Risk evaluation and monitoring in multiple sclerosis therapeutics.

Science.gov (United States)

Clanet, Michel C; Wolinsky, Jerry S; Ashton, Raymond J; Hartung, Hans-Peter; Reingold, Stephen C

2014-09-01

Risk for multiple sclerosis (MS) disease-modifying therapies (DMT) must be assessed on an ongoing basis. Early concerns regarding the first-approved DMTs for MS have been mitigated, but recently licensed therapies have been linked to possibly greater risks. The objective of this review is to discuss risk assessment in MS therapeutics based on an international workshop and comprehensive literature search and recommend strategies for risk assessment/monitoring. Assessment and perception of therapeutic risks vary between patients, doctors and regulators. Acceptability of risk depends on the magnitude of risk and the demonstrated clinical benefits of any agent. Safety signals must be distinguishable from chance occurrences in a clinical trial and in long-term use of medications. Post-marketing research is crucial for assessing longer-term safety in large patient cohorts. Reporting of adverse events is becoming more proactive, allowing more rapid identification of risks. Communication about therapeutic risks and their relationship to clinical benefit must involve patients in shared decision making. It is difficult to produce a general risk-assessment algorithm for all MS therapies. Specific algorithms are required for each DMT in every treated-patient population. New and evolving risks must be evaluated and communicated rapidly to allow patients and physicians to be well informed and able to share treatment decisions. © The Author(s) 2013.

A Benefit-Risk Analysis Approach to Capture Regulatory Decision-Making: Multiple Myeloma.

Science.gov (United States)

Raju, G K; Gurumurthi, Karthik; Domike, Reuben; Kazandjian, Dickran; Landgren, Ola; Blumenthal, Gideon M; Farrell, Ann; Pazdur, Richard; Woodcock, Janet

2018-01-01

Drug regulators around the world make decisions about drug approvability based on qualitative benefit-risk analysis. In this work, a quantitative benefit-risk analysis approach captures regulatory decision-making about new drugs to treat multiple myeloma (MM). MM assessments have been based on endpoints such as time to progression (TTP), progression-free survival (PFS), and objective response rate (ORR) which are different than benefit-risk analysis based on overall survival (OS). Twenty-three FDA decisions on MM drugs submitted to FDA between 2003 and 2016 were identified and analyzed. The benefits and risks were quantified relative to comparators (typically the control arm of the clinical trial) to estimate whether the median benefit-risk was positive or negative. A sensitivity analysis was demonstrated using ixazomib to explore the magnitude of uncertainty. FDA approval decision outcomes were consistent and logical using this benefit-risk framework. © 2017 American Society for Clinical Pharmacology and Therapeutics.

Multiple zone power forwards. A value at risk framework

International Nuclear Information System (INIS)

Demers, Jean-Guy

2009-01-01

Over the 1990s, deregulated power markets in New-England provided zones with fluctuating spot prices. Such prices have a notoriously high volatility, owing to the difficulty of storing electrical energy and the delays needed to adjust generation levels. In this context, forward contracts have become increasingly popular and understanding their dynamic is a problem facing many market players. This paper proposes a parsimonious parametric model, based on the price series of all n-month forward contracts (n = 1,2,3..), encompassing multiple zones. The model is then used for value at risk forecasts, which are backtested and compared with the ones in use by the risk management unit of an important electricity producer. Extensions to include natural gas and power-relevant oil-based future markets are discussed. (author)

Risks of multiple sclerosis in relatives of patients in Flanders, Belgium

NARCIS (Netherlands)

Carton, H; Vlietinck, R; Debruyne, J; DeKeyser, J; DHooghe, MB; Loos, R; Medaer, R; Truyen, L; Yee, IML; Sadovnick, AD

Objectives - To calculate age adjusted risks for multiple sclerosis in relatives of Flemish patients with multiple sclerosis. Methods - Lifetime risks were calculated using the maximum likelihood approach. Results - Vital information was obtained on 674 probands with multiple sclerosis in Flanders

Diagnostic x-ray procedures and risk of leukemia, lymphoma, and multiple myeloma

International Nuclear Information System (INIS)

Boice, J.D. Jr.; Morin, M.M.; Glass, A.G.; Friedman, G.D.; Stovall, M.; Hoover, R.N.; Fraumeni, J.F. Jr.

1991-01-01

Exposure to diagnostic x-rays and the risk of leukemia, non-Hodgkin's lymphoma (NHL), and multiple myeloma were studied within two prepaid health plans. Adult patients with leukemia (n = 565), NHL (n = 318), and multiple myeloma (n = 208) were matched to controls (n = 1390), and over 25,000 x-ray procedures were abstracted from medical records. Dose response was evaluated by assigning each x-ray procedure a score based on estimated bone marrow dose. X-ray exposure was not associated with chronic lymphocytic leukemia, one of the few malignant conditions never linked to radiation (relative risk [RR], 0.66). For all other forms of leukemia combined (n = 358), there was a slight elevation in risk (RR, 1.17) but no evidence of a dose-response relationship when x-ray procedures near the time of diagnosis were excluded. Similarly, patients with NHL were exposed to diagnostic x-ray procedures more often than controls (RR, 1.32), but the RR fell to 0.99 when the exposure to diagnostic x-ray procedures within 2 years of diagnosis was ignored. For multiple myeloma, overall risk was not significantly high (RR, 1.14), but there was consistent evidence of increasing risk with increasing numbers of diagnostic x-ray procedures. These data suggest that persons with leukemia and NHL undergo x-ray procedures frequently just prior to diagnosis for conditions related to the development or natural history of their disease. There was little evidence that diagnostic x-ray procedures were causally associated with leukemia or NHL. The risk for multiple myeloma, however, was increased among those patients who were frequently exposed to x-rays

STakeholder-Objective Risk Model (STORM): Determiningthe aggregated risk of multiple contaminant hazards in groundwater well catchments

DEFF Research Database (Denmark)

Enzenhoefer, R.; Binning, Philip John; Nowak, W.

2015-01-01

Risk is often defined as the product of probability, vulnerability and value. Drinking water supply from groundwater abstraction is often at risk due to multiple hazardous land use activities in the well catchment. Each hazard might or might not introduce contaminants into the subsurface at any......-pathway-receptor concept, mass-discharge-based aggregation of stochastically occuring spill events, accounts for uncertainties in the involved flow and transport models through Monte Carlo simulation, and can address different stakeholder objectives. We illustrate the application of STORM in a numerical test case inspired...

Infectious mononucleosis and multiple sclerosis - Updated review on associated risk.

Science.gov (United States)

Sheik-Ali, Sharaf

2017-05-01

There has been substantial evidence accumulating on the role of infectious mononucleosis (IM) and the subsequent risk of obtaining Multiple Sclerosis (MS). Up to date studies not previously explored were reviewed by the author to further clarify the association. Medline and Web of Science were searched with no time constraints for articles exploring an association between Multiple Sclerosis and Infectious Mononucleosis. 24 articles were found, totalling 1063 cases and 13,227 cohort/controls. 23/24 (96%) articles reported a significant association of Infectious Mononucleosis on the risk of subsequent multiple sclerosis. Overall, new literature on IM and risk of MS categorically supports the association. Future work should focus on other risk factors such as age and gender on IM and subsequent risk of MS. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Sibship characteristics and risk of multiple sclerosis

DEFF Research Database (Denmark)

Bager, P.; Nielsen, N.M.; Bihrmann, K.

2006-01-01

sibling, or exposure to younger siblings under 2 years of age and risk of MS later in life. There was no association of MS risk with multiple birth (vs. singleton birth) or with the age of the mother or father at birth. These results do not lend support to the hypothesis that number of older siblings......It has been hypothesized that age at infection with a common microbial agent may be associated with the risk of multiple sclerosis (MS). The authors addressed this hypothesis by using number of older siblings and other sibship characteristics as an approximation of age at exposure to common...... Sclerosis Register. The cohort of 1.9 million Danes was followed for 28.1 million person-years; during that time, 1,036 persons developed MS. Overall, there was no association between number of older siblings, number of younger siblings, total number of siblings, age distance from the nearest younger...

Adaptation of a Counseling Intervention to Address Multiple Cancer Risk Factors among Overweight/Obese Latino Smokers

Science.gov (United States)

Castro, Yessenia; Fernández, Maria E.; Strong, Larkin L.; Stewart, Diana W.; Krasny, Sarah; Hernandez Robles, Eden; Heredia, Natalia; Spears, Claire A.; Correa-Fernández, Virmarie; Eakin, Elizabeth; Resnicow, Ken; Basen-Engquist, Karen; Wetter, David W.

2015-01-01

More than 60% of cancer-related deaths in the United States are attributable to tobacco use, poor nutrition, and physical inactivity, and these risk factors tend to cluster together. Thus, strategies for cancer risk reduction would benefit from addressing multiple health risk behaviors. We adapted an evidence-based intervention grounded in social…

Childhood body mass index and multiple sclerosis risk

DEFF Research Database (Denmark)

Munger, Kassandra L; Bentzen, Joan; Laursen, Bjarne

2013-01-01

BACKGROUND: Obesity in late adolescence has been associated with an increased risk of multiple sclerosis (MS); however, it is not known if body size in childhood is associated with MS risk. METHODS: Using a prospective design we examined whether body mass index (BMI) at ages 7-13 years...

Is Hypovitaminosis D One of the Environmental Risk Factors for Multiple Sclerosis?

Science.gov (United States)

Pierrot-Deseilligny, Charles; Souberbielle, Jean-Claude

2010-01-01

The role of hypovitaminosis D as a possible risk factor for multiple sclerosis is reviewed. First, it is emphasized that hypovitaminosis D could be only one of the risk factors for multiple sclerosis and that numerous other environmental and genetic risk factors appear to interact and combine to trigger the disease. Secondly, the classical…

Approach to proliferation risk assessment based on multiple objective analysis framework

Energy Technology Data Exchange (ETDEWEB)

Andrianov, A.; Kuptsov, I. [Obninsk Institute for Nuclear Power Engineering of NNRU MEPhI (Russian Federation); Studgorodok 1, Obninsk, Kaluga region, 249030 (Russian Federation)

2013-07-01

The approach to the assessment of proliferation risk using the methods of multi-criteria decision making and multi-objective optimization is presented. The approach allows the taking into account of the specifics features of the national nuclear infrastructure, and possible proliferation strategies (motivations, intentions, and capabilities). 3 examples of applying the approach are shown. First, the approach has been used to evaluate the attractiveness of HEU (high enriched uranium)production scenarios at a clandestine enrichment facility using centrifuge enrichment technology. Secondly, the approach has been applied to assess the attractiveness of scenarios for undeclared production of plutonium or HEU by theft of materials circulating in nuclear fuel cycle facilities and thermal reactors. Thirdly, the approach has been used to perform a comparative analysis of the structures of developing nuclear power systems based on different types of nuclear fuel cycles, the analysis being based on indicators of proliferation risk.

Approach to proliferation risk assessment based on multiple objective analysis framework

International Nuclear Information System (INIS)

Andrianov, A.; Kuptsov, I.

2013-01-01

The approach to the assessment of proliferation risk using the methods of multi-criteria decision making and multi-objective optimization is presented. The approach allows the taking into account of the specifics features of the national nuclear infrastructure, and possible proliferation strategies (motivations, intentions, and capabilities). 3 examples of applying the approach are shown. First, the approach has been used to evaluate the attractiveness of HEU (high enriched uranium)production scenarios at a clandestine enrichment facility using centrifuge enrichment technology. Secondly, the approach has been applied to assess the attractiveness of scenarios for undeclared production of plutonium or HEU by theft of materials circulating in nuclear fuel cycle facilities and thermal reactors. Thirdly, the approach has been used to perform a comparative analysis of the structures of developing nuclear power systems based on different types of nuclear fuel cycles, the analysis being based on indicators of proliferation risk

Multiple Sex Partner and Risk Behaviour Among Secondary School ...

African Journals Online (AJOL)

Tanzania is realizing increase in adolescents engaged in multiple sex partner behaviour and premarital sex. The objective of this study was to assess the awareness of multiple sex partner behaviour and risk factors among secondary school students in Moshi, Tanzania. Anonymously, questionnaires were completed by 360 ...

Risk of Multiple Sclerosis in Patients with Psoriasis

DEFF Research Database (Denmark)

Egeberg, Alexander; Mallbris, Lotus; Gislason, Gunnar Hilmar

2016-01-01

Psoriasis and multiple sclerosis (MS) are inflammatory disorders with similarities in genetic risk variants and inflammatory pathways. Limited evidence is available on the relationship between the two diseases. We therefore investigated the risk of incident (new-onset) MS in patients with mild...

Risk Prediction Models for Other Cancers or Multiple Sites

Science.gov (United States)

Developing statistical models that estimate the probability of developing other multiple cancers over a defined period of time will help clinicians identify individuals at higher risk of specific cancers, allowing for earlier or more frequent screening and counseling of behavioral changes to decrease risk.

Concurrent multiple health risk behaviors among adolescents in Luangnamtha province, Lao PDR

Directory of Open Access Journals (Sweden)

Thomsen Sarah

2011-01-01

Full Text Available Abstract Background Multiple health risk behaviors (HRBs among adolescents pose a threat to their health, including HIV/AIDS. Health risk behaviors such as alcohol use, smoking, substance use, and sexual risk behaviors among youth have been shown to co-occur with each others. The objectives of this study was to estimate the prevalence of single and concurrent health risk behaviors and to explore how health risk behavior is associated with socio-demographic factors and peers' behaviors. Methods A cross sectional design was used to examine health risk behaviors of adolescents between the age 14 and 19 years living in the Luangnamtha province, Lao PDR. The study was conducted between June and August, 2008. An ordinal logistic regression model that simultaneously explored demographic factors and the influence of the behavior of peers on three categories of multiple HRBs (no risk, one risk, and two or more health risk behaviors was performed. Results A total of 1360 respondents, 669 (49.1% boys with mean age 16.7 ± 1.6 and 699 (50.9% girls aged 16.1 ± 1.5 were recruited into the study. The majority reported two or fewer risk behaviors. However, multiple risk behaviors increased with age for both sexes. About 46.8% (n = 637 reported no risk, 39.3 percent (n = 535 reported one risk, 8.1 percent (n = 110 reported two risks, and 5.8 percent reported more than two health risk behaviors. The protective factors among boys were school attendance (OR = .53, CI = .33-.86, being Hmong and Yao ethnicity (OR = .48, CI-.26-.90, while being above the age of 15 (OR = 2.20, 95% CI = 1.33-3.60, Akha ethnicity (OR = 2.20, 95% CI = 1.04-4.61, peer's smoking (OR = 3.11, 95% CI = 2.1-4.6, and peer's drinking alcohol (OR = 1.88, 95% CI = 1.1-3.21 were significantly associated with the presence of multiple risk behaviors among boys. Having some education (OR = 0.17, 95% CI = 0.06-0.45, and being of Hmong and Yao ethnicity (OR = 0.38, 95% CI = 0.18-0.80 were factors that

Effects of Comprehensive, Multiple High-Risk Behaviors Prevention Program on High School Students

Science.gov (United States)

Collier, Crystal

2013-01-01

The purpose of this mixed methods study was to examine the effect of a multiple high-risk behaviors prevention program applied comprehensively throughout an entire school-system involving universal, selective, and indicated levels of students at a local private high school during a 4-year period. The prevention program was created based upon the…

Safety from physical viewpoint: ''two-risk model in multiple risk problem''

International Nuclear Information System (INIS)

Kuz'Min, I.I.; Akimov, V.A.

1998-01-01

Full text of publication follows: the problem of safety provision for people and environment within the framework of a certain socio-economic system (SES) as a problem of managing a great number of interacting risks characterizing numerous hazards (natural, manmade, social, economic once, etc.) inherent in the certain SES has been discussed. From the physical point of view, it can be considered a problem of interaction of many bodies which has no accurate mathematical solution even if the laws of interaction of this bodies are known. In physics, to solve this problem, an approach based on the reduction of the above-mentioned problem of the problem of two-body interaction which can be solved accurately in mathematics has been used. The report presents a similar approach to the problem of risk management in the SES. This approach includes the subdivision of numerous hazards inherent within the framework of the SES into two classes of hazards, so that each of the classes could be considered an integrated whole one, each of them being characterized by the appropriate risk. Consequently, problem of 'multiple-risk' management (i.e. the problem of many bodies, as represented in physics) can be reduced to the 'two-risk' management problem (that is, to the problem two-bodies). Within the framework of the two-risk model the optimization of costs to reduce the two kinds of risk, that is, the risk inherent in the SES as a whole, as well as the risk potentially provoked by lots of activities to be introduced in the SES economy has been described. The model has made it possible to formulate and prove the theorem of equilibrium in risk management. Using the theorem, a relatively simple and practically applicable procedure of optimizing the threshold costs to reduce diverse kinds of risk has been elaborated. The procedure provides to assess the minimum value of the cost that can be achieved regarding the socio-economic factors typical of the SES under discussion. The aimed

Taking Multiple Exposure Into Account Can Improve Assessment of Chemical Risks.

Science.gov (United States)

Clerc, Frédéric; Bertrand, Nicolas Jean Hyacinthe; La Rocca, Bénédicte

2017-12-15

During work, operators may be exposed to several chemicals simultaneously. Most exposure assessment approaches only determine exposure levels for each substance individually. However, such individual-substance approaches may not correctly estimate the toxicity of 'cocktails' of chemicals, as the toxicity of a cocktail may differ from the toxicity of substances on their own. This study presents an approach that can better take into account multiple exposure when assessing chemical risks. Almost 30000 work situations, monitored between 2005 and 2014 and recorded in two French databases, were analysed using MiXie software. The algorithms employed in MiXie can identify toxicological classes associated with several substances, based on the additivity of the selected effects of each substance. The results of our retrospective analysis show that MiXie was able to identify almost 20% more potentially hazardous situations than identified using a single-substance approach. It therefore appears essential to review the ways in which multiple exposure is taken into account during risk assessment. © The Author(s) 2017. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

STakeholder-Objective Risk Model (STORM): Determining the aggregated risk of multiple contaminant hazards in groundwater well catchments

Science.gov (United States)

Enzenhoefer, R.; Binning, P. J.; Nowak, W.

