have reported an association between the two coding polymorphisms (91T>A and 169G>A) of the serine/threonine kinase 15 (STK15) gene and the risk of digestive system cancers; however, the results are inconsistent. In the present study, a meta-analysis was carried out to assess the association between the two STK15 polymorphisms and the risk of digestive system cancers. Relevant studies were identified using PubMed, Web of Science, China National Knowledge Infrastructure, WanFang and VIP databases up to February 18, 2014. The pooled odds ratio (OR) with a 95% confidence interval (CI) was calculated using the fixed or random effects model. A total of 15 case-control studies from 14 publications were included. Of these, 15 studies concerned the 91T>A polymorphism and included 7,619 cases and 7,196 controls and four studies concerned the 161G>A polymorphism and included 826 cases and 713 controls. A significantly increased risk of digestive system cancers was observed for the 91T>A polymorphism (recessive model: OR, 1.19; 95% CI, 1.07-1.31). In subgroup analysis by ethnicity, a significant association was detected in Asian populations (recessive model: OR, 1.21; 95% CI, 1.08-1.36) but not in Caucasian and mixed populations. Stratification by tumor type indicated that the 91T>A polymorphism was associated with an increased risk of esophageal and colorectal cancers under the recessive model (OR, 1.19; 95% CI, 1.03-1.38; and OR, 1.24; 95% CI, 1.04-1.46; respectively); however, no significant association was observed between the 169G>A polymorphism and the risk of digestive system cancers in any of the genetic models. Furthermore, in subgroup analysis by ethnicity, similar results were observed in the Asian and Caucasian populations. The present meta-analysis demonstrated that the STK15 gene 91T>A polymorphism, but not the 169G>A polymorphism, may be a risk factor for digestive system cancers, particularly for esophageal and colorectal cancers.

  9. Childhood leukaemia and distance from power lines in California: a population-based case-control study.

    PubMed

    Crespi, Catherine M; Vergara, Ximena P; Hooper, Chris; Oksuzyan, Sona; Wu, Sheng; Cockburn, Myles; Kheifets, Leeka

    2016-06-28

    Studies have reported an increased risk of childhood leukaemia associated with living near high-voltage electric power transmission lines that extend to distances at which magnetic fields from lines are negligible. We conducted a large records-based case-control study of childhood leukaemia risk in the population living near power lines in California. The study included 5788 childhood leukaemia and 3308 central nervous system (CNS) cancer cases (for comparison) born in and diagnosed in California (1986-2008), and matched to population-based controls by age and sex. We geocoded birth address and estimated the distance from residence to transmission lines using geographic information systems, aerial imagery, and, for some residences, site visits. For leukaemia, there was a slight excess of cases within 50 m of a transmission line over 200 kV (odds ratio 1.4, 95% confidence interval 0.7-2.7). There was no evidence of increased risk for distances beyond 50 m, for lower-voltage lines, or for CNS cancers. Our findings did not clearly support an increased childhood leukaemia risk associated with close proximity (<50 m) to higher voltage lines, but could be consistent with a small increased risk. Reports of increased risk for distances beyond 50 m were not replicated.

  10. Advantages and Disadvantages of Physiological Assessment For Next Generation Control Room Design

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

    Tuan Q. Tran; Ronald L. Boring; Donald D. Dudenhoeffer

    2007-08-01

    Abstract - We propose using non-obtrusive physiological assessment (e.g., eye tracking,) to assess human information processing errors (e.g., loss of vigilance) and limitations (e.g., workload) for advanced energy systems early in the design process. This physiological approach for assessing risk will circumvent many limitations of current risk methodologies such as subjective rating (e.g., rater’s biases) and performance modeling (e.g., risk assessment is scripted and is based upon the individual modeler’s judgment). Key uses will be to evaluate (early in the design process) novel control room equipment and configurations as well as newly developed automated systems that will inevitably place amore » high information load on operators. The physiological risk assessment tool will allow better precision in pinpointing problematic design issues and will provide a “real-time” assessment of risk. Furthermore, this physiological approach would extend the state-of-the-art of human reliability methods from a “static” measure to more “dynamic.” This paper will discuss a broad range of the current popular online performance gauges as well as its advantages and disadvantages for use in next generation control room.« less

  11. Air traffic control : good progress on interim replacement for outage-plagued system, but risks can be further reduced

    DOT National Transportation Integrated Search

    1996-10-01

    Certain air traffic control(ATC) centers experienced a series of major outages, : some of which were caused by the Display Channel Complex or DCC-a mainframe : computer system that processes radar and other data into displayable images on : controlle...

  12. An Exploratory Study of Risk Factors for Implementing Service-Oriented IS Projects

    NASA Astrophysics Data System (ADS)

    Chang, Hsin-Lu; Lue, Chia-Pei

    For IS project managers, how to implement the projects successfully is always a challenge. Further, as more and more enterprises start to develop service-oriented IS projects, it is essential to assess the sources and impacts of relevant risks. This research aimed at identifying risk factors related to service-oriented IS projects and analyzing the impact of these risk factors. Applying the SIMM (service integrated maturity model) proposed by IBM, customer service systems were selected to justify the research framework. Result showed that the risk factors influencing the adoption of service-oriented systems were insufficient technology planning, lack of expertise, ineffective project governance, and organizational misalignment, listed in the order of strength of influence. The findings of this research is expected to assist managers realize the risks and the importance of these risks that have to be noticed and controlled when making decisions on service-oriented systems adoption.

  13. Ground Data System Risk Mitigation Techniques for Faster, Better, Cheaper Missions

    NASA Technical Reports Server (NTRS)

    Catena, John J.; Saylor, Rick; Casasanta, Ralph; Weikel, Craig; Powers, Edward I. (Technical Monitor)

    2000-01-01

    With the advent of faster, cheaper, and better missions, NASA Projects acknowledged that a higher level of risk was inherent and accepted with this approach. It was incumbent however upon each component of the Project whether spacecraft, payload, launch vehicle, or ground data system to ensure that the mission would nevertheless be an unqualified success. The Small Explorer (SMEX) program's ground data system (GDS) team developed risk mitigation techniques to achieve these goals starting in 1989. These techniques have evolved through the SMEX series of missions and are practiced today under the Triana program. These techniques are: (1) Mission Team Organization--empowerment of a closeknit ground data system team comprising system engineering, software engineering, testing, and flight operations personnel; (2) Common Spacecraft Test and Operational Control System--utilization of the pre-launch spacecraft integration system as the post-launch ground data system on-orbit command and control system; (3) Utilization of operations personnel in pre-launch testing--making the flight operations team an integrated member of the spacecraft testing activities at the beginning of the spacecraft fabrication phase; (4) Consolidated Test Team--combined system, mission readiness and operations testing to optimize test opportunities with the ground system and spacecraft; and (5). Reuse of Spacecraft, Systems and People--reuse of people, software and on-orbit spacecraft throughout the SMEX mission series. The SMEX ground system development approach for faster, cheaper, better missions has been very successful. This paper will discuss these risk management techniques in the areas of ground data system design, implementation, test, and operational readiness.

  14. Examining the link between adolescent brain development and risk taking from a social-developmental perspective.

    PubMed

    Willoughby, Teena; Good, Marie; Adachi, Paul J C; Hamza, Chloe; Tavernier, Royette

    2013-12-01

    The adolescent age period is often characterized as a health paradox because it is a time of extensive increases in physical and mental capabilities, yet overall mortality/morbidity rates increase significantly from childhood to adolescence, often due to preventable causes such as risk taking. Asynchrony in developmental time courses between the affective/approach and cognitive control brain systems, as well as the ongoing maturation of neural connectivity are thought to lead to increased vulnerability for risk taking in adolescence. A critical analysis of the frequency of risk taking behaviors, as well as mortality and morbidity rates across the lifespan, however, challenges the hypothesis that the peak of risk taking occurs in middle adolescence when the asynchrony between the different developmental time courses of the affective/approach and cognitive control systems is the largest. In fact, the highest levels of risk taking behaviors, such as alcohol and drug use, often occur among emerging adults (e.g., university/college students), and highlight the role of the social context in predicting risk taking behavior. Moreover, risk taking is not always unregulated or impulsive. Future research should broaden the scope of risk taking to include risks that are relevant to older adults, such as risky financial investing, gambling, and marital infidelity. In addition, a lifespan perspective, with a focus on how associations between neural systems and behavior are moderated by context and trait-level characteristics, and which includes diverse samples (e.g., divorced individuals), will help to address some important limitations in the adolescent brain development and risk taking literature. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Application of hazard analysis and critical control point methodology and risk-based grading to consumer food safety surveys.

    PubMed

    Røssvoll, Elin Halbach; Ueland, Øydis; Hagtvedt, Therese; Jacobsen, Eivind; Lavik, Randi; Langsrud, Solveig

    2012-09-01

    Traditionally, consumer food safety survey responses have been classified as either "right" or "wrong" and food handling practices that are associated with high risk of infection have been treated in the same way as practices with lower risks. In this study, a risk-based method for consumer food safety surveys has been developed, and HACCP (hazard analysis and critical control point) methodology was used for selecting relevant questions. We conducted a nationally representative Web-based survey (n = 2,008), and to fit the self-reported answers we adjusted a risk-based grading system originally developed for observational studies. The results of the survey were analyzed both with the traditional "right" and "wrong" classification and with the risk-based grading system. The results using the two methods were very different. Only 5 of the 10 most frequent food handling violations were among the 10 practices associated with the highest risk. These 10 practices dealt with different aspects of heat treatment (lacking or insufficient), whereas the majority of the most frequent violations involved storing food at room temperature for too long. Use of the risk-based grading system for survey responses gave a more realistic picture of risks associated with domestic food handling practices. The method highlighted important violations and minor errors, which are performed by most people and are not associated with significant risk. Surveys built on a HACCP-based approach with risk-based grading will contribute to a better understanding of domestic food handling practices and will be of great value for targeted information and educational activities.

  16. Peer Influences on Adolescent Decision Making.

    PubMed

    Albert, Dustin; Chein, Jason; Steinberg, Laurence

    2013-04-01

    Research efforts to account for elevated risk behavior among adolescents have arrived at an exciting new stage. Moving beyond laboratory studies of age differences in "cool" cognitive processes related to risk perception and reasoning, new approaches have shifted focus to the influence of social and emotional factors on adolescent neurocognition. We review recent research suggesting that adolescent risk-taking propensity derives in part from a maturational gap between early adolescent remodeling of the brain's socio-emotional reward system and a gradual, prolonged strengthening of the cognitive control system. At a time when adolescents spend an increasing amount of time with their peers, research suggests that peer-related stimuli may sensitize the reward system to respond to the reward value of risky behavior. As the cognitive control system gradually matures over the course of the teenage years, adolescents grow in their capacity to coordinate affect and cognition, and to exercise self-regulation even in emotionally arousing situations. These capacities are reflected in gradual growth in the capacity to resist peer influence.

  17. Financial risk management of pharmacy benefits.

    PubMed

    Saikami, D

    1997-10-01

    Financial risk management of pharmacy benefits in integrated health systems is explained. A managed care organization should assume financial risk for pharmacy benefits only if it can manage the risk. Horizontally integrated organizations often do not have much control over the management of drug utilization and costs. Vertically integrated organizations have the greatest ability to manage pharmacy financial risk; virtual integration may also be compatible. Contracts can be established in which the provider is incentivized or placed at partial or full risk. The main concerns that health plans have with respect to pharmacy capitation are formulary management and the question of who should receive rebates from manufacturers. The components needed to managed pharmacy financial risk depend on the type of contract negotiated. Health-system pharmacists are uniquely positioned to take advantage of opportunities opening up through pharmacy risk contracting. Functions most organizations must provide when assuming pharmacy financial risk can be divided into internal and external categories. Internally performed functions include formulary management, clinical pharmacy services and utilization management, and utilization reports for physicians. Functions that can be outsourced include claims processing and administration, provider- and customer support services, and rebates. Organizations that integrate the pharmacy benefit across the health care continuum will be more effective in controlling costs and improving outcomes than organizations that handle this benefit as separate from others. Patient care should not focus on payment mechanisms and unit costs but on developing superior processes and systems that improve health care.

  18. HIV quality report cards: impact of case-mix adjustment and statistical methods.

    PubMed

    Ohl, Michael E; Richardson, Kelly K; Goto, Michihiko; Vaughan-Sarrazin, Mary; Schweizer, Marin L; Perencevich, Eli N

    2014-10-15

    There will be increasing pressure to publicly report and rank the performance of healthcare systems on human immunodeficiency virus (HIV) quality measures. To inform discussion of public reporting, we evaluated the influence of case-mix adjustment when ranking individual care systems on the viral control quality measure. We used data from the Veterans Health Administration (VHA) HIV Clinical Case Registry and administrative databases to estimate case-mix adjusted viral control for 91 local systems caring for 12 368 patients. We compared results using 2 adjustment methods, the observed-to-expected estimator and the risk-standardized ratio. Overall, 10 913 patients (88.2%) achieved viral control (viral load ≤400 copies/mL). Prior to case-mix adjustment, system-level viral control ranged from 51% to 100%. Seventeen (19%) systems were labeled as low outliers (performance significantly below the overall mean) and 11 (12%) as high outliers. Adjustment for case mix (patient demographics, comorbidity, CD4 nadir, time on therapy, and income from VHA administrative databases) reduced the number of low outliers by approximately one-third, but results differed by method. The adjustment model had moderate discrimination (c statistic = 0.66), suggesting potential for unadjusted risk when using administrative data to measure case mix. Case-mix adjustment affects rankings of care systems on the viral control quality measure. Given the sensitivity of rankings to selection of case-mix adjustment methods-and potential for unadjusted risk when using variables limited to current administrative databases-the HIV care community should explore optimal methods for case-mix adjustment before moving forward with public reporting. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  19. Buffering social influence: neural correlates of response inhibition predict driving safety in the presence of a peer.

    PubMed

    Cascio, Christopher N; Carp, Joshua; O'Donnell, Matthew Brook; Tinney, Francis J; Bingham, C Raymond; Shope, Jean T; Ouimet, Marie Claude; Pradhan, Anuj K; Simons-Morton, Bruce G; Falk, Emily B

    2015-01-01

    Adolescence is a period characterized by increased sensitivity to social cues, as well as increased risk-taking in the presence of peers. For example, automobile crashes are the leading cause of death for adolescents, and driving with peers increases the risk of a fatal crash. Growing evidence points to an interaction between neural systems implicated in cognitive control and social and emotional context in predicting adolescent risk. We tested such a relationship in recently licensed teen drivers. Participants completed an fMRI session in which neural activity was measured during a response inhibition task, followed by a separate driving simulator session 1 week later. Participants drove alone and with a peer who was randomly assigned to express risk-promoting or risk-averse social norms. The experimentally manipulated social context during the simulated drive moderated the relationship between individual differences in neural activity in the hypothesized cognitive control network (right inferior frontal gyrus, BG) and risk-taking in the driving context a week later. Increased activity in the response inhibition network was not associated with risk-taking in the presence of a risky peer but was significantly predictive of safer driving in the presence of a cautious peer, above and beyond self-reported susceptibility to peer pressure. Individual differences in recruitment of the response inhibition network may allow those with stronger inhibitory control to override risky tendencies when in the presence of cautious peers. This relationship between social context and individual differences in brain function expands our understanding of neural systems involved in top-down cognitive control during adolescent development.

  20. Buffering Social Influence: Neural Correlates of Response Inhibition Predict Driving Safety in the Presence of a Peer

    PubMed Central

    Cascio, Christopher N.; Carp, Joshua; O'Donnell, Matthew Brook; Tinney, Francis J.; Bingham, C. Raymond; Shope, Jean T.; Ouimet, Marie Claude; Pradhan, Anuj K.; Simons-Morton, Bruce G.; Falk, Emily B.

    2016-01-01

    Adolescence is a period characterized by increased sensitivity to social cues, as well as increased risk-taking in the presence of peers. For example, automobile crashes are the leading cause of death for adolescents, and driving with peers increases the risk of a fatal crash. Growing evidence points to an interaction between neural systems implicated in cognitive control and social and emotional context in predicting adolescent risk. We tested such a relationship in recently licensed teen drivers. Participants completed an fMRI session in which neural activity was measured during a response inhibition task, followed by a separate driving simulator session 1 week later. Participants drove alone and with a peer who was randomly assigned to express risk-promoting or risk-averse social norms. The experimentally manipulated social context during the simulated drive moderated the relationship between individual differences in neural activity in the hypothesized cognitive control network (right inferior frontal gyrus, BG) and risk-taking in the driving context a week later. Increased activity in the response inhibition network was not associated with risk-taking in the presence of a risky peer but was significantly predictive of safer driving in the presence of a cautious peer, above and beyond self-reported susceptibility to peer pressure. Individual differences in recruitment of the response inhibition network may allow those with stronger inhibitory control to override risky tendencies when in the presence of cautious peers. This relationship between social context and individual differences in brain function expands our understanding of neural systems involved in top–down cognitive control during adolescent development. PMID:25100217

  1. On the Risk Management and Auditing of SOA Based Business Processes

    NASA Astrophysics Data System (ADS)

    Orriens, Bart; Heuvel, Willem-Jan V./D.; Papazoglou, Mike

    SOA-enabled business processes stretch across many cooperating and coordinated systems, possibly crossing organizational boundaries, and technologies like XML and Web services are used for making system-to-system interactions commonplace. Business processes form the foundation for all organizations, and as such, are impacted by industry regulations. This requires organizations to review their business processes and ensure that they meet the compliance standards set forth in legislation. In this paper we sketch a SOA-based service risk management and auditing methodology including a compliance enforcement and verification system that assures verifiable business process compliance. This is done on the basis of a knowledge-based system that allows integration of internal control systems into business processes conform pre-defined compliance rules, monitor both the normal process behavior and those of the control systems during process execution, and log these behaviors to facilitate retrospective auditing.

  2. Increased congenital heart defects in children born to women with systemic lupus erythematosus: results from the offspring of Systemic Lupus Erythematosus Mothers Registry Study.

    PubMed

    Vinet, Évelyne; Pineau, Christian A; Scott, Susan; Clarke, Ann E; Platt, Robert W; Bernatsky, Sasha

    2015-01-13

    In a large population-based study, we aimed to determine whether children born to women with systemic lupus erythematosus (SLE) have an increased risk of congenital heart defects (CHDs) in comparison with children born to women without SLE. The Offspring of SLE Mothers Registry (OSLER) includes all women who had ≥1 hospitalization for delivery after SLE diagnosis, identified through Quebec's healthcare databases (1989-2009), and a randomly selected control group of women, matched ≥4:1 for age and year of delivery. We identified children born live to SLE mothers and their matched controls, and ascertained CHD based on ≥1 hospitalization or physician visit with relevant diagnostic codes, within the first 12 months of life. We performed multivariable logistic regression analyses, using the generalized estimating equation method, to adjust for relevant covariates. Five hundred nine women with SLE had 719 children, whereas 5824 matched controls had 8493 children. In comparison with controls, children born to women with SLE experienced more CHD (5.2% [95% confidence interval (CI), 3.7-7.1] versus 1.9% [95% CI, 1.6-2.2], difference 3.3% [95% CI, 1.9-5.2]). In multivariable analyses, children born to women with SLE had a substantially increased risk of CHD (odds ratio, 2.62; 95% CI, 1.77-3.88) in comparison with controls. In addition, in comparison with controls, offspring of SLE mothers had a substantially increased risk of having a CHD repair procedure (odds ratio, 5.82; 95% CI, 1.77-19.09). In comparison with children from the general population, children born to women with SLE have an increased risk of CHD, and an increased risk of having a CHD repair procedure, as well. © 2014 American Heart Association, Inc.

  3. Temperament and risk for exercise dependence: results of a pilot study in female patients with eating disorders compared to elite athletes.

    PubMed

    Müller, Astrid; Claes, Laurence; Wos, Katharina; Kerling, Arno; Wünsch-Leiteritz, Wally; Cook, Brian; de Zwaan, Martina

    2015-01-01

    The present pilot study investigated the relationship between temperament and the risk for exercise dependence (EXD). A total of 32 female patients with eating disorders (potentially at risk for secondary EXD) and 29 female elite athletes without eating disturbances (potentially at risk for primary EXD) answered the Eating Disorder Examination-Questionnaire (EDE-Q), the Exercise Dependence Scale-German version (EDS-G), the Behavioral Inhibition System/Behavioral Activation System (BIS/BAS) scales, and the effortful control subscale of the Adult Temperament Questionnaire (ATQ-EC). There were significant positive correlations of the EDS-G with the BIS in women with an eating disorder and with the BAS in elite athletes. No significant association was found between the EDS-G and effortful control. The results indicate that the risk for EXD is associated with avoidance tendencies in women with eating disorders and with approach tendencies in elite athletes. Implications for secondary and primary EXD are discussed. © 2015 S. Karger AG, Basel.

  4. Tuberculosis prevention and control in large jails: a challenge to tuberculosis elimination.

    PubMed

    Roberts, Cheryl A; Lobato, Mark N; Bazerman, Lauri B; Kling, Ryan; Reichard, Audrey A; Hammett, Theodore M

    2006-02-01

    This study assessed the extent to which 20 large jail systems have implemented national recommendations for tuberculosis (TB) prevention and control in correctional facilities. Data were collected through questionnaires to jail medical directors and TB control directors, observation at the jails, and abstraction of medical records of inmates with TB disease and latent TB infection. Twenty percent of jail systems (4/20) had conducted an assessment of risk for TB transmission in their facilities, and 55% (11/20) monitored tuberculin skin test conversions of inmates and staff. Sixty-five percent (13/20) of jails had an aggregate record-keeping system for tracking TB status and treatment, which was usually paper based. Forty-five percent of jails (9/20) had policies to offer HIV counseling and testing to tuberculin skin test-positive patients, and 75% (15/20) screen HIV-infected inmates with chest radiographs. Three quarters of jails (15/20) had policies to always isolate patients with suspected or confirmed pulmonary TB in an airborne infection isolation room. Half of jails with airborne infection isolation rooms (6/12) conformed to Centers for Disease Control and Prevention (CDC) guidelines for monitoring negative pressure. Improvements are needed in conducting TB risk assessments and evaluations to determine priorities and reduce risk of transmission. Inadequate medical information systems are impeding TB control and evaluation efforts. Although HIV infection is the greatest cofactor for development of TB disease, jails have inadequate information on patients' HIV status to make informed decisions in screening and management of TB and latent TB infection. Jails need to improve the use of environmental controls.

  5. 78 FR 13924 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing Amendment No. 2 and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-01

    ... systemic risk since the reversals may override DTC's risk management controls such as the Collateral...,\\11\\ require that clearing agencies establish, implement, maintain and enforce written policies and...

  6. Managing security risks for inter-organisational information systems: a multiagent collaborative model

    NASA Astrophysics Data System (ADS)

    Feng, Nan; Wu, Harris; Li, Minqiang; Wu, Desheng; Chen, Fuzan; Tian, Jin

    2016-09-01

    Information sharing across organisations is critical to effectively managing the security risks of inter-organisational information systems. Nevertheless, few previous studies on information systems security have focused on inter-organisational information sharing, and none have studied the sharing of inferred beliefs versus factual observations. In this article, a multiagent collaborative model (MACM) is proposed as a practical solution to assess the risk level of each allied organisation's information system and support proactive security treatment by sharing beliefs on event probabilities as well as factual observations. In MACM, for each allied organisation's information system, we design four types of agents: inspection agent, analysis agent, control agent, and communication agent. By sharing soft findings (beliefs) in addition to hard findings (factual observations) among the organisations, each organisation's analysis agent is capable of dynamically predicting its security risk level using a Bayesian network. A real-world implementation illustrates how our model can be used to manage security risks in distributed information systems and that sharing soft findings leads to lower expected loss from security risks.

  7. Cardiovascular risk in systemic lupus erythematosus--evidence of increased oxidative stress and dyslipidaemia.

    PubMed

    Nuttall, S L; Heaton, S; Piper, M K; Martin, U; Gordon, C

    2003-06-01

    Systemic lupus erythematosus (SLE) is associated with severe and premature cardiovascular disease, which is not explained by traditional risk factors alone. This study aimed to investigate markers of oxidative stress, lipid metabolism and inflammation as potential cardiovascular risk factors in women with SLE. Venous blood samples were taken from 53 female Caucasian patients with SLE and from healthy age- and sex-matched controls. Samples were analysed for markers of oxidative stress, lipid metabolism [including low-density lipoprotein (LDL) subfraction profile] and C-reactive protein (CRP). Female SLE patients had an atherogenic lipid profile characterized by raised total cholesterol and triglycerides, and the presence of small, dense LDL subfractions compared with healthy controls. These changes were associated with increased oxidative damage and a moderately raised CRP. The results provide evidence for free radical and inflammatory activity in SLE and suggest potential targets to reduce the risk of cardiovascular disease in these patients.

  8. A Lengthy Career's Lessons on Risk

    NASA Technical Reports Server (NTRS)

    Guastaferro, Angelo

    2005-01-01

    I BECAME A PROJECT MANAGER AT AGE TWENTY-TWO AT Eglin Air Force Base. I managed the droning of the B47 to fly unmanned, and 1 had zero experience to take on that task. What 1 learned is the real way you acquire risk aversion: 1 was scared to death that I d fail. This developed a characteristic that 1 carried with me throughout my career. The strongest thing a project leader can feel, in terms of risk, is the risk of failing. So I took it upon myself to learn everything about the airplane and the guidance control system by searching out the best in the aerospace community. At that time, Lockheed was doing a modification of the aircraft. Boeing designed and built the aircraft, and Sperry was doing the guidance control system. I made sure that I spent hours and hours with each of them to understand exactly what 1 was responsible for.

  9. A Statistical Testing Approach for Quantifying Software Reliability; Application to an Example System

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

    Chu, Tsong-Lun; Varuttamaseni, Athi; Baek, Joo-Seok

    The U.S. Nuclear Regulatory Commission (NRC) encourages the use of probabilistic risk assessment (PRA) technology in all regulatory matters, to the extent supported by the state-of-the-art in PRA methods and data. Although much has been accomplished in the area of risk-informed regulation, risk assessment for digital systems has not been fully developed. The NRC established a plan for research on digital systems to identify and develop methods, analytical tools, and regulatory guidance for (1) including models of digital systems in the PRAs of nuclear power plants (NPPs), and (2) incorporating digital systems in the NRC's risk-informed licensing and oversight activities.more » Under NRC's sponsorship, Brookhaven National Laboratory (BNL) explored approaches for addressing the failures of digital instrumentation and control (I and C) systems in the current NPP PRA framework. Specific areas investigated included PRA modeling digital hardware, development of a philosophical basis for defining software failure, and identification of desirable attributes of quantitative software reliability methods. Based on the earlier research, statistical testing is considered a promising method for quantifying software reliability. This paper describes a statistical software testing approach for quantifying software reliability and applies it to the loop-operating control system (LOCS) of an experimental loop of the Advanced Test Reactor (ATR) at Idaho National Laboratory (INL).« less

  10. Using network analysis to explore if professional opinions on Japanese encephalitis risk factors in Nepal reflect a socio-ecological system perspective.

    PubMed

    Hecker, Kent; El Kurdi, Syliva; Joshi, Durgadatt; Stephen, Craig

    2013-12-01

    Japanese encephalitis (JE) is the leading cause of viral encephalitis in Asia and a significant public health problem in Nepal. Its epidemiology is influenced by factors affecting its amplifying hosts (pigs), vectors (mosquitoes), and dead-end hosts (including people). While most control efforts target reduced susceptibility to infection either by vaccination of people or pigs or by reduced exposure to mosquitoes; the economic reality of Nepal makes it challenging to implement standard JE control measures. An ecohealth approach has been nominated as a way to assist in finding and prioritizing locally relevant strategies for JE control that may be viable, feasible, and acceptable. We sought to understand if Nepalese experts responsible for JE management conceived of its epidemiology in terms of a socio-ecological system to determine if they would consider ecohealth approaches. Network analysis suggested that they did not conceive JE risk as a product of a socio-ecological system. Traditional proximal risk factors of pigs, mosquitoes, and vaccination predominated experts' conception of JE risk. People seeking to encourage an ecohealth approach or social change models to JE management in Nepal may benefit from adopting social marketing concepts to encourage and empower local experts to examine JE from a socio-ecological perspective.

  11. Hepatitis C virus antibodies in high risk juvenile onset systemic lupus erythematosus.

    PubMed

    Aikawa, Nádia E; Nascimento, Ana P; Hayata, André L S; Bonfá, Eloisa; Goldenstein-Schainberg, Cláudia

    2016-01-01

    To evaluate the prevalence of hepatitis C virus (HCV) infection in high risk juvenile systemic lupus erythematosus (JSLE). Forty low income JSLE patients (6M:34F; mean age 19±4.4 yrs; mean disease duration 6±3.2 yrs) were studied. Twenty healthy children and adolescents matched for social economical level were included as controls. Anti-HCV tests were performed using a third generation microparticle enzyme immunoassay. Inclusion criterion was low social economical level. The frequencies of anti-HCV antibody were low and comparable between JSLE and control group (2.5% vs. 0, p=1.0). JSLE patients had significantly more risk factors for HCV infection compared to the control group, including immunosuppressive treatment (90% vs. 0, p<0.0001), hospitalization (50% vs. 12.5%, p=0.0006) and invasive procedures (47.5% vs. 12.5%, p=0.001). The observed low frequency of anti-HCV antibodies in high risk JSLE suggests that this virus does not seem to have a relevant role in the pathogenesis of this disease. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

  12. Failure probability under parameter uncertainty.

    PubMed

    Gerrard, R; Tsanakas, A

    2011-05-01

    In many problems of risk analysis, failure is equivalent to the event of a random risk factor exceeding a given threshold. Failure probabilities can be controlled if a decisionmaker is able to set the threshold at an appropriate level. This abstract situation applies, for example, to environmental risks with infrastructure controls; to supply chain risks with inventory controls; and to insurance solvency risks with capital controls. However, uncertainty around the distribution of the risk factor implies that parameter error will be present and the measures taken to control failure probabilities may not be effective. We show that parameter uncertainty increases the probability (understood as expected frequency) of failures. For a large class of loss distributions, arising from increasing transformations of location-scale families (including the log-normal, Weibull, and Pareto distributions), the article shows that failure probabilities can be exactly calculated, as they are independent of the true (but unknown) parameters. Hence it is possible to obtain an explicit measure of the effect of parameter uncertainty on failure probability. Failure probability can be controlled in two different ways: (1) by reducing the nominal required failure probability, depending on the size of the available data set, and (2) by modifying of the distribution itself that is used to calculate the risk control. Approach (1) corresponds to a frequentist/regulatory view of probability, while approach (2) is consistent with a Bayesian/personalistic view. We furthermore show that the two approaches are consistent in achieving the required failure probability. Finally, we briefly discuss the effects of data pooling and its systemic risk implications. © 2010 Society for Risk Analysis.

  13. An extended ASLD trading system to enhance portfolio management.

    PubMed

    Hung, Kei-Keung; Cheung, Yiu-Ming; Xu, Lei

    2003-01-01

    An adaptive supervised learning decision (ASLD) trading system has been presented by Xu and Cheung (1997) to optimize the expected returns of investment without considering risks. In this paper, we propose an extension of the ASLD system (EASLD), which combines the ASLD with a portfolio optimization scheme to take a balance between the expected returns and risks. This new system not only keeps the learning adaptability of the ASLD, but also dynamically controls the risk in pursuit of great profits by diversifying the capital to a time-varying portfolio of N assets. Consequently, it is shown that: 1) the EASLD system gives the investment risk much smaller than the ASLD one; and 2) more returns are gained through the EASLD system in comparison with the two individual portfolio optimization schemes that statically determine the portfolio weights without adaptive learning. We have justified these two issues by the experiments.

  14. Association of a common interferon regulatory factor 5 (IRF5) variant with increased risk of systemic lupus erythematosus (SLE).

    PubMed

    Demirci, F Y K; Manzi, S; Ramsey-Goldman, R; Minster, R L; Kenney, M; Shaw, P S; Dunlop-Thomas, C M; Kao, A H; Rhew, E; Bontempo, F; Kammerer, C; Kamboh, M I

    2007-05-01

    Interferon regulatory factor 5 (IRF5) belongs to a family of transcription factors that control the transactivation of type I interferon system-related genes, as well as the expression of several other genes involved in immune response, cell signalling, cell cycle control and apoptosis. Two recent studies reported a significant association between the IRF5/rs2004640 T allele and systemic lupus erythematosus (SLE). The purpose of this study was to determine whether the reported rs2004640 T allele association could be replicated in our independent SLE case-control sample. We genotyped DNA samples from 370 white SLE-affected female subjects and 462 white healthy female controls using the TaqMan Assay-on-Demand for rs2004640, and performed a case-control genetic association analysis. Frequency of the rs2004640 T allele was significantly higher in cases than in controls (56.5% vs. 50%; P= 0.008). The odds ratio for T allele carriers was 1.68 (95% CI: 1.20 - 2.34; P= 0.003). Our results in an independent case-control sample confirm the robust association of the IRF5/rs2004640 T allele with SLE risk, and further support the relevance of the type I interferon system in the pathogenesis of SLE and autoimmunity.

  15. Sunway Medical Laboratory Quality Control Plans Based on Six Sigma, Risk Management and Uncertainty.

    PubMed

    Jairaman, Jamuna; Sakiman, Zarinah; Li, Lee Suan

    2017-03-01

    Sunway Medical Centre (SunMed) implemented Six Sigma, measurement uncertainty, and risk management after the CLSI EP23 Individualized Quality Control Plan approach. Despite the differences in all three approaches, each implementation was beneficial to the laboratory, and none was in conflict with another approach. A synthesis of these approaches, built on a solid foundation of quality control planning, can help build a strong quality management system for the entire laboratory. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Parental age and risk of genetic syndromes predisposing to nervous system tumors: nested case–control study

    PubMed Central

    Adel Fahmideh, Maral; Tettamanti, Giorgio; Lavebratt, Catharina; Talbäck, Mats; Mathiesen, Tiit; Lannering, Birgitta; Johnson, Kimberly J; Feychting, Maria

    2018-01-01

    Purpose Phacomatoses are genetic syndromes that are associated with increased risk of developing nervous system tumors. Phacomatoses are usually inherited, but many develop de novo, with unknown etiology. In this population-based study, we investigated the effect of parental age on the risk of phacomatoses in offspring. Patients and methods The study was a population-based nested case–control study. All individuals born and residing in Sweden between January 1960 and December 2010 were eligible for inclusion. Using the Patient Register, 4625 phacomatosis cases were identified and further classified as familial or nonfamilial. Ten matched controls per case were randomly selected from the eligible population. Data were analyzed using conditional logistic regression. Analyses were conducted for neurofibromatosis alone (n=2089) and other phacomatoses combined (n=2536). Results Compared with offspring of fathers aged 25–29 years, increased risk estimates of nonfamilial neurofibromatosis were found for offspring of fathers aged 35–39 years (odds ratio [OR]=1.43 [95% CI 1.16–1.74]) and ≥40 years (OR =1.74 [95% CI 1.38–2.19]). For other nonfamilial phacomatoses, the risk estimate for offspring of fathers aged ≥40 years was OR =1.23 (95% CI 1.01–1.50). Paternal age was not associated with familial phacomatoses, and no consistent association was observed with maternal age. Conclusion The findings show a consistent increase in risk of de novo occurrence of phacomatoses predisposing to nervous system tumors in offspring with increasing paternal age, most pronounced for neurofibromatosis, while maternal age did not seem to influence the risk. These findings suggest an increasing rate of new mutations in the NF1 and NF2 genes in spermatozoa of older fathers.

  17. Risk analysis of hematopoietic stem cell transplant process: failure mode, effect, and criticality analysis and hazard analysis critical control point methods integration based on guidelines to good manufacturing practice for medicinal product ANNEX 20 (February 2008).

    PubMed

    Gianassi, S; Bisin, S; Bindi, B; Spitaleri, I; Bambi, F

    2010-01-01

    The collection and handling of hematopoietic stem cells (HSCs) must meet high quality requirements. An integrated Quality Risk Management can help to identify and contain potential risks related to HSC production. Risk analysis techniques allow one to "weigh" identified hazards, considering the seriousness of their effects, frequency, and detectability, seeking to prevent the most harmful hazards. The Hazard Analysis Critical Point, recognized as the most appropriate technique to identify risks associated with physical, chemical, and biological hazards for cellular products, consists of classifying finished product specifications and limits of acceptability, identifying all off-specifications, defining activities that can cause them, and finally establishing both a monitoring system for each Critical Control Point and corrective actions for deviations. The severity of possible effects on patients, as well as the occurrence and detectability of critical parameters, are measured on quantitative scales (Risk Priority Number [RPN]). Risk analysis was performed with this technique on manipulation process of HPC performed at our blood center. The data analysis showed that hazards with higher values of RPN with greater impact on the process are loss of dose and tracking; technical skills of operators and manual transcription of data were the most critical parameters. Problems related to operator skills are handled by defining targeted training programs, while other critical parameters can be mitigated with the use of continuous control systems. The blood center management software was completed by a labeling system with forms designed to be in compliance with standards in force and by starting implementation of a cryopreservation management module. Copyright 2010 Elsevier Inc. All rights reserved.

  18. 78 FR 73577 - Self-Regulatory Organizations; BATS Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-06

    ...)(ii). Overview Currently, the Exchange's Risk Monitor Mechanism operates by the System maintaining a... Makers and other Users with greater control and flexibility with respect to managing risk and the manner...'', in order to modify the risk monitoring functionality offered to all Users \\5\\ of the BATS equity...

  19. Improving Flood Risk Management for California's Central Valley: How the State Developed a Toolbox for Large, System-wide Studies

    NASA Astrophysics Data System (ADS)

    Pingel, N.; Liang, Y.; Bindra, A.

    2016-12-01

    More than 1 million Californians live and work in the floodplains of the Sacramento-San Joaquin Valley where flood risks are among the highest in the nation. In response to this threat to people, property and the environment, the Department of Water Resources (DWR) has been called to action to improve flood risk management. This has transpired through significant advances in development of flood information and tools, analysis, and planning. Senate Bill 5 directed DWR to prepare the Central Valley Flood Protection Plan (CVFPP) and update it every 5 years. A key component of this aggressive planning approach is answering the question: What is the current flood risk, and how would proposed improvements change flood risk throughout the system? Answering this question is a substantial challenge due to the size and complexity of the watershed and flood control system. The watershed is roughly 42,000 sq mi, and flows are controlled by numerous reservoirs, bypasses, and levees. To overcome this challenge, the State invested in development of a comprehensive analysis "tool box" through various DWR programs. Development of the tool box included: collection of hydro-meteorological, topographic, geotechnical, and economic data; development of rainfall-runoff, reservoir operation, hydraulic routing, and flood risk analysis models; and development of specialized applications and computing schemes to accelerate the analysis. With this toolbox, DWR is analyzing flood hazard, flood control system performance, exposure and vulnerability of people and property to flooding, consequence of flooding for specific events, and finally flood risk for a range of CVFPP alternatives. Based on the results, DWR will put forward a State Recommended Plan in the 2017 CVFPP. Further, the value of the analysis tool box extends beyond the CVFPP. It will serve as a foundation for other flood studies for years to come and has already been successfully applied for inundation mapping to support emergency response, reservoir operation analysis, and others.

  20. Implementation science and the pregnancy risk assessment monitoring system.

    PubMed

    Grigorescu, Violanda I; D'Angelo, Denise V; Harrison, Leslie L; Taraporewalla, Aspy J; Shulman, Holly; Smith, Ruben A

    2014-12-01

    This paper describes the restructuring of the Pregnancy Risk Assessment Monitoring System (PRAMS), a surveillance system of the Centers for Disease Control and Prevention (CDC)'s Division of Reproductive Health conducted for 25 years in collaboration with state and city health departments. With the ultimate goal to better inform health care providers, public health programs, and policy, changes were made to various aspects of PRAMS to enhance its capacity on assessing and monitoring public health interventions and clinical practices in addition to risk behaviors, disease prevalence, comorbidities, and service utilization. Specifically, the three key PRAMS changes identified as necessary and described in this paper are questionnaire revision, launching the web-based centralized PRAMS Integrated Data Collection System, and enhancing the access to PRAMS data through the web query system known as Centers for Disease Control and Prevention's PRAMS Online Data for Epidemiologic Research/PRAMStat. The seven action steps of Knowledge To Action cycle, an illustration of the implementation science process, that reflect the milestones necessary in bridging the knowledge-to-action gap were used as framework for each of these key changes.

  1. 48 CFR 34.202 - Integrated Baseline Reviews.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 1 2014-10-01 2014-10-01 false Integrated Baseline... SPECIAL CATEGORIES OF CONTRACTING MAJOR SYSTEM ACQUISITION Earned Value Management System 34.202... inherent risks in offerors'/contractors' performance plans and the underlying management control systems...

  2. 48 CFR 34.202 - Integrated Baseline Reviews.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false Integrated Baseline... SPECIAL CATEGORIES OF CONTRACTING MAJOR SYSTEM ACQUISITION Earned Value Management System 34.202... inherent risks in offerors'/contractors' performance plans and the underlying management control systems...

  3. 48 CFR 34.202 - Integrated Baseline Reviews.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 1 2013-10-01 2013-10-01 false Integrated Baseline... SPECIAL CATEGORIES OF CONTRACTING MAJOR SYSTEM ACQUISITION Earned Value Management System 34.202... inherent risks in offerors'/contractors' performance plans and the underlying management control systems...

  4. Risk Financing for Schools: The Capital Markets Approach.

    ERIC Educational Resources Information Center

    Rudolph, Richard G.

    1988-01-01

    The capital markets approach is an alternative means of risk financing whereby a school system establishes and controls its own insurance company and makes systematic contributions to pay for expected and anticipated losses and their associated costs. (MLF)

  5. BNSF San Bernardino case study : positive train control risk assessment.

    DOT National Transportation Integrated Search

    2014-09-01

    The Federal Railroad Administration funded the BNSF San Bernardino Case Study to verify its Generalized Train Movement : Simulator (GTMS) risk assessment capabilities on a planned implementation of the I-ETMS PTC system. The analysis explicitly : sim...

  6. 12 CFR 217.122 - Qualification requirements.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... related processes; (ii) Have and document a process (which must capture business environment and internal... current business activities, risk profile, technological processes, and risk management processes; and (ii... assessment systems. (D) Business environment and internal control factors. The Board-regulated institution...

  7. 12 CFR 324.122 - Qualification requirements.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... related processes; (ii) Have and document a process (which must capture business environment and internal... current business activities, risk profile, technological processes, and risk management processes; and (ii... assessment systems. (D) Business environment and internal control factors. The FDIC-supervised institution...

  8. A new in vitro bioassay system for discovery and quantitative evaluation of mosquito repellents

    USDA-ARS?s Scientific Manuscript database

    Mosquitoes are vectors of many pathogens that cause human diseases. Although prevention and control of immature stages is the best method to control mosquitoes, repellents play a significant role in reducing the risk of these diseases by preventing mosquito bites. The In vitro K & D bioassay system ...

  9. Data Acquisition, Analysis and Transmission Platform for a Pay-As-You-Drive System

    PubMed Central

    Boquete, Luciano; Rodríguez-Ascariz, José Manuel; Barea, Rafael; Cantos, Joaquín; Miguel-Jiménez, Juan Manuel; Ortega, Sergio

    2010-01-01

    This paper presents a platform used to acquire, analyse and transmit data from a vehicle to a Control Centre as part of a Pay-As-You-Drive system. The aim is to monitor vehicle usage (how much, when, where and how) and, based on this information, assess the associated risk and set an appropriate insurance premium. To determine vehicle usage, the system analyses the driver’s respect for speed limits, driving style (aggressive or non-aggressive), mobile telephone use and the number of vehicle passengers. An electronic system on board the vehicle acquires these data, processes them and transmits them by mobile telephone (GPRS/UMTS) to a Control Centre, at which the insurance company assesses the risk associated with vehicles monitored by the system. The system provides insurance companies and their customers with an enhanced service and could potentially increase responsible driving habits and reduce the number of road accidents. PMID:22219668

  10. Data acquisition, analysis and transmission platform for a Pay-As-You-Drive system.

    PubMed

    Boquete, Luciano; Rodríguez-Ascariz, José Manuel; Barea, Rafael; Cantos, Joaquín; Miguel-Jiménez, Juan Manuel; Ortega, Sergio

    2010-01-01

    This paper presents a platform used to acquire, analyse and transmit data from a vehicle to a Control Centre as part of a Pay-As-You-Drive system. The aim is to monitor vehicle usage (how much, when, where and how) and, based on this information, assess the associated risk and set an appropriate insurance premium. To determine vehicle usage, the system analyses the driver's respect for speed limits, driving style (aggressive or non-aggressive), mobile telephone use and the number of vehicle passengers. An electronic system on board the vehicle acquires these data, processes them and transmits them by mobile telephone (GPRS/UMTS) to a Control Centre, at which the insurance company assesses the risk associated with vehicles monitored by the system. The system provides insurance companies and their customers with an enhanced service and could potentially increase responsible driving habits and reduce the number of road accidents.