2015-09-01

Risk is often defined as the product of probability, vulnerability and value. Drinking water supply from groundwater abstraction is often at risk due to multiple hazardous land use activities in the well catchment. Each hazard might or might not introduce contaminants into the subsurface at any point in time, which then affects the pumped quality upon transport through the aquifer. In such situations, estimating the overall risk is not trivial, and three key questions emerge: (1) How to aggregate the impacts from different contaminants and spill locations to an overall, cumulative impact on the value at risk? (2) How to properly account for the stochastic nature of spill events when converting the aggregated impact to a risk estimate? (3) How will the overall risk and subsequent decision making depend on stakeholder objectives, where stakeholder objectives refer to the values at risk, risk attitudes and risk metrics that can vary between stakeholders. In this study, we provide a STakeholder-Objective Risk Model (STORM) for assessing the total aggregated risk. Or concept is a quantitative, probabilistic and modular framework for simulation-based risk estimation. It rests on the source-pathway-receptor concept, mass-discharge-based aggregation of stochastically occuring spill events, accounts for uncertainties in the involved flow and transport models through Monte Carlo simulation, and can address different stakeholder objectives. We illustrate the application of STORM in a numerical test case inspired by a German drinking water catchment. As one may expect, the results depend strongly on the chosen stakeholder objectives, but they are equally sensitive to different approaches for risk aggregation across different hazards, contaminant types, and over time.

Multiple violence victimisation associated with sexual ill health and sexual risk behaviours in Swedish youth.

Science.gov (United States)

Blom, Helena; Högberg, Ulf; Olofsson, Niclas; Danielsson, Ingela

2016-01-01

To address the associations between emotional, physical and sexual violence, specifically multiple violence victimisation, and sexual ill health and sexual risk behaviours in youth, as well as possible gender differences. A cross-sectional population-based survey among sexually experienced youth using a questionnaire with validated questions on emotional, physical, and sexual violence victimisation, sociodemographics, health risk behaviours, and sexual ill health and sexual risk behaviours. Proportions, unadjusted/adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. The participants comprised 1192 female and 1021 male students aged 15 to 22 years. The females had experienced multiple violence (victimisation with two or three types of violence) more often than the males (21% vs. 16%). The associations between multiple violence victimisation and sexual ill health and sexual risk behaviours were consistent for both genders. Experience of/involvement in pregnancy yielded adjusted ORs of 2.4 (95% CI 1.5-3.7) for females and 2.1 (95% CI 1.3-3.4) for males, and early age at first intercourse 2.2 (95% CI 1.6-3.1) for females and 1.9 (95% CI 1.2-3.0) for males. No significantly raised adjusted ORs were found for non-use of contraceptives in young men or young women, or for chlamydia infection in young men. Several types of sexual ill health and sexual risk behaviours are strongly associated with multiple violence victimisation in both genders. This should be taken into consideration when counselling young people and addressing their sexual and reproductive health.

Blended Risk Approach in Applying PSA Models to Risk-Based Regulations

International Nuclear Information System (INIS)

Dimitrijevic, V. B.; Chapman, J. R.

1996-01-01

In this paper, the authors will discuss a modern approach in applying PSA models in risk-based regulation. The Blended Risk Approach is a combination of traditional and probabilistic processes. It is receiving increased attention in different industries in the U. S. and abroad. The use of the deterministic regulations and standards provides a proven and well understood basis on which to assess and communicate the impact of change to plant design and operation. Incorporation of traditional values into risk evaluation is working very well in the blended approach. This approach is very application specific. It includes multiple risk attributes, qualitative risk analysis, and basic deterministic principles. In blending deterministic and probabilistic principles, this approach ensures that the objectives of the traditional defense-in-depth concept are not compromised and the design basis of the plant is explicitly considered. (author)

A Risk-based Assessment And Management Framework For Multipollutant Air Quality

OpenAIRE

Frey, H. Christopher; Hubbell, Bryan

2009-01-01

The National Research Council recommended both a risk- and performance-based multipollutant approach to air quality management. Specifically, management decisions should be based on minimizing the exposure to, and risk of adverse effects from, multiple sources of air pollution and that the success of these decisions should be measured by how well they achieved this objective. We briefly describe risk analysis and its application within the current approach to air quality management. Recommend...

A comparison of perinatal outcomes in singletons and multiples born after IVF or ICSI, stratified for neonatal risk criteria

NARCIS (Netherlands)

van Heesch, Mirjam M. J.; Evers, Johannes L. H.; Dumoulin, John C. M.; van der Hoeven, Mark A. H. B. M.; van Beijsterveldt, Catharina E. M.; Bonsel, Gouke J.; Dykgraaf, Ramon H. M.; van Goudoever, Johannes B.; Koopman-Esseboom, Corine; Nelen, Willianne L. D. M.; Steiner, Katerina; Tamminga, Pieter; Tonch, Nino; van Zonneveld, Piet; Dirksen, Carmen D.

2014-01-01

To compare perinatal singleton and multiple outcomes in a large Dutch in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) population and within risk subgroups. Newborns were assigned to a risk category based on gestational age, birthweight, Apgar score and congenital malformation.

Chronic periodontitis with multiple risk factor syndrome: a case report.

Science.gov (United States)

Shimoe, Masayuki; Yamamoto, Tadashi; Iwamoto, Yoshihiro; Shiomi, Nobuyuki; Maeda, Hiroshi; Nishimura, Fusanori; Takashiba, Shogo

2011-07-01

Multiple risk factor syndrome is a clustering of cardiovascular risk factors, such as diabetes, dyslipidemia, hypertension, and obesity associated epidemiologically with insulin resistance. This report describes the clinical course of a patient suffering from severe periodontitis with multiple risk factor syndrome, and discusses the association between periodontal infection and systemic health. The patient had a history of type 2 diabetes, dyslipidemia, and hypertension for over 10 years. At baseline, her hemoglobin A1 c was 8.1%. However, she had no diabetic complications except periodontitis. The IgG antibody titers against Porphyromonas gingivalis FDC 381 and SU63 were elevated above the mean of healthy subjects +2 standard deviations. Intensive periodontal treatment, including periodontal surgery, was performed to reduce periodontal infection and bacteremia. Her systemic and periodontal conditions were evaluated longitudinally for 10 years. Following periodontal treatment, antibody titers against Porphyromonas gingivalis and hemoglobin A1c values were significantly improved. The other clinical data and medication for her systemic condition also remained stable during supportive periodontal therapy. However, she developed myocardial infarction, and showed continuous deterioration of hemoglobin A1 c level and periodontitis. The long-term clustering of risk factors, such as diabetes, dyslipidemia, hypertension, and periodontitis, are associated with the development of myocardial infarction. Treatment of systemic conditions in combination with comprehensive periodontal treatment is important in management of patients with multiple risk factor syndrome.

Prevalence and risk of Down syndrome in monozygotic and dizygotic multiple pregnancies in Europe: implications for prenatal screening

DEFF Research Database (Denmark)

Boyle, B; Morris, J K; McConkey, R

2014-01-01

OBJECTIVE: To determine risk of Down syndrome (DS) in multiple relative to singleton pregnancies, and compare prenatal diagnosis rates and pregnancy outcome. DESIGN: Population-based prevalence study based on EUROCAT congenital anomaly registries. SETTING: Eight European countries. POPULATION: 14...

The risk of venous thromboembolism in patients with multiple sclerosis

DEFF Research Database (Denmark)

Peeters, P J H L; Bazelier, M T; Uitdehaag, B M J

2014-01-01

BACKGROUND: In patients with multiple sclerosis (MS), disability and autoinflammatory processes may result in an increased risk of venous thromboembolism (VTE) OBJECTIVE: To evaluate the risk of VTE associated with MS. METHODS: We conducted an observational-cohort study within the Clinical Practice...

War-related trauma exposure and multiple risk behaviors among school-going adolescents in Northern Uganda: the mediating role of depression symptoms.

Science.gov (United States)

Okello, James; Nakimuli-Mpungu, Etheldreda; Musisi, Seggane; Broekaert, Eric; Derluyn, Ilse

2013-11-01

The relationship between war-related trauma exposure, depressive symptoms and multiple risk behaviors among adolescents is less clear in sub-Saharan Africa. We analyzed data collected from a sample of school-going adolescents four years postwar. Participants completed interviews assessing various risk behaviors defined by the Youth Self Report (YSR) and a sexual risk behavior survey, and were screened for post-traumatic stress, anxiety and depression symptoms based on the Impact of Events Scale Revised (IESR) and Hopkins Symptom Checklist for Adolescents (HSCL-37A) respectively. Multivariate logistic regression was used to assess factors independently associated with multiple risk behaviors. The logistic regression model of Baron and Kenny (1986) was used to evaluate the mediating role of depression in the relationship between stressful war events and multiple risk behaviors. Of 551 participants, 139 (25%) reported multiple (three or more) risk behaviors in the past year. In the multivariate analyses, depression symptoms remained uniquely associated with multiple risk behavior after adjusting for potential confounders including socio-demographic characteristics, war-related trauma exposure variables, anxiety and post-traumatic stress symptoms. In mediation analysis, depression symptoms mediated the associations between stressful war events and multiple risk behaviors. The psychometric properties of the questionnaires used in this study are not well established in war affected African samples thus ethno cultural variation may decrease the validity of our measures. Adolescents with depression may be at a greater risk of increased engagement in multiple risk behaviors. Culturally sensitive and integrated interventions to treat and prevent depression among adolescents in post-conflict settings are urgently needed. © 2013 Elsevier B.V. All rights reserved.

Perceptions of risk in adults with a low or high risk profile of developing type 2 diabetes; a cross sectional population-bases study.

NARCIS (Netherlands)

Adriaanse, M.C.; Twisk, J.W.R.; Dekker, J.M.; Spijkerman, A.M.W.; Nijpels, G.; Heine, R.J.; Snoek, F.J.

2008-01-01

Objective: To compare the perceived seriousness and risk of type 2 diabetes among low risk with high risk profile non-diabetic subjects and examine the relationship of perceived risk with multiple self-reported risk indicators. Methods: A cross-sectional population-based study among 4435 low risk

The design, implementation and acceptability of an integrated intervention to address multiple behavioral and psychosocial risk factors among pregnant African American women

Directory of Open Access Journals (Sweden)

Rossi Maryann

2008-06-01

Full Text Available Abstract Background African American women are at increased risk for poor pregnancy outcomes compared to other racial-ethnic groups. Single or multiple psychosocial and behavioral factors may contribute to this risk. Most interventions focus on singular risks. This paper describes the design, implementation, challenges faced, and acceptability of a behavioral counseling intervention for low income, pregnant African American women which integrated multiple targeted risks into a multi-component format. Methods Six academic institutions in Washington, DC collaborated in the development of a community-wide, primary care research study, DC-HOPE, to improve pregnancy outcomes. Cigarette smoking, environmental tobacco smoke exposure, depression and intimate partner violence were the four risks targeted because of their adverse impact on pregnancy. Evidence-based models for addressing each risk were adapted and integrated into a multiple risk behavior intervention format. Pregnant women attending six urban prenatal clinics were screened for eligibility and risks and randomized to intervention or usual care. The 10-session intervention was delivered in conjunction with prenatal and postpartum care visits. Descriptive statistics on risk factor distributions, intervention attendance and length (i.e., with Results Forty-eight percent of women screened were eligible based on presence of targeted risks, 76% of those eligible were enrolled, and 79% of those enrolled were retained postpartum. Most women reported a single risk factor (61%; 39% had multiple risks. Eighty-four percent of intervention women attended at least one session (60% attended ≥ 4 sessions without disruption of clinic scheduling. Specific risk factor content was delivered as prescribed in 80% or more of the sessions; 78% of sessions were fully completed (where all required risk content was covered. Ninety-three percent of the subsample of intervention women had a positive view of their

Morphological characteristics associated with rupture risk of multiple intracranial aneurysms.

Science.gov (United States)

Wang, Guang-Xian; Liu, Lan-Lan; Wen, Li; Cao, Yun-Xing; Pei, Yu-Chun; Zhang, Dong

2017-10-01

To identify the morphological parameters that are related to intracranial aneurysms (IAs) rupture using a case-control model. A total of 107 patients with multiple IAs and aneurysmal subarachnoid hemorrhage between August 2011 and February 2017 were enrolled in this study. Characteristics of IAs location, shape, neck width, perpendicular height, depth, maximum size, flow angle, parent vessel diameter (PVD), aspect ratio (AR) and size ratio (SR) were evaluated using CT angiography. Multiple logistic regression analysis was used to identify the independent risk factors associated with IAs rupture. Receiver operating characteristic curve analysis was performed on the final model, and the optimal thresholds were obtained. IAs located in the internal carotid artery (ICA) was associated with a negative risk of rupture, whereas AR, SR1 (height/PVD) and SR2 (depth/PVD) were associated with increased risk of rupture. When SR was calculated differently, the odds ratio values of these factors were also different. The receiver operating characteristic curve showed that AR, SR1 and SR2 had cut-off values of 1.01, 1.48 and 1.40, respectively. SR3 (maximum size/PVD) was not associated with IAs rupture. IAs located in the ICA are associated with a negative risk of rupture, while high AR (>1.01), SR1 (>1.48) or SR2 (>1.40) are risk factors for multiple IAs rupture. Copyright © 2017 Hainan Medical University. Production and hosting by Elsevier B.V. All rights reserved.

Estimation of effective dose and lifetime attributable risk from multiple head CT scans in ventriculoperitoneal shunted children

International Nuclear Information System (INIS)

Aw-Zoretic, J.; Seth, D.; Katzman, G.; Sammet, S.

2014-01-01

Purpose: The purpose of this review is to determine the averaged effective dose and lifetime attributable risk factor from multiple head computed tomography (CT) dose data on children with ventriculoperitoneal shunts (VPS). Method and materials: A total of 422 paediatric head CT exams were found between October 2008 and January 2011 and retrospectively reviewed. The CT dose data was weighted with the latest IRCP 103 conversion factor to obtain the effective dose per study and the averaged effective dose was calculated. Estimates of the lifetime attributable risk were also calculated from the averaged effective dose using a conversion factor from the latest BEIR VII report. Results: Our study found the highest effective doses in neonates and the lowest effective doses were observed in the 10–18 years age group. We estimated a 0.007% potential increase risk in neonates and 0.001% potential increased risk in teenagers over the base risk. Conclusion: Multiple head CTs in children equates to a slight potential increase risk in lifetime attributable risk over the baseline risk for cancer, slightly higher in neonates relative to teenagers. The potential risks versus clinical benefit must be assessed

Role of socio-economic and reproductive factors in the risk of multiple sclerosis

DEFF Research Database (Denmark)

Magyari, Melinda

2015-01-01

rapid to be explained by gene alterations. We investigated the effect of numerous biological social physical and chemical environmental exposures in different periods of life. These data were available from population-based registries and were used in a case-control approach. This study database...... children reduced the risk of multiple sclerosis (MS) in women but not in men. Childbirths reduced the risk of MS by about 46% during the following 5 years. Even pregnancies terminated early had a protective effect on the risk of developing MS suggesting a temporary immunosuppression during pregnancy. Our...... data on social behaviour regarding educational level income and relationship stability did not indicate reverse causality. A greater likelihood to be exposed to common infections did not show any effect on the risk of MS neither in puberty nor in adulthood. Socio-economic status and lifestyle expressed...

Population-based absolute risk estimation with survey data

Science.gov (United States)

Kovalchik, Stephanie A.; Pfeiffer, Ruth M.

2013-01-01

Absolute risk is the probability that a cause-specific event occurs in a given time interval in the presence of competing events. We present methods to estimate population-based absolute risk from a complex survey cohort that can accommodate multiple exposure-specific competing risks. The hazard function for each event type consists of an individualized relative risk multiplied by a baseline hazard function, which is modeled nonparametrically or parametrically with a piecewise exponential model. An influence method is used to derive a Taylor-linearized variance estimate for the absolute risk estimates. We introduce novel measures of the cause-specific influences that can guide modeling choices for the competing event components of the model. To illustrate our methodology, we build and validate cause-specific absolute risk models for cardiovascular and cancer deaths using data from the National Health and Nutrition Examination Survey. Our applications demonstrate the usefulness of survey-based risk prediction models for predicting health outcomes and quantifying the potential impact of disease prevention programs at the population level. PMID:23686614

Longitudinal patterns and predictors of multiple health risk behaviors among adolescents : the TRAILS study

NARCIS (Netherlands)

Visser, Leenke; de Winter, Andrea F.; Verhulst, Frank C.; Vollebergh, Wilma A.M.; Reijneveld, Sijmen A.

BACKGROUND: Most studies on multiple health risk behaviors among adolescents have cross-sectionally studied a limited number of health behaviors or determinants. PURPOSE: To examine the prevalence, longitudinal patterns and predictors of individual and multiple health risk behaviors among

Up and down the sanitation ladder: Harmonizing the treatment and multiple-barrier perspectives on risk reduction in wastewater irrigated agriculture

DEFF Research Database (Denmark)

Keraita, Bernard; Drechsel, P.; Konradsen, Flemming

2010-01-01

This paper discusses two prominent perspectives in the debate on risk reduction in wastewater irrigation; reliance on conventional wastewater treatment and the multiple-barrier approach. The treatment perspective is based on water-quality standards for wastewater irrigation with treatment...... considered the ultimate risk reductionmeasure. The somewhat broader multiple-barrier perspective supports the use of a combination of pre-farm, on-farm and postfarm barriers, including, where possible, wastewater treatment, to meet required health targets. The discussion in this paper shows that each...

Alpha-risk: a European project on the quantification of risks associated with multiple radiation exposures

International Nuclear Information System (INIS)

Laurier, D.; Monchaux, G.; Tirmarche, M.; Darby, S.; Cardis, E.; Binks, K.; Hofmann, W.; Muirhead, C.

2006-01-01

The Alpha-Risk research project is being conducted within the Sixth European Framework Programme (EC-FP6, 2005 -2008). It aims to improve the quantification of risks associated with multiple exposures, taking into account the contribution of different radionuclides and external exposure using specific organ dose calculations. The Alpha-Risk Consortium involves 18 partners from 9 countries, and is coordinated by the IRSN. Its composition allows a multidisciplinary collaboration between researchers in epidemiology, dosimetry, statistics, modelling and risk assessment. Alpha-Risk brings together major epidemiological studies in Europe, which are able to evaluate long-term health effects of internal exposure from radionuclides. It includes large size cohort and case-control studies, with accurate registration of individual annual exposures: uranium miner studies, studies on lung cancer and indoor radon exposure, and studies of lung cancer and leukaemia among nuclear workers exposed to transuranic nuclides (mainly uranium and plutonium), for whom organ doses will be reconstructed individually. The contribution of experts in dosimetry will allow the calculation of organ doses in presence of multiple exposures (radon decay products, uranium dust and external gamma exposure). Expression of the risk per unit organ dose will make it possible to compare results with those from other populations exposed to external radiation. The multidisciplinary approach of Alpha-Risk promotes the development of coherent and improved methodological approaches regarding risk modelling. A specific work - package is dedicated to the integration of results and their use for risk assessment, especially for radon. Alpha-Risk will contribute to a better understanding of long-term health risks following chronic low doses from internal exposures. The project also has the great potential to help resolve major public health concerns about the effects of low and/or protracted exposures, especially

Multiplicative Effects of Social and Psychological Risk Factors on College Students’ Suicidal Behaviors

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Shervin Assari

2018-05-01

Full Text Available Less is known about the multiplicative effects of social and psychological risk and protective factors of suicidality on college campuses. The current study aimed to investigate the multiplicative effects of social (identifying oneself as gay/lesbian, financial difficulty, violence victimization, and religiosity and psychological (anxiety, depression, problem alcohol use, drug use and risk/protective factors on suicidal behaviors among college students in the United States. Using a cross-sectional design, the Healthy Mind Study (HMS; 2016–2017, is a national online survey of college students in the United States. Social (identifying oneself as gay/lesbian, violence victimization, financial difficulty, and religiosity and psychological (anxiety, depression, problem alcohol use, and drug use risk/protective factors were assessed among 27,961 individuals. Three aspects of suicidality, including ideation, plan, and attempt, were also assessed. Logistic regression models were used for data analysis. Financial difficulty, violence victimization, identifying oneself as gay/lesbian, anxiety, depression, and drug use increased, while religiosity reduced the odds of suicidal behaviors. Multiplicative effects were found between the following social and psychological risk factors: (1 financial difficulty and anxiety; (2 financial difficulty and depression; (3 depression and drug use; (4 problem alcohol use and drug use; and (5 depression and problem alcohol use. There is a considerable overlap in the social and psychological processes, such as financial stress, mood disorders, and substance use problems, on risk of suicide in college students. As social and psychological risk factors do not operate independently, comprehensive suicidal risk evaluations that simultaneously address multiple social and psychological risk factors may be superior to programs that only address a single risk factor.

Physical and social environment and the risk of multiple sclerosis

DEFF Research Database (Denmark)

Magyari, Melinda; Koch-Henriksen, Nils; Pfleger, Claudia C.

2014-01-01

, or social environmental influence the risk of MS differently in women than in men. Methods: The cohort consists of all 1403 patients (939 women, 464 men) identified through Danish Multiple Sclerosis Registry aged 1-55 of years at clinical onset between 2000 and 2004, and up to 25 control persons for each...... case, matched by sex, year of birth and residential municipality. The same cohort was previously used to investigate the influence of the reproductive factors on the risk of MS. Results: By linkage to Danish population registers we found a slight albeit statistically significant excess for 6 female MS...... patients who had been employed in agriculture: OR 3.52; 95% CI 1.38-9.00, p=0.008 (0.046 when corrected for multiple significance) and a trend for exposure to outdoor work in 12 : OR 1.94, 95% CI 1.06-3.55, p=0.03 (0.09 when corrected for multiple significance), but the numbers of cases were small...

The third spatial dimension risk approach for individual risk and group risk in multiple use of space

International Nuclear Information System (INIS)

Suddle, Shahid; Ale, Ben

2005-01-01

Buildings above roads and railways are examples of multiple use of space. Safety is one of the critical issues for such projects. Risk analyses can be undertaken to investigate what safety measures that are required to realise these projects. The results of these analyses can also be compared to risk acceptance criteria, if they are applicable. In The Netherlands, there are explicit criteria for acceptability of individual risk and societal risk. Traditionally calculations of individual risk result in contours of equal risk on a map and thus are considered in two-dimensional space only. However, when different functions are layered the third spatial dimension, height, becomes an important parameter. The various activities and structures above and below each other impose mutual risks. There are no explicit norms or policies about how to deal with the individual or group risk approach in the third dimension. This paper proposes an approach for these problems and gives some examples. Finally, the third dimension risk approach is applied in a case study of Bos en Lommer, Amsterdam

A self-determination multiple risk intervention trial to improve smokers' health.

Science.gov (United States)

Williams, Geoffrey C; McGregor, Holly; Sharp, Daryl; Kouldes, Ruth W; Lévesque, Chantal S; Ryan, Richard M; Deci, Edward L

2006-12-01

Little is known about how interventions motivate individuals to change multiple health risk behaviors. Self-determination theory (SDT) proposes that patient autonomy is an essential factor for motivating change. An SDT-based intervention to enhance autonomous motivation for tobacco abstinence and improving cholesterol was tested. The Smokers' Health Study is a randomized multiple risk behavior change intervention trial. Smokers were recruited to a tobacco treatment center. A total of 1.006 adult smokers were recruited between 1999 and 2002 from physician offices and by newspaper advertisements. A 6-month clinical intervention (4 contacts) to facilitate internalization of autonomy and perceived competence for tobacco abstinence and reduced percent calories from fat was compared with community care. Clinicians elicited patient perspectives and life strivings, provided absolute coronary artery disease risk estimates,enumerated effective treatment options, supported patient initiatives,minimized clinician control, assessed motivation for change, and developed a plan for change. Twelve-month prolonged tobacco abstinence, and change in percent calories from fat and low-density lipoprotein-cholesterol (LDL-C) from baseline to 18 months. RESULTS- Intention to treat analyses revealed that the intervention significantly increased 12-month prolonged tobacco abstinence (6.2% vs 2.4%; odds ratio [OR]=2.7, P=.01, number needed to treat [NNT] =26), and reduced LDL-C (-8.9 vs -4.1 mg/dL; P=.05). There was no effect on percent calories from fat. An intervention focused on supporting smokers'autonomy was effective in increasing prolonged tobacco abstinence and lowering LDL-C. Clinical interventions for behavior change may be improved by increasing patient autonomy and perceived competence.

A Multiple Criteria Decision Making Method Based on Relative Value Distances

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Shyur Huan-jyh

2015-12-01

Full Text Available This paper proposes a new multiple criteria decision-making method called ERVD (election based on relative value distances. The s-shape value function is adopted to replace the expected utility function to describe the risk-averse and risk-seeking behavior of decision makers. Comparisons and experiments contrasting with the TOPSIS (Technique for Order Preference by Similarity to the Ideal Solution method are carried out to verify the feasibility of using the proposed method to represent the decision makers’ preference in the decision making process. Our experimental results show that the proposed approach is an appropriate and effective MCDM method.

An Updated Meta-Analysis of Risk of Multiple Sclerosis following Infectious Mononucleosis

Science.gov (United States)

Handel, Adam E.; Williamson, Alexander J.; Disanto, Giulio; Handunnetthi, Lahiru; Giovannoni, Gavin; Ramagopalan, Sreeram V.

2010-01-01

Background Multiple sclerosis (MS) appears to develop in genetically susceptible individuals as a result of environmental exposures. Epstein-Barr virus (EBV) infection is an almost universal finding among individuals with MS. Symptomatic EBV infection as manifested by infectious mononucleosis (IM) has been shown in a previous meta-analysis to be associated with the risk of MS, however a number of much larger studies have since been published. Methods/Principal Findings We performed a Medline search to identify articles published since the original meta-analysis investigating MS risk following IM. A total of 18 articles were included in this study, including 19390 MS patients and 16007 controls. We calculated the relative risk of MS following IM using a generic inverse variance with random effects model. This showed that the risk of MS was strongly associated with IM (relative risk (RR) 2.17; 95% confidence interval 1.97–2.39; pmononucleosis significantly increases the risk of multiple sclerosis. Future work should focus on the mechanism of this association and interaction with other risk factors. PMID:20824132

An updated meta-analysis of risk of multiple sclerosis following infectious mononucleosis.

Directory of Open Access Journals (Sweden)

Adam E Handel

2010-09-01

Full Text Available Multiple sclerosis (MS appears to develop in genetically susceptible individuals as a result of environmental exposures. Epstein-Barr virus (EBV infection is an almost universal finding among individuals with MS. Symptomatic EBV infection as manifested by infectious mononucleosis (IM has been shown in a previous meta-analysis to be associated with the risk of MS, however a number of much larger studies have since been published.We performed a Medline search to identify articles published since the original meta-analysis investigating MS risk following IM. A total of 18 articles were included in this study, including 19390 MS patients and 16007 controls. We calculated the relative risk of MS following IM using a generic inverse variance with random effects model. This showed that the risk of MS was strongly associated with IM (relative risk (RR 2.17; 95% confidence interval 1.97-2.39; p<10(-54.Our results establish firmly that a history of infectious mononucleosis significantly increases the risk of multiple sclerosis. Future work should focus on the mechanism of this association and interaction with other risk factors.

A risk-based decision-aiding tool for waste disposal

International Nuclear Information System (INIS)

Weiner, R.F.; Reiser, A.S.; Elcock, C.G.; Nevins, S.

1997-01-01

N-CART (the National Spent Nuclear Fuel Program Cost Analysis and Risk Tool) is being developed to aid in low-risk, cost-effective, timely management of radioactive waste and spent nuclear fuel, and can therefore be used in management of mixed waste. N-CART provides evaluation of multiple alternatives and presents the consequences of proposed waste management activities in a clear and concise format. N-CART's decision-aiding analyses include comparisons and sensitivity analyses of multiple alternatives and allows the user to perform quick turn-around open-quotes what ifclose quotes studies to investigate various scenarios. Uncertainties in data (such as cost and schedule of various activities) are represented as distributions. N-CART centralizes documentation of the bases of program alternatives and program decisions, thereby supporting responses to stakeholders concerns. The initial N-CART design considers regulatory requirements, costs, and schedules for alternative courses of action. The final design will include risks (public health, occupational, economic, scheduling), economic benefits, and the impacts of secondary waste generation. An optimization tool is being incorporated that allows the user to specify the relative importance of cost, time risks, and other bases for decisions. The N-CART prototype can be used to compare the costs and schedules of disposal alternatives for mixed low-level radioactive waste (MLLW) and greater-than-Class-C (GTCC) waste, as well as spent nuclear fuel (SNF) and related scrap material

Youth suicide attempts and the dose-response relationship to parental risk factors: a population-based study

DEFF Research Database (Denmark)

Christiansen, E; Goldney, R D; Beautrai, A L

2011-01-01

BACKGROUND: There is a lack of specific knowledge about the dose-response effect of multiple parental risk factors for suicide attempts among children and adolescents. The aim of this study was to determine the dose-response effect of multiple parental risk factors on an offspring's risk for suic......BACKGROUND: There is a lack of specific knowledge about the dose-response effect of multiple parental risk factors for suicide attempts among children and adolescents. The aim of this study was to determine the dose-response effect of multiple parental risk factors on an offspring's risk...... for suicide attempt.MethodWe designed a population-based two-generation nested case-control study and used Danish register data. A population of 403 431 individuals born between 1983 and 1989 was sampled. Among these, 3465 (0.8%) were registered as having had a suicide attempt. Twenty controls were matched...... to each case and a link to the offspring's biological parents was established. RESULTS: There was a dose-response relationship between the number of exposures and the risk of suicide attempts, with the increased risk seeming to be a multiplicative effect. Parental suicide, suicide attempt, psychiatric...

Making assessments while taking repeated risks: a pattern of multiple response pathways.

Science.gov (United States)

Pleskac, Timothy J; Wershbale, Avishai

2014-02-01

Beyond simply a decision process, repeated risky decisions also require a number of cognitive processes including learning, search and exploration, and attention. In this article, we examine how multiple response pathways develop over repeated risky decisions. Using the Balloon Analogue Risk Task (BART) as a case study, we show that 2 different response pathways emerge over the course of the task. The assessment pathway is a slower, more controlled pathway where participants deliberate over taking a risk. The 2nd pathway is a faster, more automatic process where no deliberation occurs. Results imply the slower assessment pathway is taken as choice conflict increases and that the faster automatic response is a learned response. Based on these results, we modify an existing formal cognitive model of decision making during the BART to account for these dual response pathways. The slower more deliberative response process is modeled with a sequential sampling process where evidence is accumulated to a threshold, while the other response is given automatically. We show that adolescents with conduct disorder and substance use disorder symptoms not only evaluate risks differently during the BART but also differ in the rate at which they develop the more automatic response. More broadly, our results suggest cognitive models of judgment decision making need to transition from treating observed decisions as the result of a single response pathway to the result of multiple response pathways that change and develop over time.

A method of risk assessment for a multi-plant site

International Nuclear Information System (INIS)

White, R.F.

1983-06-01

A model is presented which can be used in conjunction with probabilistic risk assessment to estimate whether a site on which there are several plants (reactors or chemical plants containing radioactive materials) meets whatever risk acceptance criteria or numerical risk guidelines are applied at the time of the assessment in relation to various groups of people and for various sources of risk. The application of the multi-plant site model to the direct and inverse methods of risk assessment is described. A method is proposed by which the potential hazard rating associated with a given plant can be quantified so that an appropriate allocation can be made when assessing the risks associated with each of the plants on a site. (author)

Multiple sclerosis in women having children by multiple partners. A population-based study in Denmark

DEFF Research Database (Denmark)

Basso, Olga; Campi, Rita; Frydenberg, Morten

2004-01-01

We investigated whether having children with multiple men is a risk factor for being diagnosed with multiple sclerosis (MS). We studied a cohort of 151,328 women, of whom 64,704 had different men fathering their children and 86,624 the same partner for all births. Women were included if they had ...

Volumetry based biomarker speed of growth: Quantifying the change of total tumor volume in whole-body magnetic resonance imaging over time improves risk stratification of smoldering multiple myeloma patients.

Science.gov (United States)

Wennmann, Markus; Kintzelé, Laurent; Piraud, Marie; Menze, Bjoern H; Hielscher, Thomas; Hofmanninger, Johannes; Wagner, Barbara; Kauczor, Hans-Ulrich; Merz, Maximilian; Hillengass, Jens; Langs, Georg; Weber, Marc-André

2018-05-18

The purpose of this study was to improve risk stratification of smoldering multiple myeloma patients, introducing new 3D-volumetry based imaging biomarkers derived from whole-body MRI. Two-hundred twenty whole-body MRIs from 63 patients with smoldering multiple myeloma were retrospectively analyzed and all focal lesions >5mm were manually segmented for volume quantification. The imaging biomarkers total tumor volume, speed of growth (development of the total tumor volume over time), number of focal lesions, development of the number of focal lesions over time and the recent imaging biomarker '>1 focal lesion' of the International Myeloma Working Group were compared, taking 2-year progression rate, sensitivity and false positive rate into account. Speed of growth, using a cutoff of 114mm 3 /month, was able to isolate a high-risk group with a 2-year progression rate of 82.5%. Additionally, it showed by far the highest sensitivity in this study and in comparison to other biomarkers in the literature, detecting 63.2% of patients who progress within 2 years. Furthermore, its false positive rate (8.7%) was much lower compared to the recent imaging biomarker '>1 focal lesion' of the International Myeloma Working Group. Therefore, speed of growth is the preferable imaging biomarker for risk stratification of smoldering multiple myeloma patients.

Assessing and managing multiple risks in a changing world-The Roskilde recommendations.

Science.gov (United States)

Selck, Henriette; Adamsen, Peter B; Backhaus, Thomas; Banta, Gary T; Bruce, Peter K H; Burton, G Allen; Butts, Michael B; Boegh, Eva; Clague, John J; Dinh, Khuong V; Doorn, Neelke; Gunnarsson, Jonas S; Hauggaard-Nielsen, Henrik; Hazlerigg, Charles; Hunka, Agnieszka D; Jensen, John; Lin, Yan; Loureiro, Susana; Miraglia, Simona; Munns, Wayne R; Nadim, Farrokh; Palmqvist, Annemette; Rämö, Robert A; Seaby, Lauren P; Syberg, Kristian; Tangaa, Stine R; Thit, Amalie; Windfeld, Ronja; Zalewski, Maciej; Chapman, Peter M

2017-01-01

Roskilde University (Denmark) hosted a November 2015 workshop, Environmental Risk-Assessing and Managing Multiple Risks in a Changing World. This Focus article presents the consensus recommendations of 30 attendees from 9 countries regarding implementation of a common currency (ecosystem services) for holistic environmental risk assessment and management; improvements to risk assessment and management in a complex, human-modified, and changing world; appropriate development of protection goals in a 2-stage process; dealing with societal issues; risk-management information needs; conducting risk assessment of risk management; and development of adaptive and flexible regulatory systems. The authors encourage both cross-disciplinary and interdisciplinary approaches to address their 10 recommendations: 1) adopt ecosystem services as a common currency for risk assessment and management; 2) consider cumulative stressors (chemical and nonchemical) and determine which dominate to best manage and restore ecosystem services; 3) fully integrate risk managers and communities of interest into the risk-assessment process; 4) fully integrate risk assessors and communities of interest into the risk-management process; 5) consider socioeconomics and increased transparency in both risk assessment and risk management; 6) recognize the ethical rights of humans and ecosystems to an adequate level of protection; 7) determine relevant reference conditions and the proper ecological context for assessments in human-modified systems; 8) assess risks and benefits to humans and the ecosystem and consider unintended consequences of management actions; 9) avoid excessive conservatism or possible underprotection resulting from sole reliance on binary, numerical benchmarks; and 10) develop adaptive risk-management and regulatory goals based on ranges of uncertainty. Environ Toxicol Chem 2017;36:7-16. © 2016 SETAC. © 2016 SETAC.