  11. An optimization-based approach for facility energy management with uncertainties, and, Power portfolio optimization in deregulated electricity markets with risk management

    NASA Astrophysics Data System (ADS)

    Xu, Jun

    Topic 1. An Optimization-Based Approach for Facility Energy Management with Uncertainties. Effective energy management for facilities is becoming increasingly important in view of the rising energy costs, the government mandate on the reduction of energy consumption, and the human comfort requirements. This part of dissertation presents a daily energy management formulation and the corresponding solution methodology for HVAC systems. The problem is to minimize the energy and demand costs through the control of HVAC units while satisfying human comfort, system dynamics, load limit constraints, and other requirements. The problem is difficult in view of the fact that the system is nonlinear, time-varying, building-dependent, and uncertain; and that the direct control of a large number of HVAC components is difficult. In this work, HVAC setpoints are the control variables developed on top of a Direct Digital Control (DDC) system. A method that combines Lagrangian relaxation, neural networks, stochastic dynamic programming, and heuristics is developed to predict the system dynamics and uncontrollable load, and to optimize the setpoints. Numerical testing and prototype implementation results show that our method can effectively reduce total costs, manage uncertainties, and shed the load, is computationally efficient. Furthermore, it is significantly better than existing methods. Topic 2. Power Portfolio Optimization in Deregulated Electricity Markets with Risk Management. In a deregulated electric power system, multiple markets of different time scales exist with various power supply instruments. A load serving entity (LSE) has multiple choices from these instruments to meet its load obligations. In view of the large amount of power involved, the complex market structure, risks in such volatile markets, stringent constraints to be satisfied, and the long time horizon, a power portfolio optimization problem is of critical importance but difficulty for an LSE to serve the load, maximize its profit, and manage risks. In this topic, a mid-term power portfolio optimization problem with risk management is presented. Key instruments are considered, risk terms based on semi-variances of spot market transactions are introduced, and penalties on load obligation violations are added to the objective function to improve algorithm convergence and constraint satisfaction. To overcome the inseparability of the resulting problem, a surrogate optimization framework is developed enabling a decomposition and coordination approach. Numerical testing results show that our method effectively provides decisions for various instruments to maximize profit, manage risks, and is computationally efficient.

  12. Risk Modeling of Interdependent Complex Systems of Systems: Theory and Practice.

    PubMed

    Haimes, Yacov Y

    2018-01-01

    The emergence of the complexity characterizing our systems of systems (SoS) requires a reevaluation of the way we model, assess, manage, communicate, and analyze the risk thereto. Current models for risk analysis of emergent complex SoS are insufficient because too often they rely on the same risk functions and models used for single systems. These models commonly fail to incorporate the complexity derived from the networks of interdependencies and interconnectedness (I-I) characterizing SoS. There is a need to reevaluate currently practiced risk analysis to respond to this reality by examining, and thus comprehending, what makes emergent SoS complex. The key to evaluating the risk to SoS lies in understanding the genesis of characterizing I-I of systems manifested through shared states and other essential entities within and among the systems that constitute SoS. The term "essential entities" includes shared decisions, resources, functions, policies, decisionmakers, stakeholders, organizational setups, and others. This undertaking can be accomplished by building on state-space theory, which is fundamental to systems engineering and process control. This article presents a theoretical and analytical framework for modeling the risk to SoS with two case studies performed with the MITRE Corporation and demonstrates the pivotal contributions made by shared states and other essential entities to modeling and analysis of the risk to complex SoS. A third case study highlights the multifarious representations of SoS, which require harmonizing the risk analysis process currently applied to single systems when applied to complex SoS. © 2017 Society for Risk Analysis.

  13. Protecting ICS Systems Within the Energy Sector from Cyber Attacks

    NASA Astrophysics Data System (ADS)

    Barnes, Shaquille

    Advance persistent threat (APT) groups are continuing to attack the energy sector through cyberspace, which poses a risk to our society, national security, and economy. Industrial control systems (ICSs) are not designed to handle cyber-attacks, which is why asset owners need to implement the correct proactive and reactive measures to mitigate the risk to their ICS environments. The Industrial Control Systems Cyber Emergency Response Team (ICS-CERT) responded to 290 incidents for fiscal year 2016, where 59 of those incidents came from the Energy Sector. APT groups know how vulnerable energy sector ICS systems are and the destruction they can cause when they go offline such as loss of production, loss of life, and economic impact. Defending against APT groups requires more than just passive controls such as firewalls and antivirus solutions. Asset owners should implement a combination of best practices and active defense in their environment to defend against APT groups. Cyber-attacks against critical infrastructure will become more complex and harder to detect and respond to with traditional security controls. The purpose of this paper was to provide asset owners with the correct security controls and methodologies to help defend against APT groups.

  14. Efficacy of a Web-based Intelligent Tutoring System for Communicating Genetic Risk of Breast Cancer: A Fuzzy-Trace Theory Approach

    PubMed Central

    Wolfe, Christopher R.; Reyna, Valerie F.; Widmer, Colin L.; Cedillos, Elizabeth M.; Fisher, Christopher R.; Brust-Renck, Priscila G.; Weil, Audrey M.

    2014-01-01

    Background Many healthy women consider genetic testing for breast cancer risk, yet BRCA testing issues are complex. Objective Determining whether an intelligent tutor, BRCA Gist, grounded in fuzzy-trace theory (FTT), increases gist comprehension and knowledge about genetic testing for breast cancer risk, improving decision-making. Design In two experiments, 410 healthy undergraduate women were randomly assigned to one of three groups: an online module using a web-based tutoring system (BRCA Gist) that uses artificial intelligence technology, a second group read highly similar content from the NCI web site, and a third completed an unrelated tutorial. Intervention BRCA Gist applied fuzzy trace theory and was designed to help participants develop gist comprehension of topics relevant to decisions about BRCA genetic testing, including how breast cancer spreads, inherited genetic mutations, and base rates. Measures We measured content knowledge, gist comprehension of decision-relevant information, interest in testing, and genetic risk and testing judgments. Results Control knowledge scores ranged from 54% to 56%, NCI improved significantly to 65% and 70%, and BRCA Gist improved significantly more to 75% and 77%, p<.0001. BRCA Gist scored higher on gist comprehension than NCI and control, p<.0001. Control genetic risk-assessment mean was 48% correct; BRCA Gist (61%), and NCI (56%) were significantly higher, p<.0001. BRCA Gist participants recommended less testing for women without risk factors (not good candidates), (24% and 19%) than controls (50%, both experiments) and NCI, (32%) Experiment 2, p<.0001. BRCA Gist testing interest was lower than controls, p<.0001. Limitations BRCA Gist has not been tested with older women from diverse groups. Conclusions Intelligent tutors, such as BRCA Gist, are scalable, cost effective ways of helping people understand complex issues, improving decision-making. PMID:24829276

  15. Exercise and physical activity in systemic lupus erythematosus: A systematic review with meta-analyses.

    PubMed

    O'Dwyer, Tom; Durcan, Laura; Wilson, Fiona

    2017-10-01

    Systemic lupus erythematosus (SLE) associates with enhanced cardiovascular (CV) risk frequently unexplained by traditional risk factors. Physical inactivity, common in SLE, likely contributes to the burden of CV risk and may also be a factor in co-morbid chronic fatigue. This systematic review evaluates whether exercise has a deleterious effect on disease activity in SLE, and explores effects on CV function and risk factors, physical fitness and function and health-related measures. A systematic review, with meta-analyses, was conducted; quasi-randomised and randomised controlled trials in SLE comparing at least one exercise group to controls were included. MEDLINE/PubMed, EMBASE, PEDro, AMED, CINAHL, The Cochrane Central Register of Controlled Trials, and relevant conference abstracts were searched. Random-effects meta-analyses were used to pool extracted data as mean differences. Heterogeneity was evaluated with χ 2 test and I 2 , with p < 0.05 considered significant. The search identified 3068 records, and 31 full-texts were assessed for eligibility. Eleven studies, including 469 participants, were included. Overall risk of bias of these studies was unclear. Exercise interventions were reported to be safe, while adverse effects were rare. Meta-analyses suggest that exercise does not adversely affect disease activity, positively influences depression, improves cardiorespiratory capacity and reduces fatigue, compared to controls. Exercise programmes had no significant effects on CV risk factors compared to controls. Therapeutic exercise programmes appear safe, and do not adversely affect disease activity. Fatigue, depression and physical fitness were improved following exercise-based interventions. A multimodal approach may be suggested, however the optimal exercise protocol remains unclear. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Autonomic nervous system dysfunction in psychiatric disorders and the impact of psychotropic medications: a systematic review and meta-analysis

    PubMed Central

    Alvares, Gail A.; Quintana, Daniel S.; Hickie, Ian B.; Guastella, Adam J.

    2016-01-01

    Background Autonomic nervous system (ANS) dysfunction is a putative underlying mechanism for increased cardiovascular disease risk in individuals with psychiatric disorders. Previous studies suggest that this risk may be related to psychotropic medication use. In the present study we systematically reviewed and analyzed published studies of heart rate variability (HRV), measuring ANS output, to determine the effect of psychiatric illness and medication use. Methods We searched for studies comparing HRV in physically healthy adults with a diagnosed psychiatric disorder to controls and comparing HRV pre- and post-treatment with a psychotropic medication. Results In total, 140 case–control (mood, anxiety, psychosis, dependent disorders, k = 151) and 30 treatment (antidepressants, antipsychotics; k = 43) studies were included. We found that HRV was reduced in all patient groups compared to controls (Hedges g = −0.583) with a large effect for psychotic disorders (Hedges g = −0.948). Effect sizes remained highly significant for medication-free patients compared to controls across all disorders. Smaller and significant reductions in HRV were observed for specific antidepressants and antipsychotics. Limitations Study quality significantly moderated effect sizes in case–control analyses, underscoring the importance of assessing methodological quality when interpreting HRV findings. Conclusion Combined findings confirm substantial reductions in HRV across psychiatric disorders, and these effects remained significant even in medication-free individuals. Reductions in HRV may therefore represent a significant mechanism contributing to elevated cardiovascular risk in individuals with psychiatric disorders. The negative impact of specific medications on HRV suggest increased risk for cardiovascular disease in these groups, highlighting a need for treatment providers to consider modifiable cardiovascular risk factors to attenuate this risk. PMID:26447819

  17. Estimating the health consequences of replacing cigarettes with nicotine inhalers

    PubMed Central

    Sumner, W

    2003-01-01

    Background: A fast acting, clean nicotine delivery system might substantially displace cigarettes. Public health consequences would depend on the subsequent prevalence of nicotine use, hazards of delivery systems, and intrinsic hazards of nicotine. Methods: A spreadsheet program, DEMANDS, estimates differences in expected mortality, adjusted for nicotine delivery system features and prevalence of nicotine use, by extending the data and methods of the SAMMEC 3 software from the US Centers for Disease Control and Prevention. The user estimates disease risks attributable to nicotine, other smoke components, and risk factors that coexist with smoking. The public health consequences of a widely used clean nicotine inhaler replacing cigarettes were compared to historical observations and public health goals, using four different risk attribution scenarios and nicotine use prevalence from 0–100%. Main outcome measures: Changes in years of potential life before age 85 (YPL85). Results: If nicotine accounts for less than a third of smokers' excess risk of SAMMEC diseases, as it most likely does, then even with very widespread use of clean nicotine DEMANDS predicts public health gains, relative to current tobacco use. Public health benefits accruing from a widely used clean nicotine inhaler probably equal or exceed the benefits of achieving Healthy People 2010 goals. Conclusions: Clean nicotine inhalers might improve public health as much as any feasible tobacco control effort. Although the relevant risk estimates are somewhat uncertain, partial nicotine deregulation deserves consideration as part of a broad tobacco control policy. PMID:12773720

  18. [Interview study on autonomous chemical management system and the contribution of occupational health specialists in companies].

    PubMed

    Mori, Koji; Takebayashi, Toru

    2004-09-01

    Under the circumstance that autonomous risk management for chemicals is required in Japan, it is necessary to define fundamental steps for developing chemical management system that are applicable in various types of companies and to understand the effective contribution of chemical or occupational health specialists to the system. For the purposes, we conducted interviews with companies which have an advanced chemical management system in Japan. As the result, each company had a certain policy about detailedness level of collected hazard and exposure information, and also had an efficient risk management system to ensure workers' health in depending on the business type and situations. Moreover, it was commonly observed that the specialists played major roles in developing tools for risk assessment and control, and then business lines led execution of the risk management with their supports. Based on the interviews, we showed a hypothesis of basic steps in introducing autonomous chemical risk management system at the workplaces. It is necessary to verify the hypothesis and to develop a simple system that is applicable to middle or small size companies as the next step.

  19. Overview of Risk Management for Engineered Nanomaterials

    NASA Astrophysics Data System (ADS)

    Schulte, P. A.; Geraci, C. L.; Hodson, L. L.; Zumwalde, R. D.; Kuempel, E. D.; Murashov, V.; Martinez, K. F.; Heidel, D. S.

    2013-04-01

    Occupational exposure to engineered nanomaterials (ENMs) is considered a new and challenging occurrence. Preliminary information from laboratory studies indicates that workers exposed to some kinds of ENMs could be at risk of adverse health effects. To protect the nanomaterial workforce, a precautionary risk management approach is warranted and given the newness of ENMs and emergence of nanotechnology, a naturalistic view of risk management is useful. Employers have the primary responsibility for providing a safe and healthy workplace. This is achieved by identifying and managing risks which include recognition of hazards, assessing exposures, characterizing actual risk, and implementing measures to control those risks. Following traditional risk management models for nanomaterials is challenging because of uncertainties about the nature of hazards, issues in exposure assessment, questions about appropriate control methods, and lack of occupational exposure limits (OELs) or nano-specific regulations. In the absence of OELs specific for nanomaterials, a precautionary approach has been recommended in many countries. The precautionary approach entails minimizing exposures by using engineering controls and personal protective equipment (PPE). Generally, risk management utilizes the hierarchy of controls. Ideally, risk management for nanomaterials should be part of an enterprise-wide risk management program or system and this should include both risk control and a medical surveillance program that assesses the frequency of adverse effects among groups of workers exposed to nanomaterials. In some cases, the medical surveillance could include medical screening of individual workers to detect early signs of work-related illnesses. All medical surveillance should be used to assess the effectiveness of risk management; however, medical surveillance should be considered as a second line of defense to ensure that implemented risk management practices are effective.

  20. National study of suicide in all people with a criminal justice history.

    PubMed

    Webb, Roger T; Qin, Ping; Stevens, Hanne; Mortensen, Preben B; Appleby, Louis; Shaw, Jenny

    2011-06-01

    Previous research has focused on suicide among male prisoners and ex-prisoners, but little is known about risk in the wider offender population. To examine suicide risk over 3 decades among all people processed by a national criminal justice system. Nested case-control study. The whole Danish population. Interlinked national registers identified all adult suicides during 1981 to 2006 according to any criminal justice system contact since 1980. Exposure was defined according to history of criminal justice adjudication, up to and including each subject's last judicial verdict before suicide (or date of matching for controls). There were 27 219 suicides and 524 899 controls matched on age, sex, and time, ie, controls were alive when their matched case died. Suicide. More than a third of all male cases had a criminal justice history, but relative risk against the general population was higher for women than men. Independent effects linked with criminal justice exposure persisted with confounder adjustment. Suicide risk was markedly elevated with custodial sentencing, but the strongest effects were with sentencing to psychiatric treatment and with charges conditionally withdrawn. Risk was raised even in people with a criminal justice history but without custodial sentences or guilty verdicts. It was especially high with recent or frequent contact and in people charged with violent offenses. We examined a section of society in which major health and social problems frequently coexist including offending, psychopathology, and suicidal behavior. The need for developing more far-reaching national suicide prevention strategies is indicated. In particular, improved mental health service provision is needed for all people in contact with the criminal justice system, including those not found guilty and those not given custodial sentences. Our findings also suggest that public services should be better coordinated to tackle co-occurring health and social problems more effectively.

  1. Risk-informed Maintenance for Non-coherent Systems

    NASA Astrophysics Data System (ADS)

    Tao, Ye

    Probabilistic Safety Assessment (PSA) is a systematic and comprehensive methodology to evaluate risks associated with a complex engineered technological entity. The information provided by PSA has been increasingly implemented for regulatory purposes but rarely used in providing information for operation and maintenance activities. As one of the key parts in PSA, Fault Tree Analysis (FTA) attempts to model and analyze failure processes of engineering and biological systems. The fault trees are composed of logic diagrams that display the state of the system and are constructed using graphical design techniques. Risk Importance Measures (RIMs) are information that can be obtained from both qualitative and quantitative aspects of FTA. Components within a system can be ranked with respect to each specific criterion defined by each RIM. Through a RIM, a ranking of the components or basic events can be obtained and provide valuable information for risk-informed decision making. Various RIMs have been applied in various applications. In order to provide a thorough understanding of RIMs and interpret the results, they are categorized with respect to risk significance (RS) and safety significance (SS) in this thesis. This has also tied them into different maintenance activities. When RIMs are used for maintenance purposes, it is called risk-informed maintenance. On the other hand, the majority of work produced on the FTA method has been concentrated on failure logic diagrams restricted to the direct or implied use of AND and OR operators. Such systems are considered as coherent systems. However, the NOT logic can also contribute to the information produced by PSA. The importance analysis of non-coherent systems is rather limited, even though the field has received more and more attention over the years. The non-coherent systems introduce difficulties in both qualitative and quantitative assessment of the fault tree compared with the coherent systems. In this thesis, a set of RIMs is analyzed and investigated. The 8 commonly used RIMs (Birnbaum's Measure, Criticality Importance Factor, Fussell-Vesely Measure, Improvement Potential, Conditional Probability, Risk Achievement, Risk Achievement Worth, and Risk Reduction Worth) are extended to non-coherent forms. Both coherent and non-coherent forms are classified into different categories in order to assist different types of maintenance activities. The real systems such as the Steam Generator Level Control System in CANDU Nuclear Power Plant (NPP), a Gas Detection System, and the Automatic Power Control System of the experimental nuclear reactor are presented to demonstrate the application of the results as case studies.

  2. Risk management abilities in multimodal maritime supply chains: Visibility and control perspectives.

    PubMed

    Vilko, Jyri; Ritala, Paavo; Hallikas, Jukka

    2016-11-29

    Supply chain complexity and disintegration lead to increased uncertainty from a stakeholders' perspective, which is emerging as one of the major challenges of risk management. The ability to identify risks has weakened, as the responsibility of supply chain risk management is handed over to outside service providers. Regardless, the risks, their visibility and their impact depend on the position of the companies in the supply chain. The actors in the chain must therefore collaborate to create effective risk management conditions. This challenging situation is especially pronounced in multimodal maritime supply chains, where the risks and actor focality are high. This paper contributes to current risk management literature by providing a holistic and systemic view of risk visibility and control in maritime supply chains. The study employs broad-based, qualitative interview data collected from actors operating in southern Finland and the Gulf of Finland as well as an expert-panel assessment of the related risk management abilities. The results show a high level of variance in the level of risk identification and visibility between the actors in question. This further suggests that collaboration in supply chain risk management is essential, as an awareness of the risks and their control mechanisms do not necessarily reside in the same company. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Effectiveness and efficiency of the two trolley system as an infection control mechanism in the operating theatre.

    PubMed

    Tuisawana, Viliame

    2009-11-01

    A good infection control manager understands the need to prevent a complete cycle of infection. The Infection Control Working Group Manual of Fiji, emphasised that the Cycle of Infection is the series of stage in which infection is spread. Operating theatres have infection control protocols. Most equipments and instruments used in operating theatre circulate within the theatre. The theatre trolleys are a main component in managing an operating theatre but the least recognised. This paper reviews the effectiveness and efficiency of the current two-trolley system as an infection control mechanism in theatre. The paper will discuss infection control using the current trolley system in relation to the layout of Labasa Hospital operating theatre, human resource, equipment standard and random swab results. The following are random swab results of theatre equipments taken by the Infection Control Nurse from 2006 to 2008. The Labasa Hospital Infection Committee have discouraged random swab sample from mid 2008 based on new guidelines on infection control. The two trolley system, in which an allocated outside trolley transports patients from the ward to a semi-sterile area in theatre. The inside trolley which transports the patient to the operating table. The two trolley system means more trolleys, extra staffs for lifting, additional handling of very sick patients, congestion and delay in taking patients to operating table in theatres should be considered. The one-trolley system in theatre greatly reduces the chances of manually lifting patients, thus reducing the risk of patient injury from fall and risk of back injuries to nurses. There are other evident based practices which can compliment the one trolley system for an effective infection control mechanism in theatres. The Fiji Infection Control Manual (2002) emphases the importance of regularly cleaning the environment and equipments in theatre but there is never a mention about using a two trolley system as an infection control mechanism for theatre.

  4. SURF - SUrvey of Risk Factor management: first report of an international audit.

    PubMed

    Cooney, Mt; Reiner, Z; Sheu, W; Ryden, L; Sutter, J de; De Bacquer, D; DeBacker, G; Mithal, A; Chung, N; Lim, Yt; Dudina, A; Reynolds, A; Dunney, K; Graham, I

    2014-07-01

    Despite the fact that subjects with established coronary heart disease (CHD) are at high risk of further events and deserve meticulous secondary prevention, current audits such as EUROASPIRE show poor control of major risk factors. Ongoing monitoring is required. We present a new risk factor audit system, SURF (Survey of Risk Factor management), that can be conducted much more quickly and easily than existing audit systems and has the potential to allow hospitals of all sizes to participate in a unified international audit system that will complement EUROASPIRE. Initial experience indicates that SURF is truly simple to undertake in an international setting, and this is illustrated with the results of a substantive pilot project conducted in Europe and Asia. The data collection system was designed to allow rapid and easy data collection as part of routine clinic work. Consecutive patients (aged 18 and over) with established CHD attending outpatient cardiology clinics were included. Information on demographics, previous coronary medical history, smoking history, history of hypertension, dyslipidaemia or diabetes, physical activity, attendance at cardiac rehabilitation, cardiac medications, lipid and glucose levels (and HbA1c in diabetics) if available within the last year, blood pressure, heart rate, body mass index, and waist circumference were collected using a one-page data collection sheet. Years spent in full time education was added as an additional question during the pilot phase. Three European countries - Ireland (n = 251), Belgium (n = 122), and Croatia (n = 124) - and four Asian countries - Singapore (n = 142), Taiwan (n = 334), India (n = 97), and Korea (n = 45) - were included in the pilot study. The results of initial field testing were confirmed in that it proved possible to collect data within 60-90 seconds per subject. There was poor control of several risk factors including high levels of physical inactivity (41-45%), overweight and obesity (59-78%), and ongoing smoking (15%). There were lower levels of individuals attending cardiac rehabilitation in Asia. More Europeans than Asians reached the low-density lipoprotein cholesterol target of <2.5 mmol/l (66 vs. 59%) reflecting differences in medication usage. However, blood pressure control was superior in Asia, with 71% <140/90 compared with 66% of Europeans (NS). This phase of SURF has confirmed its ease of use which should allow wide participation and the collection of representative risk factor data in subjects with CHD as well as ongoing data collection to monitor secular trends in risk factor control. Notwithstanding that this is a pilot study, the results suggest that risk factor control, particularly for lifestyle-related measures, is poor in both Europe and Asia. © The European Society of Cardiology 2012.

  5. [Design and implementation of Geographical Information System on prevention and control of cholera].

    PubMed

    Li, Xiu-jun; Fang, Li-qun; Wang, Duo-chun; Wang, Lu-xi; Li, Ya-pin; Li, Yan-li; Yang, Hong; Kan, Biao; Cao, Wu-chun

    2012-04-01

    To build the Geographical Information System (GIS) database for prevention and control of cholera programs as well as using management analysis and function demonstration to show the spatial attribute of cholera. Data from case reporting system regarding diarrhoea, vibrio cholerae, serotypes of vibrio cholerae at the surveillance spots and seafoods, as well as surveillance data on ambient environment and climate were collected. All the data were imported to system database to show the incidence of vibrio cholerae in different provinces, regions and counties to support the spatial analysis through the spatial analysis of GIS. The epidemic trends of cholera, seasonal characteristics of the cholera and the variation of the vibrio cholerae with times were better understood. Information on hotspots, regions and time of epidemics was collected, and helpful in providing risk prediction on the incidence of vibrio cholerae. The exploitation of the software can predict and simulate the spatio-temporal risks, so as to provide guidance for the prevention and control of the disease.

  6. An Integrated Fault Tolerant Robotic Controller System for High Reliability and Safety

    NASA Technical Reports Server (NTRS)

    Marzwell, Neville I.; Tso, Kam S.; Hecht, Myron

    1994-01-01

    This paper describes the concepts and features of a fault-tolerant intelligent robotic control system being developed for applications that require high dependability (reliability, availability, and safety). The system consists of two major elements: a fault-tolerant controller and an operator workstation. The fault-tolerant controller uses a strategy which allows for detection and recovery of hardware, operating system, and application software failures.The fault-tolerant controller can be used by itself in a wide variety of applications in industry, process control, and communications. The controller in combination with the operator workstation can be applied to robotic applications such as spaceborne extravehicular activities, hazardous materials handling, inspection and maintenance of high value items (e.g., space vehicles, reactor internals, or aircraft), medicine, and other tasks where a robot system failure poses a significant risk to life or property.

  7. 48 CFR 242.7501 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... DEFENSE CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Contractor Accounting Systems and..., shall maintain an accounting system and related internal controls throughout contract performance which... accounting system and cost data are reliable; (c) Risk of misallocations and mischarges are minimized; and (d...

  8. Risk alignment in health care quality and financing: optimizing value.

    PubMed

    Granata, A V

    1998-01-01

    How should health care best consolidate rational cost control while preserving and enhancing quality? That is, how can a system best optimize value? A limitation of many current health management modalities may be that the power to control health spending has been expropriated from physician providers, while they are still fully responsible for quality. Assigning responsibility without authority is a significant predicament. There are growing indications that well-organized, well-managed groups of high quality physicians may be able to directly manage both types of risk-quality and financial. The best way to optimize responsibility and authority, and to control financial and quality risks, is to place such responsibility and authority within the same entity.

  9. Childhood leukaemia and distance from power lines in California: a population-based case-control study

    PubMed Central

    Crespi, Catherine M; Vergara, Ximena P; Hooper, Chris; Oksuzyan, Sona; Wu, Sheng; Cockburn, Myles; Kheifets, Leeka

    2016-01-01

    Background: Studies have reported an increased risk of childhood leukaemia associated with living near high-voltage electric power transmission lines that extend to distances at which magnetic fields from lines are negligible. We conducted a large records-based case-control study of childhood leukaemia risk in the population living near power lines in California. Methods: The study included 5788 childhood leukaemia and 3308 central nervous system (CNS) cancer cases (for comparison) born in and diagnosed in California (1986–2008), and matched to population-based controls by age and sex. We geocoded birth address and estimated the distance from residence to transmission lines using geographic information systems, aerial imagery, and, for some residences, site visits. Results: For leukaemia, there was a slight excess of cases within 50 m of a transmission line over 200 kV (odds ratio 1.4, 95% confidence interval 0.7–2.7). There was no evidence of increased risk for distances beyond 50 m, for lower-voltage lines, or for CNS cancers. Conclusions: Our findings did not clearly support an increased childhood leukaemia risk associated with close proximity (<50 m) to higher voltage lines, but could be consistent with a small increased risk. Reports of increased risk for distances beyond 50 m were not replicated. PMID:27219016

  10. Systems Architectures for a Tactical Naval Command and Control System

    DTIC Science & Technology

    2009-03-01

    Supplement TST Time-sensitive Targeting TTP Tactics, Techniques, and Procedures WTP Weapons-target pairing xix GLOSSARY Analysis...target pairings ( WTPs ) and are presented to OTC [a]. 24. OTC conducts risk assessment of engagement options [a]. 25. OTC orders confirmed surface...engagement options are generated through weapon- target pairings ( WTPs ) and are presented to OTC [a]. 24. OTC conducts risk assessment of engagement

  11. 12 CFR Appendix A to Part 225 - Capital Adequacy Guidelines for Bank Holding Companies: Risk-Based Measure

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM BANK HOLDING COMPANIES AND CHANGE IN BANK CONTROL... Supervisors' Committee) and endorsed by the Group of Ten Central Bank Governors. The framework is described in...-weighted assets, calculate market risk equivalent assets, and calculate risk-based capital ratios adjusted...

  12. 12 CFR Appendix A to Part 225 - Capital Adequacy Guidelines for Bank Holding Companies: Risk-Based Measure

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM BANK HOLDING COMPANIES AND CHANGE IN BANK CONTROL... Supervisors' Committee) and endorsed by the Group of Ten Central Bank Governors. The framework is described in...-weighted assets, calculate market risk equivalent assets, and calculate risk-based capital ratios adjusted...

  13. 12 CFR Appendix A to Part 225 - Capital Adequacy Guidelines for Bank Holding Companies: Risk-Based Measure

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM BANK HOLDING COMPANIES AND CHANGE IN BANK CONTROL... Supervisors' Committee) and endorsed by the Group of Ten Central Bank Governors. The framework is described in...-weighted assets, calculate market risk equivalent assets, and calculate risk-based capital ratios adjusted...

  14. Evaluation of Contamination Inspection and Analysis Methods through Modeling System Performance

    NASA Technical Reports Server (NTRS)

    Seasly, Elaine; Dever, Jason; Stuban, Steven M. F.

    2016-01-01

    Contamination is usually identified as a risk on the risk register for sensitive space systems hardware. Despite detailed, time-consuming, and costly contamination control efforts during assembly, integration, and test of space systems, contaminants are still found during visual inspections of hardware. Improved methods are needed to gather information during systems integration to catch potential contamination issues earlier and manage contamination risks better. This research explores evaluation of contamination inspection and analysis methods to determine optical system sensitivity to minimum detectable molecular contamination levels based on IEST-STD-CC1246E non-volatile residue (NVR) cleanliness levels. Potential future degradation of the system is modeled given chosen modules representative of optical elements in an optical system, minimum detectable molecular contamination levels for a chosen inspection and analysis method, and determining the effect of contamination on the system. By modeling system performance based on when molecular contamination is detected during systems integration and at what cleanliness level, the decision maker can perform trades amongst different inspection and analysis methods and determine if a planned method is adequate to meet system requirements and manage contamination risk.

  15. Continuous Risk Management: A NASA Program Initiative

    NASA Technical Reports Server (NTRS)

    Hammer, Theodore F.; Rosenberg, Linda

    1999-01-01

    NPG 7120.5A, "NASA Program and Project Management Processes and Requirements" enacted in April, 1998, requires that "The program or project manager shall apply risk management principles..." The Software Assurance Technology Center (SATC) at NASA GSFC has been tasked with the responsibility for developing and teaching a systems level course for risk management that provides information on how to comply with this edict. The course was developed in conjunction with the Software Engineering Institute at Carnegie Mellon University, then tailored to the NASA systems community. This presentation will briefly discuss the six functions for risk management: (1) Identify the risks in a specific format; (2) Analyze the risk probability, impact/severity, and timeframe; (3) Plan the approach; (4) Track the risk through data compilation and analysis; (5) Control and monitor the risk; (6) Communicate and document the process and decisions.

  16. An inexact risk management model for agricultural land-use planning under water shortage

    NASA Astrophysics Data System (ADS)

    Li, Wei; Feng, Changchun; Dai, Chao; Li, Yongping; Li, Chunhui; Liu, Ming

    2016-09-01

    Water resources availability has a significant impact on agricultural land-use planning, especially in a water shortage area such as North China. The random nature of available water resources and other uncertainties in an agricultural system present risk for land-use planning and may lead to undesirable decisions or potential economic loss. In this study, an inexact risk management model (IRM) was developed for supporting agricultural land-use planning and risk analysis under water shortage. The IRM model was formulated through incorporating a conditional value-at-risk (CVaR) constraint into an inexact two-stage stochastic programming (ITSP) framework, and could be used to control uncertainties expressed as not only probability distributions but also as discrete intervals. The measure of risk about the second-stage penalty cost was incorporated into the model so that the trade-off between system benefit and extreme expected loss could be analyzed. The developed model was applied to a case study in the Zhangweinan River Basin, a typical agricultural region facing serious water shortage in North China. Solutions of the IRM model showed that the obtained first-stage land-use target values could be used to reflect decision-makers' opinions on the long-term development plan. The confidence level α and maximum acceptable risk loss β could be used to reflect decisionmakers' preference towards system benefit and risk control. The results indicated that the IRM model was useful for reflecting the decision-makers' attitudes toward risk aversion and could help seek cost-effective agricultural land-use planning strategies under complex uncertainties.

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

    Ramuhalli, Pradeep; Hirt, Evelyn H.; Veeramany, Arun

    This research report summaries the development and evaluation of a prototypic enhanced risk monitor (ERM) methodology (framework) that includes alternative risk metrics and uncertainty analysis. This updated ERM methodology accounts for uncertainty in the equipment condition assessment (ECA), the prognostic result, and the probabilistic risk assessment (PRA) model. It is anticipated that the ability to characterize uncertainty in the estimated risk and update the risk estimates in real time based on equipment condition assessment (ECA) will provide a mechanism for optimizing plant performance while staying within specified safety margins. These results (based on impacting active component O&M using real-time equipmentmore » condition information) are a step towards ERMs that, if integrated with AR supervisory plant control systems, can help control O&M costs and improve affordability of advanced reactors.« less

  18. An Assessment of Environmental Health Needs

    NASA Technical Reports Server (NTRS)

    Macatangay, Ariel V.

    2013-01-01

    Environmental health fundamentally addresses the physical, chemical, and biological risks external to the human body that can impact the health of a person by assessing and controlling these risks in order to generate and maintain a health-supportive environment. In manned spacecraft, environmental health risks are mitigated by a multi-disciplinary effort, employing several measures including active and passive controls, by establishing environmental standards (SMACs, SWEGs, microbial and acoustics limits), and through environmental monitoring. Human Health and Performance (HHP) scientists and Environmental Control and Life Support (ECLS) engineers consider environmental monitoring a vital component to an environmental health management strategy for maintaining a healthy crew and achieving mission success. ECLS engineers use environmental monitoring data to monitor and confirm the health of ECLS systems, whereas HHP scientists use the data to manage the health of the human system. Because risks can vary between missions and change over time, environmental monitoring is critical. Crew health risks associated with the environment were reviewed by agency experts with the goal of determining risk-based environmental monitoring needs for future NASA manned missions. Once determined, gaps in environmental health knowledge and technology, required to address those risks, were identified for various types of exploration missions. This agency-wide assessment of environmental health needs will help guide the activities/hardware development efforts to close those gaps and advance the knowledge required to meet NASA manned space exploration objectives. Details of the roadmap development and findings are presented in this paper.

  19. Options and Risk for Qualification of Electric Propulsion System

    NASA Technical Reports Server (NTRS)

    Bailey, Michelle; Daniel, Charles; Cook, Steve (Technical Monitor)

    2002-01-01

    Electric propulsion vehicle systems envelop a wide range of propulsion alternatives including solar and nuclear, which present unique circumstances for qualification. This paper will address the alternatives for qualification of electric propulsion spacecraft systems. The approach taken will be to address the considerations for qualification at the various levels of systems definition. Additionally, for each level of qualification the system level risk implications will be developed. Also, the paper will explore the implications of analysis verses test for various levels of systems definition, while retaining the objectives of a verification program. The limitations of terrestrial testing will be explored along with the risk and implications of orbital demonstration testing. The paper will seek to develop a template for structuring of a verification program based on cost, risk and value return. A successful verification program should establish controls and define objectives of the verification compliance program. Finally the paper will seek to address the political and programmatic factors, which may impact options for system verification.

  20. Risk and Outbreak Communication: Lessons from Taiwan's Experiences in the Post-SARS Era.

    PubMed

    Hsu, Yu-Chen; Chen, Yu-Ling; Wei, Han-Ning; Yang, Yu-Wen; Chen, Ying-Hwei

    In addition to the impact of a disease itself, public reaction could be considered another outbreak to be controlled during an epidemic. Taiwan's experience with SARS in 2003 highlighted the critical role played by the media during crisis communication. After the SARS outbreak, Taiwan's Centers for Disease Control (Taiwan CDC) followed the WHO outbreak communication guidelines on trust, early announcements, transparency, informing the public, and planning, in order to reform its risk communication systems. This article describes the risk communication framework in Taiwan, which has been used to respond to the 2009-2016 influenza epidemics, Ebola in West Africa (2014-16), and MERS-CoV in South Korea (2015) during the post-SARS era. Many communication strategies, ranging from traditional media to social and new media, have been implemented to improve transparency in public communication and promote civic engagement. Taiwan CDC will continue to maintain the strengths of its risk communication systems and resolve challenges as they emerge through active evaluation and monitoring of public opinion to advance Taiwan's capacity in outbreak communication and control. Moreover, Taiwan CDC will continue to implement the IHR (2005) and to promote a global community working together to fight shared risks and to reach the goal of "One World, One Health."

  1. Risk and Outbreak Communication: Lessons from Taiwan's Experiences in the Post-SARS Era

    PubMed Central

    Chen, Yu-Ling; Wei, Han-Ning; Yang, Yu-Wen; Chen, Ying-Hwei

    2017-01-01

    In addition to the impact of a disease itself, public reaction could be considered another outbreak to be controlled during an epidemic. Taiwan's experience with SARS in 2003 highlighted the critical role played by the media during crisis communication. After the SARS outbreak, Taiwan's Centers for Disease Control (Taiwan CDC) followed the WHO outbreak communication guidelines on trust, early announcements, transparency, informing the public, and planning, in order to reform its risk communication systems. This article describes the risk communication framework in Taiwan, which has been used to respond to the 2009-2016 influenza epidemics, Ebola in West Africa (2014-16), and MERS-CoV in South Korea (2015) during the post-SARS era. Many communication strategies, ranging from traditional media to social and new media, have been implemented to improve transparency in public communication and promote civic engagement. Taiwan CDC will continue to maintain the strengths of its risk communication systems and resolve challenges as they emerge through active evaluation and monitoring of public opinion to advance Taiwan's capacity in outbreak communication and control. Moreover, Taiwan CDC will continue to implement the IHR (2005) and to promote a global community working together to fight shared risks and to reach the goal of “One World, One Health.” PMID:28418746

  2. Dynamic and Personalized Risk Forecast in Step-Down Units. Implications for Monitoring Paradigms.

    PubMed

    Chen, Lujie; Ogundele, Olufunmilayo; Clermont, Gilles; Hravnak, Marilyn; Pinsky, Michael R; Dubrawski, Artur W

    2017-03-01

    Cardiorespiratory insufficiency (CRI) is a term applied to the manifestations of loss of normal cardiorespiratory reserve and portends a bad outcome. CRI occurs commonly in hospitalized patients, but its risk escalation patterns are unexplored. To describe the dynamic and personal character of CRI risk evolution observed through continuous vital sign monitoring of individual step-down unit patients. Using a machine learning model, we estimated risk trends for CRI (defined as exceedance of vital sign stability thresholds) for each of 1,971 admissions (1,880 unique patients) to a 24-bed adult surgical trauma step-down unit at an urban teaching hospital in Pittsburgh, Pennsylvania using continuously recorded vital signs from standard bedside monitors. We compared and contrasted risk trends during initial 4-hour periods after step-down unit admission, and again during the 4 hours immediately before the CRI event, between cases (ever had a CRI) and control subjects (never had a CRI). We further explored heterogeneity of risk escalation patterns during the 4 hours before CRI among cases, comparing personalized to nonpersonalized risk. Estimated risk was significantly higher for cases (918) than control subjects (1,053; P ≤ 0.001) during the initial 4-hour stable periods. Among cases, the aggregated nonpersonalized risk trend increased 2 hours before the CRI, whereas the personalized risk trend became significantly different from control subjects 90 minutes ahead. We further discovered several unique phenotypes of risk escalation patterns among cases for nonpersonalized (14.6% persistently high risk, 18.6% early onset, 66.8% late onset) and personalized risk (7.7% persistently high risk, 8.9% early onset, 83.4% late onset). Insights from this proof-of-concept analysis may guide design of dynamic and personalized monitoring systems that predict CRI, taking into account the triage and real-time monitoring utility of vital signs. These monitoring systems may prove useful in the dynamic allocation of technological and clinical personnel resources in acute care hospitals.

  3. Blood Pressure Control and Risk of Stroke or Systemic Embolism in Patients With Atrial Fibrillation: Results From the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) Trial.

    PubMed

    Rao, Meena P; Halvorsen, Sigrun; Wojdyla, Daniel; Thomas, Laine; Alexander, John H; Hylek, Elaine M; Hanna, Michael; Bahit, M Cecilia; Lopes, Renato D; De Caterina, Raffaele; Erol, Cetin; Goto, Shinya; Lanas, Fernando; Lewis, Basil S; Husted, Steen; Gersh, Bernard J; Wallentin, Lars; Granger, Christopher B

    2015-12-01

    Patients with atrial fibrillation (AF) and hypertension are at high risk for stroke. Previous studies have shown elevated risk of stroke in patients with AF who have a history of hypertension (regardless of blood pressure [BP] control) and in patients with elevated BP. We assessed the association of hypertension and BP control on clinical outcomes. In ARISTOTLE (n=18 201), BP was evaluated as history of hypertension requiring treatment and elevated BP (systolic ≥140 and/or diastolic ≥90 mm Hg) at study entry and any point during the trial. Hazard ratios (HRs) were derived from Cox proportional hazards models including BP as a time-dependent covariate. A total of 15 916 (87.5%) patients had a history of hypertension requiring treatment. In patients with elevated BP measurement at any point during the trial, the rate of stroke or systemic embolism was significantly higher (HR, 1.53; 95% confidence interval [CI], 1.25-1.86), as was hemorrhagic stroke (HR 1.85; 95% CI, 1.26-2.72) and ischemic stroke (HR, 1.50; 95% CI, 1.18-1.90). Rates of major bleeding were lower in patients with a history of hypertension (HR, 0.80; 95% CI, 0.66-0.98) and nonsignificantly lower in patients with elevated BP at study entry (HR, 0.89; 95% CI, 0.77-1.03). The benefit of apixaban versus warfarin on preventing stroke or systemic embolism was consistent among patients with and without a history of hypertension (P interaction=0.27), BP control at baseline (P interaction=0.43), and BP control during the trial (P interaction=0.97). High BP measurement at any point during the trial was independently associated with a substantially higher risk of stroke or systemic embolism. These results strongly support efforts to treat elevated BP as an important strategy to optimally lower risk of stroke in patients with AF. URL: https://ClinicalTrials.gov/. Unique identifier: NCT00412984. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  4. A genetic variant in miR-196a2 increased digestive system cancer risks: a meta-analysis of 15 case-control studies.