Assessing and managing multiple risks in a changing world ...

Science.gov (United States)

Roskilde University (Denmark) hosted a November 2015 workshop, Environmental Risk—Assessing and Managing Multiple Risks in a Changing World. This Focus article presents the consensus recommendations of 30 attendees from 9 countries regarding implementation of a common currency (ecosystem services) for holistic environmental risk assessment and management; improvements to risk assessment and management in a complex, human-modified, and changing world; appropriate development of protection goals in a 2-stage process; dealing with societal issues; risk-management information needs; conducting risk assessment of risk management; and development of adaptive and flexible regulatory systems. The authors encourage both cross-disciplinary and interdisciplinary approaches to address their 10 recommendations: 1) adopt ecosystem services as a common currency for risk assessment and management; 2) consider cumulative stressors (chemical and nonchemical) and determine which dominate to best manage and restore ecosystem services; 3) fully integrate risk managers and communities of interest into the risk-assessment process; 4) fully integrate risk assessors and communities of interest into the risk-management process; 5) consider socioeconomics and increased transparency in both risk assessment and risk management; 6) recognize the ethical rights of humans and ecosystems to an adequate level of protection; 7) determine relevant reference conditions and the proper ecological c

Gender-Based Violence Causing Severe Multiple Injuries; a Case Report

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Adalard Falschung

2018-04-01

Full Text Available Introduction: Gender-based violence (GBV against women has been identified as a global health and development issue. We reported a case of GBV causing sever, multiple injuries in a middle-aged female. Case report: A 47-year-old woman presented to emergency room with disturbed level of consciousness, shortness of breath and multiple patches of skin discoloration. On examination, the patient was semi-conscious, with multiple ecchymosis and bilateral decreased air entry. Computed tomography scan of the neck and chest showed six rib fractures on the left side, and eight rib fractures on the right side, sternal fracture, manubriosternal dislocation, bilateral hemothorax, fracture of body of eleventh thoracic vertebra, and fracture of cervical spine of fifth and seventh vertebrae. The patient was intubated and admitted to intensive care unit. She was discharged with good health condition after 23 days of hospital admission. Conclusion: GBV is still a cause of severe trauma that puts the patient’s life at risk.

An integrated probabilistic risk analysis decision support methodology for systems with multiple state variables

International Nuclear Information System (INIS)

Sen, P.; Tan, John K.G.; Spencer, David

1999-01-01

Probabilistic risk analysis (PRA) methods have been proven to be valuable in risk and reliability analysis. However, a weak link seems to exist between methods for analysing risks and those for making rational decisions. The integrated decision support system (IDSS) methodology presented in this paper attempts to address this issue in a practical manner. In consists of three phases: a PRA phase, a risk sensitivity analysis (SA) phase and an optimisation phase, which are implemented through an integrated computer software system. In the risk analysis phase the problem is analysed by the Boolean representation method (BRM), a PRA method that can deal with systems with multiple state variables and feedback loops. In the second phase the results obtained from the BRM are utilised directly to perform importance and risk SA. In the third phase, the problem is formulated as a multiple objective decision making problem in the form of multiple objective reliability optimisation. An industrial example is included. The resultant solutions of a five objective reliability optimisation are presented, on the basis of which rational decision making can be explored

Associations between multiple health risk behaviors and mental health among Chinese college students.

Science.gov (United States)

Ye, Yong-ling; Wang, Pei-gang; Qu, Geng-cong; Yuan, Shuai; Phongsavan, Philayrath; He, Qi-qiang

2016-01-01

Although there is substantial evidence that health risk behaviors increase risks of premature morbidity and mortality, little is known about the multiple health risk behaviors in Chinese college students. Here, we investigated the prevalence of multiple health risk behaviors and its relation to mental health among Chinese college students. A cross-sectional study was conducted in Wuhan, China from May to June 2012. The students reported their health risk behaviors using self-administered questionnaires. Depression and anxiety were assessed using the self-rating depression scale and self-rating anxiety scale, respectively. A total of 2422 college students (1433 males) aged 19.7 ± 1.2 years were participated in the study. The prevalence of physical inactivity, sleep disturbance, poor dietary behavior, Internet addiction disorder (IAD), frequent alcohol use and current smoking was 62.0, 42.6, 29.8, 22.3, 11.6 and 9.3%, respectively. Significantly increased risks for depression and anxiety were found among students with frequent alcohol use, sleep disturbance, poor dietary behavior and IAD. Two-step cluster analysis identified two different clusters. Participants in the cluster with more unhealthy behaviors showed significantly increased risk for depression (odds ratio (OR): 2.21; 95% confidence interval (CI): 1.83, 2.67) and anxiety (OR: 2.32; 95% CI: 1.85, 2.92). This study indicates that a relatively high prevalence of multiple health risk behaviors was found among Chinese college students. Furthermore, the clustering of health risk behaviors was significantly associated with increased risks for depression and anxiety.

A diet based on multiple functional concepts improves cardiometabolic risk parameters in healthy subjects

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Tovar Juscelino

2012-04-01

Full Text Available Abstract Background Different foods can modulate cardiometabolic risk factors in persons already affected by metabolic alterations. The objective of this study was to assess, in healthy overweight individuals, the impact of a diet combining multiple functional concepts on risk markers associated with cardiometabolic diseases (CMD. Methods Fourty-four healthy women and men (50-73 y.o, BMI 25-33, fasting glycemia ≤ 6.1 mmol/L participated in a randomized crossover intervention comparing a multifunctional (active diet (AD with a control diet (CD devoid of the "active" components. Each diet was consumed during 4 wk with a 4 wk washout period. AD included the following functional concepts: low glycemic impact meals, antioxidant-rich foods, oily fish as source of long-chain omega-3 fatty acids, viscous dietary fibers, soybean and whole barley kernel products, almonds, stanols and a probiotic strain (Lactobacillus plantarum Heal19/DSM15313. Results Although the aim was to improve metabolic markers without promoting body weight loss, minor weight reductions were observed with both diets (0.9-1.8 ± 0.2%; P P P P = 0.0056, LDL/HDL (-27 ± 2%; P P 1c (-2 ± 0.4%; P = 0.0013, hs-CRP (-29 ± 9%; P = 0.0497 and systolic blood pressure (-8 ± 1%¸ P = 0.0123. The differences remained significant after adjustment for weight change. After AD, the Framingham cardiovascular risk estimate was 30 ± 4% (P P Conclusion The improved biomarker levels recorded in healthy individuals following the multifunctional regime suggest preventive potential of this dietary approach against CMD.

Phase I metabolic genes and risk of lung cancer: multiple polymorphisms and mRNA expression.

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Melissa Rotunno

2009-05-01

Full Text Available Polymorphisms in genes coding for enzymes that activate tobacco lung carcinogens may generate inter-individual differences in lung cancer risk. Previous studies had limited sample sizes, poor exposure characterization, and a few single nucleotide polymorphisms (SNPs tested in candidate genes. We analyzed 25 SNPs (some previously untested in 2101 primary lung cancer cases and 2120 population controls from the Environment And Genetics in Lung cancer Etiology (EAGLE study from six phase I metabolic genes, including cytochrome P450s, microsomal epoxide hydrolase, and myeloperoxidase. We evaluated the main genotype effects and genotype-smoking interactions in lung cancer risk overall and in the major histology subtypes. We tested the combined effect of multiple SNPs on lung cancer risk and on gene expression. Findings were prioritized based on significance thresholds and consistency across different analyses, and accounted for multiple testing and prior knowledge. Two haplotypes in EPHX1 were significantly associated with lung cancer risk in the overall population. In addition, CYP1B1 and CYP2A6 polymorphisms were inversely associated with adenocarcinoma and squamous cell carcinoma risk, respectively. Moreover, the association between CYP1A1 rs2606345 genotype and lung cancer was significantly modified by intensity of cigarette smoking, suggesting an underlying dose-response mechanism. Finally, increasing number of variants at CYP1A1/A2 genes revealed significant protection in never smokers and risk in ever smokers. Results were supported by differential gene expression in non-tumor lung tissue samples with down-regulation of CYP1A1 in never smokers and up-regulation in smokers from CYP1A1/A2 SNPs. The significant haplotype associations emphasize that the effect of multiple SNPs may be important despite null single SNP-associations, and warrants consideration in genome-wide association studies (GWAS. Our findings emphasize the necessity of post

Operational tools to build a multicriteria territorial risk scale with multiple stakeholders

International Nuclear Information System (INIS)

Cailloux, Olivier; Mayag, Brice; Meyer, Patrick; Mousseau, Vincent

2013-01-01

Evaluating and comparing the threats and vulnerabilities associated with territorial zones according to multiple criteria (industrial activity, population, etc.) can be a time-consuming task and often requires the participation of several stakeholders. Rather than a direct evaluation of these zones, building a risk assessment scale and using it in a formal procedure permits to automate the assessment and therefore to apply it in a repeated way and in large-scale contexts and, provided the chosen procedure and scale are accepted, to make it objective. One of the main difficulties of building such a formal evaluation procedure is to account for the multiple decision makers' preferences. The procedure used in this article, ELECTRE TRI, uses the performances of each territorial zone on multiple criteria, together with preferential parameters from multiple decision makers, to qualitatively assess their associated risk level. We also present operational tools in order to implement such a procedure in practice, and show their use on a detailed example

THE ANALYSIS OF THE RELATION COUNTRY RISK – MULTIPLE VALUE

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Cristina Nicolescu

2016-12-01

Full Text Available Financial theory state that high expected growth, low risk in the company’s sector and low interest rates will push multiples higher. In this respect the goal of the empirical work is to examine country risk-multiple value relation, for the companies from emerging and frontier markets such as Central and East European ones. Specific control variables have been included in the model as proxy for growth opportunities, profitability, capital structure, and asset utilization. Using panel data analysis for period 2010-2015 as well as other financial variables for a sample of Central and East European countries during 2010-2015. The results partially support financial theories, mainly the significance of country risk and debt ratio and reject the growth opportunities hypothesis.

Multiple risk behaviors and suicidal ideation and behavior among Israeli and Palestinian adolescents.

Science.gov (United States)

Harel-Fisch, Yossi; Abdeen, Ziad; Walsh, Sophie D; Radwan, Qasrowi; Fogel-Grinvald, Haya

2012-07-01

Based conceptually on Problem Behavior Theory, Normalization Theory and theories of adolescent ethnic identity formation this study explores relationships between individual and cumulative multiple risk behaviors and suicidal ideation and behavior among mid-adolescents in three different populations in the Middle East. Data from the 2004 Health Behavior in School-Aged Children in the Middle-East (HBSC-ME) study included 8345 10th-grade pupils in three populations: Jewish Israelis (1770), Arab Israelis (2185), and Palestinians in Gaza and the West Bank (4390). We considered risk behaviors and factors including tobacco use, bullying, medically-attended injuries, excessive time with friends, parental disconnectedness, negative school experience, truancy and poor academic performance. Substantial population differences for suicidal tendency and risk behaviors were observed, with notably high levels of suicidal ideation and behavior among Arab-Israeli youth and higher levels of risk behaviors among the Jewish and Arab-Israeli youth. For all populations suicidal tendency was at least 4 times higher among adolescents reporting 4+ risk behaviors, suggesting that similar psychosocial determinants affect patterns of risk behaviors and suicidal tendency. Results highlight the importance of understanding cultural contexts of risk behaviors and suicidal ideation and behavior. Copyright © 2012 Elsevier Ltd. All rights reserved.

A comparison of perinatal outcomes in singletons and multiples born after in vitro fertilization or intracytoplasmic sperm injection stratified for neonatal risk criteria

NARCIS (Netherlands)

van Heesch, M.M.J.; Evers, J.L.H.; Dumoulin, J.C.M.; van der Hoeven, M.A.H.B.; van Beijsterveldt, C.E.M.; Bonsel, G.J.; Dykgraaf, R.H.M.; van Goudoever, J.B.; Koopman-Esseboom, C.; Nelen, W.L.D.M.; Steiner, K.; Tamminga, P.; Tonch, N.; van Zonneveld, P.; Dirksen, C.D.

2014-01-01

Objective To compare perinatal singleton and multiple outcomes in a large Dutch in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) population and within risk subgroups. Newborns were assigned to a risk category based on gestational age, birthweight, Apgar score and congenital

A comparison of perinatal outcomes in singletons and multiples born after in vitro fertilization or intracytoplasmic sperm injection stratified for neonatal risk criteria

NARCIS (Netherlands)

Heesch, M.M. van; Evers, J.L.H.; Dumoulin, J.C.; Hoeven, M.A. van der; Beijsterveldt, C.E. van; Bonsel, G.J.; Dykgraaf, R.H.; Goudoever, J.B. van; Koopman-Esseboom, C.; Nelen, W.L.D.M.; Steiner, K.; Tamminga, P.; Tonch, N.; Zonneveld, P. van; Dirksen, C.D.

2014-01-01

OBJECTIVE: To compare perinatal singleton and multiple outcomes in a large Dutch in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) population and within risk subgroups. Newborns were assigned to a risk category based on gestational age, birthweight, Apgar score and congenital

Suicide among Danes with multiple sclerosis

DEFF Research Database (Denmark)

Brønnum-Hansen, H; Stenager, E; Nylev Stenager, E

2005-01-01

OBJECTIVE: To compare the suicide risk among Danish citizens with multiple sclerosis with that of the general population, and to evaluate changes over 45 years. METHODS: The study was based on linkage of the Danish Multiple Sclerosis Registry to the Cause of Death Registry. It comprised all 10...... taken their own lives, whereas the expected number of suicides was 54.2 (29.1 men, 25.1 women). Thus the suicide risk among persons with multiple sclerosis was more than twice that of the general population (SMR = 2.12). The increased risk was particularly high during the first year after diagnosis (SMR...... = 3.15). CONCLUSIONS: The risk of suicide in multiple sclerosis was almost twice as high as expected more than 20 years after diagnosis. The excess suicide risk has not declined since 1953....

Integrated presentation of ecological risk from multiple stressors

OpenAIRE

Goussen, Benoit Regis Marc; Price, Oliver R.; Rendal, Cecilie; Ashauer, Roman

2016-01-01

Current environmental risk assessments (ERA) do not account explicitly for ecological factors (e.g. species composition, temperature or food availability) and multiple stressors. Assessing mixtures of chemical and ecological stressors is needed as well as accounting for variability in environmental conditions and uncertainty of data and models. Here we propose a novel probabilistic ERA framework to overcome these limitations, which focusses on visualising assessment outcomes by construct-ing ...

Youth experiences with multiple types of prejudice-based harassment.

Science.gov (United States)

Bucchianeri, Michaela M; Gower, Amy L; McMorris, Barbara J; Eisenberg, Marla E

2016-08-01

Despite prejudice-based harassment's associations with serious physical and mental health risks, research examining multiple forms of harassment among children/adolescents is lacking. This study documents the prevalence of prejudice-based harassment (i.e., harassment on the basis of gender, race/ethnicity, weight or physical appearance, sexual orientation, and disability status) among a large, statewide, school-based Midwestern U.S. sample of 162,034 adolescents. Weight-/appearance-based harassment was most prevalent among both girls (25.3%) and boys (19.8%). Adolescents from certain vulnerable groups experienced higher rates of multiple types of harassment, even when controlling for other sociodemographic characteristics. Prejudice-based harassment experiences are prevalent among adolescent girls and boys. Differential rates of each type of harassment are reported across groups within the corresponding sociodemographic status (e.g., white female adolescents report a significantly lower rate of race-based harassment (4.8%), as compared to Native American (18.6%), mixed/other race (18.9%), Hispanic/Latina (21.5%), Asian/Pacific Islander (24.2%), or Black/African American (24.8%) female adolescents); but a pattern of cross-harassment also is evident, such that differences in prevalence of each harassment type emerge across a variety of statuses (e.g., disability-based harassment was statistically significantly higher among discordant heterosexual (12.7%), gay (13.0%), bisexual (15.3%), and unsure (15.3%) male adolescents than among heterosexual male (7.2%) adolescents). Adolescents from specific sociodemographic groups are particularly vulnerable to certain types of harassment. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

A multi-disciplinary approach for the integrated assessment of multiple risks in delta areas.

Science.gov (United States)

Sperotto, Anna; Torresan, Silvia; Critto, Andrea; Marcomini, Antonio

2016-04-01

The assessment of climate change related risks is notoriously difficult due to the complex and uncertain combinations of hazardous events that might happen, the multiplicity of physical processes involved, the continuous changes and interactions of environmental and socio-economic systems. One important challenge lies in predicting and modelling cascades of natural and man -made hazard events which can be triggered by climate change, encompassing different spatial and temporal scales. Another regard the potentially difficult integration of environmental, social and economic disciplines in the multi-risk concept. Finally, the effective interaction between scientists and stakeholders is essential to ensure that multi-risk knowledge is translated into efficient adaptation and management strategies. The assessment is even more complex at the scale of deltaic systems which are particularly vulnerable to global environmental changes, due to the fragile equilibrium between the presence of valuable natural ecosystems and relevant economic activities. Improving our capacity to assess the combined effects of multiple hazards (e.g. sea-level rise, storm surges, reduction in sediment load, local subsidence, saltwater intrusion) is therefore essential to identify timely opportunities for adaptation. A holistic multi-risk approach is here proposed to integrate terminology, metrics and methodologies from different research fields (i.e. environmental, social and economic sciences) thus creating shared knowledge areas to advance multi risk assessment and management in delta regions. A first testing of the approach, including the application of Bayesian network analysis for the assessment of impacts of climate change on key natural systems (e.g. wetlands, protected areas, beaches) and socio-economic activities (e.g. agriculture, tourism), is applied in the Po river delta in Northern Italy. The approach is based on a bottom-up process involving local stakeholders early in different

Risk-based safety indicators

International Nuclear Information System (INIS)

Szikszai, T.