    PubMed

    Guo, Jing; Jin, Mingjuan; Zhang, Mingwu; Chen, Kun

    2012-01-01

    MicroRNAs (miRNAs) negatively regulate the gene expression and act as tumor suppressors or oncogenes in oncogenesis. The association between single nucleotide polymorphism (SNP) in miR-196a2 rs11614913 and the susceptibility of digestive system cancers was inconsistent in previous studies. An updated meta-analysis based on 15 independent case-control studies consisting of 4999 cancer patients and 7606 controls was performed to address this association. It was found that miR-196a2 polymorphism significantly elevated the risks of digestive system cancers (CT vs. TT, OR = 1.25, 95% CI = 1.07-1.45; CC vs. TT, OR = 1.38, 95% CI = 1.13-1.67; CC/CT vs. TT, OR = 1.29, 95% CI = 1.10-1.50; CC vs. CT/TT, OR = 1.14, 95% CI = 1.01-1.30; C vs. T, OR = 1.15, 95% CI = 1.05-1.26). We also found that variant in miR-196a2 increased the susceptibility of colorectal cancer (CRC) (CT vs. TT, OR = 1.23, 95% CI = 1.04-1.44; CC vs. TT, OR = 1.32, 95% CI = 1.08-1.61; CC/CT vs. TT, OR = 1.25, 95% CI = 1.07-1.46; C vs. T, OR = 1.15, 95% CI = 1.05-1.28), while the association in recessive model (CC vs. CT/TT, OR = 1.16, 95% CI = 0.98-1.38) showed a marginal significance. Additionally, significant association between miR-196a2 polymorphism and increased risk of hepatocellular cancer (HCC) was detected. By stratifying tumors on the basis of site of origin, source of controls, ethnicity and allele frequency in controls, elevated cancer risks were observed. Our findings suggest the significant association between miR-196a2 polymorphism and increased susceptibility of digestive system cancers, especially of CRC, HCC and Asians. Besides, C allele may contribute to increased digestive cancer risks.

  5. A Dynamic Model for the Evaluation of Aircraft Engine Icing Detection and Control-Based Mitigation Strategies

    NASA Technical Reports Server (NTRS)

    Simon, Donald L.; Rinehart, Aidan W.; Jones, Scott M.

    2017-01-01

    Aircraft flying in regions of high ice crystal concentrations are susceptible to the buildup of ice within the compression system of their gas turbine engines. This ice buildup can restrict engine airflow and cause an uncommanded loss of thrust, also known as engine rollback, which poses a potential safety hazard. The aviation community is conducting research to understand this phenomena, and to identify avoidance and mitigation strategies to address the concern. To support this research, a dynamic turbofan engine model has been created to enable the development and evaluation of engine icing detection and control-based mitigation strategies. This model captures the dynamic engine response due to high ice water ingestion and the buildup of ice blockage in the engines low pressure compressor. It includes a fuel control system allowing engine closed-loop control effects during engine icing events to be emulated. The model also includes bleed air valve and horsepower extraction actuators that, when modulated, change overall engine operating performance. This system-level model has been developed and compared against test data acquired from an aircraft turbofan engine undergoing engine icing studies in an altitude test facility and also against outputs from the manufacturers customer deck. This paper will describe the model and show results of its dynamic response under open-loop and closed-loop control operating scenarios in the presence of ice blockage buildup compared against engine test cell data. Planned follow-on use of the model for the development and evaluation of icing detection and control-based mitigation strategies will also be discussed. The intent is to combine the model and control mitigation logic with an engine icing risk calculation tool capable of predicting the risk of engine icing based on current operating conditions. Upon detection of an operating region of risk for engine icing events, the control mitigation logic will seek to change the engines operating point to a region of lower risk through the modulation of available control actuators while maintaining the desired engine thrust output. Follow-on work will assess the feasibility and effectiveness of such control-based mitigation strategies.

  6. 2018 Ground Robotics Capabilities Conference and Exhibiton

    DTIC Science & Technology

    2018-04-11

    Transportable Robot System (MTRS) Inc 1 Non -standard Equipment (approved) Explosive Ordnance Disposal Common Robotic System-Heavy (CRS-H) Inc 1 AROC: 3-Star...and engineering • AI risk mitigation methodologies and techniques are at best immature – E.g., V&V; Probabilistic software analytics; code level...controller to minimize potential UxS mishaps and unauthorized Command and Control (C2). • PSP-10 – Ensure that software systems which exhibit non

  7. L-Band Digital Aeronautical Communications System Engineering - Initial Safety and Security Risk Assessment and Mitigation

    NASA Technical Reports Server (NTRS)

    Zelkin, Natalie; Henriksen, Stephen

    2011-01-01

    This document is being provided as part of ITT's NASA Glenn Research Center Aerospace Communication Systems Technical Support (ACSTS) contract NNC05CA85C, Task 7: "New ATM Requirements--Future Communications, C-Band and L-Band Communications Standard Development." ITT has completed a safety hazard analysis providing a preliminary safety assessment for the proposed L-band (960 to 1164 MHz) terrestrial en route communications system. The assessment was performed following the guidelines outlined in the Federal Aviation Administration Safety Risk Management Guidance for System Acquisitions document. The safety analysis did not identify any hazards with an unacceptable risk, though a number of hazards with a medium risk were documented. This effort represents a preliminary safety hazard analysis and notes the triggers for risk reassessment. A detailed safety hazards analysis is recommended as a follow-on activity to assess particular components of the L-band communication system after the technology is chosen and system rollout timing is determined. The security risk analysis resulted in identifying main security threats to the proposed system as well as noting additional threats recommended for a future security analysis conducted at a later stage in the system development process. The document discusses various security controls, including those suggested in the COCR Version 2.0.

  8. Neonatal encephalopathy and socioeconomic status: population-based case-control study.

    PubMed

    Blume, Heidi K; Loch, Christian M; Li, Christopher I

    2007-07-01

    To investigate the association between maternal socioeconomic status and the risk of encephalopathy in full-term newborns. Population-based case-control study. Washington State births from 1994 through 2002 recorded in the linked Washington State Birth Registry and Comprehensive Hospital Abstract Reporting System. Cases (n = 1060) were singleton full-term newborns with Comprehensive Hospital Abstract Reporting System International Classification of Diseases, Ninth Revision diagnoses of seizures, birth asphyxia, central nervous system dysfunction, or cerebral irritability. Control cases (n = 5330) were singleton full-term newborns selected from the same database. Main Exposures Socioeconomic status was defined by median income of the census tract of the mother's residence, number of years of maternal educational achievement, or maternal insurance status. Odds ratios estimating the risk of encephalopathy associated with disadvantaged socioeconomic status were calculated in 3 separate analyses using multivariate adjusted logistic regression. Newborns of mothers living in neighborhoods in which residents have a low median income were at increased risk of encephalopathy compared with newborns in neighborhoods in which residents have a median income more than 3 times the poverty level (adjusted odds ratio, 1.9; 95% confidence interval, 1.5-2.3). There was also a trend for increasing risk of encephalopathy associated with decreasing neighborhood income (P<.001). Newborns of mothers with less than 12 years of educational achievement had a higher risk of encephalopathy compared with newborns of mothers with more than 16 years of educational achievement (adjusted odds ratio, 1.7; 95% confidence interval, 1.3-2.3). Newborns of mothers receiving public insurance also had a higher risk of encephalopathy compared with newborns of mothers who have commercial insurance (adjusted odds ratio, 1.4; 95% confidence interval, 1.2-1.7). Disadvantaged socioeconomic status was independently associated with an increased risk of encephalopathy in full-term newborns. These findings suggest that a mother's socioeconomic status may influence the risk of encephalopathy for her full-term newborn.

  9. Perceptions of risk, risk aversion, and barriers to adoption of decision support systems and integrated pest management: an introduction.

    PubMed

    Gent, David H; De Wolf, Erick; Pethybridge, Sarah J

    2011-06-01

    Rational management of plant diseases, both economically and environmentally, involves assessing risks and the costs associated with both correct and incorrect tactical management decisions to determine when control measures are warranted. Decision support systems can help to inform users of plant disease risk and thus assist in accurately targeting events critical for management. However, in many instances adoption of these systems for use in routine disease management has been perceived as slow. The under-utilization of some decision support systems is likely due to both technical and perception constraints that have not been addressed adequately during development and implementation phases. Growers' perceptions of risk and their aversion to these perceived risks can be reasons for the "slow" uptake of decision support systems and, more broadly, integrated pest management (IPM). Decision theory provides some tools that may assist in quantifying and incorporating subjective and/or measured probabilities of disease occurrence or crop loss into decision support systems. Incorporation of subjective probabilities into IPM recommendations may be one means to reduce grower uncertainty and improve trust of these systems because management recommendations could be explicitly informed by growers' perceptions of risk and economic utility. Ultimately though, we suggest that an appropriate measure of the value and impact of decision support systems is grower education that enables more skillful and informed management decisions independent of consultation of the support tool outputs.

  10. Road map to adaptive optimal control. [jet engine control

    NASA Technical Reports Server (NTRS)

    Boyer, R.

    1980-01-01

    A building block control structure leading toward adaptive, optimal control for jet engines is developed. This approach simplifies the addition of new features and allows for easier checkout of the control by providing a baseline system for comparison. Also, it is possible to eliminate certain features that do not have payoff by being selective in the addition of new building blocks to be added to the baseline system. The minimum risk approach specifically addresses the need for active identification of the plant to be controlled in real time and real time optimization of the control for the identified plant.

  11. Commercialization and Field Distribution of Smart Pedestrian Call Signals

    DOT National Transportation Integrated Search

    2010-06-01

    The research on this project resulted in a new design for an accessible pedestrian system (APS) that uses Ethernet communications to implement a distributed control system. Present APS designs represent a safety risk factor by APS systems having unde...

  12. 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.

  13. Hypertension as a risk factor for heart failure.

    PubMed

    Kannan, Arun; Janardhanan, Rajesh

    2014-07-01

    Hypertension remains a significant risk factor for development of congestive heart failure CHF), with various mechanisms contributing to both systolic and diastolic dysfunction. The pathogenesis of myocardial changes includes structural remodeling, left ventricular hypertrophy, and fibrosis. Activation of the sympathetic nervous system and renin-angiotensin system is a key contributing factor of hypertension, and thus interventions that antagonize these systems promote regression of hypertrophy and heart failure. Control of blood pressure is of paramount importance in improving the prognosis of patients with heart failure.

  14. [The condition of the cardiovascular prevention in Spain].

    PubMed

    Royo-Bordonada, Miguel Ángel; Lobos, José Maria; Brotons, Carlos; Villar, Fernando; de Pablo, Carmen; Armario, Pedro; Cortés, Olga; Gil Nuñez, Antonio; Lizcano, Angel; de Santiago, Ana; Sans, Susana

    2014-01-07

    In Spain, where cardiovascular diseases are the leading cause of death, control of their risk factors is low. This study analyzes the implementation of cardiovascular risk (CVR) assessment in clinical practice and the existence of control objectives amongst quality care indicators and professional incentive systems. Between 2010 and 2011, data from each autonomous community were collected, by means of a specific questionnaire concerning prevalence and control of major CVR factors, CVR assessment, and implementation of control objectives amongst quality care indicators and primary care incentive systems. Fifteen out of 17 autonomous communities filled in the questionnaire. CVR was calculated through SCORE in 9 autonomous communities, REGICOR in 3 and Framingham in 3, covering 3.4 to 77.6% of target population. The resulting control of the main CVR factors was low and variable: hypertension (22.7-61.3%), dyslipidemia (11-45.1%), diabetes (18.5-84%) and smoking (20-50.5%). Most autonomous communities did not consider CVR assessment and control amongst quality care indicators or incentive systems, highlighting the lack of initiatives on lifestyles. Variability exists in cardiovascular prevention policies among autonomous communities. It is necessary to implement a common agreed cardiovascular prevention guide, to encourage physicians to implement CVR in electronic clinical history, and to promote CVR assessment and control inclusion amongst quality care indicators and professional incentive systems, focusing on lifestyles management. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  15. RELEASE OF DRIED RADIOACTIVE WASTE MATERIALS TECHNICAL BASIS DOCUMENT

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

    KOZLOWSKI, S.D.

    2007-05-30

    This technical basis document was developed to support RPP-23429, Preliminary Documented Safety Analysis for the Demonstration Bulk Vitrification System (PDSA) and RPP-23479, Preliminary Documented Safety Analysis for the Contact-Handled Transuranic Mixed (CH-TRUM) Waste Facility. The main document describes the risk binning process and the technical basis for assigning risk bins to the representative accidents involving the release of dried radioactive waste materials from the Demonstration Bulk Vitrification System (DBVS) and to the associated represented hazardous conditions. Appendices D through F provide the technical basis for assigning risk bins to the representative dried waste release accident and associated represented hazardous conditionsmore » for the Contact-Handled Transuranic Mixed (CH-TRUM) Waste Packaging Unit (WPU). The risk binning process uses an evaluation of the frequency and consequence of a given representative accident or represented hazardous condition to determine the need for safety structures, systems, and components (SSC) and technical safety requirement (TSR)-level controls. A representative accident or a represented hazardous condition is assigned to a risk bin based on the potential radiological and toxicological consequences to the public and the collocated worker. Note that the risk binning process is not applied to facility workers because credible hazardous conditions with the potential for significant facility worker consequences are considered for safety-significant SSCs and/or TSR-level controls regardless of their estimated frequency. The controls for protection of the facility workers are described in RPP-23429 and RPP-23479. Determination of the need for safety-class SSCs was performed in accordance with DOE-STD-3009-94, Preparation Guide for US. Department of Energy Nonreactor Nuclear Facility Documented Safety Analyses, as described below.« less

  16. Real-time Simulation of Turboprop Engine Control System

    NASA Astrophysics Data System (ADS)

    Sheng, Hanlin; Zhang, Tianhong; Zhang, Yi

    2017-05-01

    On account of the complexity of turboprop engine control system, real-time simulation is the technology, under the prerequisite of maintaining real-time, to effectively reduce development cost, shorten development cycle and avert testing risks. The paper takes RT-LAB as a platform and studies the real-time digital simulation of turboprop engine control system. The architecture, work principles and external interfaces of RT-LAB real-time simulation platform are introduced firstly. Then based on a turboprop engine model, the control laws of propeller control loop and fuel control loop are studied. From that and on the basis of Matlab/Simulink, an integrated controller is designed which can realize the entire process control of the engine from start-up to maximum power till stop. At the end, on the basis of RT-LAB platform, the real-time digital simulation of the designed control system is studied, different regulating plans are tried and more ideal control effects have been obtained.

  17. A randomized, controlled trial to increase discussion of breast cancer in primary care.

    PubMed

    Kaplan, Celia P; Livaudais-Toman, Jennifer; Tice, Jeffrey A; Kerlikowske, Karla; Gregorich, Steven E; Pérez-Stable, Eliseo J; Pasick, Rena J; Chen, Alice; Quinn, Jessica; Karliner, Leah S

    2014-07-01

    Assessment and discussion of individual risk for breast cancer within the primary care setting are crucial to discussion of risk reduction and timely referral. We conducted a randomized controlled trial of a multiethnic, multilingual sample of women ages 40 to 74 years from two primary care practices (one academic, one safety net) to test a breast cancer risk assessment and education intervention. Patients were randomly assigned to control or intervention group. All patients completed a baseline telephone survey and risk assessment (via telephone for controls, via tablet computer in clinic waiting room before visit for intervention). Intervention (BreastCARE) patients and their physicians received an individualized risk report to discuss during the visit. One-week follow-up telephone surveys with all patients assessed patient-physician discussion of family cancer history, personal breast cancer risk, high-risk clinics, and genetic counseling/testing. A total of 655 control and 580 intervention women completed the risk assessment and follow-up interview; 25% were high-risk by family history, Gail, or Breast Cancer Surveillance Consortium risk models. BreastCARE increased discussions of family cancer history [OR, 1.54; 95% confidence interval (CI), 1.25-1.91], personal breast cancer risk (OR, 4.15; 95% CI, 3.02-5.70), high-risk clinics (OR, 3.84; 95% CI, 2.13-6.95), and genetic counseling/testing (OR, 2.22; 95% CI, 1.34-3.68). Among high-risk women, all intervention effects were stronger. An intervention combining an easy-to-use, quick risk assessment tool with patient-centered risk reports at the point of care can successfully promote discussion of breast cancer risk reduction between patients and primary care physicians, particularly for high-risk women. Next steps include scaling and dissemination of BreastCARE with integration into electronic medical record systems. ©2014 American Association for Cancer Research.

  18. A Randomized, Controlled Trial to Increase Discussion of Breast Cancer in Primary Care

    PubMed Central

    Kaplan, Celia P.; Livaudais-Toman, Jennifer; Tice, Jeffrey A.; Kerlikowske, Karla; Gregorich, Steven E.; Pérez-Stable, Eliseo J.; Pasick, Rena J.; Chen, Alice; Quinn, Jessica; Karliner, Leah S.

    2014-01-01

    Background Assessment and discussion of individual risk for breast cancer within the primary care setting are crucial to discussion of risk reduction and timely referral. Methods We conducted a randomized controlled trial of a multiethnic, multilingual sample of women ages 40 to 74 years from two primary care practices (one academic, one safety net) to test a breast cancer risk assessment and education intervention. Patients were randomly assigned to control or intervention group. All patients completed a baseline telephone survey and risk assessment (via telephone for controls, via tablet computer in clinic waiting room before visit for intervention). Intervention (BreastCARE) patients and their physicians received an individualized risk report to discuss during the visit. One-week follow-up telephone surveys with all patients assessed patient–physician discussion of family cancer history, personal breast cancer risk, high-risk clinics, and genetic counseling/testing. Results A total of 655 control and 580 intervention women completed the risk assessment and follow-up interview; 25% were high-risk by family history, Gail, or Breast Cancer Surveillance Consortium risk models. BreastCARE increased discussions of family cancer history [OR, 1.54; 95% confidence interval (CI), 1.25–1.91], personal breast cancer risk (OR, 4.15; 95% CI, 3.02–5.70), high-risk clinics (OR, 3.84; 95% CI, 2.13–6.95), and genetic counseling/testing (OR, 2.22; 95% CI, 1.34–3.68). Among high-risk women, all intervention effects were stronger. Conclusions An intervention combining an easy-to-use, quick risk assessment tool with patient-centered risk reports at the point of care can successfully promote discussion of breast cancer risk reduction between patients and primary care physicians, particularly for high-risk women. Impact Next steps include scaling and dissemination of BreastCARE with integration into electronic medical record systems. PMID:24762560

  19. Toxicological Risks During Human Space Exploration

    NASA Technical Reports Server (NTRS)

    James, John T.; Limero, T. F.; Lam, C. W.; Billica, Roger (Technical Monitor)

    2000-01-01

    The goal of toxicological risk assessment of human space flight is to identify and quantify significant risks to astronaut health from air pollution inside the vehicle or habitat, and to develop a strategy for control of those risks. The approach to completing a toxicological risk assessment involves data and experience on the frequency and severity of toxicological incidents that have occurred during space flight. Control of these incidents depends on being able to understand their cause from in-flight and ground-based analysis of air samples, crew reports of air quality, and known failures in containment of toxic chemicals. Toxicological risk assessment in exploration missions must be based on an evaluation of the unique toxic hazards presented by the habitat location. For example, lunar and Martian dust must be toxicologically evaluated to determine the appropriate control measures for exploration missions. Experience with near-earth flights has shown that the toxic products from fires present the highest risk to crew health from air pollution. Systems and payload leaks also present a significant hazard. The health risk from toxicity associated with materials offgassing or accumulation of human metabolites is generally well controlled. Early tests of lunar and Martian dust simulants have shown that each posses the potential to cause fibrosis in the lung in a murine model. Toxicological risks from air pollutants in space habitats originate from many sources. A number of risks have been identified through near-earth operations; however, the evaluation of additional new risks present during exploration missions will be a challenge.

  20. [The characteristics of psychosocial risks in the banking sector: a brief report].

    PubMed

    Stańczak, Aleksander; Merecz-Kot, Dorota

    2014-01-01

    Psychosocial risks in workplace are common phenomenon, stressing even for so-called white collar workers. The aim of the study was to indicate the most important threats in terms of banking sector employees. The studied subjects were 484 employees employed in 26 companies. The Scale of Psychosocial Risk (SPR) was used as a research tool. The most frequent and the most stressful categories of threats were: lack of control over workload and lack of career development chances. Banking sector employees are obliged to follow strict procedures of customer service and they regard their promotion chances as low. Employees's appraisal system is another strongly stressful factor. Work in a banking sector involves a great mental strain and the high risk of dismissal. Interpersonal relationships at work turned out to be the least stressful work facet in the banking sector. Given the most serious sources of psychosocial risks, the authors suggested to take the following actions: changes in work and work control system, education of employees and managerial staff and regular monitoring of occurring threats.

  1. A geographic information system forecast model for strategic control of fasciolosis in Ethiopia.

    PubMed

    Yilma, J M; Malone, J B

    1998-07-31

    A geographic information system (GIS) forecast model based on moisture and thermal regime was developed to assess the risk of Fasciola hepatica, a temperate species, and its tropical counterpart, Fasciola gigantica, in Ethiopia. Agroecological map zones and corresponding environmental features that control the distribution and abundance of the disease and its snail intermediate hosts were imported from the Food and Agriculture Organization (FAO) Crop Production System Zones (CPSZ) database on east Africa and used to construct a GIS using ATLAS GIS 3.0 software. Base temperatures of 10 degrees C and 16 degrees C were used for F. hepatica and F. gigantica, respectively, to calculate growing degree days in a previously developed climate forecast system that was modified to allow use of monthly climate data values. The model was validated by comparison of risk indices and environmental features to available survey data on fasciolosis. Monthly Fasciola risk indices of four climatic regions in Ethiopia were used to project infection transmission patterns under varying climatic conditions and strategic chemotherapeutic fasciolosis control schemes. Varying degrees of F. hepatica risk occurred in most parts of the country and distinct regional F. hepatica transmission patterns could be identified. In the humid west, cercariae-shedding was predicted to occur from May to October. In the south it occurred from April to May and September to October, depending on the annual abundance of rain. In the north-central and central regions, risk was highest during heavy summer rains and pasture contamination with metacercariae was predicted to occur during August-September, except in wet years, when it may start as early as July and extend up to October. At cooler sites above altitude of 2800 m, completion of an infection cycle may require more than a year. Fasciola gigantica risk was present in the western, southern and north-central regions of the country at altitudes of 1440-2560 m. However, a transmission cycle could be completed in a single year only at elevations below 1700 m. The greatest risk of F. gigantica infection was in the humid western region. Regional strategic chemotherapy schemes of two or three treatments per year were developed. Results suggest that the model can be extrapolated to all CPSZ in the country and adapted for use in control of other vector-borne diseases of economic and public health importance.

  2. Major Physical Health Conditions and Risk of Suicide.

    PubMed

    Ahmedani, Brian K; Peterson, Edward L; Hu, Yong; Rossom, Rebecca C; Lynch, Frances; Lu, Christine Y; Waitzfelder, Beth E; Owen-Smith, Ashli A; Hubley, Samuel; Prabhakar, Deepak; Williams, L Keoki; Zeld, Nicole; Mutter, Elizabeth; Beck, Arne; Tolsma, Dennis; Simon, Gregory E

    2017-09-01

    Most individuals make healthcare visits before suicide, but many do not have a diagnosed mental health condition. This study seeks to investigate suicide risk among patients with a range of physical health conditions in a U.S. general population sample and whether risk persists after adjustment for mental health and substance use diagnoses. This study included 2,674 individuals who died by suicide between 2000 and 2013 along with 267,400 controls matched on year and location in a case-control study conducted in 2016 across eight Mental Health Research Network healthcare systems. A total of 19 physical health conditions were identified using diagnostic codes within the healthcare systems' Virtual Data Warehouse, including electronic health record and insurance claims data, during the year before index date. Seventeen physical health conditions were associated with increased suicide risk after adjustment for age and sex (p<0.001); nine associations persisted after additional adjustment for mental health and substance use diagnoses. Three conditions had a more than twofold increased suicide risk: traumatic brain injury (AOR=8.80, p<0.001); sleep disorders; and HIV/AIDS. Multimorbidity was present in 38% of cases versus 15.5% of controls, and represented nearly a twofold increased risk for suicide. Although several individual conditions, for example, traumatic brain injury, were associated with high risk of suicide, nearly all physical health conditions increased suicide risk, even after adjustment for potential confounders. In addition, having multiple physical health conditions increased suicide risk substantially. These data support suicide prevention based on the overall burden of physical health. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  3. A sudden death risk score specifically for hypertension: based on 25 648 individual patient data from six randomized controlled trials.

    PubMed

    Le, Hai-Ha; Subtil, Fabien; Cerou, Marc; Marchant, Ivanny; Al-Gobari, Muaamar; Fall, Mor; Mimouni, Yanis; Kassaï, Behrouz; Lindholm, Lars; Thijs, Lutgarde; Gueyffier, François

    2017-11-01

    To construct a sudden death risk score specifically for hypertension (HYSUD) patients with or without cardiovascular history. Data were collected from six randomized controlled trials of antihypertensive treatments with 8044 women and 17 604 men differing in age ranges and blood pressure eligibility criteria. In total, 345 sudden deaths (1.35%) occurred during a mean follow-up of 5.16 years. Risk factors of sudden death were examined using a multivariable Cox proportional hazards model adjusted on trials. The model was transformed to an integer system, with points added for each factor according to its association with sudden death risk. Antihypertensive treatment was not associated with a reduction of the sudden death risk and had no interaction with other factors, allowing model development on both treatment and placebo groups. A risk score of sudden death in 5 years was built with seven significant risk factors: age, sex, SBP, serum total cholesterol, cigarette smoking, diabetes, and history of myocardial infarction. In terms of discrimination performance, HYSUD model was adequate with areas under the receiver operating characteristic curve of 77.74% (confidence interval 95%, 74.13-81.35) for the derivation set, of 77.46% (74.09-80.83) for the validation set, and of 79.17% (75.94-82.40) for the whole population. Our work provides a simple risk-scoring system for sudden death prediction in hypertension, using individual data from six randomized controlled trials of antihypertensive treatments. HYSUD score could help assessing a hypertensive individual's risk of sudden death and optimizing preventive therapeutic strategies for these patients.

  4. Fetal Growth and Childhood Cancer: A Population-Based Study

    PubMed Central

    Sørensen, Henrik Toft; Grotmol, Tom; Engeland, Anders; Stephansson, Olof; Gissler, Mika; Tretli, Steinar; Troisi, Rebecca

    2013-01-01

    OBJECTIVE: The etiology of childhood cancers is largely unknown. Studies have suggested that birth characteristics may be associated with risk. Our goal was to evaluate the risk of childhood cancers in relation to fetal growth. METHODS: We conducted a case-control study nested within Nordic birth registries. The study included cancer cases diagnosed in Denmark, Finland, Norway, and Sweden among children born from 1967 to 2010 and up to 10 matched controls per case, totaling 17 698 cases and 172 422 controls. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were derived from conditional logistic regression. RESULTS: Risks of all childhood cancers increased with increasing birth weight (Ptrend ≤ .001). Risks of acute lymphoid leukemia and Wilms tumor were elevated when birth weight was >4000 g and of central nervous system tumors when birth weight was >4500 g. Newborns large for gestational age were at increased risk of Wilms tumor (OR: 2.1 [95% CI: 1.2–3.6]) and connective/soft tissue tumors (OR: 2.1 [95% CI: 1.1–4.4]). In contrast, the risk of acute myeloid leukemia was increased among children born small for gestational age (OR: 1.8 [95% CI: 1.1–3.1]). Children diagnosed with central nervous system tumors at <1 year of age had elevated risk with increasing head circumference (Ptrend < .001). Those with head circumference >39 cm had the highest risk (OR: 4.7 [95% CI: 2.5–8.7]). CONCLUSIONS: In this large, Nordic population-based study, increased risks for several childhood tumors were associated with measures of fetal growth, supporting the hypothesis that tumorigenesis manifesting in childhood is initiated in utero. PMID:24167169

  5. Effect of electronic stability control on automobile crash risk.

    PubMed

    Farmer, Charles

    2004-12-01

    Per vehicle crash involvement rates were compared for otherwise identical vehicle models with and without electronic stability control (ESC) systems. ESC was found to affect single-vehicle crashes to a greater extent than multiple-vehicle crashes, and crashes with fatal injuries to a greater extent than less severe crashes. Based on all police-reported crashes in 7 states over 2 years, ESC reduced single-vehicle crash involvement risk by approximately 41 percent (95 percent confidence limits 3348) and single-vehicle injury crash involvement risk by 41 percent (2752). This translates to an estimated 7 percent reduction in overall crash involvement risk (310) and a 9 percent reduction in overall injury crash involvement risk (314). Based on all fatal crashes in the United States over 3 years, ESC was found to have reduced single-vehicle fatal crash involvement risk by 56 percent (3968). This translates to an estimated 34 percent reduction in overall fatal crash involvement risk (2145).

  6. Capability and Development Risk Management in System-of-Systems Architectures: A Portfolio Approach to Decision-Making

    DTIC Science & Technology

    2012-04-30

    tool that provides a means of balancing capability development against cost and interdependent risks through the use of modern portfolio theory ...Focardi, 2007; Tutuncu & Cornuejols, 2007) that are extensions of modern portfolio and control theory . The reformulation allows for possible changes...Acquisition: Wave Model context • An Investment Portfolio Approach – Mean Variance Approach – Mean - Variance : A Robust Version • Concept

  7. Fall Protection Introduction, #33462

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

    Chochoms, Michael

    The proper use of fall prevention and fall protection controls can reduce the risk of deaths and injuries caused by falls. This course, Fall Protection Introduction (#33462), is designed as an introduction to various types of recognized fall prevention and fall protection systems at Los Alamos National Laboratory (LANL), including guardrail systems, safety net systems, fall restraint systems, and fall arrest systems. Special emphasis is given to the components, inspection, care, and storage of personal fall arrest systems (PFASs). This course also presents controls for falling object hazards and emergency planning considerations for persons who have fallen.

  8. XPA A23G polymorphism and risk of digestive system cancers: a meta-analysis.

    PubMed

    He, Lei; Deng, Tao; Luo, Hesheng

    2015-01-01

    Several studies have reported an association between the A23G polymorphism (rs 1800975) in the xeroderma pigmentosum group A (XPA) gene and risk of digestive system cancers. However, the results are inconsistent. In this study, we performed a meta-analysis to assess the association between XPA A23G polymorphism and the risk of digestive system cancers. Relevant studies were identified using the PubMed, Web of Science, China National Knowledge Infrastructure, WanFang, and VIP databases up to August 30, 2014. The pooled odds ratio (OR) with a 95% confidence interval (CI) was calculated using the fixed or random effects model. A total of 18 case-control studies from 16 publications with 4,170 patients and 6,929 controls were included. Overall, no significant association was found between XPA A23G polymorphism and the risk of digestive system cancers (dominant model: GA + AA versus GG, OR 0.89, 95% CI 0.74-1.08; recessive model: AA versus GA + GG, OR 0.94, 95% CI 0.74-1.20; GA versus GG, OR 0.89, 95% CI 0.77-1.03; and AA versus GG, OR 0.87, 95% CI 0.64-1.19). When the analysis was stratified by ethnicity, similar results were observed among Asians and Caucasians in all genetic models. In stratified analysis based on tumor type, we also failed to detect any association between XPA A23G polymorphism and the risk of esophageal, gastric, or colorectal cancers. This meta-analysis indicates that the XPA A23G polymorphism is not associated with a risk of digestive system cancers.

  9. Renalguard system in high-risk patients for contrast-induced acute kidney injury.

    PubMed

    Briguori, C

    2012-06-01

    Contrast-induced acute kidney injury (CI-AKI) predicts unfavorable outcomes. The use of the RenalGuard™® system, to create high urine output and fluid balancing, may be beneficial in preventing CI-AKI. The REMEDIAL II trial is a randomized, multicenter, investigator-driven trial addressing the prevention of CI-AKI in high risk patients. Consecutive patients with an estimated glomerular filtration rate (eGFR) ≤30 mL/min/1.73 m2 and/or a risk score ≥11 were randomly assigned to 1) sodium bicarbonate solution and N-acetylcysteine (NAC) (Control group) or 2) the RenalGuard therapy, that is, hydration with saline and NAC controlled by the RenalGuard System and furosemide (RenalGuard group). CI-AKI (defined as an increase of ≥0.3 mg/dL in the serum creatinine concentration at 48 hours after the procedure) occurred in 16/146 patients in the RenalGuard group (11%) and in 30/146 patients in the Control group (20.5%) (P=0.025; OR=0.47; 95% CI=0.24-0.92). Absolute changes in CyC at 24 hours (0.02±0.32 versus -0.08±0.26; P=0.002) and at 48 hours (0.12±0.42 versus -0.03±0.31; P=0.001), as well as the rate of in-hospital dialysis (4.1% versus 0.7%; P=0.056) were higher in the Control group. In conclusion, the RenalGuard therapy seems to be a promising new approach in preventing CI-AKI in high risk patients.

  10. Risk assessment of supply chain for pharmaceutical excipients with AHP-fuzzy comprehensive evaluation.

    PubMed

    Li, Maozhong; Du, Yunai; Wang, Qiyue; Sun, Chunmeng; Ling, Xiang; Yu, Boyang; Tu, Jiasheng; Xiong, Yerong

    2016-01-01

    As the essential components in formulations, pharmaceutical excipients directly affect the safety, efficacy, and stability of drugs. Recently, safety incidents of pharmaceutical excipients posing seriously threats to the patients highlight the necessity of controlling the potential risks. Hence, it is indispensable for the industry to establish an effective risk assessment system of supply chain. In this study, an AHP-fuzzy comprehensive evaluation model was developed based on the analytic hierarchy process and fuzzy mathematical theory, which quantitatively assessed the risks of supply chain. Taking polysorbate 80 as the example for model analysis, it was concluded that polysorbate 80 for injection use is a high-risk ingredient in the supply chain compared to that for oral use to achieve safety application in clinic, thus measures should be taken to control and minimize those risks.

  11. Risk assessment of supply chain for pharmaceutical excipients with AHP-fuzzy comprehensive evaluation.

    PubMed

    Li, Maozhong; Du, Yunai; Wang, Qiyue; Sun, Chunmeng; Ling, Xiang; Yu, Boyang; Tu, Jiasheng; Xiong, Yerong

    2016-04-01

    As the essential components in formulations, pharmaceutical excipients directly affect the safety, efficacy, and stability of drugs. Recently, safety incidents of pharmaceutical excipients posing seriously threats to the patients highlight the necessity of controlling the potential risks. Hence, it is indispensable for the industry to establish an effective risk assessment system of supply chain. In this study, an AHP-fuzzy comprehensive evaluation model was developed based on the analytic hierarchy process and fuzzy mathematical theory, which quantitatively assessed the risks of supply chain. Taking polysorbate 80 as the example for model analysis, it was concluded that polysorbate 80 for injection use is a high-risk ingredient in the supply chain compared to that for oral use to achieve safety application in clinic, thus measures should be taken to control and minimize those risks.

  12. Youth Risk Behavior Survey 2003: Commonwealth of the Northern Mariana Islands, Republic of the Marshall Islands, Republic of Palau

    ERIC Educational Resources Information Center

    Balling, Allison; Grunbaum, Jo Anne; Speicher, Nancy; McManus, Tim; Kann, Laura

    2005-01-01

    To monitor priority health-risk behaviors among youth and young adults, the Centers for Disease Control and Prevention developed the Youth Risk Behavior Surveillance System (YRBSS). The YRBSS includes national, state, territory, and local school-based surveys of high school students in grades 9-12. In addition, some states, territories, and cities…

  13. Youth Risk Behavior Survey 2005: Commonwealth of the Northern Mariana Islands, Republic of Palau, Commonwealth of Puerto Rico

    ERIC Educational Resources Information Center

    Lippe, Jaclynn; Brener, Nancy D.; McManus, Tim; Kann, Laura; Speicher, Nancy

    2008-01-01

    To monitor priority health-risk behaviors among youth and young adults, the Centers for Disease Control and Prevention (CDC) developed the Youth Risk Behavior Surveillance System (YRBSS). The YRBSS includes national, state, territorial, and local school-based surveys of high school students in grades 9-12. In addition, some states, territories,…

  14. Uses of Youth Risk Behavior Survey and School Health Profiles Data: Applications for Improving Adolescent and School Health

    ERIC Educational Resources Information Center

    Foti, Kathryn; Balaji, Alexandra; Shanklin, Shari

    2011-01-01

    Background: To monitor priority health risk behaviors and school health policies and practices, respectively, the Centers for Disease Control and Prevention (CDC) developed the Youth Risk Behavior Surveillance System (YRBSS) and the School Health Profiles (Profiles). CDC is often asked about the use and application of these survey data to improve…

  15. Proband Mental Health Difficulties and Parental Stress Predict Mental Health in Toddlers at High-Risk for Autism Spectrum Disorders.

    PubMed

    Crea, Katherine; Dissanayake, Cheryl; Hudry, Kristelle

    2016-10-01

    Family-related predictors of mental health problems were investigated among 30 toddlers at familial high-risk for autism spectrum disorders (ASD) and 28 controls followed from age 2- to 3-years. Parents completed the self-report Depression Anxiety Stress Scales and the parent-report Behavior Assessment System for Children. High-risk toddlers were assessed for ASD at 3-years. Parent stress and proband mental health difficulties predicted concurrent toddler mental health difficulties at 2-years, but only baseline proband internalising problems continued to predict toddler internalising problems at 3-years; high-risk status did not confer additional risk. Baseline toddler mental health difficulties robustly predicted later difficulties, while high-risk status and diagnostic outcome conferred no additional risk. A family systems perspective may be useful for understanding toddler mental health difficulties.

  16. The risk of upcoding in casemix systems: a comparative study.

    PubMed

    Steinbusch, Paul J M; Oostenbrink, Jan B; Zuurbier, Joost J; Schaepkens, Frans J M

    2007-05-01

    With the introduction of a diagnosis related group (DRG) classification system in the Netherlands in 2005 it has become relevant to investigate the risk of upcoding. The problem of upcoding in the US casemix system is substantial. In 2004, the US Centres for Medicare and Medicaid estimated that the total number of improper Medicare payments for the Prospective Payment system for acute inpatient care (both short term and long term) amounted to US$ 4.8 billion (5.2%). By comparing the casemix systems in the US, Australian and Dutch healthcare systems, this article illustrates why certain casemix systems are more open to the risk of upcoding than other systems. This study identifies various market, control and casemix characteristics determining the weaknesses of a casemix reimbursement system to upcoding. It can be concluded that fewer opportunities for upcoding occur in casemix systems that do not allow for-profit ownership and in which the coder's salary does not depend on the outcome of the classification process. In addition, casemix systems in which the first point in time of registration is at the beginning of the care process and in which there are a limited number of occasions to alter the registration are less vulnerable to the risk of upcoding. Finally, the risk of upcoding is smaller in casemix systems that use classification criteria that are medically meaningful and aligned with clinical practice. Comparing the US, Australian and Dutch systems the following conclusions can be drawn. Given the combined occurrences of for-profit hospitals and the use of the secondary diagnosis criterion to classify DRGs, the US casemix system tends to be more open to upcoding than the Australian system. The strength of the Dutch system is related to the detailed classification scheme, using medically meaningful classification criteria. Nevertheless, the detailed classification scheme also causes a weakness, because of its increased complexity compared with the US and Australian system. It is recommended that researchers and policy makers carefully consider all relevant market, control and casemix characteristics when developing and restructuring casemix reimbursement systems.

  17. Sustainable improvement of animal health care by systematic quality risk management according to the HACCP concept.

    PubMed

    Noordhuizen, J P; Welpelo, H J

    1996-12-01

    This paper addresses the principles of the Hazard Analysis Critical Control Point (HACCP) concept as applied to animal health management strategy. Characteristics of the concept were analysed and compared with those of current animal health care strategies for disease risk identification and herd health management, insurance, and certification. HACCP is a hybrid strategy of quality control at both production process and product level. Animal health is considered a particular quality feature. We show that process control (expressed in terms of controlling both general and specific disease risk factors) and product control (expressed in terms of testing animals or animal products for specific disease agents) could form the basis for improving animal health. We conclude that HACCP provides ample opportunity for preventive health action and risk management at a relatively low cost in terms of labour, finance and documentation expenditure, at both the farm and sector level. Epidemiological field studies are currently needed to identify critical control points and to design HACCP procedures for livestock producers. In the long run, HACCP based animal health care can be further developed into a quality control systems approach to cover all aspects that are related, either directly or indirectly, to animal health.

  18. [Role of the independent microbiology laboratory in supporting infection control programs in small to mid-sized hospitals].

    PubMed

    Yanagisawa, Hideji

    2009-05-01

    With the revision of the Medical Service Law in 2006 by the Japanese Ministry of Health, Labour and Welfare (MHLW), all healthcare institutions are now required to implement a healthcare risk management program including infection control program. At a national level, an infection control surveillance program (JANIS) was implemented in July 2007. Regular weekly, monthly, and yearly infection control surveillance reports from independent microbiology laboratories can make significant contributions to infection control programs in small to mid-sized hospitals; furthermore, such programs are consistent with the framework of the MHLW's objective of strengthening risk management in healthcare institutions. Against the backdrop of current efforts to improve risk management, independent laboratories can make a significant contribution. Independent laboratories must play a role beyond merely receiving and processing specimens for microbiological examination. In addition to generating results for patients, hospital epidemiological data that contribute to local infection control programs must be a value-added component of the service. A major obstacle for independent laboratories to make a significant contribution to risk management is the current reimbursement system, which makes it economically impossible for independent laboratories to support infection control programs in healthcare institutions.

  19. Anxiety, attention, and decision making: The moderating role of heart rate variability.

    PubMed

    Ramírez, Encarnación; Ortega, Ana Raquel; Reyes Del Paso, Gustavo A

    2015-12-01

    The current exploratory research examined whether high frequency heart rate variability (HF-HRV) modulates the association between anxiety and (1) executive attentional control during situations involving neutral stimuli, in which the distractor stimuli are in conflict with the target stimulus, and (2) risk aversion in decision making. Forty-five participants (21 with low and 24 with high trait-anxiety) performed a modified version of the Attention Network Test to measure attentional control, and the Balloon Analog Risk Task to measure risk aversion. HF-HRV was recorded during a rest period before completion of the tasks. Results showed that individuals with high anxiety and low HF-HRV have worse attentional control in the face of conflicting information as well as greater risk aversion, in comparison with individuals with both high anxiety and high HF-HRV or low anxiety (regardless of HF-HRV). HF-HRV was positively associated with attentional control and negatively associated with risk aversion. Furthermore, a strong negative association was observed between attentional control and risk aversion. These results suggest that HF-HRV modulates the influence of anxiety on both attentional control to neutral stimuli, and risk aversion in decision making. Greater HF-HRV appears to fulfill a protective role in highly anxious individuals. The associations observed also suggest that executive control of attention plays a relevant role in decision making. These results support the relevance of the autonomic nervous system in sustained cognition and are in accordance with theories in which vagal-mediated heart rate variability is taken as an indicator of prefrontal cortex inhibitory influences. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Building a Secure Library System.

    ERIC Educational Resources Information Center

    Benson, Allen C.

    1998-01-01

    Presents tips for building a secure library system to guard against threats like hackers, viruses, and theft. Topics include: determining what is at risk; recovering from disasters; developing security policies; developing front-end security; securing menu systems; accessing control programs; protecting against damage from viruses; developing…

  1. A risk scoring system for prediction of haemorrhagic stroke.

    PubMed

    Zodpey, S P; Tiwari, R R

    2005-01-01

    The present pair-matched case control study was carried out at Government Medical College Hospital, Nagpur, India, a tertiary care hospital with the objective to devise and validate a risk scoring system for prediction of hemorrhagic stroke. The study consisted of 166 hospitalized CT scan proved cases of hemorrhagic stroke (ICD 9, 431-432), and a age and sex matched control per case. The controls were selected from patients who attended the study hospital for conditions other than stroke. On conditional multiple logistic regression five risk factors- hypertension (OR = 1.9. 95% Cl = 1.5-2.5). raised scrum total cholesterol (OR = 2.3, 95% Cl = 1.1-4.9). use of anticoagulants and antiplatelet agents (OR = 3.4, 95% Cl =1.1-10.4). past history of transient ischaemic attack (OR = 8.4, 95% Cl = 2.1- 33.6) and alcohol intake (OR = 2.1, 95% Cl = 1.3-3.6) were significant. These factors were ascribed statistical weights (based on regression coefficients) of 6, 8, 12, 21 and 8 respectively. The nonsignificant factors (diabetes mellitus, physical inactivity, obesity, smoking, type A personality, history of claudication, family history of stroke, history of cardiac diseases and oral contraceptive use in females) were not included in the development of scoring system. ROC curve suggested a total score of 21 to be the best cut-off for predicting haemorrhag stroke. At this cut-off the sensitivity, specificity, positive predictivity and Cohen's kappa were 0.74, 0.74, 0.74 and 0.48 respectively. The overall predictive accuracy of this additive risk scoring system (area under ROC curve by Wilcoxon statistic) was 0.79 (95% Cl = 0.73-0.84). Thus to conclude, if substantiated by further validation, this scorincy system can be used to predict haemorrhagic stroke, thereby helping to devise effective risk factor intervention strategy.