1997-01-01

The presentation discusses the following issues: The objectives of the risk-based indicator programme. The characteristics of the risk-based indicators. The objectives of risk-based safety indicators - in monitoring safety; in PSA applications. What indicators? How to produce the risk based indicators? PSA requirements

Covariance among multiple health risk behaviors in adolescents.

Directory of Open Access Journals (Sweden)

Kayla de la Haye

Full Text Available In a diverse group of early adolescents, this study explores the co-occurrence of a broad range of health risk behaviors: alcohol, cigarette, and marijuana use; physical inactivity; sedentary computing/gaming; and the consumption of low-nutrient energy-dense food. We tested differences in the associations of unhealthy behaviors over time, and by gender, race/ethnicity, and socioeconomic status.Participants were 8360 students from 16 middle schools in California (50% female; 52% Hispanic, 17% Asian, 16% White, and 15% Black/multiethnic/other. Behaviors were measured with surveys in Spring 2010 and Spring 2011. Confirmatory factor analysis was used to assess if an underlying factor accounted for the covariance of multiple behaviors, and composite reliability methods were used to determine the degree to which behaviors were related.The measured behaviors were explained by two moderately correlated factors: a 'substance use risk factor' and an 'unhealthy eating and sedentary factor'. Physical inactivity did not reflect the latent factors as expected. There were few differences in the associations among these behaviors over time or by demographic characteristics.Two distinct, yet related groups of health compromising behaviors were identified that could be jointly targeted in multiple health behavior change interventions among early adolescents of diverse backgrounds.

Risk Analysis Method Based on FMEA for Transmission Line in Lightning Hazards

Directory of Open Access Journals (Sweden)

You-Yuan WANG

2014-05-01

Full Text Available Failure rate of transmission line and reliability of power system are significantly affected by Lightning meteorological factor. In view of the complexity and variability of Lightning meteorological factors, this paper presents lightning trip-out rate model of transmission line in considering distribution of ground flash density and lightning day hours. Meanwhile, presents a failure rate model of transmission line in different condition, and a risk analysis method for transmission line considering multiple risk factors based on risk quantification. This method takes Lightning meteorological factor as the main evaluation standard, and establishes risk degree evaluation system for transmission line including another five evaluation standard. Put forward the risk indicators by quantify the risk factors based on experience date of transmission line in service. Based on the risk indexes comprehensive evaluation is conducted, and the evaluation result closer to practice is achieved, providing basis for transmission line risk warning and maintenance strategy. Through the risk analysis for 220 kV transmission line in a certain power supply bureau, the effectiveness of the proposed method is validated.

Neonatal vitamin D status and risk of multiple sclerosis

DEFF Research Database (Denmark)

Munk Nielsen, Nete; Munger, Kassandra L; Koch-Henriksen, Nils

2017-01-01

study. Dried blood spots samples (DBSS) belonging to 521 patients with MS were identified in the Danish Newborn Screening Biobank. For every patient with MS, 1-2 controls with the same sex and birth date were retrieved from the Biobank (n = 972). Level of 25-hydroxyvitamin D (25[OH]D) in the DBSS......OBJECTIVE: As previous research has suggested that exposure to vitamin D insufficiency in utero may have relevance for the risk of multiple sclerosis (MS), we aimed to examine the direct association between level of neonatal vitamin D and risk of MS. METHODS: We carried out a matched case-control...

Depressive symptoms in adolescence: the association with multiple health risk behaviors.

Science.gov (United States)

Katon, Wayne; Richardson, Laura; Russo, Joan; McCarty, Carolyn A; Rockhill, Carol; McCauley, Elizabeth; Richards, Julie; Grossman, David C

2010-01-01

Although multiple studies of adolescents have examined the association of depression with individual health risk behaviors such as obesity or smoking, this is one of the few studies that examined the association between depression and multiple risk behaviors. A brief mail questionnaire, which screened for age, gender, weight, height, sedentary behaviors, physical activity, perception of general health, functional impairment and depressive symptoms, was completed by a sample of 2291 youth (60.7% response rate) aged 13-17 enrolled in a health care plan. A subset of youth who screened positive on the two-item depression screen and a random sample of those screening negative were approached to participate in a telephone interview with more in-depth information obtained on smoking and at-risk behaviors associated with drug and alcohol use. Youth screening positive for high levels of depressive symptoms compared to those with few or no depressive symptoms were significantly more likely to meet criteria for obesity, had a poorer perception of health, spent more time on the computer, got along less well with parents and friends, had more problems completing school work and were more likely to have experimented with smoking and a wide array of behaviors associated with drug and alcohol use. Because many adverse health behaviors that develop in adolescence continue into adulthood, the association of depressive symptoms with multiple risk behaviors and poor functioning suggest that early interventions are needed at an individual, school, community and primary care level. Copyright 2010 Elsevier Inc. All rights reserved.

Multiple Primary Cancer Monograph

Science.gov (United States)

To identify groups of cancer survivors that are at increased risk for multiple primary cancers, investigators led an effort to provide the first comprehensive population-based analysis of the risk of subsequent cancer in the U.S., resulting in a monograph.

Multiplicative synergistic risk of hepatocellular carcinoma development among hepatitis B and C co-infected subjects in HBV endemic area: a community-based cohort study

International Nuclear Information System (INIS)

Oh, Jin-Kyoung; Shin, Hai-Rim; Lim, Min Kyung; Cho, Heeyoun; Kim, Dong-Il; Jee, Youngmee; Yun, Haesun; Yoo, Keun-Young

2012-01-01

There has been limited study on the effect of infection with different hepatitis C virus (HCV) genotypes on the risk of hepatocellular carcinoma (HCC) in hepatitis B virus (HBV) endemic regions of Asia. Hazard ratios of HCC development were estimated for HBV and HCV co-infected subjects among a community-based prospective cohort. HCV genotype was determined in HCV RNA-positive samples. Incident HCC cases were identified through linkage to the cancer registry. HCC incidence was 79 per 100,000 person-years in the study population (50 incident cases among 6,694 individuals within 63,170 person-years with an average of 9.4 years of follow-up); seroprevalence of HBsAg and anti-HCV was 5.2% and 5.6%. Adjusted hazard ratios of HCC by HBsAg positivity and anti-HCV positivity were 13.3 (CI: 7.3-24.4) and 6.7 (CI: 3.6-12.6). HRs of HBV and HCV monoinfection, and HBV/HCV coinfection were 17.1 (CI: 8.4-34.8), 10.4 (CI: 4.9-22.1) and 115.0 (CI: 32.5-407.3). Multiplicative synergistic effect of HBV/HCV coinfection on HCC risk was also observed (synergy index: 4.5, CI: 1.3-15.5). Infection with HCV genotype 1 (HR: 29.7, CI: 13.6-46.8) and mixed infection with genotype 1 and 2 (HR: 68.7, CI: 16.4-288.4) significantly elevated HCC risk, much higher than HBV infection. The effect of differences in HCV genotype and the multiplicative synergistic effect of HBV/HCV coinfection on HCC risk shown in the present study underline the need for comprehensive identification of hepatitis infection status in order to prevent and control HCC in this HBV endemic area

Occupation, exposure to chemicals, sensitizing agents, and risk of multiple myeloma in Sweden.

Science.gov (United States)

Lope, Virginia; Pérez-Gómez, Beatriz; Aragonés, Nuria; López-Abente, Gonzalo; Gustavsson, Per; Plato, Nils; Zock, Jan-Paul; Pollán, Marina

2008-11-01

This study sought to identify occupations with high incidence of multiple myeloma and to investigate possible excess risk associated with occupational exposure to chemicals and sensitizing agents in Sweden. A historical cohort of 2,992,166 workers was followed up (1971--1989) through record linkage with the National Cancer and Death Registries. For each job category, age and period standardized incidence ratios and age and period adjusted relative risks of multiple myeloma were calculated using Poisson models. Exposure to chemicals and to sensitizing agents was also assessed using two job-exposure matrices. Men and women were analyzed separately. During follow-up, 3,127 and 1,282 myelomas were diagnosed in men and women, respectively. In men, excess risk was detected among working proprietors, agricultural, horticultural and forestry enterprisers, bakers and pastry cooks, dental technicians, stone cutters/carvers, and prison/reformatory officials. In women, this excess was observed among attendants in psychiatric care, metal workers, bakers and pastry cooks, and paper/paperboard product workers. Workers, particularly bakers and pastry cooks, exposed to high molecular weight sensitizing agents registered an excess risk of over 40% across the sexes. Occasional, although intense, exposure to pesticides was also associated with risk of myeloma in our cohort. Our study supports a possible etiologic role for farming and use of pesticides in myeloma risk. The high incidence found in both female and male bakers and pastry cooks has not been described previously. Further research is required to assess the influence of high molecular weight sensitizing agents on risk of multiple myeloma.

Risk based modelling

International Nuclear Information System (INIS)

Chapman, O.J.V.; Baker, A.E.

1993-01-01

Risk based analysis is a tool becoming available to both engineers and managers to aid decision making concerning plant matters such as In-Service Inspection (ISI). In order to develop a risk based method, some form of Structural Reliability Risk Assessment (SRRA) needs to be performed to provide a probability of failure ranking for all sites around the plant. A Probabilistic Risk Assessment (PRA) can then be carried out to combine these possible events with the capability of plant safety systems and procedures, to establish the consequences of failure for the sites. In this way the probability of failures are converted into a risk based ranking which can be used to assist the process of deciding which sites should be included in an ISI programme. This paper reviews the technique and typical results of a risk based ranking assessment carried out for nuclear power plant pipework. (author)

Guidelines for Risk-Based Changeover of Biopharma Multi-Product Facilities.

Science.gov (United States)

Lynch, Rob; Barabani, David; Bellorado, Kathy; Canisius, Peter; Heathcote, Doug; Johnson, Alan; Wyman, Ned; Parry, Derek Willison

2018-01-01

In multi-product biopharma facilities, the protection from product contamination due to the manufacture of multiple products simultaneously is paramount to assure product quality. To that end, the use of traditional changeover methods (elastomer change-out, full sampling, etc.) have been widely used within the industry and have been accepted by regulatory agencies. However, with the endorsement of Quality Risk Management (1), the use of risk-based approaches may be applied to assess and continuously improve established changeover processes. All processes, including changeover, can be improved with investment (money/resources), parallel activities, equipment design improvements, and standardization. However, processes can also be improved by eliminating waste. For product changeover, waste is any activity not needed for the new process or that does not provide added assurance of the quality of the subsequent product. The application of a risk-based approach to changeover aligns with the principles of Quality Risk Management. Through the use of risk assessments, the appropriate changeover controls can be identified and controlled to assure product quality is maintained. Likewise, the use of risk assessments and risk-based approaches may be used to improve operational efficiency, reduce waste, and permit concurrent manufacturing of products. © PDA, Inc. 2018.

Class II HLA interactions modulate genetic risk for multiple sclerosis

DEFF Research Database (Denmark)

Moutsianas, Loukas; Jostins, Luke; Beecham, Ashley H

2015-01-01

Association studies have greatly refined the understanding of how variation within the human leukocyte antigen (HLA) genes influences risk of multiple sclerosis. However, the extent to which major effects are modulated by interactions is poorly characterized. We analyzed high-density SNP data on 17...

A risk-adapted approach is beneficial in the management of bilateral femoral shaft fractures in multiple trauma patients: an analysis based on the trauma registry of the German Trauma Society.

Science.gov (United States)

Steinhausen, Eva; Lefering, Rolf; Tjardes, Thorsten; Neugebauer, Edmund A M; Bouillon, Bertil; Rixen, Dieter

2014-05-01

Today, there is a trend toward damage-control orthopedics (DCO) in the management of multiple trauma patients with long bone fractures. However, there is no widely accepted concept. A risk-adapted approach seems to result in low acute morbidity and mortality. Multiple trauma patients with bilateral femoral shaft fractures (FSFs) are considered to be more severely injured. The objective of this study was to validate the risk-adapted approach in the management of multiple trauma patients with bilateral FSF. Data analysis is based on the trauma registry of the German Trauma Society (1993-2008, n = 42,248). Multiple trauma patients with bilateral FSF were analyzed in subgroups according to the type of primary operative strategy. Outcome parameters were mortality and major complications as (multiple) organ failure and sepsis. A total of 379 patients with bilateral FSF were divided into four groups as follows: (1) no operation (8.4%), (2) bilateral temporary external fixation (DCO) (50.9%), bilateral primary definitive osteosynthesis (early total care [ETC]) (25.1%), and primary definitive osteosynthesis of one FSF and DCO contralaterally (mixed) (15.6%). Compared with the ETC group, the DCO group was more severely injured. The incidence of (multiple) organ failure and mortality rates were higher in the DCO group but without significance. Adjusted for injury severity, there was no significant difference of mortality rates between DCO and ETC. Injury severity and mortality rates were significantly increased in the no-operation group. The mixed group was similar to the ETC group regarding injury severity and outcome. In Germany, both DCO and ETC are practiced in multiple trauma patients with bilateral FSF so far. The unstable or potentially unstable patient is reasonably treated with DCO. The clearly stable patient is reasonably treated with nailing. When in doubt, the patient is probably not totally stable, and the safest precaution may be to use DCO as a risk

Caries risk assessment in schoolchildren - a form based on Cariogram® software

Directory of Open Access Journals (Sweden)

Renata Nunes CABRAL

2014-10-01

Full Text Available Identifying caries risk factors is an important measure which contributes to best understanding of the cariogenic profile of the patient. The Cariogram® software provides this analysis, and protocols simplifying the method were suggested. Objectives: The aim of this study was to determine whether a newly developed Caries Risk Assessment (CRA form based on the Cariogram® software could classify schoolchildren according to their caries risk and to evaluate relationships between caries risk and the variables in the form. Material and Methods: 150 schoolchildren aged 5 to 7 years old were included in this survey. Caries prevalence was obtained according to International Caries Detection and Assessment System (ICDAS II. Information for filling in the form based on Cariogram® was collected clinically and from questionnaires sent to parents. Linear regression and a forward stepwise multiple regression model were applied to correlate the variables included in the form with the caries risk. Results: Caries prevalence, in primary dentition, including enamel and dentine carious lesions was 98.6%, and 77.3% when only dentine lesions were considered. Eighty-six percent of the children were classified as at moderate caries risk. The forward stepwise multiple regression model result was significant (R2=0.904; p<0.00001, showing that the most significant factors influencing caries risk were caries experience, oral hygiene, frequency of food consumption, sugar consumption and fluoride sources. Conclusion: The use of the form based on the Cariogram® software enabled classification of the schoolchildren at low, moderate and high caries risk. Caries experience, oral hygiene, frequency of food consumption, sugar consumption and fluoride sources are the variables that were shown to be highly correlated with caries risk.

Combining MCDA and risk analysis: dealing with scaling issues in the multiplicative AHP

DEFF Research Database (Denmark)

Barfod, Michael Bruhn; van den Honert, Rob; Salling, Kim Bang

the progression factor 2 is used for calculating scores of alternatives and √2 for calculation of criteria weights when transforming the verbal judgments stemming from pair wise comparisons. However, depending on the decision context, the decision-makers aversion towards risk, etc., it is most likely......This paper proposes a new decision support system (DSS) for applying risk analysis and stochastic simulation to the multiplicative AHP in order to deal with issues concerning the progression factors. The multiplicative AHP makes use of direct rating on a logarithmic scale, and for this purpose...

Low bone density risk is higher in exercising women with multiple triad risk factors.

Science.gov (United States)

Gibbs, Jenna C; Nattiv, Aurelia; Barrack, Michelle T; Williams, Nancy I; Rauh, Mitchell J; Nichols, Jeanne F; De Souza, Mary Jane

2014-01-01

The cumulative effect of the female athlete triad (Triad) risk factors on the likelihood of low bone mineral density (BMD) in exercising women is unclear. This study aimed to determine the risk of low BMD in exercising women with multiple Triad risk factors. We retrospectively examined cross-sectional data from 437 exercising women (mean ± SD age of 18.0 ± 3.5 yr, weighed 57.5 ± 7.1 kg with 24.5% ± 6.1% body fat) obtained at baseline from 4 prospective cohort studies examining Triad risk factors. Questionnaires were completed to obtain information on demographic characteristics, self-reported eating attitudes/behaviors, menstrual function, sport/activity participation, and medication use. Height and body weight were measured. BMD was measured using dual energy x-ray absorptiometry. Low BMD was defined as z-scores of exercising women. Further research should be conducted to develop a user-friendly algorithm integrating these indicators of risk for low BMD in exercising women (particularly factors associated with low BMI/body weight, menstrual dysfunction, lean sport/activity participation, and elevated dietary restraint).

Latino risk-adjusted mortality in the men screened for the Multiple Risk Factor Intervention Trial.

Science.gov (United States)

Thomas, Avis J; Eberly, Lynn E; Neaton, James D; Smith, George Davey

2005-09-15

Latinos are now the largest minority in the United States, but their distinctive health needs and mortality patterns remain poorly understood. Proportional hazards regressions were used to compare Latino versus White risk- and income-adjusted mortality over 25 years' follow-up from 5,846 Latino and 300,647 White men screened for the Multiple Risk Factor Intervention Trial. Men were aged 35-57 years and residing in 14 states when screened in 1973-1975. Data on coronary heart disease risk factors, self-reported race/ethnicity, and home addresses were obtained at baseline; income was estimated by linking addresses to census data. Mortality follow-up through 1999 was obtained using the National Death Index. The fully adjusted Latino/White hazard ratio for all-cause mortality was 0.82 (95% confidence interval (CI): 0.77, 0.87), based on 1,085 Latino and 73,807 White deaths; this pattern prevailed over time and across states (thus, likely across Latino subgroups). Hazard ratios were significantly greater than one for stroke (hazard ratio = 1.30, 95% CI: 1.01, 1.68), liver cancer (hazard ratio = 2.02, 95% CI: 1.21, 3.37), and infection (hazard ratio = 1.69, 95% CI: 1.24, 2.32). A substudy found only minor racial/ethnic differences in the quality of Social Security numbers, birth dates, soundex-adjusted names, and National Death Index searches. Results were not likely an artifact of return migration or incomplete mortality data.

Comparison of additive (absolute) risk projection models and multiplicative (relative) risk projection models in estimating radiation-induced lifetime cancer risk

International Nuclear Information System (INIS)

Kai, Michiaki; Kusama, Tomoko

1990-01-01

Lifetime cancer risk estimates depend on risk projection models. While the increasing lengths of follow-up observation periods of atomic bomb survivors in Hiroshima and Nagasaki bring about changes in cancer risk estimates, the validity of the two risk projection models, the additive risk projection model (AR) and multiplicative risk projection model (MR), comes into question. This paper compares the lifetime risk or loss of life-expectancy between the two projection models on the basis of BEIR-III report or recently published RERF report. With Japanese cancer statistics the estimates of MR were greater than those of AR, but a reversal of these results was seen when the cancer hazard function for India was used. When we investigated the validity of the two projection models using epidemiological human data and animal data, the results suggested that MR was superior to AR with respect to temporal change, but there was little evidence to support its validity. (author)

Socioeconomic Factors in Childhood and the Risk of Multiple Sclerosis

DEFF Research Database (Denmark)

Nielsen, N. M.; Jorgensen, K. T.; Bager, P.

2013-01-01

In a national cohort comprising 1.5 million Danes born from 1966 to 1992, we studied the association between childhood socioeconomic status (SES) and the risk of multiple sclerosis (MS) from 1981 to 2007 using information about household income and parental educational levels at the persons 15th ...

[Children with Multiple Risk Factor Exposition Benefit from the German "Strengthening Families Program"].

Science.gov (United States)

Bröning, Sonja; Sack, Peter-Michael; Thomsen, Monika; Thomasius, Rainer

2016-09-01

Children with Multiple Risk Factor Exposition Benefit from the German "Strengthening Families Program" The German adaptation of the substance use-preventive family-based Strengthening Families Program 10-14 (SFP, Iowa version) was evaluated in a longitudinal two-year follow-up trial. Participants were N = 292 children with a mean age of twelve years at baseline, and N = 292 parents. We employed a multi-centric, randomized-controlled, two-armed (SFP vs. minimal control condition) study design. Following a "risk moderation hypothesis", we assumed that children with an elevated risk-exposition R(+) would benefit more than children with a low risk-exposition R(-) irrespective of the preventive intervention, and that R(+) under SFP would benefit more than R(+) under the minimal control condition. "Risk-exposition" was measured in correspondence with the Communities That Care Youth Survey-questionnaire. A total of 28 % of children were classified with an elevated risk level. Children's reports confirmed our hypothesis: R(+) report a total of eleven improvements, four of these being significantly more distinct than in the other groups (Anxiety-Depressivity, Punitive Parenting of mother, Punitive Parenting of father, Unbalanced family functioning). In three measures an improvement appears solely in R(+) under SFP (Satisfaction with family functioning, School Attachment and Peer Relationship Quality, Quality of Life). Parents' reports showed a similar tendency, but were less pronounced.

Efficacy of a brief image-based multiple-behavior intervention for college students.

Science.gov (United States)

Werch, Chudley E; Moore, Michele J; Bian, Hui; DiClemente, Carlo C; Ames, Steven C; Weiler, Robert M; Thombs, Dennis; Pokorny, Steven B; Huang, I-Chan

2008-10-01

Epidemiologic data indicate most adolescents and adults experience multiple, simultaneous risk behaviors. The purpose of this study is to examine the efficacy of a brief image-based multiple-behavior intervention (MBI) for college students. A total of 303 college students were randomly assigned to: (1) a brief MBI or (2) a standard care control, with a 3-month postintervention follow-up. Omnibus treatment by time multivariate analysis of variance interactions were significant for three of six behavior groupings, with improvements for college students receiving the brief MBI on alcohol consumption behaviors, F(6, 261) = 2.73, p = 0.01, marijuana-use behaviors, F(4, 278) = 3.18, p = 0.01, and health-related quality of life, F(5, 277) = 2.80, p = 0.02, but not cigarette use, exercise, and nutrition behaviors. Participants receiving the brief MBI also got more sleep, F(1, 281) = 9.49, p = 0.00, than those in the standard care control. A brief image-based multiple-behavior intervention may be useful in influencing a number of critical health habits and health-related quality-of-life indicators of college students.

Multiple-valued logic design based on the multiple-peak BiCMOS-NDR circuits

Directory of Open Access Journals (Sweden)

Kwang-Jow Gan

2016-06-01

Full Text Available Three different multiple-valued logic (MVL designs using the multiple-peak negative-differential-resistance (NDR circuits are investigated. The basic NDR element, which is made of several Si-based metal-oxide-semiconductor field-effect-transistor (MOS and SiGe-based heterojunction-bipolar-transistor (HBT devices, can be implemented by using a standard BiCMOS process. These MVL circuits are designed based on the triggering-pulse control, saw-tooth input signal, and peak-control methods, respectively. However, there are some transient states existing between the multiple stable levels for the first two methods. These states might affect the circuit function in practical application. As a result, our proposed peak-control method for the MVL design can be used to overcome these transient states.

Modular risk analysis for assessing multiple waste sites

International Nuclear Information System (INIS)

Whelan, G.; Buck, J.W.; Nazarali, A.

1994-06-01

Human-health impacts, especially to the surrounding public, are extremely difficult to assess at installations that contain multiple waste sites and a variety of mixed-waste constituents (e.g., organic, inorganic, and radioactive). These assessments must address different constituents, multiple waste sites, multiple release patterns, different transport pathways (i.e., groundwater, surface water, air, and overland soil), different receptor types and locations, various times of interest, population distributions, land-use patterns, baseline assessments, a variety of exposure scenarios, etc. Although the process is complex, two of the most important difficulties to overcome are associated with (1) establishing an approach that allows for modifying the source term, transport, or exposure component as an individual module without having to re-evaluate the entire installation-wide assessment (i.e., all modules simultaneously), and (2) displaying and communicating the results in an understandable and useable maimer to interested parties. An integrated, physics-based, compartmentalized approach, which is coupled to a Geographical Information System (GIS), captures the regional health impacts associated with multiple waste sites (e.g., hundreds to thousands of waste sites) at locations within and surrounding the installation. Utilizing a modular/GIS-based approach overcomes difficulties in (1) analyzing a wide variety of scenarios for multiple waste sites, and (2) communicating results from a complex human-health-impact analysis by capturing the essence of the assessment in a relatively elegant manner, so the meaning of the results can be quickly conveyed to all who review them

Patterns of multiple health risk-behaviours in university students and their association with mental health: application of latent class analysis.

Science.gov (United States)

Kwan, M Y; Arbour-Nicitopoulos, K P; Duku, E; Faulkner, G

2016-08-01

University and college campuses may be the last setting where it is possible to comprehensively address the health of a large proportion of the young adult population. It is important that health promoters understand the collective challenges students are facing, and to better understand the broader lifestyle behavioural patterning evident during this life stage. The purpose of this study was to examine the clustering of modifiable health-risk behaviours and to explore the relationship between these identified clusters and mental health outcomes among a large Canadian university sample. Undergraduate students (n = 837; mean age = 21 years) from the University of Toronto completed the National College Health Assessment survey. The survey consists of approximately 300 items, including assessments of student health status, mental health and health-risk behaviours. Latent class analysis was used to identify patterning based on eight salient health-risk behaviours (marijuana use, other illicit drug use, risky sex, smoking, binge drinking, poor diet, physical inactivity, and insufficient sleep). A three-class model based on student behavioural patterns emerged: "typical," "high-risk" and "moderately healthy." Results also found high-risk students reporting significantly higher levels of stress than typical students (χ2(1671) = 7.26, p Students with the highest likelihood of engaging in multiple health-risk behaviours reported poorer mental health, particularly as it relates to stress. Although these findings should be interpreted with caution due to the 28% response rate, they do suggest that interventions targeting specific student groups with similar patterning of multiple health-risk behaviours may be needed.

Patterns of multiple health risk-behaviours in university students and their association with mental health: application of latent class analysis

Directory of Open Access Journals (Sweden)

M. Y. Kwan

2016-08-01

Full Text Available University and college campuses may be the last setting where it is possible to comprehensively address the health of a large proportion of the young adult population. It is important that health promoters understand the collective challenges students are facing, and to better understand the broader lifestyle behavioural patterning evident during this life stage. The purpose of this study was to examine the clustering of modifiable health-risk behaviours and to explore the relationship between these identified clusters and mental health outcomes among a large Canadian university sample. Methods: Undergraduate students (n = 837; mean age = 21 years from the University of Toronto completed the National College Health Assessment survey. The survey consists of approximately 300 items, including assessments of student health status, mental health and health-risk behaviours. Latent class analysis was used to identify patterning based on eight salient health-risk behaviours (marijuana use, other illicit drug use, risky sex, smoking, binge drinking, poor diet, physical inactivity, and insufficient sleep. Results: A three-class model based on student behavioural patterns emerged: "typical," "high-risk" and "moderately healthy." Results also found high-risk students reporting significantly higher levels of stress than typical students (χ2(1671 = 7.26, p < .01. Conclusion: Students with the highest likelihood of engaging in multiple health-risk behaviours reported poorer mental health, particularly as it relates to stress. Although these findings should be interpreted with caution due to the 28% response rate, they do suggest that interventions targeting specific student groups with similar patterning of multiple health-risk behaviours may be needed.

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

Science.gov (United States)

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.

Risk score modeling of multiple gene to gene interactions using aggregated-multifactor dimensionality reduction

Directory of Open Access Journals (Sweden)

Dai Hongying

2013-01-01

Full Text Available Abstract Background Multifactor Dimensionality Reduction (MDR has been widely applied to detect gene-gene (GxG interactions associated with complex diseases. Existing MDR methods summarize disease risk by a dichotomous predisposing model (high-risk/low-risk from one optimal GxG interaction, which does not take the accumulated effects from multiple GxG interactions into account. Results We propose an Aggregated-Multifactor Dimensionality Reduction (A-MDR method that exhaustively searches for and detects significant GxG interactions to generate an epistasis enriched gene network. An aggregated epistasis enriched risk score, which takes into account multiple GxG interactions simultaneously, replaces the dichotomous predisposing risk variable and provides higher resolution in the quantification of disease susceptibility. We evaluate this new A-MDR approach in a broad range of simulations. Also, we present the results of an application of the A-MDR method to a data set derived from Juvenile Idiopathic Arthritis patients treated with methotrexate (MTX that revealed several GxG interactions in the folate pathway that were associated with treatment response. The epistasis enriched risk score that pooled information from 82 significant GxG interactions distinguished MTX responders from non-responders with 82% accuracy. Conclusions The proposed A-MDR is innovative in the MDR framework to investigate aggregated effects among GxG interactions. New measures (pOR, pRR and pChi are proposed to detect multiple GxG interactions.

Risk factors of suicide mortality among multiple attempters: A national registry study in Taiwan.

Science.gov (United States)

Chen, I-Ming; Liao, Shih-Cheng; Lee, Ming-Been; Wu, Chia-Yi; Lin, Po-Hsien; Chen, Wei J

2016-05-01

Little is known about the risk factors of suicide mortality among multiple attempters. This study aims to investigate the predictors of suicidal mortality in a prospective cohort of attempters in Taiwan, focusing on the time interval and suicide method change between the last two nonfatal attempts. The representative data retrieved from the National Suicide Surveillance System (NSSS) was linked with National Mortality Database to identify the causes of death in multiple attempters during 2006-2008. Cox-proportional hazard models were applied to calculate the hazard ratios for the predictors of suicide. Among the 55,560 attempters, 6485 (11.7%) had survived attempts ranging from one to 11 times; 861 (1.5%) eventually died by suicide. Multiple attempters were characterized by female (OR = 1.56, p suicidal death were identified as male, older age (≥ 45 years), shorter interval and not maintaining methods of low lethality in the last two nonfatal attempts. Receipt of nationwide aftercare was associated with lower risk of suicide but the effect was insignificant. The time interval of the last two nonfatal attempts and alteration in the lethality of suicide method were significant factors for completed suicide. Risk assessment involving these two factors may be necessary for multiple attempters in different clinical settings. Effective strategies for suicide prevention emphasizing this high risk population should be developed in the future. Copyright © 2015. Published by Elsevier B.V.

Risks and benefits of multiple sexual partnerships: beliefs of rural Nigerian adolescent males.

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Izugbara, Chimaraoke Otutubikey; Nwabuawele Modo, Felicia

2007-09-01

Drawing on interview data from rural Nigeria, the article explores male youth perceptions of the risks and benefits of multiple sexual partnerships. Participants associated having multiple sexual partners with several harmful health and nonhealth outcomes, including sexually transmitted infections, and frequently confirmed that the practice also bolsters their sense of maleness and boosts their acceptance and ranking among peers. Young males' involvement in multiple sexual partnerships should not be seen as always consequent on their ignorance of and/or indifference to the risks inherent in the behavior. It could also result from the integrality of the behavior to the social processes through which male youths validate their masculinity, mark their transition from boyhood to malehood, and configure their identities to gain acceptance into a local male peer community. Sexuality education curricula that ignore adolescents' understandings of the benefits of their sexual practices may not deliver expected objectives.

Genetic variation in the base excision repair pathway, environmental risk factors, and colorectal adenoma risk.

Directory of Open Access Journals (Sweden)

Roman Corral

Full Text Available Cigarette smoking, high alcohol intake, and low dietary folate levels are risk factors for colorectal adenomas. Oxidative damage caused by these three factors can be repaired through the base excision repair pathway (BER. We hypothesized that genetic variation in BER might modify colorectal adenoma risk. In a sigmoidoscopy-based study, we examined associations between 182 haplotype tagging SNPs in 14 BER genes, and colorectal adenoma risk, and examined their potential role as modifiers of the effect cigarette smoking, alcohol intake, and dietary folate levels. Among all individuals, no statistically significant associations between BER SNPs and adenoma risk persisted after correction for multiple comparisons. However, among Asian-Pacific Islanders we observed two SNPs in FEN1 and one in NTHL1, and among African-Americans one SNP in APEX1 that were associated with colorectal adenoma risk. Significant associations were also observed between SNPs in the NEIL2 gene and rectal adenoma risk. Three SNPS modified the effect of smoking (MUTYH interaction p = 0.002; OGG1 interaction p = 0.013; FEN1 interaction p = 0.013, one SNP in LIG3 modified the effect of alcohol consumption (interaction p = 0.024 and two SNPs in LIG3 modified the effect of dietary folate (interaction p = 0.001 and p = 0.08 on colorectal adenoma risk. These findings support a role for genetic variants in the BER pathway as potential modifiers of colorectal adenoma risk. Our findings strengthen the role of oxidative damage induced by key lifestyle and dietary risk factors in colorectal adenoma formation.

Obesity interacts with infectious mononucleosis in risk of multiple sclerosis.

Science.gov (United States)

Hedström, A K; Lima Bomfim, I; Hillert, J; Olsson, T; Alfredsson, L

2015-03-01

The possible interaction between adolescent obesity and past infectious mononucleosis (IM) was investigated with regard to multiple sclerosis (MS) risk. This report is based on two population-based case-control studies, one with incident cases (1780 cases, 3885 controls) and one with prevalent cases (4502 cases, 4039 controls). Subjects were categorized based on adolescent body mass index (BMI) and past IM and compared with regard to occurrence of MS by calculating odds ratios with 95% confidence intervals (CIs) employing logistic regression. A potential interaction between adolescent BMI and past IM was evaluated by calculating the attributable proportion due to interaction. Regardless of human leukocyte antigen (HLA) status, a substantial interaction was observed between adolescent obesity and past IM with regard to MS risk. The interaction was most evident when IM after the age of 10 was considered (attributable proportion due to interaction 0.8, 95% CI 0.6-1.0 in the incident study, and attributable proportion due to interaction 0.7, 95% CI 0.5-1.0 in the prevalent study). In the incident study, the odds ratio of MS was 14.7 (95% CI 5.9-36.6) amongst subjects with adolescent obesity and past IM after the age of 10, compared with subjects with none of these exposures. The corresponding odds ratio in the prevalent study was 13.2 (95% CI 5.2-33.6). An obese state both impacts the cellular immune response to infections and induces a state of chronic immune-mediated inflammation which may contribute to explain our finding of an interaction between adolescent BMI and past IM. Measures taken against adolescent obesity may thus be a preventive strategy against MS. © 2014 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.

Cell-based therapeutic strategies for multiple sclerosis.