  2. Effect on injuries of assigning shoes based on foot shape in air force basic training.

    PubMed

    Knapik, Joseph J; Brosch, Lorie C; Venuto, Margaret; Swedler, David I; Bullock, Steven H; Gaines, Lorraine S; Murphy, Ryan J; Tchandja, Juste; Jones, Bruce H

    2010-01-01

    This study examined whether assigning running shoes based on the shape of the bottom of the foot (plantar surface) influenced injury risk in Air Force Basic Military Training (BMT) and examined risk factors for injury in BMT. Data were collected from BMT recruits during 2007; analysis took place during 2008. After foot examinations, recruits were randomly consigned to either an experimental group (E, n=1042 men, 375 women) or a control group (C, n=913 men, 346 women). Experimental group recruits were assigned motion control, stability, or cushioned shoes for plantar shapes indicative of low, medium, or high arches, respectively. Control group recruits received a stability shoe regardless of plantar shape. Injuries during BMT were determined from outpatient visits provided from the Defense Medical Surveillance System. Other injury risk factors (fitness, smoking, physical activity, prior injury, menstrual history, and demographics) were obtained from a questionnaire, existing databases, or BMT units. Multivariate Cox regression controlling for other risk factors showed little difference in injury risk between the groups among men (hazard ratio [E/C]=1.11, 95% CI=0.89-1.38) or women (hazard ratio [E/C]=1.20, 95% CI= 0.90-1.60). Independent injury risk factors among both men and women included low aerobic fitness and cigarette smoking. This prospective study demonstrated that assigning running shoes based on the shape of the plantar surface had little influence on injury risk in BMT even after controlling for other injury risk factors. Published by Elsevier Inc.

  3. Development of risk-based nanomaterial groups for occupational exposure control

    NASA Astrophysics Data System (ADS)

    Kuempel, E. D.; Castranova, V.; Geraci, C. L.; Schulte, P. A.

    2012-09-01

    Given the almost limitless variety of nanomaterials, it will be virtually impossible to assess the possible occupational health hazard of each nanomaterial individually. The development of science-based hazard and risk categories for nanomaterials is needed for decision-making about exposure control practices in the workplace. A possible strategy would be to select representative (benchmark) materials from various mode of action (MOA) classes, evaluate the hazard and develop risk estimates, and then apply a systematic comparison of new nanomaterials with the benchmark materials in the same MOA class. Poorly soluble particles are used here as an example to illustrate quantitative risk assessment methods for possible benchmark particles and occupational exposure control groups, given mode of action and relative toxicity. Linking such benchmark particles to specific exposure control bands would facilitate the translation of health hazard and quantitative risk information to the development of effective exposure control practices in the workplace. A key challenge is obtaining sufficient dose-response data, based on standard testing, to systematically evaluate the nanomaterials' physical-chemical factors influencing their biological activity. Categorization processes involve both science-based analyses and default assumptions in the absence of substance-specific information. Utilizing data and information from related materials may facilitate initial determinations of exposure control systems for nanomaterials.

  4. Cumulative risk exposure moderates the association between parasympathetic reactivity and inhibitory control in preschool-age children.

    PubMed

    Giuliano, Ryan J; Roos, Leslie E; Farrar, Jessica D; Skowron, Elizabeth A

    2018-04-01

    A child's cumulative risk for early exposure to stress has been linked to alterations of self-regulation outcomes, including neurobiological correlates of inhibitory control (IC). We examined whether children's ability to engage the parasympathetic nervous system impacts how risk affects IC. Children ages 3-5 years completed two laboratory measures of IC while respiratory sinus arrhythmia (RSA) was measured, indexing parasympathetic activity. Children with greater risk demonstrated lower IC; risk also moderated associations between RSA reactivity and IC. For children with less risk, greater RSA withdrawal during IC tasks was associated with better IC. In contrast, greater risk was associated with poor IC, regardless of RSA withdrawal. Effects of risk were more pronounced for cumulative than individual measures. Results suggest that cumulative risk exposure disrupts connectivity between physiological and behavioral components of self-regulation in early childhood. Parasympathetic withdrawal to cognitive tasks may be less relevant for performance in developmental samples experiencing greater life stress. © 2018 Wiley Periodicals, Inc.

  5. Reaching women through health information technology: the Gabby preconception care system.

    PubMed

    Gardiner, Paula; Hempstead, Megan B; Ring, Lazlo; Bickmore, Timothy; Yinusa-Nyahkoon, Leanne; Tran, Huong; Paasche-Orlow, Michael; Damus, Karla; Jack, Brian

    2013-01-01

    The Centers for Disease Control and Prevention have endorsed the concept of preconception care (PCC). New tools must be developed to promote PCC. Development and testing of a health information technology system to provide PCC. An urban safety net hospital and an urban university. Community recruitment of 31 women in focus groups and 15 women participating in observed usability testing; 9 students recruited from the Office of Minority Health Preconception Peer Educators program participated in pilot testing for 2 months. Online interactive animated character ("Gabby") designed to identify and modify preconception risks. Qualitative transcripts, preconception risk assessment, server data for system usage, self-administered satisfaction surveys, and follow-up phone calls. Descriptive statistics of subjects' demographics, satisfaction, PCC risks, and system usage. Transcripts coded using NVIVO. Subjects (n = 24) reported an average of 23 preconception risks; in the pilot, 83% of risks added to the "My Health To-Do List" were addressed by the subject. Seventy-three percent of risks identified as contemplative progressed to action or maintenance. Differences were noted in effectiveness of the system based on initial stage of change for each risk. Results suggest that the PCC system could be effective in influencing positive behavior change. Adding stage of change-focused functionality might have added benefits. This system has great potential to assist in the delivery of PCC.

  6. Shuttle Gaseous Hydrogen Venting Risk from Flow Control Valve Failure

    NASA Technical Reports Server (NTRS)

    Drummond, J. Philip; Baurle, Robert A.; Gafney, Richard L.; Norris, Andrew T.; Pellett, Gerald L.; Rock, Kenneth E.

    2009-01-01

    This paper describes a series of studies to assess the potential risk associated with the failure of one of three gaseous hydrogen flow control valves in the orbiter's main propulsion system during the launch of Shuttle Endeavour (STS-126) in November 2008. The studies focused on critical issues associated with the possibility of combustion resulting from release of gaseous hydrogen from the external tank into the atmosphere during assent. The Shuttle Program currently assumes hydrogen venting from the external tank will result in a critical failure. The current effort was conducted to increase understanding of the risk associated with venting hydrogen given the flow control valve failure scenarios being considered in the Integrated In-Flight Anomaly Investigation being conducted by NASA.

  7. Protecting Accelerator Control Systems in the Face of Sophisticated Cyber Attacks

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

    Hartman, Steven M

    2012-01-01

    Cyber security for industrial control systems has received significant attention in the past two years. The news coverage of the Stuxnet attack, believed to be targeted at the control system for a uranium enrichment plant, brought the issue to the attention of news media and policy makers. This has led to increased scrutiny of control systems for critical infrastructure such as power generation and distribution, and industrial systems such as chemical plants and petroleum refineries. The past two years have also seen targeted network attacks aimed at corporate and government entities including US Department of Energy National Laboratories. Both ofmore » these developments have potential repercussions for the control systems of particle accelerators. The need to balance risks from potential attacks with the operational needs of an accelerator present a unique challenge for the system architecture and access model.« less

  8. 76 FR 4703 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Pregnancy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-26

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Pregnancy Risk Assessment Monitoring System (PRAMS), DP11-001 Panel D, Initial Review Notice of Cancellation: This notice was published...

  9. The impact of the CACNA1C risk allele on limbic structures and facial emotions recognition in bipolar disorder subjects and healthy controls.

    PubMed

    Soeiro-de-Souza, Márcio Gerhardt; Otaduy, Maria Concepción Garcia; Dias, Carolina Zadres; Bio, Danielle S; Machado-Vieira, Rodrigo; Moreno, Ricardo Alberto

    2012-12-01

    Impairments in facial emotion recognition (FER) have been reported in bipolar disorder (BD) during all mood states. FER has been the focus of functional magnetic resonance imaging studies evaluating differential activation of limbic regions. Recently, the α1-C subunit of the L-type voltage-gated calcium channel (CACNA1C) gene has been described as a risk gene for BD and its Met allele found to increase CACNA1C mRNA expression. In healthy controls, the CACNA1C risk (Met) allele has been reported to increase limbic system activation during emotional stimuli and also to impact on cognitive function. The aim of this study was to investigate the impact of CACNA1C genotype on FER scores and limbic system morphology in subjects with BD and healthy controls. Thirty-nine euthymic BD I subjects and 40 healthy controls were submitted to a FER recognition test battery and genotyped for CACNA1C. Subjects were also examined with a 3D 3-Tesla structural imaging protocol. The CACNA1C risk allele for BD was associated to FER impairment in BD, while in controls nothing was observed. The CACNA1C genotype did not impact on amygdala or hippocampus volume neither in BD nor controls. Sample size. The present findings suggest that a polymorphism in calcium channels interferes FER phenotype exclusively in BD and doesn't interfere on limbic structures morphology. Copyright © 2012 Elsevier B.V. All rights reserved.

  10. Manual handling risks associated with the care, treatment and transportation of bariatric (severely obese) clients in Australia.

    PubMed

    Cowley, Stephen P; Leggett, Susan

    2011-01-01

    Carers of bariatric (morbidly obese) clients are exposed to manual handling injury risk throughout the journey that such clients take within the healthcare system. To identify the factors that affect risks associated with bariatric clients and the subsequent adoption of risk control measures focus groups were conducted in two Australian state capitals: a suburban region of Melbourne and a large regional Victorian town. Participants, were recruited from within the primary health care sector, ambulance services, fire services and funeral businesses. It was found that the risks to which nurses, ambulance officers, fire fighters, and funeral industry employees are exposed are significant. The injury risk is influenced by the nature and design of the range of environments within which client movement is undertaken; the limited range of handling equipment available for use with bariatric clients; and the efficacy of organisational procedures and training. Adoption of risk controls is hampered by the absence of a standard definition of the term ``bariatric'' and the gaps in information flow during the bariatric client journey through the health care system. Various definitions of bariatric are applied in different sectors and there are limitations to the use of both weight and body mass index in those definitions.

  11. Fractal dynamics in physiology: Alterations with disease and aging

    PubMed Central

    Goldberger, Ary L.; Amaral, Luis A. N.; Hausdorff, Jeffrey M.; Ivanov, Plamen Ch.; Peng, C.-K.; Stanley, H. Eugene

    2002-01-01

    According to classical concepts of physiologic control, healthy systems are self-regulated to reduce variability and maintain physiologic constancy. Contrary to the predictions of homeostasis, however, the output of a wide variety of systems, such as the normal human heartbeat, fluctuates in a complex manner, even under resting conditions. Scaling techniques adapted from statistical physics reveal the presence of long-range, power-law correlations, as part of multifractal cascades operating over a wide range of time scales. These scaling properties suggest that the nonlinear regulatory systems are operating far from equilibrium, and that maintaining constancy is not the goal of physiologic control. In contrast, for subjects at high risk of sudden death (including those with heart failure), fractal organization, along with certain nonlinear interactions, breaks down. Application of fractal analysis may provide new approaches to assessing cardiac risk and forecasting sudden cardiac death, as well as to monitoring the aging process. Similar approaches show promise in assessing other regulatory systems, such as human gait control in health and disease. Elucidating the fractal and nonlinear mechanisms involved in physiologic control and complex signaling networks is emerging as a major challenge in the postgenomic era. PMID:11875196

  12. [Tele-medicine system for high-risk asthmatic patients].

    PubMed

    Kokubu, F; Suzuki, H; Sano, Y; Kihara, N; Adachi, M

    1999-07-01

    We have developed a tele-medicine system to monitor the airway status at home for patients with poorly controlled asthma, whereby a nurse provides instructions to individuals via the telephone to help them manage exacerbation under the supervision of their physicians. We examined the effectiveness of this system with a randomized control study. Patients with high hospitalization risk were enrolled in the study by screening patients for those with multiple previous emergency room visits and randomly assigned to either the tele-medicine or control group. After six months of participation in the program, the number of emergency room visits decreased significantly and the activities of daily living were improved in the tele-medicine group. Most of the patients in the tele-medicine group were able to continue measuring and transmitting peak expiratory flow (PEF) value successfully, and at six months had noticed an improvement in PEF. We therefore conclude that the system effectively contributes to the management of poorly controlled asthma. In addition, further consideration suggests that the reduction of emergency room visits may lead to reduction in hospitalization since we found a good correlation between number of emergency room visits and hospitalization from the studies published previously.

  13. An Evaluation of Internal Control for a Nonappropriated Fund Instrumentality (NAFI)

    DTIC Science & Technology

    1992-03-01

    to which an internal control system meets these guidelines , a plan of investigation must be iormulated. Planning an internal control review is...INTERNAL CONTROL . ........ 7 C. INTERNAL CONTROL STANDARDS ... ... .......... 8 D. PLANNING INTERNAL CONTROL REVIEW . ....... . 13 E. EVALUATING...Dining Facility. The critical areas of research are those which present the greatest risk of material loss to the financial operation of the NAFI

  14. Platelet aggregation inhibitors, vitamin K antagonists and risk of subarachnoid hemorrhage.

    PubMed

    Risselada, R; Straatman, H; van Kooten, F; Dippel, D W J; van der Lugt, A; Niessen, W J; Firouzian, A; Herings, R M C; Sturkenboom, M C J M

    2011-03-01

    Use of platelet aggregation inhibitors and vitamin K antagonists has been associated with an increased risk of intracranial hemorrhage (ICH). Whether the use of these antithrombotic drugs is associated with an increased risk of subarachnoid hemorrhage (SAH) remains unclear, especially as confounding by indication might play a role. The aim of the present study was to investigate whether use of platelet aggregation inhibitors or vitamin K antagonists increase the risk of SAH. We applied population-based case-control, case-crossover and case-time-control designs to estimate the risk of SAH while addressing issues both of confounding by indication and time varying exposure within the PHARMO Record Linkage System database. This system includes drug dispensing records from community pharmacies and hospital discharge records of more than 3 million community-dwelling inhabitants in the Netherlands. Patients were considered a case if they were hospitalized for a first SAH (ICD-9-CM code 430) in the period between 1st January 1998 and 31st December 2006. Controls were selected from the source population, matched on age, gender and date of hospitalization. Conditional logistic regression was used to estimate multivariable adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of SAH during use of platelet aggregation inhibitors or vitamin K antagonists. In the case-crossover and case-time-control designs we selected 11 control periods preceding the index date in successive steps of 1 month in the past. In all, 1004 cases of SAH were identified. In the case-control analysis the adjusted OR for the risk of SAH in current use of platelet aggregation inhibitors was 1.32 (95% CI: 1.02-1.70) and in current use of vitamin K antagonists 1.29 (95% CI: 0.89-1.87) compared with no use. In the case-crossover analysis the ORs for the risk of SAH in current use of platelet aggregation inhibitors and vitamin K antagonists were 1.04 (95% CI: 0.56-1.94) and 2.46 (95% CI: 1.04-5.82), respectively. In the case-time-control analysis the OR for platelet aggregation inhibitors was 0.50 (95% CI: 0.26-0.98) and for vitamin K antagonists 1.98 (95% CI: 0.82-4.76). The use of platelet aggregation inhibitors was not associated with an increased SAH risk; the modest increase observed in the case-control analysis could be as a result of confounding. The use of vitamin K antagonists seemed to be associated with an increased risk of SAH. The increase was most pronounced in the case-crossover analysis and therefore cannot be explained by unmeasured confounding. © 2011 International Society on Thrombosis and Haemostasis.

  15. Disentangling the effects of predator hunting mode and habitat domain on the top-down control of insect herbivores.

    PubMed

    Woodcock, Ben A; Heard, Matthew S

    2011-03-01

    1. Polyphagous predatory invertebrates play a key role in the top-down control of insect herbivores. However, predicting predation risk for herbivores is not a simple function of predator species richness. Predation risk may be reduced or enhanced depending on the functional characteristics predator species. We predict that where predator species spatially overlap this will reduce predation risk for herbivores by allowing negative inter-specific interaction between predators to occur. Where increased predation risk occurs, we also predict that this will have a cascading effect through the food chain reducing plant growth. 2. We used a substitutive replicated block design to identify the effect of similarity and dissimilarity in predator hunting mode (e.g. 'sit and wait', 'sit and pursue', and 'active') and habitat domain (e.g. canopy or ground) on the top-down control of planthoppers in grasslands. Predators included within the mesocosms were randomly selected from a pool of 17 local species. 3. Predation risk was reduced where predators shared the same habitat domain, independent of whether they shared hunting modes. Where predators shared the same habitat domains, there was some evidence that this had a cascading negative effect on the re-growth of grass biomass. Where predator habitat domains did not overlap, there were substitutable effects on predation risk to planthoppers. Predation risk for planthoppers was affected by taxonomic identity of predator species, i.e. whether they were beetles, spiders or true bugs. 4. Our results indicated that in multi-predator systems, the risk of predation is typically reduced. Consideration of functional characteristics of individual species, in particular aspects of habitat domain and hunting mode, are crucial in predicting the effects of multi-predator systems on the top-down control of herbivores. © 2010 The Authors. Journal of Animal Ecology © 2010 British Ecological Society.

  16. Risk perceptions of public health and food safety hazards in poultry husbandry by citizens, poultry farmers and poultry veterinarians.

    PubMed

    van Asselt, M; Poortvliet, P M; Ekkel, E D; Kemp, B; Stassen, E N

    2018-02-01

    Differences in risk perceptions of public health and food safety hazards in various poultry husbandry systems by various stakeholder groups, may affect the acceptability of those husbandry systems. Therefore, the objective was to gain insight into risk perceptions of citizens, poultry farmers, and poultry veterinarians regarding food safety and public health hazards in poultry husbandry systems, and into factors explaining these risk perceptions. We surveyed risk perceptions of Campylobacter contamination of broiler meat, avian influenza introduction in laying hens, and altered dioxin levels in eggs for the most commonly used broiler and laying hen husbandry systems in Dutch citizens (n = 2,259), poultry farmers (n = 100), and poultry veterinarians (n = 41). Citizens perceived the risks of the three hazards in the indoor systems higher and in the outdoor systems lower than did the professionals. Citizens reported higher concerns regarding aspects reflecting underlying psychological factors of risk perception compared to professionals. Professionals indicated a relatively low level of personal control, which might imply risk denial. Of the socio-demographic characteristics, gender and childhood residence were associated with risk perceptions. The influence of other factors of risks perception are discussed. It is suggested that risk perceptions of all stakeholder groups are influenced by affect, stigma, and underlying values. To adapt current or new husbandry systems that can count on societal support, views of key stakeholders and multiple aspects such as animal welfare, public health, food safety, and underlying values should be considered integrally. When trade-offs, such as between animal welfare and public health have to be made, insight into underlying values might help to find consensus among stakeholders. © The Author 2017. Published by Oxford University Press on behalf of Poultry Science Association.

  17. Risk perceptions of public health and food safety hazards in poultry husbandry by citizens, poultry farmers and poultry veterinarians

    PubMed Central

    Poortvliet, P M; Ekkel, E D; Kemp, B; Stassen, E N

    2018-01-01

    Abstract Differences in risk perceptions of public health and food safety hazards in various poultry husbandry systems by various stakeholder groups, may affect the acceptability of those husbandry systems. Therefore, the objective was to gain insight into risk perceptions of citizens, poultry farmers, and poultry veterinarians regarding food safety and public health hazards in poultry husbandry systems, and into factors explaining these risk perceptions. We surveyed risk perceptions of Campylobacter contamination of broiler meat, avian influenza introduction in laying hens, and altered dioxin levels in eggs for the most commonly used broiler and laying hen husbandry systems in Dutch citizens (n = 2,259), poultry farmers (n = 100), and poultry veterinarians (n = 41). Citizens perceived the risks of the three hazards in the indoor systems higher and in the outdoor systems lower than did the professionals. Citizens reported higher concerns regarding aspects reflecting underlying psychological factors of risk perception compared to professionals. Professionals indicated a relatively low level of personal control, which might imply risk denial. Of the socio-demographic characteristics, gender and childhood residence were associated with risk perceptions. The influence of other factors of risks perception are discussed. It is suggested that risk perceptions of all stakeholder groups are influenced by affect, stigma, and underlying values. To adapt current or new husbandry systems that can count on societal support, views of key stakeholders and multiple aspects such as animal welfare, public health, food safety, and underlying values should be considered integrally. When trade-offs, such as between animal welfare and public health have to be made, insight into underlying values might help to find consensus among stakeholders. PMID:29161444

  18. Air Traffic Control: Immature Software Acquisition Processes Increase FAA System Acquisition Risks

    DOT National Transportation Integrated Search

    1997-03-01

    The General Accounting Office (GAO) at the request of Congress reviewed (1) : the maturity of Federal Aviation Administration's (FAA's) Air Traffic Control : (ATC) modernization software acquisition processes, and (2) the steps/actions : FAA has unde...

  19. A Tissue Systems Pathology Test Detects Abnormalities Associated with Prevalent High-Grade Dysplasia and Esophageal Cancer in Barrett's Esophagus.

    PubMed

    Critchley-Thorne, Rebecca J; Davison, Jon M; Prichard, Jeffrey W; Reese, Lia M; Zhang, Yi; Repa, Kathleen; Li, Jinhong; Diehl, David L; Jhala, Nirag C; Ginsberg, Gregory G; DeMarshall, Maureen; Foxwell, Tyler; Jobe, Blair A; Zaidi, Ali H; Duits, Lucas C; Bergman, Jacques J G H M; Rustgi, Anil; Falk, Gary W

    2017-02-01

    There is a need for improved tools to detect high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC) in patients with Barrett's esophagus. In previous work, we demonstrated that a 3-tier classifier predicted risk of incident progression in Barrett's esophagus. Our aim was to determine whether this risk classifier could detect a field effect in nondysplastic (ND), indefinite for dysplasia (IND), or low-grade dysplasia (LGD) biopsies from Barrett's esophagus patients with prevalent HGD/EAC. We performed a multi-institutional case-control study to evaluate a previously developed risk classifier that is based upon quantitative image features derived from 9 biomarkers and morphology, and predicts risk for HGD/EAC in Barrett's esophagus patients. The risk classifier was evaluated in ND, IND, and LGD biopsies from Barrett's esophagus patients diagnosed with HGD/EAC on repeat endoscopy (prevalent cases, n = 30, median time to HGD/EAC diagnosis 140.5 days) and nonprogressors (controls, n = 145, median HGD/EAC-free surveillance time 2,015 days). The risk classifier stratified prevalent cases and non-progressor patients into low-, intermediate-, and high-risk classes [OR, 46.0; 95% confidence interval, 14.86-169 (high-risk vs. low-risk); P < 0.0001]. The classifier also provided independent prognostic information that outperformed the subspecialist and generalist diagnosis. A tissue systems pathology test better predicts prevalent HGD/EAC in Barrett's esophagus patients than pathologic variables. The results indicate that molecular and cellular changes associated with malignant transformation in Barrett's esophagus may be detectable as a field effect using the test. A tissue systems pathology test may provide an objective method to facilitate earlier identification of Barrett's esophagus patients requiring therapeutic intervention. Cancer Epidemiol Biomarkers Prev; 26(2); 240-8. ©2016 AACR. ©2016 American Association for Cancer Research.

  20. Potentially functional COX-2-1195G>A polymorphism increases the risk of digestive system cancers: a meta-analysis.

    PubMed

    Dong, Jing; Dai, Juncheng; Zhang, Mingfeng; Hu, Zhibin; Shen, Hongbing

    2010-06-01

    Three potentially functional polymorphisms: -765G>C, -1195G>A, and 8473T>C in the cyclooxygenase-2 (COX-2) gene were identified and proposed to be associated with cancer susceptibility. The aim of this meta-analysis was to evaluate the association between these three polymorphisms and the risk of cancer in diverse populations. All case-control studies published up to November 2009 on the association between the three polymorphisms of COX-2 and cancer risk were identified by searching PubMed. The cancer risk associated with the three polymorphisms of the COX-2 gene was estimated for each study by OR together with its 95% confidence interval (CI), respectively. A total of 47 case-control studies were included, and variant genotypes GA/AA of -1195G>A were associated with a significantly increased cancer risk (GA/AA vs GG: odds ratio [OR], 1.29; 95% CI, 1.18-1.41; P(heterogeneity) = 0.113), and this significant association was mainly observed within cancers of the digestive system (e.g. colorectal, gastric, esophageal, oral, biliary tract, gallbladder, and pancreatic) without between-study heterogeneity (GA/AA vs GG: OR, 1.36; 95% CI; 1.23-1.51; P(heterogeneity) = 0.149). Furthermore, a stratification analysis showed that the risk of COX-2-1195G>A associated with cancers in the digestive system was more evident among Asians than Caucasians. However, for COX-2-765G>C and 8473T>C, no convincing association between the two polymorphisms and risk of cancer or cancer type was observed. The effect of three potentially functional polymorphisms (-765G>C, -1195G>A, and 8473T>C) in the COX-2 gene on cancer risk provided evidence that the COX-2-1195G>A polymorphism was significantly associated with increased risk of digestive system cancers, especially among Asian populations.

  1. Tuberculosis Infection Control in Health-Care Facilities: Environmental Control and Personal Protection.

    PubMed

    Lee, Ji Yeon

    2016-10-01

    Transmission of tuberculosis (TB) is a recognized risk to patients and healthcare workers in healthcare settings. The literature review suggests that implementation of combination control measures reduces the risk of TB transmission. Guidelines suggest a three-level hierarchy of controls including administrative, environmental, and respiratory protection. Among environmental controls, installation of ventilation systems is a priority because ventilation reduces the number of infectious particles in the air. Natural ventilation is cost-effective but depends on climatic conditions. Supplemented intervention such as air-cleaning methods including high efficiency particulate air filtration and ultraviolet germicidal irradiation should be considered in areas where adequate ventilation is difficult to achieve. Personal protective equipment including particulate respirators provides additional benefit when administrative and environmental controls cannot assure protection.

  2. The effect of control and display lag on unmanned air system internal pilot manual landing performance

    NASA Astrophysics Data System (ADS)

    Lloyd, Marshall Everett

    An important characteristic of UASs is lag because it can become a considerable challenge to successful human-in-the-loop control. As such, UASs are designed and configured to minimize system lag, though this can increase acquisition and operation costs considerably. In an effort to cut costs, an organization may choose to accept greater risk and deploy a UAS with high system lag. Before this risk can be responsibly accepted, it must be quantified. While many studies have examined system lag, very few have been able to quantify the risk that various levels of lag pose to an internally piloted, manually landed UAS. This study attempted to do so by evaluating pilot landing performance in a simulator with 0 ms, 240 ms, and 1000 ms of additional lag. Various measures were used, including a novel coding technique. Results indicated that 1000 ms of lag was unsafe by all measures. They also indicate that 240 ms of lag degrades performance, but participants were able to successfully land the simulated aircraft. This study showed the utility of using several measures to evaluate the effect of lag on landing performance and it helped demonstrate that while 1000 ms poses a high risk, 240 ms of lag may be a much more manageable risk. Future research suggested by this research includes: investigating lag between 240 ms and 1000 ms, introducing different weather phenomena, developing system lag training techniques for operators, and investigating the effect of aides such as predictive displays and autopilot-assisted recovery.

  3. Evaluation of Environmental Risk Due to Metro System Construction in Jinan, China

    PubMed Central

    Wang, Guo-Fu; Lyu, Hai-Min; Lu, Lin-Hai; Li, Gang; Arulrajah, Arul

    2017-01-01

    Jinan is a famous spring city in China. Construction of underground metro system may block groundwater seepage, inducing the depletion risk of springs. This paper presents an assessment of the risk due to metro line construction to groundwater in Jinan City using Analytic Hierarchy Process (AHP) and Geographic International System (GIS). Based on the characteristics of hydrogeology and engineering geology, the assessment model is established from the perspectives of surface index and underground index. The assessment results show that the high and very high risk levels of surface index exceed 98% in the north region; and high and very high risk levels of underground index exceed 56% in urban center and southern region. The assessment result also shows that about 14% of the urban area belongs to very high risk level; regions of high risk are 20% in urban area, 9% in Changqing County and 43% in Pingyin County. In the high risk region, metro lines R1 to R3, which are under construction, and metro lines L1 to L5, which are planned, have very high and high risk. Therefore, risk control measures are proposed to protect the groundwater seepage path to spring. PMID:28946709

  4. Evaluation of Environmental Risk Due to Metro System Construction in Jinan, China.

    PubMed

    Wang, Guo-Fu; Lyu, Hai-Min; Shen, Jack Shuilong; Lu, Lin-Hai; Li, Gang; Arulrajah, Arul

    2017-09-25

    Jinan is a famous spring city in China. Construction of underground metro system may block groundwater seepage, inducing the depletion risk of springs. This paper presents an assessment of the risk due to metro line construction to groundwater in Jinan City using Analytic Hierarchy Process (AHP) and Geographic International System (GIS). Based on the characteristics of hydrogeology and engineering geology, the assessment model is established from the perspectives of surface index and underground index. The assessment results show that the high and very high risk levels of surface index exceed 98% in the north region; and high and very high risk levels of underground index exceed 56% in urban center and southern region. The assessment result also shows that about 14% of the urban area belongs to very high risk level; regions of high risk are 20% in urban area, 9% in Changqing County and 43% in Pingyin County. In the high risk region, metro lines R1 to R3, which are under construction, and metro lines L1 to L5, which are planned, have very high and high risk. Therefore, risk control measures are proposed to protect the groundwater seepage path to spring.

  5. Pharmacovigilance practice and risk control of Traditional Chinese Medicine drugs in China: current status and future perspective.

    PubMed

    Zhang, Li; Yan, Jingbo; Liu, Xinmin; Ye, Zuguang; Yang, Xiaohui; Meyboom, Ronald; Chan, Kelvin; Shaw, Debbie; Duez, Pierre

    2012-04-10

    Traditional Chinese Medicine (TCM), including Traditional Chinese Medicine drugs (TCM drugs), has been playing a very important role in health protection and disease control for thousands of years in China. Relying on natural products, mainly of herbal origin, used either as raw materials for decoction, as prepared herbal medicines or as formulated traditional medicines, TCM is still widely accepted by Chinese people, especially for chronic diseases treatment. This extensive use warrants safety measures and so TCM drug safety monitoring and risk management are becoming increasingly important tasks for the Chinese State Food and Drug Administration (SFDA). The Adverse Drug Reaction (ADR) monitoring system in China was established both for western and TCM drugs in 1989 as a voluntary reporting system with a National Center collecting and compiling reports. Serious or multi-case reports on individual TCM drug or formulated products are detailed in the Chinese ADR Information Bulletin to inform the public and Drug Administrative authorities for risk management. About 10-15% of the ADR reports received by the National Center are related to TCM drugs and mainly pertaining to the formulated products. In certain cases, the suspension of a particular TCM preparation is decided by SFDA China. The model of safety monitoring and risk management of TCM drugs is still under exploration. Indeed, the characteristics and risk factors associated with these drugs require both proper understanding and control of the risk by strengthening standardization of clinical applications, basic science research, quality control in manufacturing, exploration of the actives monitoring methodology and enhancement of international communication and cooperation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  6. Parental substance abuse and function of the motivation and behavioral inhibition systems in drug-naïve youth.

    PubMed

    Ivanov, Iliyan; Liu, Xun; Shulz, Kurt; Fan, Jin; London, Edythe; Friston, Karl; Halperin, Jeffrey M; Newcorn, Jeffrey H

    2012-02-28

    It is hypothesized that the development of substance abuse (SA) may be due to imbalance in functions of the motivation-reward and behavioral inhibition systems in the brain. This speaks to the search for biological risk factors for SA in drug-naïve children who also exhibit motivational and inhibitory control deficits; however, this type of research is currently lacking. The objective of this study was to establish a neurobiological basis for addiction vulnerability using functional magnetic resonance imaging (fMRI) in drug-naïve youth with attention deficit/hyperactivity disorder (ADHD). We hypothesized that children with ADHD alone would show higher activity in regions of the motivation-reward and behavioral inhibition systems than children with ADHD and a parental history of SA. Toward this goal we scanned 20 drug-naïve children with ADHD ages 8-13 while performing an event-related reward task. High (N=10) and low (N=10) risk subjects were identified, based on parental history of SA. The effects of anticipation, conflict, and reward were assessed with appropriate linear contrasts, and between-group differences were assessed using statistical parametric mapping. The two groups did not differ on behavioral measures of the task. The fMRI results show heightened activation in the brain motivational-reward system and reduced activation of the inhibitory control system in high-risk compared to low-risk children. These results suggest that a functional mismatch between these two systems may represent one possible biological underpinning of SA risk, which is conferred by a parental history of addiction. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  7. Predicting Epidemic Risk from Past Temporal Contact Data

    PubMed Central

    Valdano, Eugenio; Poletto, Chiara; Giovannini, Armando; Palma, Diana; Savini, Lara; Colizza, Vittoria

    2015-01-01

    Understanding how epidemics spread in a system is a crucial step to prevent and control outbreaks, with broad implications on the system’s functioning, health, and associated costs. This can be achieved by identifying the elements at higher risk of infection and implementing targeted surveillance and control measures. One important ingredient to consider is the pattern of disease-transmission contacts among the elements, however lack of data or delays in providing updated records may hinder its use, especially for time-varying patterns. Here we explore to what extent it is possible to use past temporal data of a system’s pattern of contacts to predict the risk of infection of its elements during an emerging outbreak, in absence of updated data. We focus on two real-world temporal systems; a livestock displacements trade network among animal holdings, and a network of sexual encounters in high-end prostitution. We define the node’s loyalty as a local measure of its tendency to maintain contacts with the same elements over time, and uncover important non-trivial correlations with the node’s epidemic risk. We show that a risk assessment analysis incorporating this knowledge and based on past structural and temporal pattern properties provides accurate predictions for both systems. Its generalizability is tested by introducing a theoretical model for generating synthetic temporal networks. High accuracy of our predictions is recovered across different settings, while the amount of possible predictions is system-specific. The proposed method can provide crucial information for the setup of targeted intervention strategies. PMID:25763816

  8. An overview of safety assessment, regulation, and control of hazardous material use at NREL

    NASA Astrophysics Data System (ADS)

    Nelson, B. P.; Crandall, R. S.; Moskowitz, P. D.; Fthenakis, V. M.

    1992-12-01

    This paper summarizes the methodology we use to ensure the safe use of hazardous materials at the National Renewable Energy Laboratory (NREL). First, we analyze the processes and the materials used in those processes to identify the hazards presented. Then we study federal, state, and local regulations and apply the relevant requirements to our operations. When necessary, we generate internal safety documents to consolidate this information. We design research operations and support systems to conform to these requirements. Before we construct the systems, we perform a semiquantitative risk analysis on likely accident scenarios. All scenarios presenting an unacceptable risk require system or procedural modifications to reduce the risk. Following these modifications, we repeat the risk analysis to ensure that the respective accident scenarios present an acceptable risk. Once all risks are acceptable, we conduct an operational readiness review (ORR). A management-appointed panel performs the ORR ensuring compliance with all relevant requirements. After successful completion of the ORR, operations can begin.

  9. Early Warning System for West Nile Virus Risk Areas, California, USA

    PubMed Central

    Ahearn, Sean C.; McConchie, Alan; Glaser, Carol; Jean, Cynthia; Barker, Chris; Park, Bborie; Padgett, Kerry; Parker, Erin; Aquino, Ervic; Kramer, Vicki

    2011-01-01

    The Dynamic Continuous-Area Space-Time (DYCAST) system is a biologically based spatiotemporal model that uses public reports of dead birds to identify areas at high risk for West Nile virus (WNV) transmission to humans. In 2005, during a statewide epidemic of WNV (880 cases), the California Department of Public Health prospectively implemented DYCAST over 32,517 km2 in California. Daily risk maps were made available online and used by local agencies to target public education campaigns, surveillance, and mosquito control. DYCAST had 80.8% sensitivity and 90.6% specificity for predicting human cases, and κ analysis indicated moderate strength of chance-adjusted agreement for >4 weeks. High-risk grid cells (populations) were identified an average of 37.2 days before onset of human illness; relative risk for disease was >39× higher than for low-risk cells. Although prediction rates declined in subsequent years, results indicate DYCAST was a timely and effective early warning system during the severe 2005 epidemic. PMID:21801622

  10. A Social Neuroscience Perspective on Adolescent Risk-Taking

    PubMed Central

    Steinberg, Laurence

    2007-01-01

    This article proposes a framework for theory and research on risk-taking that is informed by developmental neuroscience. Two fundamental questions motivate this review. First, why does risk-taking increase between childhood and adolescence? Second, why does risk-taking decline between adolescence and adulthood? Risk-taking increases between childhood and adolescence as a result of changes around the time of puberty in the brain’s socio-emotional system leading to increased reward-seeking, especially in the presence of peers, fueled mainly by a dramatic remodeling of the brain’s dopaminergic system. Risk-taking declines between adolescence and adulthood because of changes in the brain’s cognitive control system – changes which improve individuals’ capacity for self-regulation. These changes occur across adolescence and young adulthood and are seen in structural and functional changes within the prefrontal cortex and its connections to other brain regions. The differing timetables of these changes make mid-adolescence a time of heightened vulnerability to risky and reckless behavior. PMID:18509515

  11. Turbine gas temperature measurement and control system

    NASA Technical Reports Server (NTRS)

    Webb, W. L.

    1973-01-01

    A fluidic Turbine Inlet Gas Temperature (TIGIT) Measurement and Control System was developed for use on a Pratt and Whitney Aircraft J58 engine. Based on engine operating requirements, criteria for high temperature materials selection, system design, and system performance were established. To minimize development and operational risk, the TIGT control system was designed to interface with an existing Exhaust Gas Temperature (EGT) Trim System and thereby modulate steady-state fuel flow to maintain a desired TIGT level. Extensive component and system testing was conducted including heated (2300F) vibration tests for the fluidic sensor and gas sampling probe, temperature and vibration tests on the system electronics, burner rig testing of the TIGT measurement system, and in excess of 100 hours of system testing on a J58 engine. (Modified author abstract)

  12. An intelligent and secure system for predicting and preventing Zika virus outbreak using Fog computing

    NASA Astrophysics Data System (ADS)

    Sareen, Sanjay; Gupta, Sunil Kumar; Sood, Sandeep K.

    2017-10-01

    Zika virus is a mosquito-borne disease that spreads very quickly in different parts of the world. In this article, we proposed a system to prevent and control the spread of Zika virus disease using integration of Fog computing, cloud computing, mobile phones and the Internet of things (IoT)-based sensor devices. Fog computing is used as an intermediary layer between the cloud and end users to reduce the latency time and extra communication cost that is usually found high in cloud-based systems. A fuzzy k-nearest neighbour is used to diagnose the possibly infected users, and Google map web service is used to provide the geographic positioning system (GPS)-based risk assessment to prevent the outbreak. It is used to represent each Zika virus (ZikaV)-infected user, mosquito-dense sites and breeding sites on the Google map that help the government healthcare authorities to control such risk-prone areas effectively and efficiently. The proposed system is deployed on Amazon EC2 cloud to evaluate its performance and accuracy using data set for 2 million users. Our system provides high accuracy of 94.5% for initial diagnosis of different users according to their symptoms and appropriate GPS-based risk assessment.

  13. Empirical Estimates of 0Day Vulnerabilities in Control Systems

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

    Miles A. McQueen; Wayne F. Boyer; Sean M. McBride

    2009-01-01

    We define a 0Day vulnerability to be any vulnerability, in deployed software, which has been discovered by at least one person but has not yet been publicly announced or patched. These 0Day vulnerabilities are of particular interest when assessing the risk to well managed control systems which have already effectively mitigated the publicly known vulnerabilities. In these well managed systems the risk contribution from 0Days will have proportionally increased. To aid understanding of how great a risk 0Days may pose to control systems, an estimate of how many are in existence is needed. Consequently, using the 0Day definition given above,more » we developed and applied a method for estimating how many 0Day vulnerabilities are in existence on any given day. The estimate is made by: empirically characterizing the distribution of the lifespans, measured in days, of 0Day vulnerabilities; determining the number of vulnerabilities publicly announced each day; and applying a novel method for estimating the number of 0Day vulnerabilities in existence on any given day using the number of vulnerabilities publicly announced each day and the previously derived distribution of 0Day lifespans. The method was first applied to a general set of software applications by analyzing the 0Day lifespans of 491 software vulnerabilities and using the daily rate of vulnerability announcements in the National Vulnerability Database. This led to a conservative estimate that in the worst year there were, on average, 2500 0Day software related vulnerabilities in existence on any given day. Using a smaller but intriguing set of 15 0Day software vulnerability lifespans representing the actual time from discovery to public disclosure, we then made a more aggressive estimate. In this case, we estimated that in the worst year there were, on average, 4500 0Day software vulnerabilities in existence on any given day. We then proceeded to identify the subset of software applications likely to be used in some control systems, analyzed the associated subset of vulnerabilities, and characterized their lifespans. Using the previously developed method of analysis, we very conservatively estimated 250 control system related 0Day vulnerabilities in existence on any given day. While reasonable, this first order estimate for control systems is probably far more conservative than those made for general software systems since the estimate did not include vulnerabilities unique to control system specific components. These control system specific vulnerabilities were unable to be included in the estimate for a variety of reasons with the most problematic being that the public announcement of unique control system vulnerabilities is very sparse. Consequently, with the intent to improve the above 0Day estimate for control systems, we first identified the additional, unique to control systems, vulnerability estimation constraints and then investigated new mechanisms which may be useful for estimating the number of unique 0Day software vulnerabilities found in control system components. We proceeded to identify a number of new mechanisms and approaches for estimating and incorporating control system specific vulnerabilities into an improved 0Day estimation method. These new mechanisms and approaches appear promising and will be more rigorously evaluated during the course of the next year.« less

  14. An approach to the design of operations systems

    NASA Technical Reports Server (NTRS)

    Chafin, Roy L.; Curran, Patrick S.

    1993-01-01

    The MultiMission Control Team (MMCT) consists of mission controllers which provides Real-Time operations support for the Mars Observer project. The Real-Time Operations task is to insure the integrity of the ground data system, to insure that the configuration is correct to support the mission, and to monitor the spacecraft for the Spacecraft Team. Operations systems are typically developed by adapting operations systems from previous projects. Problems tend to be solved empirically when they are either anticipated or observed in testing. This development method has worked in the past when time was available for extensive Ops testing. In the present NASA budget environment, a more cost conscious design approach has become necessary. Cost is a concern because operations is an ongoing, continuous activity. Reducing costs entails reducing staff. Reducing staffing levels potentially increases the risk of mission failure. Therefore, keeping track of the risk level is necessary.

  15. What can formal methods offer to digital flight control systems design

    NASA Technical Reports Server (NTRS)

    Good, Donald I.

    1990-01-01

    Formal methods research begins to produce methods which will enable mathematic modeling of the physical behavior of digital hardware and software systems. The development of these methods directly supports the NASA mission of increasing the scope and effectiveness of flight system modeling capabilities. The conventional, continuous mathematics that is used extensively in modeling flight systems is not adequate for accurate modeling of digital systems. Therefore, the current practice of digital flight control system design has not had the benefits of extensive mathematical modeling which are common in other parts of flight system engineering. Formal methods research shows that by using discrete mathematics, very accurate modeling of digital systems is possible. These discrete modeling methods will bring the traditional benefits of modeling to digital hardware and hardware design. Sound reasoning about accurate mathematical models of flight control systems can be an important part of reducing risk of unsafe flight control.

  16. Risk/Requirements Trade-off Guidelines for Low Cost Satellite Systems

    NASA Technical Reports Server (NTRS)

    Cornford, Steven L.; Man, Kin F.

    1996-01-01

    The accelerating trend toward faster, better, cheaper missions places increasing emphasis on the trade-offs between requirements and risk to reduce cost and development times, while still improving quality and reliability. The Risk/Requirement Trade-off Guidelines discussed in this paper are part of an integrated approach to address the main issues by focusing on the sum of prevention, analysis, control, or test (PACT) processes.