Science.gov (United States)

Scolding, Neil J; Pasquini, Marcelo; Reingold, Stephen C; Cohen, Jeffrey A

2017-11-01

The availability of multiple disease-modifying medications with regulatory approval to treat multiple sclerosis illustrates the substantial progress made in therapy of the disease. However, all are only partially effective in preventing inflammatory tissue damage in the central nervous system and none directly promotes repair. Cell-based therapies, including immunoablation followed by autologous haematopoietic stem cell transplantation, mesenchymal and related stem cell transplantation, pharmacologic manipulation of endogenous stem cells to enhance their reparative capabilities, and transplantation of oligodendrocyte progenitor cells, have generated substantial interest as novel therapeutic strategies for immune modulation, neuroprotection, or repair of the damaged central nervous system in multiple sclerosis. Each approach has potential advantages but also safety concerns and unresolved questions. Moreover, clinical trials of cell-based therapies present several unique methodological and ethical issues. We summarize here the status of cell-based therapies to treat multiple sclerosis and make consensus recommendations for future research and clinical trials. © The Author (2017). Published by Oxford University Press on behalf of the Guarantors of Brain.

Can an Internet-based health risk assessment highlight problems of heart disease risk factor awareness? A cross-sectional analysis.

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Dickerson, Justin B; McNeal, Catherine J; Tsai, Ginger; Rivera, Cathleen M; Smith, Matthew Lee; Ohsfeldt, Robert L; Ory, Marcia G

2014-04-18

Health risk assessments are becoming more popular as a tool to conveniently and effectively reach community-dwelling adults who may be at risk for serious chronic conditions such as coronary heart disease (CHD). The use of such instruments to improve adults' risk factor awareness and concordance with clinically measured risk factor values could be an opportunity to advance public health knowledge and build effective interventions. The objective of this study was to determine if an Internet-based health risk assessment can highlight important aspects of agreement between respondents' self-reported and clinically measured CHD risk factors for community-dwelling adults who may be at risk for CHD. Data from an Internet-based cardiovascular health risk assessment (Heart Aware) administered to community-dwelling adults at 127 clinical sites were analyzed. Respondents were recruited through individual hospital marketing campaigns, such as media advertising and print media, found throughout inpatient and outpatient facilities. CHD risk factors from the Framingham Heart Study were examined. Weighted kappa statistics were calculated to measure interrater agreement between respondents' self-reported and clinically measured CHD risk factors. Weighted kappa statistics were then calculated for each sample by strata of overall 10-year CHD risk. Three samples were drawn based on strategies for treating missing data: a listwise deleted sample, a pairwise deleted sample, and a multiple imputation (MI) sample. The MI sample (n=16,879) was most appropriate for addressing missing data. No CHD risk factor had better than marginal interrater agreement (κ>.60). High-density lipoprotein cholesterol (HDL-C) exhibited suboptimal interrater agreement that deteriorated (eg, κInternet-based health risk assessments such as Heart Aware may contribute to public health surveillance, but they must address selection bias of Internet-based recruitment methods.

Iodine-based contrast media, multiple myeloma and monoclonal gammopathies: literature review and ESUR Contrast Media Safety Committee guidelines.

Science.gov (United States)

Stacul, Fulvio; Bertolotto, Michele; Thomsen, Henrik S; Pozzato, Gabriele; Ugolini, Donatella; Bellin, Marie-France; Bongartz, Georg; Clement, Olivier; Heinz-Peer, Gertraud; van der Molen, Aart; Reimer, Peter; Webb, Judith A W

2018-02-01

Many radiologists and clinicians still consider multiple myeloma (MM) and monoclonal gammopathies (MG) a contraindication for using iodine-based contrast media. The ESUR Contrast Media Safety Committee performed a systematic review of the incidence of post-contrast acute kidney injury (PC-AKI) in these patients. A systematic search in Medline and Scopus databases was performed for renal function deterioration studies in patients with MM or MG following administration of iodine-based contrast media. Data collection and analysis were performed according to the PRISMA statement 2009. Eligibility criteria and methods of analysis were specified in advance. Cohort and case-control studies reporting changes in renal function were included. Thirteen studies were selected that reported 824 iodine-based contrast medium administrations in 642 patients with MM or MG, in which 12 unconfounded cases of PC-AKI were found (1.6 %). The majority of patients had intravenous urography with high osmolality ionic contrast media after preparatory dehydration and purgation. MM and MG alone are not risk factors for PC-AKI. However, the risk of PC-AKI may become significant in dehydrated patients with impaired renal function. Hypercalcaemia may increase the risk of kidney damage, and should be corrected before contrast medium administration. Assessment for Bence-Jones proteinuria is not necessary. • Monoclonal gammopathies including multiple myeloma are a large spectrum of disorders. • In monoclonal gammopathy with normal renal function, PC-AKI risk is not increased. • Renal function is often reduced in myeloma, increasing the risk of PC-AKI. • Correction of hypercalcaemia is necessary in myeloma before iodine-based contrast medium administration. • Bence-Jones proteinuria assessment in myeloma is unnecessary before iodine-based contrast medium administration.

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

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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.

Major stressful life events in adulthood and risk of multiple sclerosis

DEFF Research Database (Denmark)

Nielsen, Nete Munk; Bager, Peter; Simonsen, Jacob

2014-01-01

It is unclear whether psychological stress is associated with increased risk of multiple sclerosis (MS). We studied the association between major stressful life events and MS in a nationwide cohort study using death of a child or a spouse or marital dissolution as indicators of severe stress....

Utility of multiple rule out CT screening of high-risk atraumatic patients in an emergency department-a feasibility study

DEFF Research Database (Denmark)

Pries-Heje, Mia M; Hasselbalch, Rasmus B; Raaschou, Henriette

2018-01-01

malignant tumors in 10 (10%) cases. The mean size specific radiation dose was 15.9 mSv (± 3.1 mSv). CONCLUSION: Screening with a multi-rule out CT scan of high-risk patients in an ED is feasible and result in discovery of clinically unrecognized diagnoses and malignant tumors, but at the cost of radiation......BACKGROUND: Several large trials have evaluated the effect of CT screening based on specific symptoms, with varying outcomes. Screening of patients with CT based on their prognosis alone has not been examined before. For moderate-to-high risk patients presenting in the emergency department (ED......), the potential gain from a CT scan might outweigh the risk of radiation exposure. We hypothesized that an accelerated "multiple rule out" CT screening of moderate-to-high risk patients will detect many clinically unrecognized diagnoses that affect change in treatment. METHOD: Patients ≥ 40 years, triaged as high...

Risk of vertebral compression fractures in multiple myeloma patients

OpenAIRE

Anitha, D.; Thomas, Baum; Jan, Kirschke S.; Subburaj, Karupppasamy

2017-01-01

Abstract The purpose of this study was to develop and validate a finite element (FE) model to predict vertebral bone strength in vitro using multidetector computed tomography (MDCT) images in multiple myeloma (MM) patients, to serve as a complementing tool to assess fracture risk. In addition, it also aims to differentiate MM patients with and without vertebral compression fractures (VCFs) by performing FE analysis on vertebra segments (T1?L5) obtained from in vivo routine MDCT imaging scans....

Managing wildfire events: risk-based decision making among a group of federal fire managers

Science.gov (United States)

Robyn S. Wilson; Patricia L. Winter; Lynn A. Maguire; Timothy. Ascher

2011-01-01

Managing wildfire events to achieve multiple management objectives involves a high degree of decision complexity and uncertainty, increasing the likelihood that decisions will be informed by experience-based heuristics triggered by available cues at the time of the decision. The research reported here tests the prevalence of three risk-based biases among 206...

Multiple shooting applied to robust reservoir control optimization including output constraints on coherent risk measures

DEFF Research Database (Denmark)

Codas, Andrés; Hanssen, Kristian G.; Foss, Bjarne

2017-01-01

The production life of oil reservoirs starts under significant uncertainty regarding the actual economical return of the recovery process due to the lack of oil field data. Consequently, investors and operators make management decisions based on a limited and uncertain description of the reservoir....... In this work, we propose a new formulation for robust optimization of reservoir well controls. It is inspired by the multiple shooting (MS) method which permits a broad range of parallelization opportunities and output constraint handling. This formulation exploits coherent risk measures, a concept...

77 FR 53059 - Risk-Based Capital Guidelines: Market Risk

Science.gov (United States)

2012-08-30

...'' framework that includes (1) Risk-based capital requirements for credit risk, market risk, and operational... default and credit quality migration risk for non-securitization credit products. With respect to... securitization positions, the revisions assign a specific risk- weighting factor based on the credit rating of a...

Risk-based safety indicators

International Nuclear Information System (INIS)

Sedlak, J.

2001-12-01

The report is structured as follows: 1. Risk-based safety indicators: Typology of risk-based indicators (RBIs); Tools for defining RBIs; Requirements for the PSA model; Data sources for RBIs; Types of risks monitored; RBIs and operational safety indicators; Feedback from operating experience; PSO model modification for RBIs; RBI categorization; RBI assessment; RBI applications; Suitable RBI applications. 2. Proposal for risk-based indicators: Acquiring information from operational experience; Method of acquiring safety relevance coefficients for the systems from a PSA model; Indicator definitions; On-line indicators. 3. Annex: Application of RBIs worldwide. (P.A.)

Safety concerns and risk management of multiple sclerosis therapies

DEFF Research Database (Denmark)

Soelberg Sorensen, P.

2017-01-01

Currently, more than ten drugs have been approved for treatment of relapsing-remitting multiple sclerosis (MS). Newer treatments may be more effective, but have less favorable safety record. Interferon-β preparations and glatiramer acetate treatment require frequent subcutaneous or intramuscular...... disease activity can choose between dimethyl fumarate and teriflunomide or the “old injectable.” Patients with very active MS may choose a more effective drug as the initial treatment. In case of side effects on one drug, switch to another drug can be tried. Suboptimal effect of the first drug indicates...... escalation to a highly efficacious drug. A favorable benefit-risk balance can be maintained by appropriate patient selection and appropriate risk management on therapy. New treatments will within the coming 1-2 years change our current treatment algorithm for relapsing-remitting MS....

A population-based study of effect of multiple birth on infant mortality in Nigeria

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Uthman Mubashir B

2008-09-01

Full Text Available Abstract Background Multi-foetal pregnancies and multiple births including twins and higher order multiples births such as triplets and quadruplets are high-risk pregnancy and birth. These high-risk groups contribute to the higher rate of childhood mortality especially during early period of life. Methods We examined the relationship between multiple births and infant mortality using univariable and multivariable survival regression procedure with Weibull hazard function, controlling for child's sex, birth order, prenatal care, delivery assistance; mother's age at child birth, nutritional status, education level; household living conditions and several other risk factors. Results Children born multiple births were more than twice as likely to die during infancy as infants born singleton (hazard ratio = 2.19; 95% confidence interval: 1.50, 3.19 holding other factors constant. Maternal education and household asset index were associated with lower risk of infant mortality. Conclusion Multiple births are strongly negatively associated with infant survival in Nigeria independent of other risk factors. Mother's education played a protective role against infant death. This evidence suggests that improving maternal education may be key to improving child survival in Nigeria. A well-educated mother has a better chance of satisfying important factors that can improve infant survival: the quality of infant feeding, general care, household sanitation, and adequate use of preventive and curative health services.

Using multiple sampling approaches to measure sexual risk-taking among young people in Haiti: programmatic implications.

Science.gov (United States)

Speizer, Ilene S; Beauvais, Harry; Gómez, Anu Manchikanti; Outlaw, Theresa Finn; Roussel, Barbara

2009-12-01

No previous published research has examined the applicability of varying methods for identifying young people who are at high risk of experiencing unintended pregnancy and acquiring HIV infection. This study compares three surveys of young people aged 15-24 in Port-au-Prince, Haiti, in terms of their sociodemographic characteristics and sexual behaviors and the surveys'usefulness for identifying young people at high risk and for program planning. The surveys consist of responses from: a representative sample of young people in the 2005-06 Haiti Demographic and Health Survey (HDHS), a 2004 facility-based study, and a 2006-07 venue-based study that used the Priorities for Local AIDS Control Efforts (PLACE) method. The facility-based and PLACE studies included larger proportions of single, sexually experienced young people and people who knew someone with HIV/ AIDS than did the HDHS. More respondents in the PLACE sample had multiple sex partners in the past year and received money or gifts in return for sex, compared with respondents in the facility study. At first and last sex, more PLACE respondents used contraceptives, including condoms. Experience of pregnancy was most commonly reported in the data from the facility-based sample; however, more ever-pregnant PLACE respondents than others reported ever having terminated a pregnancy. Program managers seeking to implement prevention activities should consider using facility- or venue-based methods to identify and understand the behaviors of young people at high risk.

A METEOROLOGICAL RISK ASSESSMENT METHOD FOR POWER LINES BASED ON GIS AND MULTI-SENSOR INTEGRATION

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Z. Lin

2016-06-01

Full Text Available Power lines, exposed in the natural environment, are vulnerable to various kinds of meteorological factors. Traditional research mainly deals with the influence of a single meteorological condition on the power line, which lacks of comprehensive effects evaluation and analysis of the multiple meteorological factors. In this paper, we use multiple meteorological monitoring data obtained by multi-sensors to implement the meteorological risk assessment and early warning of power lines. Firstly, we generate meteorological raster map from discrete meteorological monitoring data using spatial interpolation. Secondly, the expert scoring based analytic hierarchy process is used to compute the power line risk index of all kinds of meteorological conditions and establish the mathematical model of meteorological risk. By adopting this model in raster calculator of ArcGIS, we will have a raster map showing overall meteorological risks for power line. Finally, by overlaying the power line buffer layer to that raster map, we will get to know the exact risk index around a certain part of power line, which will provide significant guidance for power line risk management. In the experiment, based on five kinds of observation data gathered from meteorological stations in Guizhou Province of China, including wind, lightning, rain, ice, temperature, we carry on the meteorological risk analysis for the real power lines, and experimental results have proved the feasibility and validity of our proposed method.

Risk-Sensitive Multiagent Decision-Theoretic Planning Based on MDP and One-Switch Utility Functions

Directory of Open Access Journals (Sweden)

Wei Zeng

2014-01-01

Full Text Available In high stakes situations decision-makers are often risk-averse and decision-making processes often take place in group settings. This paper studies multiagent decision-theoretic planning under Markov decision processes (MDPs framework with considering the change of agent’s risk attitude as his wealth level varies. Based on one-switch utility function that describes agent’s risk attitude change with his wealth level, we give the additive and multiplicative aggregation models of group utility and adopt maximizing expected group utility as planning objective. When the wealth level approaches infinity, the characteristics of optimal policy are analyzed for the additive and multiplicative aggregation model, respectively. Then a backward-induction method is proposed to divide the wealth level interval from negative infinity to initial wealth level into subintervals and determine the optimal policy in states and subintervals. The proposed method is illustrated by numerical examples and the influences of agent’s risk aversion parameters and weights on group decision-making are also analyzed.

MR-based conductivity imaging using multiple receiver coils.

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Lee, Joonsung; Shin, Jaewook; Kim, Dong-Hyun

2016-08-01

To propose a signal combination method for MR-based tissue conductivity mapping using a standard clinical scanner with multiple receiver coils. The theory of the proposed method is presented with two practical approaches, a coil-specific approach and a subject-specific approach. Conductivity maps were reconstructed using the transceive phase of the combined signal. The sensitivities of the coefficients used for signal combination were analyzed and the method was compared with other signal combination methods. For validation, multiple receiver brain coils and multiple receiver breast coils were used in phantom, in vivo brain, and in vivo breast studies. The variation among the conductivity estimates was conductivity estimates. MR-based tissue conductivity mapping is feasible when using a standard clinical MR scanner with multiple receiver coils. The proposed method reduces systematic errors in phase-based conductivity mapping that can occur due to the inhomogeneous magnitude of the combined receive profile. Magn Reson Med 76:530-539, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Early alveolar and systemic mediator release in patients at different risks for ARDS after multiple trauma.

Science.gov (United States)

Raymondos, Konstantinos; Martin, Michael U; Schmudlach, Tanja; Baus, Stefan; Weilbach, Christian; Welte, Tobias; Krettek, Christian; Frink, Michael; Hildebrand, Frank

2012-02-01

Alveolar IL-8 has been reported to early identify patients at-risk to develop ARDS. However, it remains unknown how alveolar IL-8 is related to pulmonary and systemic inflammation in patients predisposed for ARDS. We studied 24 patients 2-6h after multiple trauma. Patients with IL-8 >200 pg/ml in bronchoalveolar lavage (BAL) were assigned to the group at high risk for ARDS (H, n = 8) and patients with BAL IL-8 mediators. The enhanced alveolar and systemic inflammation associated with alveolar IL-8 release should be considered to identify high-risk patients for pulmonary complications after multiple trauma to adjust surgical and other treatment strategies to the individual risk profile. Copyright © 2011 Elsevier Ltd. All rights reserved.

Examining relationships between multiple health risk behaviors, well-being, and productivity.

Science.gov (United States)

Evers, Kerry E; Castle, Patricia H; Prochaska, James O; Prochaska, Janice M

2014-06-01

Traditionally, the concept of health promotion has emphasized the reduction of health risk behaviors to reduce disease and impairment. Well-being research expands this focus to include positive constructs such as thriving, productivity, life-evaluation, and emotional and physical health. The objective of the present study was to examine the relationships between health risk behaviors and specific measures of individual well-being. Participants (N = 790) from 49 states completed a one-time online assessment that included the Life-Evaluation Index, Emotional and Physical Health Ladders, the Health Risk Intervention Assessment, and the Work Productivity and Activity Improvement Questionnaire for General Health. Life Evaluation and physical and emotional health were all inversely related to the number of health risk behaviors, with higher well-being scores associated with lower number of risk behaviors. Across the three Life Evaluation categories (Suffering, Struggling, and Thriving) the number of health risk behaviors decreased, productivity loss decreased, and emotional and physical health increased. The results add to previous research on how reducing multiple health risk behaviors can be combined with well-being, i.e., an emphasis on increasing life-evaluation, emotional and physical health, better functioning, and productivity.