  17. Proband Mental Health Difficulties and Parental Stress Predict Mental Health in Toddlers at High-Risk for Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Crea, Katherine; Dissanayake, Cheryl; Hudry, Kristelle

    2016-01-01

    Family-related predictors of mental health problems were investigated among 30 toddlers at familial high-risk for autism spectrum disorders (ASD) and 28 controls followed from age 2- to 3-years. Parents completed the self-report Depression Anxiety Stress Scales and the parent-report Behavior Assessment System for Children. High-risk toddlers were…

  18. Reducing the risk of rear-end collisions with infrastructure-to-vehicle (I2V) integration of variable speed limit control and adaptive cruise control system.

    PubMed

    Li, Ye; Wang, Hao; Wang, Wei; Liu, Shanwen; Xiang, Yun

    2016-08-17

    Adaptive cruise control (ACC) has been investigated recently to explore ways to increase traffic capacity, stabilize traffic flow, and improve traffic safety. However, researchers seldom have studied the integration of ACC and roadside control methods such as the variable speed limit (VSL) to improve safety. The primary objective of this study was to develop an infrastructure-to-vehicle (I2V) integrated system that incorporated both ACC and VSL to reduce rear-end collision risks on freeways. The intelligent driver model was firstly modified to simulate ACC behavior and then the VSL strategy used in this article was introduced. Next, the I2V system was proposed to integrate the 2 advanced techniques, ACC and VSL. Four scenarios of no control, VSL only, ACC only, and the I2V system were tested in simulation experiments. Time exposed time to collision (TET) and time integrated time to collision (TIT), 2 surrogate safety measures derived from time to collision (TTC), were used to evaluate safety issues associated with rear-end collisions. The total travel times of each scenario were also compared. The simulation results indicated that both the VSL-only and ACC-only methods had a positive impact on reducing the TET and TIT values (reduced by 53.0 and 58.6% and 59.0 and 65.3%, respectively). The I2V system combined the advantages of both ACC and VSL to achieve the most safety benefits (reduced by 71.5 and 77.3%, respectively). Sensitivity analysis of the TTC threshold also showed that the I2V system obtained the largest safety benefits with all of the TTC threshold values. The impact of different market penetration rates of ACC vehicles in I2V system indicated that safety benefits increase with an increase in ACC proportions. Compared to VSL-only and ACC-only scenarios, this integrated I2V system is more effective in reducing rear-end collision risks. The findings of this study provide useful information for traffic agencies to implement novel techniques to improve safety on freeways.

  19. Understanding Genetic Breast Cancer Risk: Processing Loci of the BRCA Gist Intelligent Tutoring System

    PubMed Central

    Wolfe, Christopher R.; Reyna, Valerie F.; Widmer, Colin L.; Cedillos-Whynott, Elizabeth M.; Brust-Renck, Priscila G; Weil, Audrey M.; Hu, Xiangen

    2016-01-01

    The BRCA Gist Intelligent Tutoring System helps women understand and make decisions about genetic testing for breast cancer risk. BRCA Gist is guided by Fuzzy-Trace Theory, (FTT) and built using AutoTutor Lite. It responds differently to participants depending on what they say. Seven tutorial dialogues requiring explanation and argumentation are guided by three FTT concepts: forming gist explanations in one’s own words, emphasizing decision-relevant information, and deliberating the consequences of decision alternatives. Participants were randomly assigned to BRCA Gist, a control, or impoverished BRCA Gist conditions removing gist explanation dialogues, argumentation dialogues, or FTT images. All BRCA Gist conditions performed significantly better than controls on knowledge, comprehension, and risk assessment. Significant differences in knowledge, comprehension, and fine-grained dialogue analyses demonstrate the efficacy of gist explanation dialogues. FTT images significantly increased knowledge. Providing more elements in arguments against testing correlated with increased knowledge and comprehension. PMID:28008216

  20. Understanding Genetic Breast Cancer Risk: Processing Loci of the BRCA Gist Intelligent Tutoring System.

    PubMed

    Wolfe, Christopher R; Reyna, Valerie F; Widmer, Colin L; Cedillos-Whynott, Elizabeth M; Brust-Renck, Priscila G; Weil, Audrey M; Hu, Xiangen

    2016-07-01

    The BRCA Gist Intelligent Tutoring System helps women understand and make decisions about genetic testing for breast cancer risk. BRCA Gist is guided by Fuzzy-Trace Theory, (FTT) and built using AutoTutor Lite. It responds differently to participants depending on what they say. Seven tutorial dialogues requiring explanation and argumentation are guided by three FTT concepts: forming gist explanations in one's own words, emphasizing decision-relevant information, and deliberating the consequences of decision alternatives. Participants were randomly assigned to BRCA Gist , a control, or impoverished BRCA Gist conditions removing gist explanation dialogues, argumentation dialogues, or FTT images. All BRCA Gist conditions performed significantly better than controls on knowledge, comprehension, and risk assessment. Significant differences in knowledge, comprehension, and fine-grained dialogue analyses demonstrate the efficacy of gist explanation dialogues. FTT images significantly increased knowledge. Providing more elements in arguments against testing correlated with increased knowledge and comprehension.

  1. Research on the method of information system risk state estimation based on clustering particle filter

    NASA Astrophysics Data System (ADS)

    Cui, Jia; Hong, Bei; Jiang, Xuepeng; Chen, Qinghua

    2017-05-01

    With the purpose of reinforcing correlation analysis of risk assessment threat factors, a dynamic assessment method of safety risks based on particle filtering is proposed, which takes threat analysis as the core. Based on the risk assessment standards, the method selects threat indicates, applies a particle filtering algorithm to calculate influencing weight of threat indications, and confirms information system risk levels by combining with state estimation theory. In order to improve the calculating efficiency of the particle filtering algorithm, the k-means cluster algorithm is introduced to the particle filtering algorithm. By clustering all particles, the author regards centroid as the representative to operate, so as to reduce calculated amount. The empirical experience indicates that the method can embody the relation of mutual dependence and influence in risk elements reasonably. Under the circumstance of limited information, it provides the scientific basis on fabricating a risk management control strategy.

  2. Six Sigma Quality Management System and Design of Risk-based Statistical Quality Control.

    PubMed

    Westgard, James O; Westgard, Sten A

    2017-03-01

    Six sigma concepts provide a quality management system (QMS) with many useful tools for managing quality in medical laboratories. This Six Sigma QMS is driven by the quality required for the intended use of a test. The most useful form for this quality requirement is the allowable total error. Calculation of a sigma-metric provides the best predictor of risk for an analytical examination process, as well as a design parameter for selecting the statistical quality control (SQC) procedure necessary to detect medically important errors. Simple point estimates of sigma at medical decision concentrations are sufficient for laboratory applications. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Human factors phase IV : risk analysis tool for new train control technology.

    DOT National Transportation Integrated Search

    2005-01-31

    This report covers the theoretical development of the safety state model for railroad operations. Using data from a train control technology experiment, experimental application of the model is demonstrated. A stochastic model of system behavior is d...

  4. Human factors phase IV : risk analysis tool for new train control technology

    DOT National Transportation Integrated Search

    2005-01-01

    This report covers the theoretical development of the safety state model for railroad operations. Using data from a train control technology experiment, experimental application of the model is demonstrated. A stochastic model of system behavior is d...

  5. [Study on risk assessing indicator system after schistosomiasis transmission interruption in Wuxi City].

    PubMed

    Xiao-Jun, Meng; Sheng-Hua, Zong; Xuan, Zhang; Dong-Lin, Gao; Yan-Hua, Qian; Bing, Lu

    2017-07-27

    To establish a risk assessing indicator system after the transmission interruption of schistosomiasis in Wuxi City, so as to provide evidences for formulating strategies on schistosomiasis control and prevention. A primary risk assessing indicator system was established based on the literature review. Alternative indicators were scored and screened to establish a final indicator system through two rounds of Delphy method and the related normalized weights and combined weights were also calculated. The risk assessing indicator system was established through two rounds of expert consultation including 3 first grade indicators and 15 second grade indicators. Among the first grade indicators, the normalized weights of natural environment, key populations and social environment were 0.370 6, 0.292 9 and 0.336 5, respectively. Among the second grade indicators, the migrant population accounted for the highest combined weight of 0.125 2 compared to domestic animal of 0.037 1. The authority degree among the first grade indicators was between 0.91 and 0.93, while the authority degree among the second grade indicators was between 0.79 and 0.92. The scientific and authoritative risk assessing indicator system after the transmission interruption of schistosomiasis is established, which provides the evidences for risk assessment on schistosomiasis transmission in Wuxi City.

  6. Guidelines for Automatic Data Processing Physical Security and Risk Management. Federal Information Processing Standards Publication 31.

    ERIC Educational Resources Information Center

    National Bureau of Standards (DOC), Washington, DC.

    These guidelines provide a handbook for use by federal organizations in structuring physical security and risk management programs for their automatic data processing facilities. This publication discusses security analysis, natural disasters, supporting utilities, system reliability, procedural measures and controls, off-site facilities,…

  7. Reducing Preconception Risks among African American Women with Conversational Agent Technology

    PubMed Central

    Jack, Brian; Bickmore, Timothy; Hempstead, Megan; Yinusa-Nyahkoon, Leanne; Sadikova, Ekaterina; Mitchell, Suzanne; Gardiner, Paula; Adigun, Fatima; Penti, Brian; Schulman, Daniel; Damus, Karla

    2016-01-01

    BACKGROUND Preconception care (PCC) should be provided for all women capable of becoming pregnant to identify and treat existing risk factors for adverse perinatal outcomes for both the woman and her future baby. Additional tools are needed for providers and the public to screen for and address preconception health (PCH) risks, particularly for African American (AA) women given the national persistent health outcome and healthcare disparities. We developed and tested the “Gabby System,” featuring an online interactive conversational agent programmed to discuss women’s specific PCH risks and encourage behavioral change through evidence-based interventions. METHODS A 6-month randomized controlled trial of a purposeful, convenience sample of 100 non-gravid, primarily college-attending AA women 18–34 years of age was conducted. All participants were screened at enrollment for over 100 PCH risks and then randomized to the Gabby or control group. Controls were sent a letter listing identified PCH risks, suggesting they discuss these risks with a health care provider. The numbers, proportions, and types of risks identified and addressed were compared between groups. RESULTS Of the 100 women enrolled, 99 provided baseline data, 91 completed the online PCH risk assessment, and 80 completed the 6-month follow-up phone call. The mean participant age was 25.5 years and all had at least one PCH risk with a mean (sd) of 23.7 (5.9), range of 11 to 45 PCH risks. In 6 months the Gabby group had significantly greater reductions compared to controls in both the number of PCH risks (34% higher- 8.3 vs. 5.5, p<.05) and in the proportion of risks resolved (25% higher- 27.8% vs 20.5% p<0.01). Women in the Gabby group averaged 2.9 logins and 63.7 minutes of interaction time. The most common PCH risks triggered were nutrition, activity and infectious disease. The majority of women (78%) reported it “was easy to talk to Gabby” and that they had used information from Gabby to improve their health (64%). CONCLUSION Among a group of reproductive age African American women, use of the Gabby system was associated with a significant reduction in identified PCH risks. More research is needed to determine if Gabby can impact risk status among a larger, more socio-demographically diverse group of black women and if reducing the number of risks is clinically significant. PMID:26152434

  8. [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.

  9. FDA-iRISK--a comparative risk assessment system for evaluating and ranking food-hazard pairs: case studies on microbial hazards.

    PubMed

    Chen, Yuhuan; Dennis, Sherri B; Hartnett, Emma; Paoli, Greg; Pouillot, Régis; Ruthman, Todd; Wilson, Margaret

    2013-03-01

    Stakeholders in the system of food safety, in particular federal agencies, need evidence-based, transparent, and rigorous approaches to estimate and compare the risk of foodborne illness from microbial and chemical hazards and the public health impact of interventions. FDA-iRISK (referred to here as iRISK), a Web-based quantitative risk assessment system, was developed to meet this need. The modeling tool enables users to assess, compare, and rank the risks posed by multiple food-hazard pairs at all stages of the food supply system, from primary production, through manufacturing and processing, to retail distribution and, ultimately, to the consumer. Using standard data entry templates, built-in mathematical functions, and Monte Carlo simulation techniques, iRISK integrates data and assumptions from seven components: the food, the hazard, the population of consumers, process models describing the introduction and fate of the hazard up to the point of consumption, consumption patterns, dose-response curves, and health effects. Beyond risk ranking, iRISK enables users to estimate and compare the impact of interventions and control measures on public health risk. iRISK provides estimates of the impact of proposed interventions in various ways, including changes in the mean risk of illness and burden of disease metrics, such as losses in disability-adjusted life years. Case studies for Listeria monocytogenes and Salmonella were developed to demonstrate the application of iRISK for the estimation of risks and the impact of interventions for microbial hazards. iRISK was made available to the public at http://irisk.foodrisk.org in October 2012.

  10. [Introduction of hazard analysis and critical control points (HACCP) principles at the flight catering food production plant].

    PubMed

    Popova, A Yu; Trukhina, G M; Mikailova, O M

    In the article there is considered the quality control and safety system implemented in the one of the largest flight catering food production plant for airline passengers and flying squad. The system for the control was based on the Hazard Analysis And Critical Control Points (HACCP) principles and developed hygienic and antiepidemic measures. There is considered the identification of hazard factors at stages of the technical process. There are presented results of the analysis data of monitoring for 6 critical control points over the five-year period. The quality control and safety system permit to decline food contamination risk during acceptance, preparation and supplying of in-flight meal. There was proved the efficiency of the implemented system. There are determined further ways of harmonization and implementation for HACCP principles in the plant.

  11. General principles of institutional risks influence on pension systems

    NASA Astrophysics Data System (ADS)

    Nepp, A. N.; Shilkov, A. A.; Sheveleva, A. Y.; Mamedbakov, M. R.

    2016-12-01

    This paper examines the tools used to study the influence of institutional factors on investment returns. The research object are the tools used in the evaluation of institutional risks in the pension system, in particular, the correlation model of factors impacting on the `anti-director' index, econometric estimates combining the different determinants of savings, the model of endogenous institutional change, etc. Research work focusing on issues of institutional factors affecting pension systems (authored by La Porta, Guiso, Gianetti, El-Mekkaouide Freitas, Neyapti B., and others) is reviewed. The model is examined in terms of the impact of institutional risks on pension systems, especially with regard to the funded part. The study identified the following factors that affect financial institutions, including pension institutions: management quality, regulation quality, rule of law, political stability, and corruption control.

  12. Evidence for increased chylomicron remnants in rheumatoid arthritis.

    PubMed

    Burggraaf, Benjamin; van Breukelen-van der Stoep, Deborah F; van Zeben, Jendé; van der Meulen, Noelle; van de Geijn, Gert-Jan M; Liem, Anho; Valdivielso, Pedro; Rioja Villodres, José; Ramírez-Bollero, José; van der Zwan, Ellen; Castro Cabezas, Manuel

    2018-02-01

    Levels of apolipoprotein (apo) B48 may be increased in conditions associated with systemic inflammation and increased cardiovascular disease (CVD) risk such as rheumatoid arthritis (RA). We aimed to evaluate apo B48 levels in patients with RA in relation to subclinical atherosclerosis. Patients with RA (without CVD) and controls without RA but with high CVD risk (based on the presence of diabetes mellitus or a history of CVD) and healthy controls were included in this cross-sectional study. Carotid intima-media thickness (cIMT) was measured as a surrogate for vascular damage. In total, 312 patients with RA, 65 controls with high CVD risk and 36 healthy controls were included. Patients with RA had the highest mean apo B48 (10.00 ± 6.65 mg/L) compared to controls with high CVD risk and healthy controls (8.37 ± 5.16 and 5.22 ± 2.46, P < .001). Triglycerides levels were comparable with controls. In RA, apo B48 correlated positively with triglycerides (r = .645; P < .001) but not with cIMT. However, in RA subjects not using lipid or blood pressure lowering medication, a weak correlation was found with cIMT (r = .157; P = .014). RA patients in the highest apo B48 tertile were more often rheumatoid factor positive and anti-CCP positive compared to the lowest tertile. Rheumatoid arthritis patients have higher levels of apo B48 compared to controls with high CVD risk and healthy controls, with normal levels of triglycerides. This accumulation of atherogenic chylomicron remnants may contribute to the elevated CVD risk in RA patients. © 2017 Stichting European Society for Clinical Investigation Journal Foundation.

  13. Use of antiepileptic drugs and risk of fractures: case-control study among patients with epilepsy.

    PubMed

    Souverein, P C; Webb, D J; Weil, J G; Van Staa, T P; Egberts, A C G

    2006-05-09

    To study the association between use of antiepileptic drugs (AEDs) and risk of fractures. The authors obtained data from the General Practice Research Database (GPRD). A case-control study was nested within a cohort of patients with active epilepsy. Cases were patients with a first fracture after cohort entry. Up to four controls were matched to each case by practice, sex, year of birth, timing of first epilepsy diagnosis, index date, and duration of GPRD history. Cumulative exposure to AEDs was assessed by summing the duration of all AED prescriptions. A distinction was made between AEDs that induce the hepatic cytochrome P-450 enzyme system and AEDs that do not. Medical conditions and drugs known to be associated with bone metabolism or falls were evaluated as potential confounders. Conditional logistic regression analysis was used to calculate odds ratios (ORs) and 95% CIs. The study population comprised 1,018 cases and 1,842 matched controls. The risk of fractures increased with cumulative duration of exposure (p for trend < 0.001), with the strongest association for greater than 12 years of use: adjusted OR 4.15 (95% CI 2.71 to 6.34). Risk estimates were higher in women than in men. There was no difference between users of AEDs that induce and AEDs that do not induce the hepatic cytochrome P-450 system. Long-term use of AEDs was associated with an increased risk of fractures, especially in women. More research on mechanisms of AED-induced bone breakdown and female vulnerability to the effects of AEDs on bone health is warranted.

  14. Problem of two-level hierarchical minimax program control the final state of regional social and economic system with incomplete information

    NASA Astrophysics Data System (ADS)

    Shorikov, A. F.

    2016-12-01

    In this article we consider a discrete-time dynamical system consisting of a set a controllable objects (region and forming it municipalities). The dynamics each of these is described by the corresponding linear or nonlinear discrete-time recurrent vector relations and its control system consist from two levels: basic level (control level I) that is dominating level and auxiliary level (control level II) that is subordinate level. Both levels have different criterions of functioning and united by information and control connections which defined in advance. In this article we study the problem of optimization of guaranteed result for program control by the final state of regional social and economic system in the presence of risks vectors. For this problem we propose a mathematical model in the form of two-level hierarchical minimax program control problem of the final states of this system with incomplete information and the general scheme for its solving.

  15. Validating a Prognostic Scoring System for Postmastectomy Locoregional Recurrence in Breast Cancer

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

    Cheng, Skye Hung-Chun, E-mail: skye@kfsyscc.org; Clinical Research Office, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan; Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina

    2013-03-15

    Purpose: This study is designed to validate a previously developed locoregional recurrence risk (LRR) scoring system and further define which groups of patients with breast cancer would benefit from postmastectomy radiation therapy (PMRT). Methods and Materials: An LRR risk scoring system was developed previously at our institution using breast cancer patients initially treated with modified radical mastectomy between 1990 and 2001. The LRR score comprised 4 factors: patient age, lymphovascular invasion, estrogen receptor negativity, and number of involved lymph nodes. We sought to validate the original study by examining a new dataset of 1545 patients treated between 2002 and 2007. Results:more » The 1545 patients were scored according to the previously developed criteria: 920 (59.6%) were low risk (score 0-1), 493 (31.9%) intermediate risk (score 2-3), and 132 (8.5%) were high risk (score ≥4). The 5-year locoregional control rates with and without PMRT in low-risk, intermediate-risk, and high-risk groups were 98% versus 97% (P=.41), 97% versus 91% (P=.0005), and 89% versus 50% (P=.0002) respectively. Conclusions: This analysis of an additional 1545 patients treated between 2002 and 2007 validates our previously reported LRR scoring system and suggests appropriate patients for whom PMRT will be beneficial. Independent validation of this scoring system by other institutions is recommended.« less

  16. Efficacy of a web-based intelligent tutoring system for communicating genetic risk of breast cancer: a fuzzy-trace theory approach.

    PubMed

    Wolfe, Christopher R; Reyna, Valerie F; Widmer, Colin L; Cedillos, Elizabeth M; Fisher, Christopher R; Brust-Renck, Priscila G; Weil, Audrey M

    2015-01-01

    . Many healthy women consider genetic testing for breast cancer risk, yet BRCA testing issues are complex. . To determine whether an intelligent tutor, BRCA Gist, grounded in fuzzy-trace theory (FTT), increases gist comprehension and knowledge about genetic testing for breast cancer risk, improving decision making. . In 2 experiments, 410 healthy undergraduate women were randomly assigned to 1 of 3 groups: an online module using a Web-based tutoring system (BRCA Gist) that uses artificial intelligence technology, a second group read highly similar content from the National Cancer Institute (NCI) Web site, and a third that completed an unrelated tutorial. . BRCA Gist applied FTT and was designed to help participants develop gist comprehension of topics relevant to decisions about BRCA genetic testing, including how breast cancer spreads, inherited genetic mutations, and base rates. . We measured content knowledge, gist comprehension of decision-relevant information, interest in testing, and genetic risk and testing judgments. . Control knowledge scores ranged from 54% to 56%, NCI improved significantly to 65% and 70%, and BRCA Gist improved significantly more to 75% and 77%, P < 0.0001. BRCA Gist scored higher on gist comprehension than NCI and control, P < 0.0001. Control genetic risk-assessment mean was 48% correct; BRCA Gist (61%) and NCI (56%) were significantly higher, P < 0.0001. BRCA Gist participants recommended less testing for women without risk factors (not good candidates; 24% and 19%) than controls (50%, both experiments) and NCI (32%), experiment 2, P < 0.0001. BRCA Gist testing interest was lower than in controls, P < 0.0001. . BRCA Gist has not been tested with older women from diverse groups. . Intelligent tutors, such as BRCA Gist, are scalable, cost-effective ways of helping people understand complex issues, improving decision making. © The Author(s) 2014.

  17. Bias in effect size of systemic lupus erythematosus susceptibility loci across Europe: a case-control study

    PubMed Central

    2012-01-01

    Introduction We aimed to investigate whether the effect size of the systemic lupus erythematosus (SLE) risk alleles varies across European subpopulations. Methods European SLE patients (n = 1,742) and ethnically matched healthy controls (n = 2,101) were recruited at 17 centres from 10 different countries. Only individuals with self-reported ancestry from the country of origin were included. In addition, participants were genotyped for top ancestry informative markers and for 25 SLE associated SNPs. The results were used to compare effect sizes between the Central Eureopan and Southern European subgroups. Results Twenty of the 25 SNPs showed independent association with SLE, These SNPs showed a significant bias to larger effect sizes in the Southern subgroup, with 15/20 showing this trend (P = 0.019) and a larger mean odds ratio of the 20 SNPs (1.46 vs. 1.34, P = 0.02) as well as a larger difference in the number of risk alleles (2.06 vs. 1.63, P = 0.027) between SLE patients and controls than for Central Europeans. This bias was reflected in a very significant difference in the cumulative genetic risk score (4.31 vs. 3.48, P = 1.8 × 10-32). Effect size bias was accompanied by a lower number of SLE risk alleles in the Southern subjects, both patients and controls, the difference being more marked between the controls (P = 1.1 × 10-8) than between the Southern and Central European patients (P = 0.016). Seven of these SNPs showed significant allele frequency clines. Conclusion Our findings showed a bias to larger effect sizes of SLE loci in the Southern Europeans relative to the Central Europeans together with clines of SLE risk allele frequencies. These results indicate the need to study risk allele clines and the implications of the polygenic model of inheritance in SLE. PMID:22541939

  18. Closed-loop and robust control of quantum systems.

    PubMed

    Chen, Chunlin; Wang, Lin-Cheng; Wang, Yuanlong

    2013-01-01

    For most practical quantum control systems, it is important and difficult to attain robustness and reliability due to unavoidable uncertainties in the system dynamics or models. Three kinds of typical approaches (e.g., closed-loop learning control, feedback control, and robust control) have been proved to be effective to solve these problems. This work presents a self-contained survey on the closed-loop and robust control of quantum systems, as well as a brief introduction to a selection of basic theories and methods in this research area, to provide interested readers with a general idea for further studies. In the area of closed-loop learning control of quantum systems, we survey and introduce such learning control methods as gradient-based methods, genetic algorithms (GA), and reinforcement learning (RL) methods from a unified point of view of exploring the quantum control landscapes. For the feedback control approach, the paper surveys three control strategies including Lyapunov control, measurement-based control, and coherent-feedback control. Then such topics in the field of quantum robust control as H(∞) control, sliding mode control, quantum risk-sensitive control, and quantum ensemble control are reviewed. The paper concludes with a perspective of future research directions that are likely to attract more attention.

  19. Cost-Effective Control Systems for Colleges and Universities: A New Paradigm.

    ERIC Educational Resources Information Center

    Hubbell, Loren Loomis; Dougherty, Jennifer Dowling

    This report addresses the issue of maintaining adequate controls within a streamlined or restructured financial affairs environment at an institution of higher education. It presents a new paradigm for control structures designed to more effectively meet administrators' needs--both in terms of cost and risk management. The first section: (1)…

  20. In-flight testing of the space shuttle orbiter thermal control system

    NASA Technical Reports Server (NTRS)

    Taylor, J. T.

    1985-01-01

    In-flight thermal control system testing of a complex manned spacecraft such as the space shuttle orbiter and the considerations attendant to the definition of the tests are described. Design concerns, design mission requirements, flight test objectives, crew vehicle and mission risk considerations, instrumentation, data requirements, and real-time mission monitoring are discussed. An overview of the tests results is presented.

  1. Multiple-time scales analysis of physiological time series under neural control

    NASA Technical Reports Server (NTRS)

    Peng, C. K.; Hausdorff, J. M.; Havlin, S.; Mietus, J. E.; Stanley, H. E.; Goldberger, A. L.

    1998-01-01

    We discuss multiple-time scale properties of neurophysiological control mechanisms, using heart rate and gait regulation as model systems. We find that scaling exponents can be used as prognostic indicators. Furthermore, detection of more subtle degradation of scaling properties may provide a novel early warning system in subjects with a variety of pathologies including those at high risk of sudden death.

  2. 78 FR 3646 - Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-16

    ...The Food and Drug Administration (FDA) is proposing to amend its regulation for Current Good Manufacturing Practice In Manufacturing, Packing, or Holding Human Food (CGMPs) to modernize it and to add requirements for domestic and foreign facilities that are required to register under the Federal Food, Drug, and Cosmetic Act (the FD&C Act) to establish and implement hazard analysis and risk- based preventive controls for human food. FDA also is proposing to revise certain definitions in FDA's current regulation for Registration of Food Facilities to clarify the scope of the exemption from registration requirements provided by the FD&C Act for ``farms.'' FDA is taking this action as part of its announced initiative to revisit the CGMPs since they were last revised in 1986 and to implement new statutory provisions in the FD&C Act. The proposed rule is intended to build a food safety system for the future that makes modern, science-, and risk-based preventive controls the norm across all sectors of the food system.

  3. [Risk factors associated with bacterial growth in derivative systems from cerebrospinal liquid in pediatric patients].

    PubMed

    de Jesús Vargas-Lares, José; Andrade-Aguilera, Angélica Rocío; Díaz-Peña, Rafael; Barrera de León, Juan Carlos

    2015-01-01

    To determine risk factors associated with bacterial growth in systems derived from cerebrospinal fluid in pediatric patients. Case and controls study from January to December 2012, in patients aged <16 years who were carriers of hydrocephalus and who required placement or replacement of derivative system. Cases were considered as children with cultures with bacterial growth and controls with negative bacterial growth. Inferential statistics with Chi-squared and Mann-Whitney U tests. Association of risk with odds ratio. We reviewed 746 registries, cases n=99 (13%) and controls n=647 (87%). Masculine gender 58 (57%) vs. feminine gender 297 (46%) (p=0.530). Age of cases: median, five months and controls, one year (p=0.02). Median weight, 7 vs. 10 kg (p=0.634). Surgical interventions: median n=2 (range, 1-8) vs. n=1 (range, 1-7). Infection rate, 13.2%. Main etiology ductal stenosis, n=29 (29%) vs. n=50 (23%) (p=0.530). Non-communicating, n=50 (51%) vs. 396 (61%) (p=0.456). Predominant microorganisms: enterobacteria, pseudomonas, and enterococcus. Non-use of iodized dressing OR=2.6 (range, 1.8-4.3), use of connector OR=6.8 (range, 1.9-24.0), System replacement OR=2.0 (range, 1.3-3.1), assistant without surgical facemask OR=9.7 (range, 2.3-42.0). Being a breastfeeding infant, of low weight, non-application of iodized dressing, use of connector, previous derivation, and lack of adherence to aseptic technique were all factors associated with ependymitis.

  4. Epidemiology and quality assurance: applications at farm level.

    PubMed

    Noordhuizen, J P; Frankena, K

    1999-03-29

    Animal production is relevant with respect to farm income and the position of the sector in the market, but also with respect to the quality and safety of products of animal origin, related to public health. Animal production is part of a chain of food production. Therefore, producers have to take consumer expectations and demands in the domains of animal health, welfare and environment into account. A different attitude for production has to be adopted; this attitude can be visualized in good farming practice, GFP, codes. Farmers who focused on quality in its broadest sense need a system supporting them in their management and control of quality risks. Generally speaking, there are three systems for that purpose: GFP, ISO and HACCP. When the hypothesis followed relates to animal health being a feature of quality, or else welfare and environmental issues, then animal health care can be executed following quality control principles. The HACCP concept is well suited for quality control at farm level, involving risk identification and risk management. The on-farm monitoring and surveillance system of critical control points in the animal production process is the most important tool in this procedure. Principles for HACCP application as well as certification fitness of HACCP are elaborated upon. They are illustrated by using salmonellosis in meat-pig farms as objective for an HACCP approach. It is further discussed that, in addition to animal health and quality, animal welfare and environmental issues could also be covered by an HACCP-like system in an integrated manner. Ultimately, the HACCP modules could end up in an overall ISO certification.

  5. Risk of Impaired Control of Spacecraft/Associated Systems and Decreased Mobility Due to Vestibular/Sensorimotor Alterations Associated with Space flight

    NASA Technical Reports Server (NTRS)

    Bloomberg, Jacob J.; Reschke, Millard F.; Clement, Gilles R.; Mulavara, Ajitkumar P.; Taylor, Laura C..

    2015-01-01

    Control of vehicles and other complex systems is a high-level integrative function of the central nervous system (CNS). It requires well-functioning subsystem performance, including good visual acuity, eye-hand coordination, spatial and geographic orientation perception, and cognitive function. Evidence from space flight research demonstrates that the function of each of these subsystems is altered by removing gravity, a fundamental orientation reference, which is sensed by vestibular, proprioceptive, and haptic receptors and used by the CNS for spatial orientation, posture, navigation, and coordination of movements. The available evidence also shows that the degree of alteration of each subsystem depends on a number of crew- and mission-related factors. There is only limited operational evidence that these alterations cause functional impacts on mission-critical vehicle (or complex system) control capabilities. Furthermore, while much of the operational performance data collected during space flight has not been available for independent analysis, those that have been reviewed are somewhat equivocal owing to uncontrolled (and/or unmeasured) environmental and/or engineering factors. Whether this can be improved by further analysis of previously inaccessible operational data or by development of new operational research protocols remains to be seen. The true operational risks will be estimable only after we have filled the knowledge gaps and when we can accurately assess integrated performance in off-nominal operational settings (Paloski et al. 2008). Thus, our current understanding of the Risk of Impaired Control of Spacecraft/Associated Systems and Decreased Mobility Due to Vestibular/Sensorimotor Alterations Associated with Space flight is limited primarily to extrapolation of scientific research findings, and, since there are limited ground-based analogs of the sensorimotor and vestibular changes associated with space flight, observation of their functional impacts is limited to studies performed in the space flight environment. Fortunately, many sensorimotor and vestibular experiments have been performed during and/or after space flight missions since 1959 (Reschke et al. 2007). While not all of these experiments were directly relevant to the question of vehicle/complex system control, most provide insight into changes in aspects of sensorimotor control that might bear on the physiological subsystems underlying this high-level integrated function.

  6. Margins of safety provided by COSHH Essentials and the ILO Chemical Control Toolkit.

    PubMed

    Jones, Rachael M; Nicas, Mark

    2006-03-01

    COSHH Essentials, developed by the UK Health and Safety Executive, and the Chemical Control Toolkit (Toolkit) proposed by the International Labor Organization, are 'control banding' approaches to workplace risk management intended for use by proprietors of small and medium-sized businesses. Both systems group chemical substances into hazard bands based on toxicological endpoint and potency. COSSH Essentials uses the European Union's Risk-phrases (R-phrases), whereas the Toolkit uses R-phrases and the Globally Harmonized System (GHS) of Classification and Labeling of Chemicals. Each hazard band is associated with a range of airborne concentrations, termed exposure bands, which are to be attained by the implementation of recommended control technologies. Here we analyze the margin of safety afforded by the systems and, for each hazard band, define the minimal margin as the ratio of the minimum airborne concentration that produced the toxicological endpoint of interest in experimental animals to the maximum concentration in workplace air permitted by the exposure band. We found that the minimal margins were always <100, with some ranging to <1, and inversely related to molecular weight. The Toolkit-GHS system generally produced margins equal to or larger than COSHH Essentials, suggesting that the Toolkit-GHS system is more protective of worker health. Although, these systems predict exposures comparable with current occupational exposure limits, we argue that the minimal margins are better indicators of health protection. Further, given the small margins observed, we feel it is important that revisions of these systems provide the exposure bands to users, so as to permit evaluation of control technology capture efficiency.

  7. Analysis of en route operational errors : probability of resolution and time-on-position.

    DOT National Transportation Integrated Search

    2012-02-01

    The Federation Administrations Air Traffic Control Organization Safety Management System (SMS) is : designed to prevent the introduction of unacceptable safety risk into the National Airspace System. One of the : most important safety metrics used...

  8. [Design and application of implantable medical device information management system].

    PubMed

    Cao, Shaoping; Yin, Chunguang; Zhao, Zhenying

    2013-03-01

    Through the establishment of implantable medical device information management system, with the aid of the regional joint sharing of resources, we further enhance the implantable medical device traceability management level, strengthen quality management, control of medical risk.

  9. China's approach to control of HIV. Modern use of tradition in a public security system.

    PubMed

    Anderson, A F

    1995-01-01

    HIV/AIDS control policy in China focuses on high risk populations. The public security system is intricately intertwined with the Chinese government's HIV control activities. The government can justify its control of high risk activities because prostitution, related trafficking in females, drug abuse, and drug trafficking are elements of the Six Evils: social problems considered to be pre-revolutionary, influenced by decadent western morality, and incompatible with modernization. Public security campaigns involve arresting tens of thousands of people annually in the combined efforts against HIV and the social evils. Instigators of crime are given punitive prison sentences. For their victims, however, incarceration leans toward treatment. The moral-rehabilitative philosophy is the normative foundation of the Chinese criminal justice process. Confucian thought holds that teaching the disobedient person proper social conduct, not punishment, will effect endless change. So correction officials use patient persuasion and re-education with most criminals. The public security system coercively collects drug abusers for as much as three months of counseling and detoxification (methadone or clonidine). The police detain prostitutes for 6 months to 2 years for re-education, including legal indoctrination, labor, and prevention of sexually transmitted diseases. Family members and community groups participate in treatment and aftercare. All drug abusers and prostitutes undergo HIV testing. HIV-positive offenders are separated from HIV-negative offenders. Pimps, panderers, or traffickers in females or drugs are either executed or put in prison for at least 10 years. A weakness of China's approach is its exclusive focus on high-risk groups rather than on high-risk practices. This approach assumes HIV will be restricted to these groups. Police will likely increase its punitive and regressive responses to group members as its approach fails to prevent HIV transmission.

  10. 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.

  11. Systemic Candidiasis in Extremely Low Birthweight (ELBW) Neonates Despite the Routine Use of Topical Miconazole Prophylaxis: Trends, Risk Factors and Outcomes over an 11-Year Period.

    PubMed

    Sriram, Bhavani; Agarwal, Pratibha K; Tee, Nancy W S; Rajadurai, Victor S

    2014-05-01

    This study aims to determine the incidence, trends of systemic candidiasis and meningitis in extremely low birthweight (ELBW) neonates (<1000 gms) despite the routine use of topical miconazole prophylaxis and to compare the risk factors, adverse outcomes and comorbidities with controls. Retrospective cohort study of ELBW neonates with systemic candidiasis and meningitis over an 11-year period (1997 to 2007). Matched case control analyses were performed to determine the risk factors and comorbidities which were severe intraventricular haemorrhage (IVH), severe retinopathy of prematurity (ROP), patent ductus arteriosus (PDA) requiring treatment, necrotising enterocolitis (NEC), chronic lung disease (CLD) and cholestatic jaundice. Mortality and end organ involvement secondary to systemic candidiasis were identified as adverse outcomes. Of the 757 ELBW neonates, 51 (6.7%) had evidence of systemic candidiasis with a significant 3-fold increase in trend noted in 2007 as compared against 1997 (12.1% vs 3.8%) (RR 1.2, 95% CI, 1.06 to 1.36, P <0.001). This corresponds to a significant increasing trend of preceding or co-existent bacterial blood stream infections (BSI) in neonates with systemic candidiasis (0% in 1997 vs 7.1% in 2007, RR 1.40, 95% CI, 1.04 to 1.25, P = 0.005). On logistic regression analysis, decreasing gestational age was an independent risk factor for systemic candidiasis (OR 2.0, 95% CI, 1.52 to 2.63, P <0.001). Candida meningitis was detected in 4/38 (10.5%) and end organ involvement in 17 (33%). The organisms isolated were Candida parapsilosis 31 (61%), Candida albicans 17 (33%) and Candida glabrata 3 (5.8%). Significantly higher mortality was seen in cases when compared to controls 10/51 (19.6%) vs 76/706 (10.7%) (OR 2.02, 95% CI, 1.02 to 4.40, P <0.001). Increasing trend in the incidence of systemic candidiasis despite routine use of topical miconazole prophylaxis is of concern and future studies comparing the use of systemic fl uconazole versus oral nystatin may need to be considered.

  12. Combined influence of serious mental illness and criminal offending on suicide risk in younger adults.

    PubMed

    Webb, Roger T; Qin, Ping; Stevens, Hanne; Appleby, Louis; Shaw, Jenny; Mortensen, Preben Bo

    2013-01-01

    We conducted a national epidemiological study to determine how mental illness and criminal offending combine to influence suicide risk in younger adults. Using completely interlinked registers, we generated a nested case-control study from the cohort of all Danish people born 1965 and onwards. We identified 2,384 suicides aged 15-41 years during 1981-2006, and 56,016 age and sex-matched living controls. We examined all criminal charges from 1980, and all psychiatric admissions from 1969 and outpatient episodes from 1995. Exposure odds ratios were estimated using conditional logistic regression models. A quarter of male and 17 % of female suicides had histories of both criminal justice system contact and secondary care psychiatric treatment, with a marked elevation in risk seen compared with having neither risk factor: male odds ratio (OR) 34.0, 95 % confidence interval (CI) 29.1-39.6; female OR 72.7, CI 49.4-107.1. Among those treated for psychiatric illness, contact with the criminal justice system predicted higher risk: male OR 1.4, CI 1.1-1.7; female OR 1.7, CI 1.1-2.4, although these effects were attenuated and became non-significant with adjustment for socio-demographic risk factors. In men, risk was especially high if first criminal justice system contact occurred before first psychiatric treatment episode, and if these two challenging life events coalesced within a year of each other. These younger age adults should be monitored carefully for signs of suicidal behaviour. The need for well coordinated multiagency care is indicated, and a broad range of psychiatric illnesses should be considered carefully when assessing their suicide risk.

  13. Transient AC voltage related phenomena for HVDC schemes connected to weak AC systems

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

    Pilotto, L.A.S.; Szechtman, M.; Hammad, A.E.

    1992-07-01

    In this paper a didactic explanation of voltage stability associated phenomena at HVDC terminals is presented. Conditions leading to ac voltage collapse problems are identified. A mechanism that excites control-induced voltage oscillations is shown. The voltage stability factor is used for obtaining the maximum power limits of ac/dc systems operating with different control strategies. Correlation to Pd {times} Id curves is given. Solutions for eliminating the risks of voltage collapse and for avoiding control-induced oscillations are discussed. The results are supported by detailed digital simulations of a weak ac/dc system using EMTP.

  14. Risk Assessment and Hierarchical Risk Management of Enterprises in Chemical Industrial Parks Based on Catastrophe Theory

    PubMed Central

    Chen, Yu; Song, Guobao; Yang, Fenglin; Zhang, Shushen; Zhang, Yun; Liu, Zhenyu

    2012-01-01

    According to risk systems theory and the characteristics of the chemical industry, an index system was established for risk assessment of enterprises in chemical industrial parks (CIPs) based on the inherent risk of the source, effectiveness of the prevention and control mechanism, and vulnerability of the receptor. A comprehensive risk assessment method based on catastrophe theory was then proposed and used to analyze the risk levels of ten major chemical enterprises in the Songmu Island CIP, China. According to the principle of equal distribution function, the chemical enterprise risk level was divided into the following five levels: 1.0 (very safe), 0.8 (safe), 0.6 (generally recognized as safe, GRAS), 0.4 (unsafe), 0.2 (very unsafe). The results revealed five enterprises (50%) with an unsafe risk level, and another five enterprises (50%) at the generally recognized as safe risk level. This method solves the multi-objective evaluation and decision-making problem. Additionally, this method involves simple calculations and provides an effective technique for risk assessment and hierarchical risk management of enterprises in CIPs. PMID:23208298

  15. 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.

  16. Heart rate variability regression and risk of sudden unexpected death in epilepsy.

    PubMed

    Galli, Alessio; Lombardi, Federico

    2017-02-01

    The exact mechanisms of sudden unexpected death in epilepsy remain elusive, despite there is consensus that SUDEP is associated with severe derangements in the autonomic control to vital functions as breathing and heart rate regulation. Heart rate variability (HRV) has been advocated as biomarker of autonomic control to the heart. Cardiac dysautonomia has been found in diseases where other branches of the autonomous nervous system are damaged, as Parkinson disease and multiple system atrophy. In this perspective, an impaired HRV not only is a risk factor for sudden cardiac death mediated by arrhythmias, but also a potential biomarker for monitoring a progressive decline of the autonomous nervous system. This slope may lead to an acute imbalance of the regulatory pathways of vital functions after seizure and then to SUDEP. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Postmenopausal hormone therapy-also use of estradiol plus levonorgestrel-intrauterine system is associated with an increased risk of primary fallopian tube carcinoma.

    PubMed

    Koskela-Niska, Virpi; Pukkala, Eero; Lyytinen, Heli; Ylikorkala, Olavi; Dyba, Tadeusz

    2015-10-15

    Data on the possible impact of postmenopausal hormone therapy (HT) on the incidence of rare primary fallopian tube carcinoma (PFTC) are scarce. Therefore, we conducted a nationwide case-control study analyzing the association between the use of different HTs and PFTC. All women aged 50 years or older with an incident PFTC (n = 360) during 1995-2007 were identified from the Finnish Cancer Registry. For each case of PFTC, ten age- and place of residence-matched controls were selected from the Finnish National Population Register, which also provided information on parity. Data on HT purchases were received from the Prescription Register, and data on hysterectomies and sterilizations from the National Care Register. Controls with a salpingectomy before the PFTC diagnosis of the respective case were excluded. The PFTC risk in relation to different HTs was estimated with a conditional logistic regression model, adjusted for parity, age at last delivery, hysterectomy and sterilization. The use for five years or more of estradiol combined with levonorgestrel-releasing-intrauterine system (odds ratio 2.84, 95% confidence interval 1.10-7.38) and sequential estradiol-progestin therapy (EPT; 3.37; 2.23-5.08) were both linked with increases in the risk of PFTC, while the risk with use of estradiol-only therapy or continuous EPT was not statistically significantly increased. The OR for the use of tibolone for one year or more was 1.56 (0.55-4.41). The use of HT is related to an increased risk of PFTC, particularly when a progestin component is intrauterine or systemic progestin is given in sequential manner. © 2015 UICC.

  18. Resilience of sewage services to climate change uncertainty: analysis of the management of sewer overflows in two Parisian suburban areas.

    NASA Astrophysics Data System (ADS)

    Rioust, E.; Deroubaix, J. F.; Barroca, B.; Bonierbale, T.; de Gouvello, B.; Deutsch, J. C.; Hubert, G.

    2009-04-01

    This paper considers the resilience perspective as an approach for understanding social and political vulnerabilities of urban services. The authors examine to what extend uncertainty due to climate change may affect the resilience of these urban services. The resilience perspective is increasingly used for analysing social groups' capacities to adapt to and live with disturbances. A lot of work on resilience has focused on the capacity to absorb shocks and still maintain functions. But there is also another aspect of resilience, which leads to take into account systems vulnerabilities and to aim at understanding their equilibrium and re-organization capacity. The purpose with this paper is to assess sewage systems capacities to adapt to climate change. Indeed, climate change could cause an increase of extreme rain events and, as a matter of consequence, an increase of sewer overflows and flooding of urbanised areas. Sewer systems have to cope with this change that may gravely affect urban planning. In recent studies of political science, risk management has been considered as a public policy involving and resulting from complex social, political and technical processes (Gilbert et al. 2003). From this point of view, the management of wastewaters and storm waters has to be considered not only as a technical but also as a political and a social system. Therefore, political science can be a fruitful perspective to understand the stakeholders perceptions of uncertainty and the way they are going to integrate this issue in their practices. The authors analyse the adaptive capacities of two sewer systems located in the Parisian suburban area. The chosen areas are highly populated. Each network is managed within a political and administrative unit called "Département". Both authorities of these "Départements" implement a public sewage service. Nonetheless these networks are connected and part of the greater Paris sewage policy. In both areas a real time control of urban wastewater systems has been developed. At last, both sewage services have make flood management their prior objective. Both "Départements" have developed retention capacities. One of them has implemented a source control strategy including daywatering while the other one has intent on building up a "culture of risk" on the territory. In this paper we compare how these social and technical systems cope with risks and face to climate change. Relying on interviews conducted with engineers and technical agents of water and sewage services and with a few residents in the concerned areas, we define three types of actors who take part to the social and technical systems. There are, on the one hand, the technical actors, including the agents currently managing the sewer network. On the other hand, there are the political actors in charge of elaborating and implementing a policy of risk prevention and managing the security force. Last but not least, there are the inhabitants who take an important part in the crisis management and in the mobilisations against the existing risk policy. The first part of the paper describes the sewage systems while there is no crisis. We explicit the actors' perceptions of risk and the risk management strategies they develop. The risk perceptions of technicians are truly different than the citizens' ones. For the technicians, floods, and their possible worsening, could be controlled. The problem is generated by the increasing impervious areas but it can be solved with technologies (real time control, best management practices and compensatory measures). In the technicians' perceptions, the risk is inherent to technical failures and can be reduced. For citizens, the concern is more for economics and personal goods losses. However both types of actors deal with the matter of submerged territories as a problem of institutional inertia (lack of financial resource, problem of governance). The second part presents the crisis management in these areas. We explain how various actors cope with flood when the risk occurs. The analysis of the actors' reaction to the flood event contributes (1) to further characterise the social and political system dealing with the flooding risk and, (2) to assess the adaptive capacities of the technicians to the risk. The crisis moment gives a specific role for each actor of the social, political and technical systems. Technical actors manage natural hazard through the remote control system and their major concern is for network disruption. Once flood has occurred, they may assist residents cleaning out public space. Nonetheless, after the crisis, the technical actors are seen by the others as the responsible for the flood. They are considered as the ones in charge of preventing the future flood event, even if they claim that they cannot protect urban areas and population up to a determined risk threshold. Neither technicians nor other actor settle the question of urban planning or existing vulnerability of the flooded areas.

  19. Implementing system-wide risk stratification approaches: A review of critical success and failure factors.

    PubMed

    Huckel Schneider, Carmen; Gillespie, James A; Wilson, Andrew

    2017-05-01

    Risk stratification has become a widely used tool for linking people identified at risk of health deterioration to the most appropriate evidence-based care. This article systematically reviews recent literature to determine key factors that have been identified as critical enablers and/or barriers to successful implementation of risk stratification tools at a system level. A systematic search found 23 articles and four promising protocols for inclusion in the review, covering the use to 20 different risk stratification tools. These articles reported on only a small fraction of the risk stratification tools used in health systems; suggesting that while the development and statistical validation of risk stratification algorithms is widely reported, there has been little published evaluation of how they are implemented in real-world settings. Controlled studies provided some evidence that the use of risk stratification tools in combination with a care management plan offer patient benefits and that the use of a risk stratification tool to determine components of a care management plan may contribute to reductions in hospital readmissions, patient satisfaction and improved patient outcomes. Studies with the strongest focus on implementation used qualitative and case study methods. Among these, the literature converged on four key areas of implementation that were found to be critical for overcoming barriers to success: the engagement of clinicians and safeguarding equity, both of which address barriers of acceptance; the health system context to address administrative, political and system design barriers; and data management and integration to address logistical barriers.

  20. [Health threats and health system crises. An approach to early warning and response. 2008 SESPAS Report].

    PubMed

    Simón Soria, Fernando; Guillén Enríquez, Francisco Javier

    2008-04-01

    The world is changing more and faster than ever before. New diseases are coming to light each year, controlled diseases are reemerging as potential threats, and natural or man-made disasters are increasingly affecting human health. The "International Health Regulations (2005)" reflect the changes in the response of public health to this new situation. Surveillance of specific diseases and predefined control measures have been replaced by surveillance of public health events of international concern and control measures adapted to each situation. The public health events of international interest are characterized by their seriousness, predictability, the risk of international spread and potential for travel or trade restrictions. The development of the European Early Warning and Response System in 1998 and the creation of the European Center for Disease Prevention and Control in 2005 demonstrate political commitment in Europe, with early detection of and response to public health threats. However, timely risk evaluation and response at a national level requires improved data digitalization and accessibility, automatic notification processes, data analysis and dissemination of information, the combination of information from multiple sources and adaptation of public health services. The autonomous regions in Spain are initiating this adaptation process, but interoperability between systems and the development of guidelines for a coordinated response should be steered by the National Interregional Health Council and coordinated by the Ministry of Health. Efficient early warning systems of health threats that allow for a timely response and reduce uncertainty about information would help to minimize the risk of public health crises. The profile of public health threats is nonspecific. Early detection of threats requires access to information from multiple sources and efficient risk assessment. Key factors for improving the response to public health threats are the development of surveillance methods and operational research in public health.

  1. Why do drivers maintain short headways in fog? A driving-simulator study evaluating feeling of risk and lateral control during automated and manual car following.

    PubMed

    Saffarian, M; Happee, R; Winter, J C F de

    2012-01-01

    Drivers in fog tend to maintain short headways, but the reasons behind this phenomenon are not well understood. This study evaluated the effect of headway on lateral control and feeling of risk in both foggy and clear conditions. Twenty-seven participants completed four sessions in a driving simulator: clear automated (CA), clear manual (CM), fog automated (FA) and fog manual (FM). In CM and FM, the drivers used the steering wheel, throttle and brake pedals. In CA and FA, a controller regulated the distance to the lead car, and the driver only had to steer. Drivers indicated how much risk they felt on a touchscreen. Consistent with our hypothesis, feeling of risk and steering activity were elevated when the lead car was not visible. These results might explain why drivers adopt short headways in fog. Practitioner Summary: Fog poses a serious road safety hazard. Our driving-simulator study provides the first experimental evidence to explain the role of risk-feeling and lateral control in headway reduction. These results are valuable for devising effective driver assistance and support systems.

  2. Prevalence of prescription opioid use disorder among chronic opioid therapy patients after health plan opioid dose and risk reduction initiatives.

    PubMed

    Von Korff, Michael; Walker, Rod L; Saunders, Kathleen; Shortreed, Susan M; Thakral, Manu; Parchman, Michael; Hansen, Ryan N; Ludman, Evette; Sherman, Karen J; Dublin, Sascha

    2017-08-01

    No studies have assessed the comparative effectiveness of guideline-recommended interventions to reduce risk of prescription opioid use disorder among chronic opioid therapy (COT) patients. We compared the prevalence of prescription opioid use disorder among COT patients from intervention clinics that had implemented opioid dose and risk reduction initiatives for more than 4 years relative to control clinics that had not. After a healthcare system in Washington State implemented interventions to reduce opioid dose and risks, we surveyed 1588 adult primary care COT patients to compare the prevalence of prescription opioid use disorder among COT patients from the intervention and control clinics. Intervention clinics managed COT patients at lower COT doses and with more consistent use of risk reduction practices. Control clinics cared for similar COT patients but prescribed higher opioid doses and used COT risk reduction practices inconsistently. Prescription opioid use disorder was assessed with the Psychiatric Research Interview for Substance and Mental Disorders. The prevalence of prescription opioid use disorder was 21.5% (95% CI=18.9% to 24.4%) among COT patients in the intervention clinics and 23.9% (95% CI=20.5% to 27.6%) among COT patients in the control clinics. The adjusted relative risk of prescription opioid use disorder was 1.08 (95% CI=0.89, 1.32) among the control clinic patients relative to the intervention clinic patients. Long-term implementation of opioid dose and risk reduction initiatives was not associated with lower rates of prescription opioid use disorder among prevalent COT patients. Extreme caution should be exercised by clinicians considering COT for patients with chronic non-cancer pain until benefits of this treatment and attendant risks are clarified. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Risk factors for clinical coronary heart disease in systemic lupus erythematosus: the lupus and atherosclerosis evaluation of risk (LASER) study.

    PubMed

    Haque, Sahena; Gordon, Caroline; Isenberg, David; Rahman, Anisur; Lanyon, Peter; Bell, Aubrey; Emery, Paul; McHugh, Neil; Teh, Lee Suan; Scott, David G I; Akil, Mohamed; Naz, Sophia; Andrews, Jacqueline; Griffiths, Bridget; Harris, Helen; Youssef, Hazem; McLaren, John; Toescu, Veronica; Devakumar, Vinodh; Teir, Jamal; Bruce, Ian N

    2010-02-01

    Accelerated atherosclerosis and premature coronary heart disease (CHD) are recognized complications of systemic lupus erythematosus (SLE), but the exact etiology remains unclear and is likely to be multifactorial. We hypothesized that SLE patients with CHD have increased exposure to traditional risk factors as well as differing disease phenotype and therapy-related factors compared to SLE patients free of CHD. Our aim was to examine risk factors for development of clinical CHD in SLE in the clinical setting. In a UK-wide multicenter retrospective case-control study we recruited 53 SLE patients with verified clinical CHD (myocardial infarction or angina pectoris) and 96 SLE patients without clinical CHD. Controls were recruited from the same center as the case and matched by disease duration. Charts were reviewed up to time of event for cases, or the same "dummy-date" in controls. SLE patients with clinical CHD were older at the time of event [mean (SD) 53 (10) vs 42 (10) yrs; p < 0.001], more likely to be male [11 (20%) vs 3 (7%); p < 0.001], and had more exposure to all classic CHD risk factors compared to SLE patients without clinical CHD. They were also more likely to have been treated with corticosteroids (OR 2.46; 95% CI 1.03, 5.88) and azathioprine (OR 2.33; 95% CI 1.16, 4.67) and to have evidence of damage on the pre-event SLICC damage index (SDI) (OR 2.20; 95% CI 1.09, 4.44). There was no difference between groups with regard to clinical organ involvement or autoantibody profile. Our study highlights the need for clinical vigilance to identify modifiable risk factors in the clinical setting and in particular with male patients. The pattern of organ involvement did not differ in SLE patients with CHD events. However, the higher pre-event SDI, azathioprine exposure, and pattern of damage items (disease-related rather than therapy-related) in cases suggests that a persistent active lupus phenotype contributes to CHD risk. In this regard, corticosteroids and azathioprine may not control disease well enough to prevent CHD. Clinical trials are needed to determine whether classic risk factor modification will have a role in primary prevention of CHD in SLE patients and whether new therapies that control disease activity can better reduce CHD risk.

  4. Association Study of ITGAM, ITGAX, and CD58 Autoimmune Risk Loci in Systemic Sclerosis: Results from 2 Large European Caucasian Cohorts

    PubMed Central

    COUSTET, BAPTISTE; AGARWAL, SANDEEP K.; GOURH, PRAVITT; GUEDJ, MICKAEL; MAYES, MAUREEN D.; DIEUDE, PHILIPPE; WIPFF, JULIEN; AVOUAC, JEROME; HACHULLA, ERIC; DIOT, ELISABETH; CRACOWSKI, JEAN LUC; TIEV, KIET; SIBILIA, JEAN; MOUTHON, LUC; FRANCES, CAMILLE; AMOURA, ZAHIR; CARPENTIER, PATRICK; MEYER, OLIVIER; KAHAN, ANDRE; BOILEAU, CATHERINE; ARNETT, FRANK C.; ALLANORE, YANNICK

    2012-01-01

    Objective Accumulating evidence shows that shared autoimmunity is critical for the pathogenesis of many autoimmune diseases. Systemic sclerosis (SSc) belongs to the connective tissue disorders, and recent data have highlighted strong associations with autoimmunity genes shared with other autoimmune diseases. To determine whether novel risk loci associated with systemic lupus erythematosus or multiple sclerosis may confer susceptibility to SSc, we tested single-nucleotide polymorphisms (SNP) from ITGAM, ITGAX, and CD58 for associations. Methods SNP harboring associations with autoimmune diseases, ITGAM rs9937837, ITGAX rs11574637, and CD58 rs12044852, were genotyped in 2 independent cohorts of European Caucasian ancestry: 1031 SSc patients and 1014 controls from France and 1038 SSc patients and 691 controls from the USA, providing a combined study population of 3774 individuals. ITGAM rs1143679 was additionally genotyped in the French cohort. Results The 4 polymorphisms were in Hardy-Weinberg equilibrium in the 2 control populations, and allelic frequencies were similar to those expected in European Caucasian populations. Allelic and genotypic frequencies for these 3 SNP were found to be statistically similar in SSc patients and controls. Subphenotype analyses for subgroups having diffuse cutaneous subtype disease, specific autoantibodies, or fibrosing alveolitis did not reveal any difference between SSc patients and controls. Conclusion These results obtained through 2 large cohorts of SSc patients of European Caucasian ancestry do not support the implication of ITGAM, ITGAX, and CD58 genes in the genetic susceptibility of SSc, although they were recently identified as autoimmune disease risk genes. PMID:21362770

  5. Frequency of and risk factors for symptomatic bone fractures in patients with systemic lupus erythematosus.

    PubMed

    Ekblom-Kullberg, S; Kautiainen, H; Alha, P; Leirisalo-Repo, M; Julkunen, H

    2013-01-01

    To study risk factors for symptomatic bone fractures in patients with systemic lupus erythematosus (SLE) and to compare the frequency of fractures between SLE patients and population controls. The study included 222 SLE patients [mean age 47.0 years, disease duration 13.1 years, 204 (92%) women] and 720 population controls living in the metropolitan area of Helsinki. The history of symptomatic bone fractures in SLE patients and controls was recorded by interview, and demographic and clinical data of SLE patients were obtained by interview, clinical examination, and chart review. A history of at least one symptomatic bone fracture was recorded in 93 (42%) of all 222 patients with SLE. The risk of any fracture in 204 women with SLE compared to controls was 1.8 [95% confidence interval (CI) 1.3-2.4] and fractures in the ankle, hip, and vertebral column were more common than in female controls, with odds ratios (ORs) of 2.0 (95% CI 1.1-3.7), 5.1 (95% CI 1.2-21.5), and 4.0 (95% CI 1.8-8.6), respectively. In 18 men with SLE, compared to male controls, no difference in the frequency of fractures was observed (OR 0.7, 95% CI 0.3-2.0). Risk factors for bone fractures in women with SLE were age (p = 0.008), comorbidity (p = 0.050), and the duration of corticosteroid use (p = 0.025). Symptomatic bone fractures, especially in the ankle, hip, and vertebral column, are common in women with SLE. Special attention should be paid to preventing fractures in elderly female patients with comorbidities and a long duration of corticosteroid use.

  6. Bionic models for identification of biological systems

    NASA Astrophysics Data System (ADS)

    Gerget, O. M.

    2017-01-01

    This article proposes a clinical decision support system that processes biomedical data. For this purpose a bionic model has been designed based on neural networks, genetic algorithms and immune systems. The developed system has been tested on data from pregnant women. The paper focuses on the approach to enable selection of control actions that can minimize the risk of adverse outcome. The control actions (hyperparameters of a new type) are further used as an additional input signal. Its values are defined by a hyperparameter optimization method. A software developed with Python is briefly described.

  7. Traceability System For Agricultural Productsbased on Rfid and Mobile Technology

    NASA Astrophysics Data System (ADS)

    Sugahara, Koji

    In agriculture, it is required to establish and integrate food traceability systems and risk management systems in order to improve food safety in the entire food chain. The integrated traceability system for agricultural products was developed, based on innovative technology of RFID and mobile computing. In order to identify individual products on the distribution process efficiently,small RFID tags with unique ID and handy RFID readers were applied. On the distribution process, the RFID tags are checked by using the readers, and transit records of the products are stored to the database via wireless LAN.Regarding agricultural production, the recent issues of pesticides misuse affect consumer confidence in food safety. The Navigation System for Appropriate Pesticide Use (Nouyaku-navi) was developed, which is available in the fields by Internet cell-phones. Based on it, agricultural risk management systems have been developed. These systems collaborate with traceability systems and they can be applied for process control and risk management in agriculture.

  8. Alcohol, smoking and illicit drug use in pediatric systemic lupus erythematosus patients.

    PubMed

    van Weelden, Marlon; Queiroz, Lígia B; Lourenço, Daniela M R; Kozu, Katia; Lourenço, Benito; Silva, Clovis A

    2016-01-01

    To evaluate alcohol, smoking and/or illicit drug use, and history of bullying in adolescent childhood-onset systemic lupus erythematosus and healthy controls. 174 adolescents with pediatric rheumatic diseases were selected. All of the 34 childhood-onset systemic lupus erythematosus patients and 35 healthy controls participated in this study. A cross-sectional study included demographic/anthropometric data and puberty markers assessments; structured questionnaire and CRAFFT screening interview. McNemar tests indicated an excellent test-retest reliability of the structured questionnaire (p=1.0). The median current age was similar between childhood-onset systemic lupus erythematosus patients and controls [15 (12-18) vs. 15 (12-18) years, p=0.563]. The median of menarche age was significantly higher in childhood-onset systemic lupus erythematosus patients compared to controls [12 (10-15) vs. 11.5 (9-15) years, p=0.041], particularly in those that lupus had occurred before first menstruation [13 (12-15) vs. 11.5(9-15) years, p=0.007]. The other puberty marker and sexual function parameters were similar in both groups (p>0.05). Alcohol use was similar in both childhood-onset systemic lupus erythematosus patients and controls (38% vs. 46%, p=0.628). A trend of lower frequency of CRAFFT score ≥2 (high risk for substance abuse/dependence) was evidenced in childhood-onset systemic lupus erythematosus patients compared to controls (0% vs. 15%, p=0.053). Bullying was reported similarly for the two groups (43% vs. 44%, p=0.950). Further analysis in lupus patients regarding alcohol/smoking/illicit drug use showed no differences in demographic data, puberty markers, history of bullying, sexual function, contraceptive use, disease activity/damage scores, clinical/laboratorial features and treatments (p>0.05). This study showed high frequencies of early alcohol use in lupus adolescents and healthy controls, despite of a possible low risk for substance abuse/dependence in childhood-onset systemic lupus erythematosus patients. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

  9. [Cardiovascular disease and systemic inflammatory diseases].

    PubMed

    Cuende, José I; Pérez de Diego, Ignacio J; Godoy, Diego

    2016-01-01

    More than a century of research has shown that atherosclerosis is an inflammatory process more than an infiltrative or thrombogenic process. It has been demonstrated epidemiologically and by imaging techniques, that systemic inflammatory diseases (in particular, but not exclusively, rheumatoid arthritis and systemic lupus erythematosus) increase the atherosclerotic process, and has a demonstrated pathophysiological basis. Furthermore, treatments to control inflammatory diseases can modify the course of the atherosclerotic process. Although there are no specific scales for assessing cardiovascular risk in patients with these diseases, cardiovascular risk is high. A number of specific risk scales are being developed, that take into account specific factors such as the degree of inflammatory activity. Copyright © 2015 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

  10. Diet-quality scores and risk of hip fractures in elderly urban Chinese in Guangdong, China: a case-control study.

    PubMed

    Zeng, F F; Xue, W Q; Cao, W T; Wu, B H; Xie, H L; Fan, F; Zhu, H L; Chen, Y M

    2014-08-01

    This case-control study compared the associations of four widely used diet-quality scoring systems with the risk of hip fractures and assessed their utility in elderly Chinese. We found that individuals avoiding a low-quality diet have a lower risk of hip fractures in elderly Chinese. Few studies examined the associations of diet-quality scores on bone health, and no studies were available in Asians and compared their validity and utility in a study. We assessed the associations and utility of four widely used diet-quality scoring systems with the risk of hip fractures. A case-control study of 726 patients with hip fractures (diagnosed within 2 weeks) aged 55-80 years and 726 age- (within 3 years) and gender-matched controls was conducted in Guangdong, China (2009-2013). Dietary intake was assessed using a 79-item food frequency questionnaire with face-to-face interviews, and the Healthy Eating Index-2005 (HEI-2005, 12 items), the alternate Healthy Eating Index (aHEI, 8 items), the Diet Quality Index-International (DQI-I, 17 items), and the alternate Mediterranean Diet Score (aMed, 9 items) (the simplest one) were calculated. All greater values of the diet-quality scores were significantly associated with a similar decreased risk of hip fractures (all p trends <0.001). The multivariate-adjusted odds ratios (ORs) and 95% confidential intervals (95% CIs) comparing the extreme groups of diet-quality scores were 0.29 (0.18, 0.46) (HEI-2005), 0.20 (0.12, 0.33) (aHEI), 0.25 (0.16, 0.39) (DQI-I), and 0.28 (0.18, 0.43) (aMed) in total subjects; and the corresponding ORs ranged from 0.04 to 0.27 for men and from 0.26 to 0.44 for women (all p trends <0.05), respectively. Avoiding a low-quality diet is associated with a lower risk of hip fractures, and the aMed score is the best scoring system due to its equivalent performance and simplicity for the user.

  11. Report: EPA Lacks Internal Controls to Prevent Misuse of Emergency Drinking Water Facilities

    EPA Pesticide Factsheets

    Report #11-P-0001, October 12, 2010. EPA cannot accurately assess the risk of public water systems delivering contaminated drinking water from emergency facilities because of limitations in Safe Drinking Water Information System (SDWIS) data management.

  12. 48 CFR 34.202 - Integrated Baseline Reviews.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... inherent risks in offerors'/contractors' performance plans and the underlying management control systems...) The degree to which the management process provides effective and integrated technical/schedule/cost... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Integrated Baseline...

  13. 75 FR 77645 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Pregnancy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-13

    ... Monitoring System (PRAMS), DP11-001 Panel D, Initial Review In accordance with Section 10(a)(2) of the... initial review, discussion, and evaluation of ``Pregnancy Risk Assessment Monitoring System (PRAMS), DP11...

  14. 75 FR 77645 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Pregnancy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-13

    ... Monitoring System (PRAMS), DP11-001 Panel F, Initial Review In accordance with Section 10(a)(2) of the... initial review, discussion, and evaluation of ``Pregnancy Risk Assessment Monitoring System (PRAMS), DP11...

  15. An infectious disease/fever screening radar system which stratifies higher-risk patients within ten seconds using a neural network and the fuzzy grouping method.

    PubMed

    Sun, Guanghao; Matsui, Takemi; Hakozaki, Yukiya; Abe, Shigeto

    2015-03-01

    To classify higher-risk influenza patients within 10 s, we developed an infectious disease and fever screening radar system. The system screens infected patients based on vital signs, i.e., respiration rate measured by a radar, heart rate by a finger-tip photo-reflector, and facial temperature by a thermography. The system segregates subjects into higher-risk influenza (HR-I) group, lower-risk influenza (LR-I) group, and non-influenza (Non-I) group using a neural network and fuzzy clustering method (FCM). We conducted influenza screening for 35 seasonal influenza patients and 48 normal control subjects at the Japan Self-Defense Force Central Hospital. Pulse oximetry oxygen saturation (SpO2) was measured as a reference. The system classified 17 subjects into HR-I group, 26 into LR-I group, and 40 into Non-I group. Ten out of the 17 HR-I subjects indicated SpO2 <96%, whereas only two out of the 26 LR-I subjects showed SpO2 <96%. The chi-squared test revealed a significant difference in the ratio of subjects showed SpO2 <96% between HR-I and LR-I group (p < 0.001). There were zero and nine normal control subjects in HR-I and LR-I groups, respectively, and there was one influenza patient in Non-I group. The combination of neural network and FCM achieved efficient detection of higher-risk influenza patients who indicated SpO2 96% within 10 s. Copyright © 2014 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  16. ICT-based system to predict and prevent falls (iStoppFalls): results from an international multicenter randomized controlled trial.

    PubMed

    Gschwind, Yves J; Eichberg, Sabine; Ejupi, Andreas; de Rosario, Helios; Kroll, Michael; Marston, Hannah R; Drobics, Mario; Annegarn, Janneke; Wieching, Rainer; Lord, Stephen R; Aal, Konstantin; Vaziri, Daryoush; Woodbury, Ashley; Fink, Dennis; Delbaere, Kim

    2015-01-01

    Falls and fall-related injuries are a serious public health issue. Exercise programs can effectively reduce fall risk in older people. The iStoppFalls project developed an Information and Communication Technology-based system to deliver an unsupervised exercise program in older people's homes. The primary aims of the iStoppFalls randomized controlled trial were to assess the feasibility (exercise adherence, acceptability and safety) of the intervention program and its effectiveness on common fall risk factors. A total of 153 community-dwelling people aged 65+ years took part in this international, multicentre, randomized controlled trial. Intervention group participants conducted the exercise program for 16 weeks, with a recommended duration of 120 min/week for balance exergames and 60 min/week for strength exercises. All intervention and control participants received educational material including advice on a healthy lifestyle and fall prevention. Assessments included physical and cognitive tests, and questionnaires for health, fear of falling, number of falls, quality of life and psychosocial outcomes. The median total exercise duration was 11.7 h (IQR = 22.0) over the 16-week intervention period. There were no adverse events. Physiological fall risk (Physiological Profile Assessment, PPA) reduced significantly more in the intervention group compared to the control group (F1,127 = 4.54, p = 0.035). There was a significant three-way interaction for fall risk assessed by the PPA between the high-adherence (>90 min/week; n = 18, 25.4 %), low-adherence (<90 min/week; n = 53, 74.6 %) and control group (F2,125 = 3.12, n = 75, p = 0.044). Post hoc analysis revealed a significantly larger effect in favour of the high-adherence group compared to the control group for fall risk (p = 0.031), postural sway (p = 0.046), stepping reaction time (p = 0.041), executive functioning (p = 0.044), and quality of life (p for trend = 0.052). The iStoppFalls exercise program reduced physiological fall risk in the study sample. Additional subgroup analyses revealed that intervention participants with better adherence also improved in postural sway, stepping reaction, and executive function. Australian New Zealand Clinical Trials Registry Trial ID: ACTRN12614000096651 International Standard Randomised Controlled Trial Number: ISRCTN15932647.

  17. High and low-risk specialties experience with the U.S. medical malpractice system

    PubMed Central

    2013-01-01

    Background “High-liability risk specialties” tend to be the focus of medical malpractice system research and debate, but concerns and fears are not limited to this group. The objective of this study was to examine whether “high-liability risk” medical specialties have a different experience with the malpractice system than “low-liability risk” specialties. Methods We reviewed claims data from the Physician Insurers Association of America’s Data Sharing Project between January 1985 and December 2008. We used linear regression, controlling for year, to determine how liability risk affected outcomes of interest. Results In high-liability risk specialties, 33% of claims result in indemnity payments compared to 28% for low-liability risk specialties (p < 0.001). The average indemnity payment for high-liability risk specialties was $315,314 compared to $267,146 for low-liability risk specialties (p = 0.25). Although only a small percentage of claims go to trial, low-liability risk specialties have significantly more claims that are ultimately dropped, withdrawn or dismissed, while high-liability risk specialties have significantly more claims that result in plaintiff settlement (p < 0.001). Conclusions Malpractice risk exists for all specialties. Variability in indemnity costs are found in both high- and low-liability risk specialties. Differences in the reasons for which claims are initiated for high- and low-liability risk specialties likely necessitate different risk management solutions. PMID:24192524

  18. Ultrasonic Sensors in Urban Traffic Driving-Aid Systems

    PubMed Central

    Alonso, Luciano; Milanés, Vicente; Torre-Ferrero, Carlos; Godoy, Jorge; Oria, Juan P.; de Pedro, Teresa

    2011-01-01

    Currently, vehicles are often equipped with active safety systems to reduce the risk of accidents, most of which occur in urban environments. The most prominent include Antilock Braking Systems (ABS), Traction Control and Stability Control. All these systems use different kinds of sensors to constantly monitor the conditions of the vehicle, and act in an emergency. In this paper the use of ultrasonic sensors in active safety systems for urban traffic is proposed, and the advantages and disadvantages when compared to other sensors are discussed. Adaptive Cruise Control (ACC) for urban traffic based on ultrasounds is presented as an application example. The proposed system has been implemented in a fully-automated prototype vehicle and has been tested under real traffic conditions. The results confirm the good performance of ultrasonic sensors in these systems. PMID:22346596

  19. Ultrasonic sensors in urban traffic driving-aid systems.

    PubMed

    Alonso, Luciano; Milanés, Vicente; Torre-Ferrero, Carlos; Godoy, Jorge; Oria, Juan P; de Pedro, Teresa

    2011-01-01

    Currently, vehicles are often equipped with active safety systems to reduce the risk of accidents, most of which occur in urban environments. The most prominent include Antilock Braking Systems (ABS), Traction Control and Stability Control. All these systems use different kinds of sensors to constantly monitor the conditions of the vehicle, and act in an emergency. In this paper the use of ultrasonic sensors in active safety systems for urban traffic is proposed, and the advantages and disadvantages when compared to other sensors are discussed. Adaptive Cruise Control (ACC) for urban traffic based on ultrasounds is presented as an application example. The proposed system has been implemented in a fully-automated prototype vehicle and has been tested under real traffic conditions. The results confirm the good performance of ultrasonic sensors in these systems.

  20. Increased Arterial Stiffness in Systemic Lupus Erythematosus (SLE) Patients at Low Risk for Cardiovascular Disease: A Cross-Sectional Controlled Study

    PubMed Central

    Sacre, Karim; Escoubet, Brigitte; Pasquet, Blandine; Chauveheid, Marie-Paule; Zennaro, Maria-Christina; Tubach, Florence; Papo, Thomas

    2014-01-01

    Cardiovascular disease (CVD) is a major cause of death in systemic lupus erythematosus (SLE) patients. Although the risk for cardiovascular events in patients with SLE is significant, the absolute number of events per year in any given cohort remains small. Thus, CVD risks stratification in patients with SLE focuses on surrogate markers for atherosclerosis at an early stage, such as reduced elasticity of arteries. Our study was designed to determine whether arterial stiffness is increased in SLE patients at low risk for CVD and analyze the role for traditional and non-traditional CVD risk factors on arterial stiffness in SLE. Carotid-femoral pulse wave velocity (PWV) was prospectively assessed as a measure of arterial stiffness in 41 SLE patients and 35 controls (CTL). Adjustment on age or Framingham score was performed using a logistic regression model. Factors associated with PWV were identified separately in SLE patients and in controls using Pearson's correlation coefficient for univariate analysis and multiple linear regression for multivariate analysis. SLE patients and controls displayed a low 10-year risk for CVD according to Framingham score (1.8±3.6% in SLE vs 1.6±2.8% in CTL, p = 0.46). Pulse wave velocity was, however, higher in SLE patients (7.1±1.6 m/s) as compared to controls (6.3±0.8 m/s; p = 0.01, after Framingham score adjustment) and correlated with internal carotid wall thickness (p = 0.0017). In multivariable analysis, only systolic blood pressure (p = 0.0005) and cumulative dose of glucocorticoids (p = 0.01) were associated with PWV in SLE patients. Interestingly, the link between systolic blood pressure (SBP) and arterial stiffness was also confirmed in SLE patients with normal systolic blood pressure. In conclusion, arterial stiffness is increased in SLE patients despite a low risk for CVD according to Framingham score and is associated with systolic blood pressure and glucocorticoid therapy. PMID:24722263

  1. Assessment and Control of Spacecraft Charging Risks on the International Space Station

    NASA Technical Reports Server (NTRS)

    Koontz, Steve; Edeen, Marybeth; Spetch, William; Dalton, Penni; Keening, Thomas

    2003-01-01

    Electrical interactions between the F2 region ionospheric plasma and the 160V photovoltaic (PV) electrical power system on the International Space Station (ISS) can produce floating potentials (FP) on the ISS conducting structure of greater magnitude than are usually observed on spacecraft in low-Earth orbit. Flight through the geomagnetic field also causes magnetic induction charging of ISS conducting structure. Charging processes resulting from interaction of ISS with auroral electrons may also contribute to charging albeit rarely. The magnitude and frequency of occurrence of possibly hazardous charging events depends on the ISS assembly stage (six more 160V PV arrays will be added to ISS), ISS flight configuration, ISS position (latitude and longitude), and the natural variability in the ionospheric flight environment. At present, ISS is equipped with two plasma contactors designed to control ISS FP to within 40 volts of the ambient F2 plasma. The negative-polarity grounding scheme utilized in the ISS 160V power system leads, naturally, to negative values of ISS FP. A negative ISS structural FP leads to application of electrostatic fields across the dielectrics that separate conducting structure from the ambient F2 plasma, thereby enabling dielectric breakdown and arcing. Degradation of some thermal control coatings and noise in electrical systems can result. Continued review and evaluation of the putative charging hazards, as required by the ISS Program Office, revealed that ISS charging could produce a risk of electric shock to the ISS crew during extra vehicular activity. ISS charging risks are being evaluated in ongoing ISS charging measurements and analysis campaigns. The results of ISS charging measurements are combined with a recently developed detailed model of the ISS charging process and an extensive analysis of historical ionospheric variability data, to assess ISS charging risks using Probabilistic Risk Assessment (PRA) methods. The PRA analysis (estimated frequency of occurrence and severity of the charging hazards) are then used to select the hazard control strategy that provides the best overall safety and mission success environment for ISS and the ISS crew. This paper presents: 1) a summary of ISS spacecraft charging analysis, measurements, observations made to date, 2) plans for future ISS spacecraft charging measurement campaigns, and 3) a detailed discussion of the PRA strategy used to assess ISS spacecraft charging risks and select charging hazard control strategies

  2. Assessment and Control of International Space Station Spacecraft Charging Risks

    NASA Astrophysics Data System (ADS)

    Koontz, S.; Edeen, M.; Spetch, W.; Dalton, P.; Keeping, T.; Minow, J.

    2003-12-01

    Electrical interactions between the F2 region ionospheric plasma and the 160V photovoltaic (PV) electrical power system on the International Space Station (ISS) can produce floating potentials (FP) on ISS conducting structure of greater magnitude than are usually observed on spacecraft in low-Earth orbit. Flight through the geomagnetic field also causes magnetic induction charging of ISS conducting structure. Charging processes resulting from interaction of ISS with auroral electrons may also contribute to charging, albeit rarely. The magnitude and frequency of occurrence of possibly hazardous charging events depends on the ISS assembly stage (six more 160V PV arrays will be added to ISS), ISS flight configuration, ISS position (latitude and longitude), and the natural variability in the ionospheric flight environment. At present, ISS is equipped with two plasma contactors designed to control ISS FP to within 40 volts of the ambient F2 plasma. The negative-polarity grounding scheme utilized in the ISS 160V power system leads, naturally, to negative values of ISS FP. A negative ISS structural FP leads to application of electrostatic fields across the dielectrics that separate conducting structure from the ambient F2 plasma, thereby enabling dielectric breakdown and arcing. Degradation of some thermal control coatings and noise in electrical systems can result. Continued review and evaluation of the putative charging hazards, as required by the ISS Program Office, revealed that ISS charging could produce a risk of electric shock to the ISS crew during extra vehicular activity. ISS charging risks are being evaluated in ongoing ISS charging measurements and analysis campaigns. The results of ISS charging measurements are combined with a recently developed detailed model of the ISS charging process and an extensive analysis of historical ionospheric variability data, to assess ISS charging risks using Probabilistic Risk Assessment (PRA) methods. The PRA analysis (estimated frequency of occurrence and severity of the charging hazards) are then used to select the hazard control strategy that provides the best overall safety and mission success environment for ISS and the ISS crew. This paper presents: 1) a summary of ISS spacecraft charging analysis, measurements, observations made to date, 2) plans for future ISS spacecraft charging measurement campaigns, and 3) a detailed discussion of the PRA strategy used to assess ISS spacecraft charging risks and select charging hazard control strategies.

  3. The cardiovascular system in growth hormone excess and growth hormone deficiency.

    PubMed

    Lombardi, G; Di Somma, C; Grasso, L F S; Savanelli, M C; Colao, A; Pivonello, R

    2012-12-01

    The clinical conditions associated with GH excess and GH deficiency (GHD) are known to be associated with an increased risk for the cardiovascular morbidity and mortality, suggesting that either an excess or a deficiency in GH and/or IGF-I is deleterious for cardiovascular system. In patients with acromegaly, chronic GH and IGF-I excess commonly causes a specific cardiomyopathy characterized by a concentric cardiac hypertrophy associated with diastolic dysfunction and, in later stages, with systolic dysfunction ending in heart failure if GH/IGF-I excess is not controlled. Abnormalities of cardiac rhythm and anomalies of cardiac valves can also occur. Moreover, the increased prevalence of cardiovascular risk factors, such as hypertension, diabetes mellitus, and insulin resistance, as well as dyslipidemia, confer an increased risk for vascular atherosclerosis. Successful control of the disease is accompanied by a decrease of the cardiac mass and improvement of cardiac function and an improvement in cardiovascular risk factors. In patients with hypopituitarism, GHD has been considered the under- lying factor of the increased mortality when appropriate standard replacement of the pituitary hormones deficiencies is given. Either childhood-onset or adulthood-onset GHD are characterized by a cluster of abnormalities associated with an increased cardiovascular risk, including altered body composition, unfavorable lipid profile, insulin resistance, endothelial dysfunction and vascular atherosclerosis, a decrease in cardiac mass together with an impairment of systolic function mainly after exercise. Treatment with recombinant GH in patients with GHD is followed by an improvement of the cardiovascular risk factors and an increase in cardiac mass together with an improvement in cardiac performance. In conclusion, acromegaly and GHD are associated with an increased risk for cardiovascular morbidity and mortality, but the control of GH/IGF-I secretion reverses cardiovascular abnormalities and restores the normal life expectancy.

  4. Environmental (Saprozoic) Pathogens of Engineered Water Systems: Understanding Their Ecology for Risk Assessment and Management

    PubMed Central

    Ashbolt, Nicholas J.

    2015-01-01

    Major waterborne (enteric) pathogens are relatively well understood and treatment controls are effective when well managed. However, water-based, saprozoic pathogens that grow within engineered water systems (primarily within biofilms/sediments) cannot be controlled by water treatment alone prior to entry into water distribution and other engineered water systems. Growth within biofilms or as in the case of Legionella pneumophila, primarily within free-living protozoa feeding on biofilms, results from competitive advantage. Meaning, to understand how to manage water-based pathogen diseases (a sub-set of saprozoses) we need to understand the microbial ecology of biofilms; with key factors including biofilm bacterial diversity that influence amoebae hosts and members antagonistic to water-based pathogens, along with impacts from biofilm substratum, water temperature, flow conditions and disinfectant residual—all control variables. Major saprozoic pathogens covering viruses, bacteria, fungi and free-living protozoa are listed, yet today most of the recognized health burden from drinking waters is driven by legionellae, non-tuberculous mycobacteria (NTM) and, to a lesser extent, Pseudomonas aeruginosa. In developing best management practices for engineered water systems based on hazard analysis critical control point (HACCP) or water safety plan (WSP) approaches, multi-factor control strategies, based on quantitative microbial risk assessments need to be developed, to reduce disease from largely opportunistic, water-based pathogens. PMID:26102291

  5. Nuclear power plant digital system PRA pilot study with the dynamic flow-graph methodology

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

    Yau, M.; Motamed, M.; Guarro, S.

    2006-07-01

    Current Probabilistic Risk Assessment (PRA) methodology is well established in analyzing hardware and some of the key human interactions. However processes for analyzing the software functions of digital systems within a plant PRA framework, and accounting for the digital system contribution to the overall risk are not generally available nor are they well understood and established. A recent study reviewed a number of methodologies that have potential applicability to modeling and analyzing digital systems within a PRA framework. This study identified the Dynamic Flow-graph Methodology (DFM) and the Markov Methodology as the most promising tools. As a result of thismore » study, a task was defined under the framework of a collaborative agreement between the U.S. Nuclear Regulatory Commission (NRC) and the Ohio State Univ. (OSU). The objective of this task is to set up benchmark systems representative of digital systems used in nuclear power plants and to evaluate DFM and the Markov methodology with these benchmark systems. The first benchmark system is a typical Pressurized Water Reactor (PWR) Steam Generator (SG) Feedwater System (FWS) level control system based on an earlier ASCA work with the U.S. NRC 2, upgraded with modern control laws. ASCA, Inc. is currently under contract to OSU to apply DFM to this benchmark system. The goal is to investigate the feasibility of using DFM to analyze and quantify digital system risk, and to integrate the DFM analytical results back into the plant event tree/fault tree PRA model. (authors)« less

  6. 17 CFR 240.3b-15 - Definition of ancillary portfolio management securities activities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... governing body of the dealer and included in the internal risk management control system for the dealer... of incidental trading activities for portfolio management purposes; and (3) Are limited to risk... portfolio management securities activities. 240.3b-15 Section 240.3b-15 Commodity and Securities Exchanges...

  7. Neurobehavioral and Neurophysiological Assessment of Healthy and "At-Risk" Full-Term Infants.

    ERIC Educational Resources Information Center

    Eldredge, Lynnette; Salamy, Alan

    1988-01-01

    Study evaluates the functioning of the central nervous system (CNS) of 15 neonates born at-risk for neurological sequelae and 15 healthy controls. CNS information was generated through the use of two measures: (1) the Neurological and Adaptive Capacity Score (NACS) and the auditory brainstem response (ABR). (Author/RWB)

  8. 76 FR 50276 - STP Nuclear Operating Company, South Texas Project, Units 1 and 2; Notice of Withdrawal of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-12

    ... revised the application of Risk- Managed Technical Specifications to Technical Specification 3.7.7, ``Control Room Makeup and Cleanup Filtration System.'' The purpose of the change was to correct a misapplication of the Configuration Risk Management Program that is currently allowed by the Technical...

  9. Affordable, automatic quantitative fall risk assessment based on clinical balance scales and Kinect data.

    PubMed

    Colagiorgio, P; Romano, F; Sardi, F; Moraschini, M; Sozzi, A; Bejor, M; Ricevuti, G; Buizza, A; Ramat, S

    2014-01-01

    The problem of a correct fall risk assessment is becoming more and more critical with the ageing of the population. In spite of the available approaches allowing a quantitative analysis of the human movement control system's performance, the clinical assessment and diagnostic approach to fall risk assessment still relies mostly on non-quantitative exams, such as clinical scales. This work documents our current effort to develop a novel method to assess balance control abilities through a system implementing an automatic evaluation of exercises drawn from balance assessment scales. Our aim is to overcome the classical limits characterizing these scales i.e. limited granularity and inter-/intra-examiner reliability, to obtain objective scores and more detailed information allowing to predict fall risk. We used Microsoft Kinect to record subjects' movements while performing challenging exercises drawn from clinical balance scales. We then computed a set of parameters quantifying the execution of the exercises and fed them to a supervised classifier to perform a classification based on the clinical score. We obtained a good accuracy (~82%) and especially a high sensitivity (~83%).

  10. Schistosomiasis: Geospatial Surveillance and Response Systems in Southeast Asia

    NASA Astrophysics Data System (ADS)

    Malone, John; Bergquist, Robert; Rinaldi, Laura; Xiao-nong, Zhou

    2016-10-01

    Geographic information system (GIS) and remote sensing (RS) from Earth-observing satellites offer opportunities for rapid assessment of areas endemic for vector-borne diseases including estimates of populations at risk and guidance to intervention strategies. This presentation deals with GIS and RS applications for the control of schistosomiasis in China and the Philippines. It includes large-scale risk mapping including identification of suitable habitats for Oncomelania hupensis, the intermediate host snail of Schistosoma japonicum. Predictions of infection risk are discussed with reference to ecological transformations and the potential impact of climate change and the potential for long-term temperature increases in the North as well as the impact on rivers, lakes and water resource developments. Potential integration of geospatial mapping and modeling in schistosomiasis surveillance and response systems in Asia within Global Earth Observation System of Systems (GEOSS) guidelines in the health societal benefit area is discussed.

  11. Nested case-control study of autoimmune disease in an asbestos-exposed population.

    PubMed

    Noonan, Curtis W; Pfau, Jean C; Larson, Theodore C; Spence, Michael R

    2006-08-01

    To explore the potential association between asbestos exposure and risk of autoimmune disease, we conducted a case-control study among a cohort of 7,307 current and former residents of Libby, Montana, a community with historical occupational and environmental exposure to asbestos-contaminated vermiculite. Cases were defined as those who reported having one of three systemic autoimmune diseases (SAIDs): systemic lupus erythematosus, scleroderma, or rheumatoid arthritis (RA). Controls were randomly selected at a 3:1 ratio from among the remaining 6,813 screening participants using frequency-matched age and sex groupings. The odds ratios (ORs) and 95% confidence intervals (CIs) for SAIDs among those >or=65 years of age who had worked for the vermiculite mining company were 2.14 (95% CI, 0.90-5.10) for all SAIDs and 3.23 (95% CI, 1.31-7.96) for RA. In this age group, exposure to asbestos while in the military was also an independent risk factor, resulting in a tripling in risk. Other measures of occupational exposure to vermiculite indicated 54% and 65% increased risk for SAIDs and RA, respectively. Those who had reported frequent contact with vermiculite through various exposure pathways also demonstrated elevated risk for SAIDs and RA. We found increasing risk estimates for SAIDs with increasing numbers of reported vermiculite exposure pathways (p<0.001). These preliminary findings support the hypothesis that asbestos exposure is associated with autoimmune disease. Refined measurements of asbestos exposure and SAID status among this cohort will help to further clarify the relationship between these variables.

  12. Post-marketing surveillance system for drugs in pregnancy--15 years experience of ENTIS.

    PubMed

    Schaefer, Christof; Hannemann, Doreen; Meister, Reinhard

    2005-01-01

    Teratology Information Services (TIS) provide the public and health professionals with tailor-made information on drug risks in pregnancy. TIS in Europe, Israel and Latin America collaborate in the European Network of Teratology Information Services (ENTIS) in order to optimise interpretation of risk data, risk communication and risk management as well as recommendations for drug treatment in pregnant women. In addition, efforts are undertaken to enhance and harmonise documentation of exposed pregnancies and their outcomes. These prospectively ascertained data are evaluated like controlled, observational cohort studies, where exposed pregnancies are compared to a non-exposed control group for various outcome variables such as (major) malformations, birth measures and the state of the new-born infant, spontaneous abortion. The prospective methodology minimises recall bias of the studied drugs. Evaluating the data collected according to standardised protocols with appropriate statisticals methods substantially improves risk assessment. The comparison of spontaneous abortions between coumarin exposed pregnancies and controls enrolled in the Berlin TIS demonstrates the benefit of the methodology of survival analysis within the framework of the proportional hazard model. The ENTIS multi-centre approach permits studying large exposed cohorts even with seldomly used medicinal products. In terms of post-marketing surveillance there are no alternatives to TIS data. Data collection by TIS uses an already established risk communication system, and has the advantage of low costs and motivated responders. As a TIS is contacted mainly for insufficiently documented drugs or those suspected of acting as developmental toxicants there is even a selection for products needing research.

  13. Anthrax Vaccine and the Risk of Rheumatoid Arthritis and Systemic Lupus Erythematosus in the U.S. Military: A Case-Control Study.

    PubMed

    Bardenheier, Barbara H; Duffy, Jonathan; Duderstadt, Susan K; Higgs, Jay B; Keith, Michael P; Papadopoulos, Patricia J; Gilliland, William R; McNeil, Michael M

    2016-10-01

    U.S. military personnel assigned to areas deemed to be at high risk for anthrax attack receive Anthrax Vaccine Adsorbed (AVA). Few cases of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) have been reported in persons who received AVA. Using a matched case-control study design, we assessed the relationship of RA and SLE with AVA vaccination using the Defense Medical Surveillance System. We identified potential cases using International Classification of Diseases, 9th Revision, Clinical Modification codes and confirmed cases with medical record review and rheumatologist adjudication. Using conditional logistic regression, we estimated odds ratios (OR) for AVA exposure during time intervals ranging from 90 to 1,095 days before disease onset. Among 77 RA cases, 13 (17%) had ever received AVA. RA cases were no more likely than controls to have received AVA when looking back 1,095 days (OR: 1.03; 95% confidence interval [CI]: 0.48-2.19) but had greater odds of exposure in the prior 90 days (OR: 3.93; 95% CI: 1.08-14.27). Among the 39 SLE cases, 5 (13%) had ever received AVA; no significant difference in receipt of AVA was found when compared with controls (OR: 0.91; 95% CI: 0.26-3.25). AVA was associated with recent onset RA, but did not increase the risk of developing RA in the long term. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  14. Analyzing simulation-based PRA data through traditional and topological clustering: A BWR station blackout case study

    DOE PAGES

    Maljovec, D.; Liu, S.; Wang, B.; ...

    2015-07-14

    Here, dynamic probabilistic risk assessment (DPRA) methodologies couple system simulator codes (e.g., RELAP and MELCOR) with simulation controller codes (e.g., RAVEN and ADAPT). Whereas system simulator codes model system dynamics deterministically, simulation controller codes introduce both deterministic (e.g., system control logic and operating procedures) and stochastic (e.g., component failures and parameter uncertainties) elements into the simulation. Typically, a DPRA is performed by sampling values of a set of parameters and simulating the system behavior for that specific set of parameter values. For complex systems, a major challenge in using DPRA methodologies is to analyze the large number of scenarios generated,more » where clustering techniques are typically employed to better organize and interpret the data. In this paper, we focus on the analysis of two nuclear simulation datasets that are part of the risk-informed safety margin characterization (RISMC) boiling water reactor (BWR) station blackout (SBO) case study. We provide the domain experts a software tool that encodes traditional and topological clustering techniques within an interactive analysis and visualization environment, for understanding the structures of such high-dimensional nuclear simulation datasets. We demonstrate through our case study that both types of clustering techniques complement each other for enhanced structural understanding of the data.« less

  15. Orbiter subsystem hardware/software interaction analysis. Volume 8: Forward reaction control system

    NASA Technical Reports Server (NTRS)

    Becker, D. D.

    1980-01-01

    The results of the orbiter hardware/software interaction analysis for the AFT reaction control system are presented. The interaction between hardware failure modes and software are examined in order to identify associated issues and risks. All orbiter subsystems and interfacing program elements which interact with the orbiter computer flight software are analyzed. The failure modes identified in the subsystem/element failure mode and effects analysis are discussed.

  16. Risk factors for criminal recidivism - a prospective follow-up study in prisoners with substance abuse.

    PubMed

    Håkansson, Anders; Berglund, Mats

    2012-08-15

    Substance use in general has been shown to predict criminal recidivism. The present study aimed to examine potential predictors of criminal recidivism, including substance-specific substance use patterns, in prisoners with substance use. A cohort of prisoners with substance use problems (N = 4,152) were assessed with the Addiction Severity Index (ASI) in the Swedish criminal justice system. Clients were followed for an average of 2.7 years. Criminal recidivism was defined as any return to the criminal justice system. During follow-up, 69 percent (n = 2,862) returned to the criminal justice system. Recidivism was associated with amphetamine and heroin use, with an additive risk for injectors, and with polysubstance use. Also, recidivism was negatively associated with alcohol, other opioids than heroin/methadone and with hallucinogenic drugs, and positively associated with previous psychiatric in-patient treatment, violent behaviour, and with a shorter index sentence. Associations remained when controlling for type of crime. Even when controlling for type and severity of crime, and for psychiatric problems, risk of criminal relapse was increased by substance use variables, including amphetamine, heroin and polysubstance use, and an additional risk was shown for injection drug users. These findings have implications for the need for substance abuse treatment after release from prison.

  17. Propulsion Risk Reduction Activities for Non-Toxic Cryogenic Propulsion

    NASA Technical Reports Server (NTRS)

    Smith, Timothy D.; Klem, Mark D.; Fisher, Kenneth

    2010-01-01

    The Propulsion and Cryogenics Advanced Development (PCAD) Project s primary objective is to develop propulsion system technologies for non-toxic or "green" propellants. The PCAD project focuses on the development of non-toxic propulsion technologies needed to provide necessary data and relevant experience to support informed decisions on implementation of non-toxic propellants for space missions. Implementation of non-toxic propellants in high performance propulsion systems offers NASA an opportunity to consider other options than current hypergolic propellants. The PCAD Project is emphasizing technology efforts in reaction control system (RCS) thruster designs, ascent main engines (AME), and descent main engines (DME). PCAD has a series of tasks and contracts to conduct risk reduction and/or retirement activities to demonstrate that non-toxic cryogenic propellants can be a feasible option for space missions. Work has focused on 1) reducing the risk of liquid oxygen/liquid methane ignition, demonstrating the key enabling technologies, and validating performance levels for reaction control engines for use on descent and ascent stages; 2) demonstrating the key enabling technologies and validating performance levels for liquid oxygen/liquid methane ascent engines; and 3) demonstrating the key enabling technologies and validating performance levels for deep throttling liquid oxygen/liquid hydrogen descent engines. The progress of these risk reduction and/or retirement activities will be presented.

  18. Propulsion Risk Reduction Activities for Nontoxic Cryogenic Propulsion

    NASA Technical Reports Server (NTRS)

    Smith, Timothy D.; Klem, Mark D.; Fisher, Kenneth L.

    2010-01-01

    The Propulsion and Cryogenics Advanced Development (PCAD) Project s primary objective is to develop propulsion system technologies for nontoxic or "green" propellants. The PCAD project focuses on the development of nontoxic propulsion technologies needed to provide necessary data and relevant experience to support informed decisions on implementation of nontoxic propellants for space missions. Implementation of nontoxic propellants in high performance propulsion systems offers NASA an opportunity to consider other options than current hypergolic propellants. The PCAD Project is emphasizing technology efforts in reaction control system (RCS) thruster designs, ascent main engines (AME), and descent main engines (DME). PCAD has a series of tasks and contracts to conduct risk reduction and/or retirement activities to demonstrate that nontoxic cryogenic propellants can be a feasible option for space missions. Work has focused on 1) reducing the risk of liquid oxygen/liquid methane ignition, demonstrating the key enabling technologies, and validating performance levels for reaction control engines for use on descent and ascent stages; 2) demonstrating the key enabling technologies and validating performance levels for liquid oxygen/liquid methane ascent engines; and 3) demonstrating the key enabling technologies and validating performance levels for deep throttling liquid oxygen/liquid hydrogen descent engines. The progress of these risk reduction and/or retirement activities will be presented.

  19. 77 FR 58219 - National Emission Standards for Hazardous Air Pollutant Emissions: Hard and Decorative Chromium...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-19

    ..., and control technologies) no less frequently than every 8 years. Section 112(f)(2) of the CAA requires... Classification System. \\2\\ Maximum Achievable Control Technology. C. Where can I get a copy of this document and... areas of air pollution control. Additional information is available on the residual risk and technology...

  20. [Epidemic situation of oversea imported schistosomiasis in China and thinking about its prevention and control].

    PubMed

    Zhu, Rong; Xu, Jing

    2014-04-01

    The imported schistosomiasis cases in the Chinese literature and reports from the infectious disease monitoring information system from 1979 to 2013 were collected and compiled. Totally 365 cases were reported to be infected with outside schistosomiasis, including 239 cases of schistosomiasis haematobia (74.0%) and 71 cases of schistosomiasis mansoni (22.0%), and 42 foreigners (11.5%) and 323 Chinese (88.5%). The infection areas involved 15 countries and regions in Africa. Totally 74.92% of patients worked in the construction or geological prospecting in the wild field. According to the analysis of these cases, we found that the management system of prevention and control of imported schistosomiasis cases was not perfect including the high missing re-port rate, high misdiagnosis rate, and no standard diagnostic criteria. We suggest that all the levels of CDC or health administrative authorities should adopt the following relevant control measures to strengthen the imported schistosomiasis prevention and control in order to reduce the damage to the public health and the risk of the spread of African schistosomiasis in China: (1) to establish and perfect the imported schistosomiasis monitoring and control system in China; (2) to integrate the dynamic information platform of labor export and establish the comprehensive prevention and control management system of infectious diseases; (3) to standardize the diagnosis and treatment of oversea imported schistosomiasis; (4) to strengthen the research on the transmission risk of imported schistosomiasis in the territory of China.

  1. Absenteeism due to mental health problems and systems for return to work: an internet-based unmatched case-control study.

    PubMed

    Doki, Shotaro; Sasahara, Shinichiro; Hirai, Yasuhito; Oi, Yuichi; Matsuzaki, Ichiyo

    2016-11-01

    The aim of this study was to investigate the risk factors for absenteeism due to mental health problems with regard to company characteristics and systems for return to work in Japan. This was an Internet-based unmatched case-control study. Two hundred and fifty-eight workers who experienced over 28 days of sick leave due to mental health problems (cases) and 258 workers who have not taken sick leave (controls) were recruited. Company characteristics and the awareness and presence of systems for return to work were analysed as indicators of absenteeism. A total of 501 workers were included in the analysis. Females were less likely to experience absenteeism when adjustments were made for both the awareness and presence of systems [odds ratio (OR) = 0.51 and 0.41, respectively]. Large companies showed an increased risk of having absentee workers than small companies. The awareness of a gradual resumption system and the presence of a sick pay system were related to absenteeism (OR = 2.75 and 2.40, respectively). The awareness and presence of systems for return to work are related to the long-term absenteeism. The predictors of sex and company size are also related to the experience of the long-term absenteeism. To understand the effect of systems for return to work on absenteeism due to mental problems, further studies are needed.

  2. Cardio-respiratory control during sleep in infancy.

    PubMed

    Horne, Rosemary S C

    2014-06-01

    During the first year of life and particularly the first 6 months autonomic control of the cardio-respiratory system is still undergoing maturation and infants are at risk of cardio-respiratory instability. These instabilities are most marked during sleep, which is important as infants spend the majority of each 24 hours in sleep. Sleep state has a marked effect on the cardio-respiratory system with instabilities being more common in active sleep compared to quiet sleep. Responses to hypoxia are also immature during infancy and may make young infants more vulnerable to cardio-respiratory instability. It has been proposed that an inability to respond appropriately to a life threatening event underpins the Sudden Infant Death Syndrome (SIDS). The major risk factors for SIDS, prone sleeping and maternal smoking, both impair cardio-respiratory control in normal healthy term infants. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  3. Influence of dorsolateral prefrontal cortex and ventral striatum on risk avoidance in addiction: a mediation analysis*

    PubMed Central

    Yamamoto, Dorothy J.; Woo, Choong-Wan; Wager, Tor D.; Regner, Michael F.; Tanabe, Jody

    2015-01-01

    Background Alterations in frontal and striatal function are hypothesized to underlie risky decision-making in drug users, but how these regions interact to affect behavior is incompletely understood. We used mediation analysis to investigate how prefrontal cortex and ventral striatum together influence risk avoidance in abstinent drug users. Method Thirty-seven abstinent substance-dependent individuals (SDI) and 43 controls underwent fMRI while performing a decision-making task involving risk and reward. Analyses of a priori regions-of-interest tested whether activity in dorsolateral prefrontal cortex (DLPFC) and ventral striatum (VST) explained group differences in risk avoidance. Whole-brain analysis was conducted to identify brain regions influencing the negative VST-risk avoidance relationship. Results Right DLPFC (RDLPFC) positively mediated the group-risk avoidance relationship (p < 0.05); RDLPFC activity was higher in SDI and predicted higher risk avoidance across groups, controlling for SDI vs. controls. Conversely, VST activity negatively influenced risk avoidance (p < 0.05); it was higher in SDI, and predicted lower risk avoidance. Whole-brain analysis revealed that, across group, RDLPFC and left temporal-parietal junction positively (p ≤ 0.001) while right thalamus and left middle frontal gyrus negatively (p < 0.005) mediated the VST activity-risk avoidance relationship. Conclusion RDLPFC activity mediated less risky decision-making while VST mediated more risky decision-making across drug users and controls. These results suggest a dual pathway underlying decision-making, which, if imbalanced, may adversely influence choices involving risk. Modeling contributions of multiple brain systems to behavior through mediation analysis could lead to a better understanding of mechanisms of behavior and suggest neuromodulatory treatments for addiction. PMID:25736619

  4. Automated Risk Assessment for Stroke in Atrial Fibrillation (AURAS-AF)--an automated software system to promote anticoagulation and reduce stroke risk: study protocol for a cluster randomised controlled trial.

    PubMed

    Holt, Tim A; Fitzmaurice, David A; Marshall, Tom; Fay, Matthew; Qureshi, Nadeem; Dalton, Andrew R H; Hobbs, F D Richard; Lasserson, Daniel S; Kearley, Karen; Hislop, Jenny; Jin, Jing

    2013-11-13

    Patients with atrial fibrillation (AF) are at significantly increased risk of stroke. Oral anticoagulants (OACs) substantially reduce this risk, with gains seen across the spectrum of baseline risk. Despite the benefit to patients, OAC prescribing remains suboptimal in the United Kingdom (UK). We will investigate whether an automated software system, operating within primary care electronic medical records, can improve the management of AF by identifying patients eligible for OAC therapy and increasing uptake of this treatment. We will conduct a cluster randomised controlled trial, involving general practices using the Egton Medical Information Systems (EMIS) Web clinical system. We will randomise practices to use an electronic software tool or to continue with usual care. The tool will a) produce (and continually refresh) a list of patients with AF who are eligible for OAC therapy--practices will invite these patients to discuss therapy at the start of the trial--and b) generate electronic screen reminders in the medical records of those eligible, appearing throughout the trial. The software will run for 6 months in 23 intervention practices. A total of 23 control practices will manage their AF register in line with the usual care offered. The primary outcome is change in proportion of eligible patients with AF who have been prescribed OAC therapy after six months. Secondary outcomes are incidence of stroke, transient ischaemic attack, other major thromboembolism, major haemorrhage and reports of inappropriate OAC prescribing in the data collection sample--those deemed eligible for OACs. We will conduct a process evaluation in parallel with the randomised trial. We will use qualitative methods to examine patient and practitioner views of the intervention and its impact on primary care practice, including its time implications. AURAS-AF will investigate whether a simple intervention, using electronic primary care records, can improve OAC uptake in a high risk group for stroke. Given previous concerns about safety, especially surrounding inappropriate prescribing, we will also examine whether electronic reminders safely impact care in this clinical area. http://ISRCTN 55722437.

  5. Crew Exploration Vehicle (CEV) Avionics Integration Laboratory (CAIL) Independent Analysis

    NASA Technical Reports Server (NTRS)

    Davis, Mitchell L.; Aguilar, Michael L.; Mora, Victor D.; Regenie, Victoria A.; Ritz, William F.

    2009-01-01

    Two approaches were compared to the Crew Exploration Vehicle (CEV) Avionics Integration Laboratory (CAIL) approach: the Flat-Sat and Shuttle Avionics Integration Laboratory (SAIL). The Flat-Sat and CAIL/SAIL approaches are two different tools designed to mitigate different risks. Flat-Sat approach is designed to develop a mission concept into a flight avionics system and associated ground controller. The SAIL approach is designed to aid in the flight readiness verification of the flight avionics system. The approaches are complimentary in addressing both the system development risks and mission verification risks. The following NESC team findings were identified: The CAIL assumption is that the flight subsystems will be matured for the system level verification; The Flat-Sat and SAIL approaches are two different tools designed to mitigate different risks. The following NESC team recommendation was provided: Define, document, and manage a detailed interface between the design and development (EDL and other integration labs) to the verification laboratory (CAIL).

  6. Tradeoffs in the Design of Health Plan Payment Systems: Fit, Power and Balance

    PubMed Central

    Geruso, Michael; McGuire, Thomas G.

    2016-01-01

    In many markets, including the new U.S. Marketplaces, health insurance plans are paid by risk-adjusted capitation, sometimes combined with reinsurance and other payment mechanisms. This paper proposes a framework for evaluating the de facto insurer incentives embedded in these complex payment systems. We discuss fit, power and balance, each of which addresses a distinct market failure in health insurance. We implement empirical metrics of fit, power, and balance in a study of Marketplace payment systems. Using data similar to that used to develop the Marketplace risk adjustment scheme, we quantify tradeoffs among the three classes of incentives. We show that an essential tradeoff arises between the goals of limiting costs and limiting cream skimming because risk adjustment, which is aimed at discouraging cream-skimming, weakens cost control incentives in practice. A simple reinsurance system scores better on our measures of fit, power and balance than the risk adjustment scheme in use in the Marketplaces. PMID:26922122

  7. Tradeoffs in the design of health plan payment systems: Fit, power and balance.

    PubMed

    Geruso, Michael; McGuire, Thomas G

    2016-05-01

    In many markets, including the new U.S. Marketplaces, health insurance plans are paid by risk-adjusted capitation, sometimes combined with reinsurance and other payment mechanisms. This paper proposes a framework for evaluating the de facto insurer incentives embedded in these complex payment systems. We discuss fit, power and balance, each of which addresses a distinct market failure in health insurance. We implement empirical metrics of fit, power, and balance in a study of Marketplace payment systems. Using data similar to that used to develop the Marketplace risk adjustment scheme, we quantify tradeoffs among the three classes of incentives. We show that an essential tradeoff arises between the goals of limiting costs and limiting cream skimming because risk adjustment, which is aimed at discouraging cream-skimming, weakens cost control incentives in practice. A simple reinsurance system scores better on our measures of fit, power and balance than the risk adjustment scheme in use in the Marketplaces. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. A systems approach to the policy-level risk assessment of exotic animal diseases: network model and application to classical swine fever.

    PubMed

    Delgado, João; Pollard, Simon; Snary, Emma; Black, Edgar; Prpich, George; Longhurst, Phil

    2013-08-01

    Exotic animal diseases (EADs) are characterized by their capacity to spread global distances, causing impacts on animal health and welfare with significant economic consequences. We offer a critique of current import risk analysis approaches employed in the EAD field, focusing on their capacity to assess complex systems at a policy level. To address the shortcomings identified, we propose a novel method providing a systematic analysis of the likelihood of a disease incursion, developed by reference to the multibarrier system employed for the United Kingdom. We apply the network model to a policy-level risk assessment of classical swine fever (CSF), a notifiable animal disease caused by the CSF virus. In doing so, we document and discuss a sequence of analyses that describe system vulnerabilities and reveal the critical control points (CCPs) for intervention, reducing the likelihood of U.K. pig herds being exposed to the CSF virus. © 2012 Society for Risk Analysis.

  9. Association between traditional systemic antipsoriatic drugs and tuberculosis risk in patients with psoriasis with or without psoriatic arthritis: results of a nationwide cohort study from Taiwan.

    PubMed

    Chen, Yi-Ju; Wu, Chun-Ying; Shen, Jui-Lung; Chen, Tzu-Ting; Chang, Yun-Ting

    2013-07-01

    Although the link between tuberculosis (TB) and biologics use is well established, the risk of TB among patients with psoriasis exposed to traditional systemic therapies remains elusive. The aim is to investigate the association between traditional systemic therapies and TB among patients with psoriasis. We conducted a retrospective cohort study on the risk of active TB among patients with psoriasis and psoriatic arthritis, using the National Health Insurance Research Database of Taiwan, 1996 through 2008. Standardized incidence ratios of TB were analyzed in comparison with age- and gender-matched general population. Logistic regression was used in a nested case-control analysis to estimate the odds ratios of TB related to exposure to traditional systemic agents during the year before TB development. Among the 81,266 patients in the psoriasis cohort, 497 new active TB cases were identified. The incidence rate of TB was 102 cases per 100,000 person-years among patients with psoriasis (standardized incidence ratio 1.22, 95% confidence interval 1.18-1.33). The risk of TB was higher in patients with severe disease (standardized incidence ratio 1.52, 95% confidence interval 1.46-1.74). To facilitate comparisons with the 497 active TB cases, a total of 1988 matched control subjects were selected for a nested case-control study. Patients taking systemic corticosteroids and nonsteroidal anti-inflammatory drugs were associated with higher incidence of TB, especially frequent users, after adjustment for multiple TB risk factors, drug exposures, hospital visits, and level of urbanization. Stratified analyses of current users and new users of these drugs revealed similar results. Finally, traditional systemic antipsoriatic treatment was not associated with TB on any of the analyses. The National Health Insurance Research Database did not contain information regarding severity of psoriasis, smoking status, alcohol use, diet, laboratory parameters, chest radiograph, or history of recent contact with an individual with TB. Misclassification of disease cannot be ruled out in a registry-based database. The accessibility of health care may be associated with the level of urbanization, which could confound the effect of drugs in multivariate analyses. Severe psoriasis may be associated with an elevated TB risk. Traditional systemic therapies do not seem to be strongly associated with TB occurrence. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  10. Employee control over working times and risk of cause-specific disability pension: the Finnish Public Sector Study

    PubMed Central

    Vahtera, Jussi; Laine, Sari; Virtanen, Marianna; Oksanen, Tuula; Koskinen, Aki; Pentti, Jaana; Kivimaki, Mika

    2011-01-01

    Objective To examine the association between worktime control and subsequent retirement on health ground (disability pension) among employees. Methods A prospective cohort study of 30 700 public sector employees (78% women) aged 18 to 64 at baseline. Two scores of worktime control, self-assessed and co-worker assessed, were obtained from responses to the baseline survey in 2000-2001 (score range 1 to 5). Information on cause-specific disability pension during follow-up was collected from national registers. Results During a mean follow-up of 4.4 years, 1178 employees were granted disability pension (incidence per 1000 person-years 9.2 in women and 8.7 in men). The most common causes of a disability pension were musculoskeletal disorders (43% of all pensions), mental disorders (25%), tumours (8%), and diseases of the circulatory system (6%) and the nervous system (6%). A 1 unit increase in self-assessed and co-worker assessed worktime control score was associated with a 41-48% lowering of the risk of disabling musculoskeletal disorders in men and 33-35% lowering in women. This association was robust to adjustment for all 17 baseline covariates (in men and women combined, adjusted hazard ratio 0.76, 95% CI 0.67-0.87 and 0.64, 95% CI 0.51-0.79 per 1 unit increase in self-assessed and co-worker assessed worktime control, respectively).Self-assessed worktime control was also associated with the risk of disability retirement due to mental disorders in women, but this association was not replicated using co-workers’ assessment. Disability pensions from other disease categories were not related to control over working times. Conclusions In this cohort of public sector employees, high worktime control among employees was associated with reduced risk of early retirement caused by musculoskeletal disorders independent of baseline characteristics. PMID:19914911

  11. Strengthening the management of ESA - the Inter-Directorate Reform of Corporate and Risk Management

    NASA Astrophysics Data System (ADS)

    Feustel-Büechl, Jörg; Arend, Harald; Derio, Eric; Infante, Giovanni; Kreiner, Gerhard; Phaler, Jesse; Tabbert, Michael

    2007-02-01

    ESA has undertaken the Inter-Directorate Reform of Corporate and Risk Management to strengthen the Agency's internal operations. The reform was completed at the end of 2006, encompassing five dedicated projects on Risk Management, Agency-Wide Controlling System, Project Plan and Integrated Project Review, General Budget Structure and Charging Policy, and Corporate Information Systems. It has contributed to improved management of the Agency's internal operations by engaging all internal stakeholders in a common objective, introducing improvements to planning and management methods, elaborating consolidated information structures and tools, contributing to enhanced transparency and accountability, and by providing qualified new policies, processes and tools.

  12. International perspectives on food safety and regulations - a need for harmonized regulations: perspectives in China.

    PubMed

    Liu, Xiumei

    2014-08-01

    Food safety is a major livelihood issue and a priority concern in China. Since the Food Safety Law of the People's Republic of China was issued in 2009, the food safety control system has been strengthened through, inter alia, the Food Safety Risk Surveillance System, the Food Safety Risk Assessment System and the Food Safety Standards System. In accordance with the Food Safety Law and regulations for implementation, the Ministry of Health released the 'Twelfth Five-year Plan' of Food Safety Standards. The existing 5000 food-related standards will be integrated. Notwithstanding, the supervision system in China needs to be further improved and strengthened. © 2014 Society of Chemical Industry.

  13. The Design of Power System Stability Controller Based on the PCH Theory and Improved Genetic Algorithm

    NASA Astrophysics Data System (ADS)

    Liu, Zhijian; Yin, Donghui; Yan, Jun

    2017-05-01

    Low frequency oscillation is still frequently happened in the power system and it affects the safety and stability of power system directly. With the continuously expending of the interconnection scale of power grid, the risk of low frequency oscillation becomes more and more noticeable. Firstly, the basic theory of port-controlled Hamilton (PCH) and its application is analyzed. Secondly, based on the PCH theory and the dynamic model of system, from the viewpoint of energy, the nonlinear stability controller of power system is designed. By the improved genetic algorithm, the parameters of the PCH model are optimized. Finally, a simulation model with PCH is built to vary the effectiveness of the method proposed in this paper.

  14. The influence of mechanical vibration on local and central balance control.

    PubMed

    Ehsani, Hossein; Mohler, Jane; Marlinski, Vladimir; Rashedi, Ehsan; Toosizadeh, Nima

    2018-04-11

    Fall prevention has an indispensable role in enhancing life expectancy and quality of life among older adults. The first step to prevent falls is to devise reliable methods to identify individuals at high fall risk. The purpose of the current study was to assess alterations in local postural muscle and central sensory balance control mechanisms due to low-frequency externally applied vibration among elders at high fall risk, in comparison with healthy controls, as a potential tool for assessing fall risk. Three groups of participants were recruited: healthy young (n = 10; age = 23 ± 2 years), healthy elders (n = 10; age = 73 ± 3 years), and elders at high fall risk (n = 10; age = 84 ± 9 years). Eyes-open and eyes-closed upright standing balance performance was measured with no vibration, 30 Hz, and 40 Hz vibration of Gastrocnemius muscles. When vibratory stimulation was applied, changes in local-control performance manifested significant differences among the groups (p < 0.01). On average between conditions, we observed 97% and 92% less change among high fall risk participants when compared to healthy young and older adults, respectively. On the other hand, vibration-induced changes in the central-control performance were not significant between groups (p ≥ 0.19). Results suggest that local-control deficits are responsible for balance behavior alterations among elders at high fall risk and healthy individuals. This observation may be attributable to deterioration of short-latency reflexive loop in elders at high fall risk. On the other hand, we could not ascribe the balance alterations to problems related to central nervous system performance or long-latency responses. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Comparing Pain and Depressive Symptoms of Chronic Opioid Therapy Patients Receiving Dose Reduction and Risk Mitigation Initiatives With Usual Care.

    PubMed

    Thakral, Manu; Walker, Rod L; Saunders, Kathleen; Shortreed, Susan M; Parchman, Michael; Hansen, Ryan N; Ludman, Evette; Sherman, Karen J; Dublin, Sascha; Von Korff, Michael

    2018-01-01

    Dose reduction and risk mitigation initiatives have been recommended to reduce opioid-related risks among patients receiving chronic opioid therapy (COT), but questions remain over whether these initiatives worsen pain control and quality of life. In 2014 to 2015, we interviewed 1,588 adult COT patients within a health care system in Washington State and compared those who received dose reduction and risk mitigation initiatives in primary care clinics (intervention) with patients in comparable health care settings without initiatives (control). The primary outcomes were pain assessed using the pain, enjoyment, and general activity (PEG) scale, a 3-item scale to assess global pain intensity and interference, with secondary measures including depression (Patient Health Questionnaire-8 scale). Generalized estimating equations for linear regression models were used to estimate differences in mean scores between intervention and control sites. Estimated differences, adjusted for patient characteristics and weighted for nonresponse, between patients at intervention and control clinics were not clinically significant for the PEG (-.03, 95% confidence interval = -.25 to .19) or Patient Health Questionnaire-8 (-.64, 95% confidence interval = -1.19 to -.08). We found no evidence that COT patients in clinics with dose reduction and risk mitigation initiatives had clinically meaningful differences in pain intensity, interference with activities and enjoyment of life, or depressive symptoms compared with control health care settings. This article evaluates the effect of dose reduction and risk mitigation initiatives, such as those recently recommended by the Centers for Disease Control and Prevention, to reduce risks associated with COT on global pain and interference, depressive symptoms, and perceived pain relief and bothersomeness of side effects. Copyright © 2017 The American Pain Society. Published by Elsevier Inc. All rights reserved.

  16. The effect of combination treatment with aliskiren and blockers of the renin-angiotensin system on hyperkalaemia and acute kidney injury: systematic review and meta-analysis

    PubMed Central

    Gilbert, Cameron; Wald, Ron; Bell, Chaim; Perl, Jeff; Juurlink, David; Beyene, Joseph; Shah, Prakesh S

    2012-01-01

    Objective To examine the safety of using aliskiren combined with agents used to block the renin-angiotensin system. Design Systematic review and meta-analysis of randomised controlled trials. Data sources Medline, Embase, the Cochrane Library, and two trial registries, published up to 7 May 2011. Study selection Published and unpublished randomised controlled trials that compared combined treatment using aliskiren and angiotensin converting enzyme inhibitors or angiotensin receptor blockers with monotherapy using these agents for at least four weeks and that provided numerical data on the adverse event outcomes of hyperkalaemia and acute kidney injury. A random effects model was used to calculate pooled risk ratios and 95% confidence intervals for these outcomes. Results 10 randomised controlled studies (4814 participants) were included in the analysis. Combination therapy with aliskiren and angiotensin converting enzyme inhibitors or angiotensin receptor blockers significantly increased the risk of hyperkalaemia compared with monotherapy using angiotensin converting enzymes or angiotensin receptor blockers (relative risk 1.58, 95% confidence interval 1.24 to 2.02) or aliskiren alone (1.67, 1.01 to 2.79). The risk of acute kidney injury did not differ significantly between the combined therapy and monotherapy groups (1.14, 0.68 to 1.89). Conclusion Use of aliskerin in combination with angiotensin converting enzyme inhibitors or angiotensin receptor blockers is associated with an increased risk for hyperkalaemia. The combined use of these agents warrants careful monitoring of serum potassium levels. PMID:22232539

  17. Manual handling risks associated with the care, treatment and transportation of bariatric patients and clients in Australia.

    PubMed

    Cowley, Stephen P; Leggett, Susan

    2010-06-01

    To gain an understanding of the factors that affect the risks and the adoption of risk control measures during the care of bariatric patients, focus groups were conducted in rural and metropolitan locations in Australia. It was found that the manual handling injury risk to carers is influenced by the design of the environments within which patient movement is undertaken; the limited range of handling equipment available for use with bariatric patients; and the efficacy of organizational procedures and training. Adoption of risk controls is hampered by the absence of a standard definition of the term 'bariatric' and limitations in the use of weight and body mass index in definitions. There are gaps in information flow during the bariatric patient journey through the health-care system and a lack of knowledge about how to safely manage the unique needs of bariatric patients.

  18. Continuous Risk Management at NASA

    NASA Technical Reports Server (NTRS)

    Hammer, Theodore F.; Rosenberg, Linda

    1999-01-01

    NPG 7120.5A, "NASA Program and Project Management Processes and Requirements" enacted in April, 1998, requires that "The program or project manager shall apply risk management principles..." The Software Assurance Technology Center (SATC) at NASA GSFC has been tasked with the responsibility for developing and teaching a systems level course for risk management that provides information on how to comply with this edict. The course was developed in conjunction with the Software Engineering Institute at Carnegie Mellon University, then tailored to the NASA systems community. This presentation will briefly discuss the six functions for risk management: (1) Identify the risks in a specific format; (2) Analyze the risk probability, impact/severity, and timeframe; (3) Plan the approach; (4) Track the risk through data compilation and analysis; (5) Control and monitor the risk; (6) Communicate and document the process and decisions. This risk management structure of functions has been taught to projects at all NASA Centers and is being successfully implemented on many projects. This presentation will give project managers the information they need to understand if risk management is to be effectively implemented on their projects at a cost they can afford.

  19. Hormone, metabolic peptide, and nutrient levels in the earliest phases of rheumatoid arthritis-contribution of free fatty acids to an increased cardiovascular risk during very early disease.

    PubMed

    Tang, Man Wai; Koopman, Frieda A; Visscher, Jan P M; de Hair, Maria J; Gerlag, Danielle M; Tak, Paul Peter

    2017-02-01

    Rheumatoid arthritis (RA) is a chronic autoimmune disease associated with changes in several hormones and metabolic peptides. Crosstalk between these factors and the immune system may be important for homeostasis during inflammation. Here, we studied the levels of hormones, metabolic peptides, and nutrients in individuals at risk for developing RA (at risk). In total, 18 hormones, metabolic peptides, and nutrients were measured in fasting serum samples from 45 autoantibody-positive individuals at risk, 22 RA patients, and 16 healthy subjects. Triglyceride (TG) levels were also measured in an independent validation cohort of 32 individuals at risk, 20 early arthritis patients, and 20 healthy controls. We found an elevated TG level in individuals at risk and significantly higher TG levels in RA patients compared to healthy controls. These results were confirmed in the validation cohort. Similarly, free fatty acid (FFA) levels showed an increase in individuals at risk and were significantly higher in RA patients compared to healthy controls. In RA patients, FFA levels were positively correlated with disease activity. Pancreatic polypeptide (PP) and norepinephrine levels were highly significantly increased in individuals at risk and RA patients compared to healthy controls. TG and FFA levels are increased in RA patients and positively correlated with disease activity parameters. The results presented here suggest a role for FFAs in the pathogenesis of RA. Furthermore, PP and norepinephrine may be a biomarker that could assist in the identification of individuals at risk.

  20. Incident command structure using a daily management system and the Centers for Disease Control and Prevention's Patient Notification Toolkit drives effective response to an infection control breach.

    PubMed

    Schoonover, Heather; Haydon, Kristin

    2018-06-14

    When breaches in infection control occur, it is imperative that organizations respond in a manner that is effective, efficient, and rebuilds trust with patients. Readers will learn how the incident command structure, daily management system, and the Centers for Disease Control and Prevention's Patient Notification Toolkit were used to drive an effective response to an infection control breach-resulting in 92% of affected patients completing the recommended testing for hepatitis B, hepatitis C, and human immunodeficiency virus. © 2018 American Society for Healthcare Risk Management of the American Hospital Association.

  1. Renal Insufficiency After Contrast Media Administration Trial II (REMEDIAL II): RenalGuard System in high-risk patients for contrast-induced acute kidney injury.

    PubMed

    Briguori, Carlo; Visconti, Gabriella; Focaccio, Amelia; Airoldi, Flavio; Valgimigli, Marco; Sangiorgi, Giuseppe Massimo; Golia, Bruno; Ricciardelli, Bruno; Condorelli, Gerolama

    2011-09-13

    The RenalGuard System, which creates high urine output and fluid balancing, may be beneficial in preventing contrast-induced acute kidney injury. The Renal Insufficiency After Contrast Media Administration Trial II (REMEDIAL II) trial is a randomized, multicenter, investigator-driven trial addressing the prevention of contrast-induced acute kidney injury in high-risk patients. Patients with an estimated glomerular filtration rate ≤30 mL · min(-1) · 1.73 m(-2) and/or a risk score ≥11 were randomly assigned to sodium bicarbonate solution and N-acetylcysteine (control group) or hydration with saline and N-acetylcysteine controlled by the RenalGuard System and furosemide (RenalGuard group). The primary end point was an increase of ≥0.3 mg/dL in the serum creatinine concentration at 48 hours after the procedure. The secondary end points included serum cystatin C kinetics and rate of in-hospital dialysis. Contrast-induced acute kidney injury occurred in 16 of 146 patients in the RenalGuard group (11%) and in 30 of 146 patients in the control group (20.5%; odds ratio, 0.47; 95% confidence interval, 0.24 to 0.92). There were 142 patients (48.5%) with an estimated glomerular filtration rate ≤30 mL · min(-1) · 1.73 and 149 patients (51.5%) with only a risk score ≥11. Subgroup analysis according to inclusion criteria showed a similarly lower risk of adverse events (estimated glomerular filtration rate ≤30 mL · min(-1) · 1.73 m(-2): odds ratio, 0.44; risk score ≥11: odds ratio, 0.45; P for interaction=0.97). Changes in cystatin C at 24 hours (0.02±0.32 versus -0.08±0.26; P=0.002) and 48 hours (0.12±0.42 versus 0.03±0.31; P=0.001) and the rate of in-hospital dialysis (4.1% versus 0.7%; P=0.056) were higher in the control group. RenalGuard therapy is superior to sodium bicarbonate and N-acetylcysteine in preventing contrast-induced acute kidney injury in high-risk patients. URL: http://www.clinicaltrial.gov. Unique identifier: NCT01098032.

  2. Comparative assessment of the prevalence of periodontal disease in subjects with and without systemic autoimmune diseases: A case-control study.

    PubMed

    Ramesh Kumar, S G; Aswath Narayanan, M B; Jayanthi, D

    2016-01-01

    Immune mechanism shares a common pathway both for systemic autoimmune diseases and periodontal diseases. Scientific exploration of literature revealed limited studies on the association between systemic autoimmune diseases and periodontal diseases in India. The aim of the study is to find whether the presence of systemic autoimmune diseases in an individual is a risk factor for the development of periodontal disease. This was a hospital-based case-control study. A sample of 253 patients with systemic autoimmune diseases, attending the Rheumatology Department of Government General Hospital, Chennai-3, and 262 patients without systemic autoimmune diseases, attending the outpatient department of the Tamil Nadu Government Dental College and Hospital, Chennai-3, constituted the case and control groups, respectively. Age, gender, and oral hygiene status matching was done. Oral hygiene status was assessed using oral hygiene index (OHI) and periodontal status was assessed using community periodontal index (CPI) and loss of attachment (LOA) index. Statistical analysis was done using SPSS version 15 (SPSS Inc, 2006, Chicago). Results showed 99.2% and 73.9% prevalence of gingivitis and periodontitis, respectively, in the case group as compared to 85.5% and 14.9%, respectively, in the control group. There is no linear relationship between OHI scores and prevalence of periodontitis (CPI and LOA scores) in the case group. Patients suffering from systemic autoimmune diseases showed more prevalence of periodontal diseases irrespective of oral hygiene scores. It is postulated that the presence of systemic autoimmune diseases may pose a risk for the development of periodontal diseases.

  3. Reflections on Being a Department of the Army Systems Coordinator (DASC)

    DTIC Science & Technology

    1977-11-01

    essential to successful development. Extensive reductions will adversely affect essential tasks, thereby i.ncreasing the program risk and making the program...necessary staffing and to make adjo~tmetits for problems ariiit$g at the ASARC prlimillary review. Lessa thaf 20 day, inicreajes risk if incoplete ASARC...he risks losing control of the orogram, and being reduced to a reaction officer rather than a DASC. In addition to understanding the overall

  4. Conversion of Questionnaire Data

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

    Powell, Danny H; Elwood Jr, Robert H

    During the survey, respondents are asked to provide qualitative answers (well, adequate, needs improvement) on how well material control and accountability (MC&A) functions are being performed. These responses can be used to develop failure probabilities for basic events performed during routine operation of the MC&A systems. The failure frequencies for individual events may be used to estimate total system effectiveness using a fault tree in a probabilistic risk analysis (PRA). Numeric risk values are required for the PRA fault tree calculations that are performed to evaluate system effectiveness. So, the performance ratings in the questionnaire must be converted to relativemore » risk values for all of the basic MC&A tasks performed in the facility. If a specific material protection, control, and accountability (MPC&A) task is being performed at the 'perfect' level, the task is considered to have a near zero risk of failure. If the task is performed at a less than perfect level, the deficiency in performance represents some risk of failure for the event. As the degree of deficiency in performance increases, the risk of failure increases. If a task that should be performed is not being performed, that task is in a state of failure. The failure probabilities of all basic events contribute to the total system risk. Conversion of questionnaire MPC&A system performance data to numeric values is a separate function from the process of completing the questionnaire. When specific questions in the questionnaire are answered, the focus is on correctly assessing and reporting, in an adjectival manner, the actual performance of the related MC&A function. Prior to conversion, consideration should not be given to the numeric value that will be assigned during the conversion process. In the conversion process, adjectival responses to questions on system performance are quantified based on a log normal scale typically used in human error analysis (see A.D. Swain and H.E. Guttmann, 'Handbook of Human Reliability Analysis with Emphasis on Nuclear Power Plant Applications,' NUREG/CR-1278). This conversion produces the basic event risk of failure values required for the fault tree calculations. The fault tree is a deductive logic structure that corresponds to the operational nuclear MC&A system at a nuclear facility. The conventional Delphi process is a time-honored approach commonly used in the risk assessment field to extract numerical values for the failure rates of actions or activities when statistically significant data is absent.« less

  5. Use of the Dynamic Visual Acuity Test as a screener for community-dwelling older adults who fall.

    PubMed

    Honaker, Julie A; Shepard, Neil T

    2011-01-01

    Adequate function of the peripheral vestibular system, specifically the vestibulo-ocular reflex (VOR; a network of neural connections between the peripheral vestibular system and the extraocular muscles) is essential for maintaining stable vision during head movements. Decreased visual acuity resulting from an impaired peripheral vestibular system may impede balance and postural control and place an individual at risk of falling. Therefore, sensitive measures of the vestibular system are warranted to screen for the tendency to fall, alerting clinicians to recommend further risk of falling assessment and referral to a falling risk reduction program. Dynamic Visual Acuity (DVA) testing is a computerized VOR assessment method to evaluate the peripheral vestibular system during head movements; reduced visual acuity as documented with DVA testing may be sensitive to screen for falling risk. This study examined the sensitivity and specificity of the computerized DVA test with yaw plane head movements for identifying community-dwelling adults (58-78 years) who are prone to falling. A total of 16 older adults with a history of two or more unexplained falls in the previous twelve months and 16 age and gender matched controls without a history of falls in the previous twelve months participated. Computerized DVA with horizontal head movements at a fixed velocity of 120 deg/sec was measured and compared with the Dynamic Gait Index (DGI) a gold standard gait assessment measurement for identifying falling risk. Receiver operating characteristics (ROC) curve analysis and area under the ROC curve (AUC) were used to assess the sensitivity and specificity of the computerized DVA as a screening measure for falling risk as determined by the DGI. Results suggested a link between computerized DVA and the propensity to fall; DVA in the yaw plane was found to be a sensitive (92%) and accurate screening measure when using a cutoff logMAR value of >0.25.

  6. Healthcare Data Gateways: Found Healthcare Intelligence on Blockchain with Novel Privacy Risk Control.

    PubMed

    Yue, Xiao; Wang, Huiju; Jin, Dawei; Li, Mingqiang; Jiang, Wei

    2016-10-01

    Healthcare data are a valuable source of healthcare intelligence. Sharing of healthcare data is one essential step to make healthcare system smarter and improve the quality of healthcare service. Healthcare data, one personal asset of patient, should be owned and controlled by patient, instead of being scattered in different healthcare systems, which prevents data sharing and puts patient privacy at risks. Blockchain is demonstrated in the financial field that trusted, auditable computing is possible using a decentralized network of peers accompanied by a public ledger. In this paper, we proposed an App (called Healthcare Data Gateway (HGD)) architecture based on blockchain to enable patient to own, control and share their own data easily and securely without violating privacy, which provides a new potential way to improve the intelligence of healthcare systems while keeping patient data private. Our proposed purpose-centric access model ensures patient own and control their healthcare data; simple unified Indicator-Centric Schema (ICS) makes it possible to organize all kinds of personal healthcare data practically and easily. We also point out that MPC (Secure Multi-Party Computing) is one promising solution to enable untrusted third-party to conduct computation over patient data without violating privacy.

  7. Safety Analysis of Soybean Processing for Advanced Life Support

    NASA Technical Reports Server (NTRS)

    Hentges, Dawn L.

    1999-01-01

    Soybeans (cv. Hoyt) is one of the crops planned for food production within the Advanced Life Support System Integration Testbed (ALSSIT), a proposed habitat simulation for long duration lunar/Mars missions. Soybeans may be processed into a variety of food products, including soymilk, tofu, and tempeh. Due to the closed environmental system and importance of crew health maintenance, food safety is a primary concern on long duration space missions. Identification of the food safety hazards and critical control points associated with the closed ALSSIT system is essential for the development of safe food processing techniques and equipment. A Hazard Analysis Critical Control Point (HACCP) model was developed to reflect proposed production and processing protocols for ALSSIT soybeans. Soybean processing was placed in the type III risk category. During the processing of ALSSIT-grown soybeans, critical control points were identified to control microbiological hazards, particularly mycotoxins, and chemical hazards from antinutrients. Critical limits were suggested at each CCP. Food safety recommendations regarding the hazards and risks associated with growing, harvesting, and processing soybeans; biomass management; and use of multifunctional equipment were made in consideration of the limitations and restraints of the closed ALSSIT.

  8. Indoor risk factors for atopic eczema in school children from East Germany.

    PubMed

    Schäfer, T; Heinrich, J; Wjst, M; Krause, C; Adam, H; Ring, J; Wichmann, H E

    1999-08-01

    This study aimed to investigate the relation between environmental influences such as arsenic, cadmium, lead, and mercury, as well as environmental tobacco smoke, pet keeping, and heating systems on the prevalence of atopic eczema. Therefore, a multicenter cross-sectional study of school children aged 5-14 years, including a standardized questionnaire, blood and urine analyses, and a dermatological examination, was undertaken. A cases-control approach was chosen in order to identify relevant risk factors. A total of 2200 school children (response 79.1%) of two areas (Bitterfeld, Hettstedt) polluted by industrial activities and an agricultural control region (Zerbst) of the former German Democratic Republic were examined. Atopic eczema as identified by dermatological examination and history was the outcome variable of interest. Body burden of arsenic and heavy metals and questionnaire data on environmental tobacco smoke exposure, pet keeping, and heating system were investigated as potential risk factors. The overall prevalence of atopic eczema was 2.6%, with higher prevalences in the industrial areas (2.5 and 2.9%) compared to the control area (1.6%, not significant). Bivariate analyses did not reveal statistically significant associations between atopic eczema and tobacco smoke exposure or the body burden of arsenic and heavy metals. According to multiple logistic regression analysis, atopic eczema was significantly more frequent in predisposed families and those who reported keeping guinea pigs (OR=4.37, CI 2.15-8.91), but not other pets, like dogs, cats, and hamsters. In comparison to a distant heating system, a decreased risk was observed in households with central heating system (OR=0.30, CI 0.10-0.90), whereas the presence of a gas heater with an exhaust pipe connection to the wall was associated with a significantly elevated risk for eczema (OR=8.22, CI 2.44-27.66). The heating system and exposure to certain animal allergens are related to the manifestation of atopic eczema. Further studies are needed to clarify how far a causal relationship is reflected by these findings. Copyright 1999 Academic Press.

  9. Marriage and divorce among young adult cancer survivors.

    PubMed

    Kirchhoff, Anne C; Yi, Jaehee; Wright, Jennifer; Warner, Echo L; Smith, Ken R

    2012-12-01

    We examined marital outcomes among cancer survivors diagnosed during early adulthood from the 2009 Behavioral Risk Factor Surveillance System dataset. Eligible participants were ages 20-39 years. Of the 74,433 eligible, N = 1,198 self-reported a cancer diagnosis between the ages of 18 and 37, were ≥2 years past diagnosis, and did not have non-melanoma skin cancer. The remaining N = 67,063 were controls. Using generalized linear models adjusted for age, gender, race, and education, we generated relative risks (RR) and 95 % confidence intervals (95 % CI) to examine survivor status on indicators of ever married, currently married, and divorced/separated. Survivors were slightly older than controls [33.0 (SD = 3.8) vs. 30.0 (SD = 4.0); p < 0.001]. Average time since diagnosis was 7.4 years. Most common diagnoses were cervical (females; 45 %) and non-Hodgkin lymphoma (males; 20 %). Survivors were less likely to be currently married than controls (58 % vs. 64 %; RR = 0.92, 95 % CI 0.85-0.99). Among ever married participants, survivors were at an increased risk of divorce/separation than controls (18 % vs. 10 %; RR = 1.77, 95 % CI 1.43-2.19). Divorce/separation risk persisted for female survivors (RR 1.83, 95 % CI 1.49-2.25), survivors ages 20-29 (RR 2.57, 95 % CI 1.53-4.34), and survivors ages 30-39 (RR 1.62, 95 % CI 1.29-2.04). The emotional and financial burdens of cancer may lead to marital stress for younger cancer survivors. Young survivors may face a higher risk of divorce; support systems are needed to assist them in the years following diagnosis.

  10. 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...

  11. Closed-Loop and Robust Control of Quantum Systems

    PubMed Central

    Wang, Lin-Cheng

    2013-01-01

    For most practical quantum control systems, it is important and difficult to attain robustness and reliability due to unavoidable uncertainties in the system dynamics or models. Three kinds of typical approaches (e.g., closed-loop learning control, feedback control, and robust control) have been proved to be effective to solve these problems. This work presents a self-contained survey on the closed-loop and robust control of quantum systems, as well as a brief introduction to a selection of basic theories and methods in this research area, to provide interested readers with a general idea for further studies. In the area of closed-loop learning control of quantum systems, we survey and introduce such learning control methods as gradient-based methods, genetic algorithms (GA), and reinforcement learning (RL) methods from a unified point of view of exploring the quantum control landscapes. For the feedback control approach, the paper surveys three control strategies including Lyapunov control, measurement-based control, and coherent-feedback control. Then such topics in the field of quantum robust control as H ∞ control, sliding mode control, quantum risk-sensitive control, and quantum ensemble control are reviewed. The paper concludes with a perspective of future research directions that are likely to attract more attention. PMID:23997680

  12. Selected Aspects Of The Risk In The Supply Chain In Context Of The Supplier Quality Management

    NASA Astrophysics Data System (ADS)

    Koblen, Ivan; Lestyánszka Škůrková, Katarína

    2015-06-01

    The introductory part of the paper underlines the importance of "Risk-based thinking" in the Quality Management System (QMS) and risk in the supply chain, as a principle part of the QMS. After introducing the key terms, the authors focused on the principle part of the article - explanation of the external and internal supply chain risks and the main factors concerning the supply risks, demand risks and environmental risks (as cardinal types of external supply chain risks) as well as the manufacturing and process risks, network/planning and control risks (as most important types of internal supply chain risks). The authors inform on the selected supply chain risk management tools, especially on those which are linked to the appropriate utilization of quality management tools.

  13. Use of Organic Nitrates and the Risk of Hip Fracture: A Population-Based Case-Control Study

    PubMed Central

    Pouwels, Sander; Lalmohamed, Arief; van Staa, Tjeerd; Cooper, Cyrus; Souverein, Patrick; Leufkens, Hubertus G.; Rejnmark, Lars; de Boer, Anthonius; Vestergaard, Peter; de Vries, Frank

    2010-01-01

    Context: Use of organic nitrates has been associated with increased bone mineral density. Moreover, a large Danish case-control study reported a decreased fracture risk. However, the association with duration of nitrate use, dose frequency, and impact of discontinuation has not been extensively studied. Objective: Our objective was to evaluate the association between organic nitrates and hip fracture risk. Methods: A case-control study was conducted using the Dutch PHARMO Record Linkage System (1991–2002, n = 6,763 hip fracture cases and 26,341 controls). Cases had their first admission for hip fracture, whereas controls had not sustained any fracture after enrollment. Current users of organic nitrates were patients who had received a prescription within 90 d before the index date. The analyses were adjusted for disease and drug history. Results: Current use of nitrates was not associated with a decreased risk of hip fracture [adjusted odds ratio (OR) = 0.93; 95% confidence interval (CI) = 0.83–1.04]. Those who used as-needed medication only had a lower risk of hip fracture (adjusted OR = 0.83; 95% CI = 0.63–1.08) compared with users of maintenance medication only (adjusted OR = 1.17; 95% CI = 0.97–1.40). No association was found between duration of nitrate use and fracture risk. Conclusions: Our overall analyses showed that risk of a hip fracture was significantly lower among users of as-needed organic nitrates, when compared with users of maintenance medication. Our analyses of hip fracture risks with duration of use did not further support a beneficial effect of organic nitrates on hip fracture, although residual confounding may have masked beneficial effects. PMID:20130070

  14. Use of organic nitrates and the risk of hip fracture: a population-based case-control study.

    PubMed

    Pouwels, Sander; Lalmohamed, Arief; van Staa, Tjeerd; Cooper, Cyrus; Souverein, Patrick; Leufkens, Hubertus G; Rejnmark, Lars; de Boer, Anthonius; Vestergaard, Peter; de Vries, Frank

    2010-04-01

    Use of organic nitrates has been associated with increased bone mineral density. Moreover, a large Danish case-control study reported a decreased fracture risk. However, the association with duration of nitrate use, dose frequency, and impact of discontinuation has not been extensively studied. Our objective was to evaluate the association between organic nitrates and hip fracture risk. A case-control study was conducted using the Dutch PHARMO Record Linkage System (1991-2002, n = 6,763 hip fracture cases and 26,341 controls). Cases had their first admission for hip fracture, whereas controls had not sustained any fracture after enrollment. Current users of organic nitrates were patients who had received a prescription within 90 d before the index date. The analyses were adjusted for disease and drug history. Current use of nitrates was not associated with a decreased risk of hip fracture [adjusted odds ratio (OR) = 0.93; 95% confidence interval (CI) = 0.83-1.04]. Those who used as-needed medication only had a lower risk of hip fracture (adjusted OR = 0.83; 95% CI = 0.63-1.08) compared with users of maintenance medication only (adjusted OR = 1.17; 95% CI = 0.97-1.40). No association was found between duration of nitrate use and fracture risk. Our overall analyses showed that risk of a hip fracture was significantly lower among users of as-needed organic nitrates, when compared with users of maintenance medication. Our analyses of hip fracture risks with duration of use did not further support a beneficial effect of organic nitrates on hip fracture, although residual confounding may have masked beneficial effects.

  15. Minimalist Running Shoes and Injury Risk Among United States Army Soldiers.

    PubMed

    Grier, Tyson; Canham-Chervak, Michelle; Bushman, Timothy; Anderson, Morgan; North, William; Jones, Bruce H

    2016-06-01

    Minimalist running shoes (MRS) are lightweight, are extremely flexible, and have little to no cushioning. It has been thought that MRS will enhance running performance and decrease injury risk. To compare physical characteristics, fitness performance, and injury risks associated with soldiers wearing MRS and those wearing traditional running shoes (TRS). Case series; Level of evidence, 4. Participants were men in a United States Army brigade (N = 1332). Physical characteristics and Army Physical Fitness Test data were obtained by survey. Fitness performance testing was administered at the brigade, and the types of footwear worn were identified by visual inspection. Shoe types were categorized into 2 groups: TRS (stability, cushioning, and motion control) and MRS. Injuries from the previous 12 months were obtained from the Defense Medical Surveillance System. A t test was used to determine mean differences between personal characteristics, training, and fitness performance metrics by shoe type. Hazard ratios and 95% CIs were calculated to determine injury risk by shoe type, controlling for other risk factors. A majority of soldiers wore cushioning shoes (57%), followed by stability shoes (24%), MRS (17%), and motion control shoes (2%). Soldiers wearing MRS were slightly younger than those wearing TRS (P < .01); performed more push-ups, sit-ups, and pull-ups (P < .01); and ran faster during the 2-mile run (P = .01). When other risk factors were controlled, there was no difference in injury risk for running shoe type between soldiers wearing MRS compared with TRS. Soldiers who chose to wear MRS were younger and had higher physical performance scores compared with soldiers wearing TRS. When these differences are controlled, use of MRS does not appear to be associated with higher or lower injury risk in this population. © 2016 The Author(s).

  16. Patients' Risk of Causing Traffic Violations and Traffic Accidents while Driving.

    PubMed

    Šestan, Nevenka; Dodič Fikfak, Metoda; Balantič, Zvone

    2017-09-01

    This study examines whether drivers suffering from epilepsy, chronic alcoholism and/or hazardous drinking, psychoactive substance abuse, other diseases of the nervous system, mental and behavioural disorders, cardiovascular diseases, severe diabetes, and severe eye diseases are at a greater risk of causing traffic accidents and traffic violations than drivers that cause accidents and violations without these diagnoses. A case control study was carried out. The cases were drivers checked by a special medical committee in the period observed suffering from the diseases listed above. Matched controls were taken from the cohort of those that caused accidents and violations during the same period observed. The descriptive statistics were followed by calculation of correlations, t-tests and χ 2 , and the odds ratio. Drivers with referrals for diseases of the nervous system are five times more likely to cause a traffic accident compared to controls (OR=5.18; 95% CI=2.59-10.34); in addition, a high risk is associated with drivers with mental and behavioural disorders (OR=3.64; 95% CI=1.91-6.94), drivers with epilepsy (OR=1.99; 95% CI=1.01-3.92), and drivers addicted to alcohol (OR=1.71; 95% CI=1.01-2.89). Drivers suffering from addiction, a disease of the nervous system, or epilepsy are more likely to cause a traffic accident, which is a contribution to the inconclusive findings of previous studies. The multiple reasons for risks of patients suffering from mental and behavioural disorders need to be further investigated. Copyright© by the National Institute of Public Health, Prague 2017

  17. A web-based personalized risk communication and decision-making tool for women with dense breasts: Design and methods of a randomized controlled trial within an integrated health care system.

    PubMed

    Knerr, Sarah; Wernli, Karen J; Leppig, Kathleen; Ehrlich, Kelly; Graham, Amanda L; Farrell, David; Evans, Chalanda; Luta, George; Schwartz, Marc D; O'Neill, Suzanne C

    2017-05-01

    Mammographic breast density is one of the strongest risk factors for breast cancer after age and family history. Mandatory breast density disclosure policies are increasing nationally without clear guidance on how to communicate density status to women. Coupling density disclosure with personalized risk counseling and decision support through a web-based tool may be an effective way to allow women to make informed, values-consistent risk management decisions without increasing distress. This paper describes the design and methods of Engaged, a prospective, randomized controlled trial examining the effect of online personalized risk counseling and decision support on risk management decisions in women with dense breasts and increased breast cancer risk. The trial is embedded in a large integrated health care system in the Pacific Northwest. A total of 1250 female health plan members aged 40-69 with a recent negative screening mammogram who are at increased risk for interval cancer based on their 5-year breast cancer risk and BI-RADS® breast density will be randomly assigned to access either a personalized web-based counseling and decision support tool or standard educational content. Primary outcomes will be assessed using electronic health record data (i.e., chemoprevention and breast MRI utilization) and telephone surveys (i.e., distress) at baseline, six weeks, and twelve months. Engaged will provide evidence about whether a web-based personalized risk counseling and decision support tool is an effective method for communicating with women about breast density and risk management. An effective intervention could be disseminated with minimal clinical burden to align with density disclosure mandates. Clinical Trials Registration Number:NCT03029286. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Application of QC_DR software for acceptance testing and routine quality control of direct digital radiography systems: initial experiences using the Italian Association of Physicist in Medicine quality control protocol.

    PubMed

    Nitrosi, Andrea; Bertolini, Marco; Borasi, Giovanni; Botti, Andrea; Barani, Adriana; Rivetti, Stefano; Pierotti, Luisa

    2009-12-01

    Ideally, medical x-ray imaging systems should be designed to deliver maximum image quality at an acceptable radiation risk to the patient. Quality assurance procedures are employed to ensure that these standards are maintained. A quality control protocol for direct digital radiography (DDR) systems is described and discussed. Software to automatically process and analyze the required images was developed. In this paper, the initial results obtained on equipment of different DDR manufacturers were reported. The protocol was developed to highlight even small discrepancies in standard operating performance.

  19. [Construction of occupational zoonoses control system at a zoo].

    PubMed

    Hori, Ai; Nakamura, Sachiko; Sotohira, Yukari; Iwano, Toshiro; Taniguchi, Hatsumi

    2006-12-01

    More than 200 diseases are known to be transmitable from animals to humans. These zoonotic infections (zoonoses) are considered as a major occupational health risk among zoo workers, including veterinarians and animal handlers. In order to prevent possible pathogen transmission, precaution measures for workers, visitors and animals are important, as well as institutional hygiene. Construction of a zoonoses control system at a zoo is presented in this report. There are two main components of this system: 1. routine disease prevention activity, 2. action planning for crisis. Workers, an operating officer, an occupational physician and a veterinarian from the zoo cooperated with infection control professionals from the local community.

  20. Risk Management Implementation Tool

    NASA Technical Reports Server (NTRS)

    Wright, Shayla L.

    2004-01-01

    Continuous Risk Management (CM) is a software engineering practice with processes, methods, and tools for managing risk in a project. It provides a controlled environment for practical decision making, in order to assess continually what could go wrong, determine which risk are important to deal with, implement strategies to deal with those risk and assure the measure effectiveness of the implemented strategies. Continuous Risk Management provides many training workshops and courses to teach the staff how to implement risk management to their various experiments and projects. The steps of the CRM process are identification, analysis, planning, tracking, and control. These steps and the various methods and tools that go along with them, identification, and dealing with risk is clear-cut. The office that I worked in was the Risk Management Office (RMO). The RMO at NASA works hard to uphold NASA s mission of exploration and advancement of scientific knowledge and technology by defining and reducing program risk. The RMO is one of the divisions that fall under the Safety and Assurance Directorate (SAAD). I worked under Cynthia Calhoun, Flight Software Systems Engineer. My task was to develop a help screen for the Continuous Risk Management Implementation Tool (RMIT). The Risk Management Implementation Tool will be used by many NASA managers to identify, analyze, track, control, and communicate risks in their programs and projects. The RMIT will provide a means for NASA to continuously assess risks. The goals and purposes for this tool is to provide a simple means to manage risks, be used by program and project managers throughout NASA for managing risk, and to take an aggressive approach to advertise and advocate the use of RMIT at each NASA center.

  1. The Association between Childhood Maltreatment Experiences and the Onset of Maltreatment Perpetration in Young Adulthood Controlling for Proximal and Distal Risk Factors

    PubMed Central

    Ben-David, Vered; Jonson-Reid, Melissa; Drake, Brett; Kohl, Patricia L.

    2015-01-01

    The evidence for association between child maltreatment victimization and later maltreatment perpetration is both scant and mixed. The objective of the present study was to assess the association between childhood maltreatment experiences and later perpetration of maltreatment in young adulthood controlling for proximal young adult functioning, prior youth risk behaviors, and childhood poverty. The study included 6935 low-income children with (n=4470) or without (n=2465) maltreatment reports prior to age 18 followed from ages 1.5 through11 years through early adulthood (ages 18-26). Administrative data from multiple regional and statewide agencies captured reports of maltreatment, family poverty and characteristics, system contact for health, behavioral risks and mental health in adolescence, and concurrent adult functioning (crime, mental health and poverty). After controlling for proximal adult functioning, repeated instances of neglect or mixed type maltreatment remained associated with young adult perpetration. Females and subjects with adolescent history of runaway, violent behaviors or non-violent delinquency also had higher risk. Greater caregiver education remained associated with reduced risk. The study concludes that prevention of recurrent neglect and mixed forms of maltreatment may reduce risk of maltreatment for future generations. Intervening to increase parental education and decrease adolescent risk behaviors may offer additional benefit. PMID:25682732

  2. Protocol for the 'e-Nudge trial': a randomised controlled trial of electronic feedback to reduce the cardiovascular risk of individuals in general practice [ISRCTN64828380

    PubMed Central

    Holt, Tim A; Thorogood, Margaret; Griffiths, Frances; Munday, Stephen

    2006-01-01

    Background Cardiovascular disease (including coronary heart disease and stroke) is a major cause of death and disability in the United Kingdom, and is to a large extent preventable, by lifestyle modification and drug therapy. The recent standardisation of electronic codes for cardiovascular risk variables through the United Kingdom's new General Practice contract provides an opportunity for the application of risk algorithms to identify high risk individuals. This randomised controlled trial will test the benefits of an automated system of alert messages and practice searches to identify those at highest risk of cardiovascular disease in primary care databases. Design Patients over 50 years old in practice databases will be randomised to the intervention group that will receive the alert messages and searches, and a control group who will continue to receive usual care. In addition to those at high estimated risk, potentially high risk patients will be identified who have insufficient data to allow a risk estimate to be made. Further groups identified will be those with possible undiagnosed diabetes, based either on elevated past recorded blood glucose measurements, or an absence of recent blood glucose measurement in those with established cardiovascular disease. Outcome measures The intervention will be applied for two years, and outcome data will be collected for a further year. The primary outcome measure will be the annual rate of cardiovascular events in the intervention and control arms of the study. Secondary measures include the proportion of patients at high estimated cardiovascular risk, the proportion of patients with missing data for a risk estimate, and the proportion with undefined diabetes status at the end of the trial. PMID:16646967

  3. Frequency-selective design of wireless power transfer systems for controlled access applications

    NASA Astrophysics Data System (ADS)

    Maschino, Tyler Stephen

    Wireless power transfer (WPT) has become a common way to charge or power many types of devices, ranging from cell phones to electric toothbrushes. WPT became popular through the introduction of a transmission mode known as strongly coupled magnetic resonance (SCMR). This means of transmission is non-radiative and enables mid-range WPT. Shortly after the development of WPT via SCMR, a group of researchers introduced the concept of resonant repeaters, which allows power to hop from the source to the device. These repeaters are in resonance with the WPT system, which enables them to propagate the power wirelessly with minimal losses to the environment. Resonant repeaters have rekindled the dream of ubiquitous wireless power. Inherent risks come with the realization of such a dream. One of the most prominent risks, which we set out in this thesis to address, is that of accessibility to the WPT system. We propose the incorporation of a controlled access schema within a WPT system to prevent unwarranted use of wireless power. Our thesis discusses the history of electromagnetism, examines the inception of WPT via SCMR, evaluates recent developments in WPT, and further elaborates on the controlled access schema we wish to contribute to the field.

  4. Preliminary design study of advanced composite blade and hub and nonmechanical control system for the tilt-rotor aircraft. Volume 1: Engineering studies

    NASA Technical Reports Server (NTRS)

    Alexander, H. R.; Smith, K. E.; Mcveigh, M. A.; Dixon, P. G.; Mcmanus, B. L.

    1979-01-01

    Composite structures technology is applied in a preliminary design study of advanced technology blades and hubs for the XV-15 tilt rotor research demonstrator aircraft. Significant improvements in XV-15 hover and cruise performance are available using blades designed for compatibility with the existing aircraft, i.e., blade installation would not require modification of the airframe, hub or upper controls. Provision of a low risk nonmechanical control system was also studied, and a development specification is given.

  5. Ground test experiment for large space structures

    NASA Technical Reports Server (NTRS)

    Tollison, D. K.; Waites, H. B.

    1985-01-01

    In recent years a new body of control theory has been developed for the design of control systems for Large Space Structures (LSS). The problems of testing this theory on LSS hardware are aggravated by the expense and risk of actual in orbit tests. Ground tests on large space structures can provide a proving ground for candidate control systems, but such tests require a unique facility for their execution. The current development of such a facility at the NASA Marshall Space Flight Center (MSFC) is the subject of this report.

  6. Diabetes Care and Treatment Project: A Diabetes Institute of the Walter Reed Health Care System and Joslin Telemedicine Initiative

    DTIC Science & Technology

    2007-04-01

    measures of behavior corresponding to the sub-sections in the BAT (construct validation). 3. To assess the relationship of scores on the BAT and HbA1c ...318:246-50. 33. The Diabetes Control and Complications Trial Research Group. The relationship of glycemic exposure ( HbA1c ) to the risk of...glycemic exposure ( HbA1c ) to the risk of development and progression of retinopathy in the Diabetes Control and Complications Trial. Diabetes 1995;44

  7. 77 FR 5155 - Interest Rate Risk Policy and Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-02

    ... directors and management; appropriate IRR measurement and monitoring systems; good internal controls; and informed decision-making based on IRR measurement system results. It also provides guidelines for... technical aspects of IRR measurement methods. Of these, some said Appendix B implied a preference for the...

  8. 77 FR 75679 - Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-21

    ... register, upon Commission approval, as an OTC derivatives dealer to develop and maintain an internal risk management system based on Value-at-Risk (``VaR'') models. It is anticipated that a total of four (4) broker..., Washington, DC 20549-0213. Extension: Appendix F to Rule 15c3-1; SEC File No. 270-440; OMB Control No. 3235...

  9. Community context and sub-neighborhood scale detail to explain dengue, chikungunya and Zika patterns in Cali, Colombia.

    PubMed

    Krystosik, Amy R; Curtis, Andrew; Buritica, Paola; Ajayakumar, Jayakrishnan; Squires, Robert; Dávalos, Diana; Pacheco, Robinson; Bhatta, Madhav P; James, Mark A

    2017-01-01

    Cali, Colombia has experienced chikungunya and Zika outbreaks and hypoendemic dengue. Studies have explained Cali's dengue patterns but lack the sub-neighborhood-scale detail investigated here. Spatial-video geonarratives (SVG) with Ministry of Health officials and Community Health Workers were collected in hotspots, providing perspective on perceptions of why dengue, chikungunya and Zika hotspots exist, impediments to control, and social outcomes. Using spatial video and Google Street View, sub-neighborhood features possibly contributing to incidence were mapped to create risk surfaces, later compared with dengue, chikungunya and Zika case data. SVG captured insights in 24 neighborhoods. Trash and water risks in Calipso were mapped using SVG results. Perceived risk factors included proximity to standing water, canals, poverty, invasions, localized violence and military migration. These risks overlapped case density maps and identified areas that are suitable for transmission but are possibly underreporting to the surveillance system. Resulting risk maps with local context could be leveraged to increase vector-control efficiency- targeting key areas of environmental risk.

  10. Governance of innovation and appropriateness of hospitalization for high-risk pregnancy: the TOCOMAT system.

    PubMed

    Tagliaferri, Salvatore; Ippolito, Adelaide; Cuccaro, Patrizia; Annunziata, Maria Laura; Campanile, Marta; Di Lieto, Andrea

    2013-07-01

    Over the last 30 years, a great increase in the application of technologies in public health, with an undisputed impact on both the effectiveness of performance and the investment and management costs, has occurred. This evidence has induced the development of assessment tools to clarify the relationships among resources, outputs, and outcomes of technological innovations. This analysis was developed in order to examine the use of a telematic system for reporting remotely transmitted cardiotocographic traces, specifically (1) its impact on the health organization and on the appropriateness of the care setting used and (2) the efficiency of its adoption in a regional network. We adopted a case-control study on patients' medical records during the first 4 months of 2009, 2010, and 2011 and a cost analysis of resources used for the creation of a computerized telecardiotocography network connecting eight peripheral areas to the operations center. The case-control study showed a reduction in the average hospital stay days for high-risk patients (1.32) and for low-risk patient (1.7) with a total of cost savings of €89,628 for high-risk patients and €170,170 for low-risk patients. The cost savings of the regional network was €20,769.04. The adoption of a remote transmission system of cardiotocography provided a managerial and economic advantage in the reduction of inappropriate admissions for prepartum symptoms and an improvement in the admission indicators (hospital stay days).

  11. Functional polymorphisms in the CYP2C19 gene contribute to digestive system cancer risk: evidence from 11,042 subjects.

    PubMed

    Zhou, Bo; Song, Zhenshun; Qian, Mingping; Li, Liang; Gong, Jian; Zou, Shaowu

    2013-01-01

    CYP2C19 belongs to the cytochrome P450 superfamily of enzymes involved in activating and detoxifying many carcinogens and endogenous compounds, which has attracted considerable attention as a candidate gene for digestive system cancer. CYP2C19 has two main point mutation sites (CYP2C19*2, CYP2C19*3) leading to poor metabolizer (PM) phenotype. In the past decade, the relationship between CYP2C19 polymorphism and digestive system cancer has been reported in various ethnic groups; however, these studies have yielded contradictory results. To clarify this inconsistency, we performed this meta-analysis. Databases including Pubmed, EMBASE, Web of Science and China National Knowledge Infrastructure (CNKI) were searched to find relevant studies. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of association. In total, 18 studies with 4,414 cases and 6,628 controls were included. Overall, significantly elevated digestive system cancer risk was associated CYP2C19 PM with OR of 1.66 (95%CI: 1.31-2.10, P<10(-5)) when all studies were pooled into the meta-analysis. There was strong evidence of heterogeneity (P = 0.006), which largely disappeared after stratification by cancer type. In the stratified analyses according to cancer type, ethnicity, control source and sample size, significantly increased risks were found. In summary, our meta-analysis suggested that the PM phenotype caused by the variation on CYP2C19 gene is associated with increased risk of digestive system cancer, especially in East Asians.

  12. Exploration Systems Development (ESD) Approach to Enterprise Risk Management

    NASA Technical Reports Server (NTRS)

    Bauder, Stephen P.

    2014-01-01

    The National Aeronautics and Space Administration (NASA) Exploration Systems Development (ESD) Division has implemented an innovative approach to Enterprise Risk Management under a unique governance structure and streamlined integration model. ESD's mission is to design and build the capability to extend human existence to deep space. The Enterprise consists of three Programs: Space Launch System (SLS), Orion, and Ground Systems Development and Operations (GSDO). The SLS is a rocket and launch system that will be capable of powering humans, habitats, and support systems to deep space. Orion will be the first spacecraft in history capable of taking humans to multiple destinations within deep space. GSDO is modernizing Kennedy's spaceport to launch spacecraft built and designed by both NASA and private industry. ESD's approach to Enterprise Risk Management is commensurate with affordability and a streamlined management philosophy. ESD Enterprise Risk Management leverages off of the primary mechanisms for integration within the Enterprise. The Enterprise integration approach emphasizes delegation of authority to manage and execute the majority of cross-program activities and products to the individual Programs, while maintaining the overall responsibility for all cross-program activities at the Division. The intent of the ESD Enterprise Risk Management approach is to improve risk communication, to avoid replication and/or contradictory strategies, and to minimize overhead process burden. This is accomplished by the facilitation and integration of risk information within ESD. The ESD Division risks, Orion risks, SLS risks, and GSDO risks are owned and managed by the applicable Program. When the Programs have shared risks with multiple consequences, they are jointly owned and managed. When a risk is associated with the integrated system that involves more than one Program in condition, consequence, or mitigation plan, it is considered an Exploration Systems Integration (ESI) Risk. An ESI risk may require visibility and risk handling by multiple organizations. The Integrated Risk Working Group (IRWG) is a small team of Risk experts that are responsible for collaborating and communicating best practices. In addition, the forum facilitates proper integration of risks across the Enterprise. The IRWG uses a Continuous Risk Management approach for facilitating the identification, analysis, planning, tracking, and controlling of ESI Risks. The ESD Division, Programs, and Integrated Task Teams identify ESI Risks. The IRWG maintains a set of metrics for understanding Enterprise Risk process and the overall Risk Posture. The team is also actively involved in the modeling of risk for Enterprise Performance Management. With the Enterprise being constrained in Schedule and Budget, and with significant technical complexity, the appropriate use of Risk Management techniques is crucial to the success of the Enterprise. The IRWG achieves this through the modified approach, providing a forum for collaboration on risks that cross boundaries between the separate entities.

  13. The potential for health risks from intrusion of contaminants into the distribution system from pressure transients.

    PubMed

    LeChevallier, Mark W; Gullick, Richard W; Karim, Mohammad R; Friedman, Melinda; Funk, James E

    2003-03-01

    The potential for public health risks associated with intrusion of contaminants into water supply distribution systems resulting from transient low or negative pressures is assessed. It is shown that transient pressure events occur in distribution systems; that during these negative pressure events pipeline leaks provide a potential portal for entry of groundwater into treated drinking water; and that faecal indicators and culturable human viruses are present in the soil and water exterior to the distribution system. To date, all observed negative pressure events have been related to power outages or other pump shutdowns. Although there are insufficient data to indicate whether pressure transients are a substantial source of risk to water quality in the distribution system, mitigation techniques can be implemented, principally the maintenance of an effective disinfectant residual throughout the distribution system, leak control, redesign of air relief venting, and more rigorous application of existing engineering standards. Use of high-speed pressure data loggers and surge modelling may have some merit, but more research is needed.

  14. Opportunities for improving risk communication during the permitting process for entomophagous biological control agents: A review of current systems

    USDA-ARS?s Scientific Manuscript database

    Concerns about potentially irreversible non-target impacts from the importation and release of entomophagous biological control agents (BCAs) have resulted in increasingly stringent import requirements by National Plant Protection Organizations. Despite numerous scientific publications on the poten...

  15. Trends in Nuclear Proliferation, 1975-1995. Projections, Problems, and Policy Options

    DTIC Science & Technology

    1976-05-15

    Communications and Services Section, Washington, DC 20451. AUTHORITY usacda ltr, 18 may 1978 THIS PAGE IS UNCLASSIFIED TOHIS REPORT HAS BEEN DELIMITED AND CLEARED...Bureaucratic Politics .. .. .. ... . .. ... .... 88 Command, Control, and Communication .. .. .. ... . .... 89 Controlling Against Unauthorized or...survivable command, control, and communication system may well exceed the resources of many Nth countries, Preemptive pressures and the risk of

  16. Identifying and Mitigating the Impact of the Budget Control Act on High Risk Sectors and Tiers of the Defense Industrial Base: Assessment Approach to Industrial Base Risks

    DTIC Science & Technology

    2016-04-30

    Ü~åÖÉ= - 351 - products, similar to those found in a bill of material. Figure 3 provides an example of the relationship between sectors , sub- sectors ...defense aircraft. Defense aircraft are divided in three main sub- sectors : fixed-wing, rotary wing, and unmanned systems. The fixed-wing sub- sector ...Risk Sectors and Tiers of the Defense Industrial Base: Assessment Approach to Industrial Base Risks Lirio Avilés, Engineer, MIBP, OUSD(AT&L) Sally

  17. Apoptosis in the homeostasis of the immune system and in human immune mediated diseases.

    PubMed

    Giovannetti, A; Pierdominici, M; Di Iorio, A; Cianci, R; Murdaca, G; Puppo, F; Pandolfi, F; Paganelli, R

    2008-01-01

    The immune system has evolved sophisticated mechanisms controlling the development of responses to dangerous antigens while avoiding unnecessary attacks to innocuous, commensal or self antigens. The risk of autoimmunity is continuously checked and balanced against the risk of succumbing to exogenous infectious agents. It is therefore of paramount importance to understand the molecular events linking the breakdown of tolerance and the development of immunodeficiency. Apoptotic mechanisms are used to regulate the development of thymocytes, the shaping of T cell repertoire, its selection and the coordinate events leading to immune responses in the periphery. Moreover, they are at the heart of the homeostatic controls restoring T cell numbers and establishing T cell memory. T lymphocytes shift continuously from survival to death signals to ensure immune responsiveness without incurring in autoimmune damage. In this review we shall consider some key facts on the relationship of lymphopenia to autoreactivity, the mechanisms controlling positive and negative selection in the thymus, the role of apoptosis in selected primary immunodeficiency states and in systemic and organ-specific autoimmunity, with examples from human diseases and their animal models.

  18. Pre- and perinatal risk factors for childhood leukaemia and other malignancies: a Scottish case control study

    PubMed Central

    McKinney, P A; Juszczak, E; Findlay, E; Smith, K; Thomson, C S

    1999-01-01

    A case control study of Scottish children aimed to identify risk factors for leukaemia and other cancers operating in the prenatal environment, during delivery and neonatally. Cases (0–14 years) were age-and sex- matched to two population-based controls and details abstracted from the mother's hospital obstetric notes. Analyses of 144 leukaemias (124 acute lymphoblastic leukaemias (ALL)), 45 lymphomas, 75 central nervous system (CNS) tumours and 126 ‘other solid tumours’ were conducted using conditional logistic regression. The presence of a neonatal infection significantly reduced the risk of ALL (odds ratio (OR) 0.49, 95% confidence interval (CI) 0.26–0.95), particularly in 0- to 4-year-olds. Positive swab tests confirmed 47% of ALL cases with any infection and 46% of controls. This is consistent with the hypothesis that early exposure to infections may reduce the risk of childhood ALL. Asphyxia at birth significantly increased the risk of leukaemia, which was accounted for by ALL. For the ‘other solid tumours’ higher levels of maternal education were inversely associated with risk (OR 0.59, 95% CI 0.37–0.94) but positively associated with antibiotics (OR 2.16 95% CI 1.10–4.25) and respiratory tract infections (OR 14.1, 95% CI 1.76–113.7) in pregnancy. No obvious plausible patterns of risk were detected either within or across disease subgroups. © 1999 Cancer Research Campaign PMID:10468308

  19. Association between zolpidem use and glaucoma risk: a Taiwanese population-based case-control study.

    PubMed

    Ho, Yi-Hao; Chang, Yue-Cune; Huang, Wei-Cheng; Chen, Hsin-Yi; Lin, Che-Chen; Sung, Fung-Chang

    2015-01-01

    To date, the relationship between zolpidem use and subsequent risk of glaucoma in a Taiwanese population has not been assessed. We used data from the National Health Insurance system to investigate whether zolpidem use was related to glaucoma risk. A 1:4 matched case-control study was conducted. The cases were patients newly diagnosed with glaucoma from 2001 to 2010. The controls were randomly selected non-glaucoma subjects matched by sex and age (± 5 years). Zolpidem exposure and/or the average dosage of zolpidem used (mg/year) were evaluated. Medical comorbidities were considered as confounding factors. Multiple logistic regression models were used to evaluate the potential risk of zolpidem exposure on glaucoma with/without adjustment for the effects of confounding variables. The exposure rate of zolpidem use in the glaucoma group was significantly higher than that of the control group (2.8% vs. 2.0%, P < 0.0001). The adjusted odds ratio (OR) of the risk of glaucoma for those with zolpidem use vs. those without was 1.19 (95% confidence interval [CI], 1.02-1.38). Compared to non-zolpidem users, zolpidem users with an average dose of more than 200 mg/year had significantly increased risk of glaucoma (OR 1.31, 95% CI 1.03-1.68). This study suggests that the use of zolpidem might increase the risk of subsequent glaucoma. Further confirmatory studies are recommended to clarify this important issue.

  20. Association Between Zolpidem Use and Glaucoma Risk: A Taiwanese Population-Based Case-Control Study

    PubMed Central

    Ho, Yi-Hao; Chang, Yue-Cune; Huang, Wei-Cheng; Chen, Hsin-Yi; Lin, Che-Chen; Sung, Fung-Chang

    2015-01-01

    Background To date, the relationship between zolpidem use and subsequent risk of glaucoma in a Taiwanese population has not been assessed. Methods We used data from the National Health Insurance system to investigate whether zolpidem use was related to glaucoma risk. A 1:4 matched case-control study was conducted. The cases were patients newly diagnosed with glaucoma from 2001 to 2010. The controls were randomly selected non-glaucoma subjects matched by sex and age (±5 years). Zolpidem exposure and/or the average dosage of zolpidem used (mg/year) were evaluated. Medical comorbidities were considered as confounding factors. Multiple logistic regression models were used to evaluate the potential risk of zolpidem exposure on glaucoma with/without adjustment for the effects of confounding variables. Results The exposure rate of zolpidem use in the glaucoma group was significantly higher than that of the control group (2.8% vs. 2.0%, P < 0.0001). The adjusted odds ratio (OR) of the risk of glaucoma for those with zolpidem use vs. those without was 1.19 (95% confidence interval [CI], 1.02–1.38). Compared to non-zolpidem users, zolpidem users with an average dose of more than 200 mg/year had significantly increased risk of glaucoma (OR 1.31, 95% CI 1.03–1.68). Conclusions This study suggests that the use of zolpidem might increase the risk of subsequent glaucoma. Further confirmatory studies are recommended to clarify this important issue. PMID:25720944

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