Multiple Sclerosis: associated cardiometabolic risks and impact of exercise therapy

OpenAIRE

Jacobs, Jasper

2016-01-01

Multiple sclerosis (MS) is characterized by complex heterogeneous symptoms, which often leads to a more sedentary lifestyle. This lifestyle increases the likelihood to develop secondary health problems, like cardiometabolic risk (CMR) profile. However, in other population these secondary health problems can be, partly, reversed by exercise therapy. We hypothesized that MS affects the CMR profile, but the outcome can be reversed following exercise therapy. Persons with MS and matched healthy c...

Impact of high-intensity concurrent training on cardiovascular risk factors in persons with multiple sclerosis - pilot study.

Science.gov (United States)

Keytsman, Charly; Hansen, Dominique; Wens, Inez; O Eijnde, Bert

2017-10-27

High-intensity concurrent training positively affects cardiovascular risk factors. Because this was never investigated in multiple sclerosis, the present pilot study explored the impact of this training on cardiovascular risk factors in this population. Before and after 12 weeks of high-intense concurrent training (interval and strength training, 5 sessions per 2 weeks, n = 16) body composition, resting blood pressure and heart rate, 2-h oral glucose tolerance (insulin sensitivity, glycosylated hemoglobin, blood glucose and insulin concentrations), blood lipids (high- and low-density lipoprotein, total cholesterol, triglyceride levels) and C-reactive protein were analyzed. Twelve weeks of high-intense concurrent training significantly improved resting heart rate (-6%), 2-h blood glucose concentrations (-13%) and insulin sensitivity (-24%). Blood pressure, body composition, blood lipids and C-reactive protein did not seem to be affected. Under the conditions of this pilot study, 12 weeks of concurrent high-intense interval and strength training improved resting heart rate, 2-h glucose and insulin sensitivity in multiple sclerosis but did not affect blood C-reactive protein levels, blood pressure, body composition and blood lipid profiles. Further, larger and controlled research investigating the effects of high-intense concurrent training on cardiovascular risk factors in multiple sclerosis is warranted. Implications for rehabilitation High-intensity concurrent training improves cardiovascular fitness. This pilot study explores the impact of this training on cardiovascular risk factors in multiple sclerosis. Despite the lack of a control group, high-intense concurrent training does not seem to improve cardiovascular risk factors in multiple sclerosis.

Signal Recovery in Compressive Sensing via Multiple Sparsifying Bases

DEFF Research Database (Denmark)

Wijewardhana, U. L.; Belyaev, Evgeny; Codreanu, M.

2017-01-01

is sparse is the key assumption utilized by such algorithms. However, the basis in which the signal is the sparsest is unknown for many natural signals of interest. Instead there may exist multiple bases which lead to a compressible representation of the signal: e.g., an image is compressible in different...... wavelet transforms. We show that a significant performance improvement can be achieved by utilizing multiple estimates of the signal using sparsifying bases in the context of signal reconstruction from compressive samples. Further, we derive a customized interior-point method to jointly obtain multiple...... estimates of a 2-D signal (image) from compressive measurements utilizing multiple sparsifying bases as well as the fact that the images usually have a sparse gradient....

Network Diffusion-Based Prioritization of Autism Risk Genes Identifies Significantly Connected Gene Modules

Directory of Open Access Journals (Sweden)

Ettore Mosca

2017-09-01

Full Text Available Autism spectrum disorder (ASD is marked by a strong genetic heterogeneity, which is underlined by the low overlap between ASD risk gene lists proposed in different studies. In this context, molecular networks can be used to analyze the results of several genome-wide studies in order to underline those network regions harboring genetic variations associated with ASD, the so-called “disease modules.” In this work, we used a recent network diffusion-based approach to jointly analyze multiple ASD risk gene lists. We defined genome-scale prioritizations of human genes in relation to ASD genes from multiple studies, found significantly connected gene modules associated with ASD and predicted genes functionally related to ASD risk genes. Most of them play a role in synapsis and neuronal development and function; many are related to syndromes that can be in comorbidity with ASD and the remaining are involved in epigenetics, cell cycle, cell adhesion and cancer.

Deep convolutional neural network based antenna selection in multiple-input multiple-output system

Science.gov (United States)

Cai, Jiaxin; Li, Yan; Hu, Ying

2018-03-01

Antenna selection of wireless communication system has attracted increasing attention due to the challenge of keeping a balance between communication performance and computational complexity in large-scale Multiple-Input MultipleOutput antenna systems. Recently, deep learning based methods have achieved promising performance for large-scale data processing and analysis in many application fields. This paper is the first attempt to introduce the deep learning technique into the field of Multiple-Input Multiple-Output antenna selection in wireless communications. First, the label of attenuation coefficients channel matrix is generated by minimizing the key performance indicator of training antenna systems. Then, a deep convolutional neural network that explicitly exploits the massive latent cues of attenuation coefficients is learned on the training antenna systems. Finally, we use the adopted deep convolutional neural network to classify the channel matrix labels of test antennas and select the optimal antenna subset. Simulation experimental results demonstrate that our method can achieve better performance than the state-of-the-art baselines for data-driven based wireless antenna selection.

Cumulative Risk Assessment (CRA): transforming the way we assess health risks.

Science.gov (United States)

Williams, Pamela R D; Dotson, G Scott; Maier, Andrew

2012-10-16

Human health risk assessments continue to evolve and now focus on the need for cumulative risk assessment (CRA). CRA involves assessing the combined risk from coexposure to multiple chemical and nonchemical stressors for varying health effects. CRAs are broader in scope than traditional chemical risk assessments because they allow for a more comprehensive evaluation of the interaction between different stressors and their combined impact on human health. Future directions of CRA include greater emphasis on local-level community-based assessments; integrating environmental, occupational, community, and individual risk factors; and identifying and implementing common frameworks and risk metrics for incorporating multiple stressors.

Integrative assessment of multiple pesticides as risk factors for non-Hodgkin's lymphoma among men.

Science.gov (United States)

De Roos, A J; Zahm, S H; Cantor, K P; Weisenburger, D D; Holmes, F F; Burmeister, L F; Blair, A

2003-09-01

An increased rate of non-Hodgkin's lymphoma (NHL) has been repeatedly observed among farmers, but identification of specific exposures that explain this observation has proven difficult. During the 1980s, the National Cancer Institute conducted three case-control studies of NHL in the midwestern United States. These pooled data were used to examine pesticide exposures in farming as risk factors for NHL in men. The large sample size (n = 3417) allowed analysis of 47 pesticides simultaneously, controlling for potential confounding by other pesticides in the model, and adjusting the estimates based on a prespecified variance to make them more stable. Reported use of several individual pesticides was associated with increased NHL incidence, including organophosphate insecticides coumaphos, diazinon, and fonofos, insecticides chlordane, dieldrin, and copper acetoarsenite, and herbicides atrazine, glyphosate, and sodium chlorate. A subanalysis of these "potentially carcinogenic" pesticides suggested a positive trend of risk with exposure to increasing numbers. Consideration of multiple exposures is important in accurately estimating specific effects and in evaluating realistic exposure scenarios.

Multiple Gene-Environment Interactions on the Angiogenesis Gene-Pathway Impact Rectal Cancer Risk and Survival

Directory of Open Access Journals (Sweden)

Noha Sharafeldin

2017-09-01

Full Text Available Characterization of gene-environment interactions (GEIs in cancer is limited. We aimed at identifying GEIs in rectal cancer focusing on a relevant biologic process involving the angiogenesis pathway and relevant environmental exposures: cigarette smoking, alcohol consumption, and animal protein intake. We analyzed data from 747 rectal cancer cases and 956 controls from the Diet, Activity and Lifestyle as a Risk Factor for Rectal Cancer study. We applied a 3-step analysis approach: first, we searched for interactions among single nucleotide polymorphisms on the pathway genes; second, we searched for interactions among the genes, both steps using Logic regression; third, we examined the GEIs significant at the 5% level using logistic regression for cancer risk and Cox proportional hazards models for survival. Permutation-based test was used for multiple testing adjustment. We identified 8 significant GEIs associated with risk among 6 genes adjusting for multiple testing: TNF (OR = 1.85, 95% CI: 1.10, 3.11, TLR4 (OR = 2.34, 95% CI: 1.38, 3.98, and EGR2 (OR = 2.23, 95% CI: 1.04, 4.78 with smoking; IGF1R (OR = 1.69, 95% CI: 1.04, 2.72, TLR4 (OR = 2.10, 95% CI: 1.22, 3.60 and EGR2 (OR = 2.12, 95% CI: 1.01, 4.46 with alcohol; and PDGFB (OR = 1.75, 95% CI: 1.04, 2.92 and MMP1 (OR = 2.44, 95% CI: 1.24, 4.81 with protein. Five GEIs were associated with survival at the 5% significance level but not after multiple testing adjustment: CXCR1 (HR = 2.06, 95% CI: 1.13, 3.75 with smoking; and KDR (HR = 4.36, 95% CI: 1.62, 11.73, TLR2 (HR = 9.06, 95% CI: 1.14, 72.11, EGR2 (HR = 2.45, 95% CI: 1.42, 4.22, and EGFR (HR = 6.33, 95% CI: 1.95, 20.54 with protein. GEIs between angiogenesis genes and smoking, alcohol, and animal protein impact rectal cancer risk. Our results support the importance of considering the biologic hypothesis to characterize GEIs associated with cancer outcomes.

Tehran Survey of Potential Risk Factors for Multiple Births

Directory of Open Access Journals (Sweden)

Reza Omani Samani

2017-09-01

Full Text Available Background The multiple pregnancy incidence is increasing worldwide. This increased incidence is concerning to the health care system. This study aims to determine the frequency of multiple pregnancy and identify factors that affect this frequency in Tehran, Iran. Materials and Methods This cross-sectional study included 5170 mothers in labor between July 6-21, 2015 from 103 hospitals with Obstetrics and Gynecology Wards. The questionnaire used in this study consisted of five parts: demographic characteristics; information related to pregnancy; information related to the infant; information regarding the multiple pregnancy; and information associated with infertility. We recruited 103 trained midwives to collect data related to the questionnaire from eligible participants through an interview and medical records review. Frequencies and odds ratios (OR for the association between multiple pregnancy and the selected characteristics (maternal age, economic status, history of multiple pregnancy in first-degree relatives, and reproductive history were computed by multiple logistic regression. Stata software, version 13 (Stata Corp, College Station, TX, USA was used for all statistical analyses. Results Multiple pregnancy had a prevalence of 1.48% [95% confidence interval (CI: 1.19-1.85]. After controlling for confounding variables, we observed a significant association between frequency of multiple pregnancy and mother’s age (OR=1.04, 95% CI: 1.001-1.09, P=0.044, assisted reproductive technique (ART, OR=6.11, 95% CI: 1.7- 21.97, P=0.006, and history of multiple pregnancy in the mother’s family (OR=5.49, 95% CI: 3.55-9.93, P=0.001. Conclusion The frequency of multiple pregnancy approximated results reported in previous studies in Iran. Based on the results, we observed significantly greater frequency of multiple pregnancy in older women, those with a history of ART, and a history of multiple pregnancy in the mother’s family compared to the other

Cumulative health risk assessment: integrated approaches for multiple contaminants, exposures, and effects

International Nuclear Information System (INIS)

Rice, Glenn; Teuschler, Linda; MacDonel, Margaret; Butler, Jim; Finster, Molly; Hertzberg, Rick; Harou, Lynne

2007-01-01

Available in abstract form only. Full text of publication follows: As information about environmental contamination has increased in recent years, so has public interest in the combined effects of multiple contaminants. This interest has been highlighted by recent tragedies such as the World Trade Center disaster and hurricane Katrina. In fact, assessing multiple contaminants, exposures, and effects has long been an issue for contaminated sites, including U.S. Department of Energy (DOE) legacy waste sites. Local citizens have explicitly asked the federal government to account for cumulative risks, with contaminants moving offsite via groundwater flow, surface runoff, and air dispersal being a common emphasis. Multiple exposures range from ingestion and inhalation to dermal absorption and external gamma irradiation. Three types of concerns can lead to cumulative assessments: (1) specific sources or releases - e.g., industrial facilities or accidental discharges; (2) contaminant levels - in environmental media or human tissues; and (3) elevated rates of disease - e.g., asthma or cancer. The specific initiator frames the assessment strategy, including a determination of appropriate models to be used. Approaches are being developed to better integrate a variety of data, extending from environmental to internal co-location of contaminants and combined effects, to support more practical assessments of cumulative health risks. (authors)

Risk-based configuration control

International Nuclear Information System (INIS)

Szikszai, T.

1997-01-01

The presentation discusses the following issues: The Configuration Control; The Risk-based Configuration Control (during power operation mode, and during shutdown mode). PSA requirements. Use of Risk-based Configuration Control System. Configuration Management (basic elements, benefits, information requirements)

Class II HLA interactions modulate genetic risk for multiple sclerosis

Science.gov (United States)

Dilthey, Alexander T; Xifara, Dionysia K; Ban, Maria; Shah, Tejas S; Patsopoulos, Nikolaos A; Alfredsson, Lars; Anderson, Carl A; Attfield, Katherine E; Baranzini, Sergio E; Barrett, Jeffrey; Binder, Thomas M C; Booth, David; Buck, Dorothea; Celius, Elisabeth G; Cotsapas, Chris; D’Alfonso, Sandra; Dendrou, Calliope A; Donnelly, Peter; Dubois, Bénédicte; Fontaine, Bertrand; Fugger, Lars; Goris, An; Gourraud, Pierre-Antoine; Graetz, Christiane; Hemmer, Bernhard; Hillert, Jan; Kockum, Ingrid; Leslie, Stephen; Lill, Christina M; Martinelli-Boneschi, Filippo; Oksenberg, Jorge R; Olsson, Tomas; Oturai, Annette; Saarela, Janna; Søndergaard, Helle Bach; Spurkland, Anne; Taylor, Bruce; Winkelmann, Juliane; Zipp, Frauke; Haines, Jonathan L; Pericak-Vance, Margaret A; Spencer, Chris C A; Stewart, Graeme; Hafler, David A; Ivinson, Adrian J; Harbo, Hanne F; Hauser, Stephen L; De Jager, Philip L; Compston, Alastair; McCauley, Jacob L; Sawcer, Stephen; McVean, Gil

2016-01-01

Association studies have greatly refined the understanding of how variation within the human leukocyte antigen (HLA) genes influences risk of multiple sclerosis. However, the extent to which major effects are modulated by interactions is poorly characterized. We analyzed high-density SNP data on 17,465 cases and 30,385 controls from 11 cohorts of European ancestry, in combination with imputation of classical HLA alleles, to build a high-resolution map of HLA genetic risk and assess the evidence for interactions involving classical HLA alleles. Among new and previously identified class II risk alleles (HLA-DRB1*15:01, HLA-DRB1*13:03, HLA-DRB1*03:01, HLA-DRB1*08:01 and HLA-DQB1*03:02) and class I protective alleles (HLA-A*02:01, HLA-B*44:02, HLA-B*38:01 and HLA-B*55:01), we find evidence for two interactions involving pairs of class II alleles: HLA-DQA1*01:01–HLA-DRB1*15:01 and HLA-DQB1*03:01–HLA-DQB1*03:02. We find no evidence for interactions between classical HLA alleles and non-HLA risk-associated variants and estimate a minimal effect of polygenic epistasis in modulating major risk alleles. PMID:26343388

Waste management project’s alternatives: A risk-based multi-criteria assessment (RBMCA) approach

International Nuclear Information System (INIS)

Karmperis, Athanasios C.; Sotirchos, Anastasios; Aravossis, Konstantinos; Tatsiopoulos, Ilias P.

2012-01-01

Highlights: ► We examine the evaluation of a waste management project’s alternatives. ► We present a novel risk-based multi-criteria assessment (RBMCA) approach. ► In the RBMCA the evaluation criteria are based on the quantitative risk analysis of the project’s alternatives. ► Correlation between the criteria weight values and the decision makers’ risk preferences is examined. ► Preference to the multi-criteria against the one-criterion evaluation process is discussed. - Abstract: This paper examines the evaluation of a waste management project’s alternatives through a quantitative risk analysis. Cost benefit analysis is a widely used method, in which the investments are mainly assessed through the calculation of their evaluation indicators, namely benefit/cost (B/C) ratios, as well as the quantification of their financial, technical, environmental and social risks. Herein, a novel approach in the form of risk-based multi-criteria assessment (RBMCA) is introduced, which can be used by decision makers, in order to select the optimum alternative of a waste management project. Specifically, decision makers use multiple criteria, which are based on the cumulative probability distribution functions of the alternatives’ B/C ratios. The RBMCA system is used for the evaluation of a waste incineration project’s alternatives, where the correlation between the criteria weight values and the decision makers’ risk preferences is analyzed and useful conclusions are discussed.

Multiple sclerosis risk loci and disease severity in 7,125 individuals from 10 studies

DEFF Research Database (Denmark)

George, Michaela F; Briggs, Farren B S; Shao, Xiaorong

2016-01-01

associated with disease severity after accounting for cohort, sex, age at onset, and HLA-DRB1*15:01. After restricting analyses to cases with disease duration ≥10 years, associations were null (p value ≥0.05). No SNP was associated with disease severity after adjusting for multiple testing. CONCLUSIONS......OBJECTIVE: We investigated the association between 52 risk variants identified through genome-wide association studies and disease severity in multiple sclerosis (MS). METHODS: Ten unique MS case data sets were analyzed. The Multiple Sclerosis Severity Score (MSSS) was calculated using the Expanded...

Prognostic risk estimates of patients with multiple sclerosis and their physicians: comparison to an online analytical risk counseling tool.

Directory of Open Access Journals (Sweden)

Christoph Heesen

Full Text Available BACKGROUND: Prognostic counseling in multiple sclerosis (MS is difficult because of the high variability of disease progression. Simultaneously, patients and physicians are increasingly confronted with making treatment decisions at an early stage, which requires taking individual prognoses into account to strike a good balance between benefits and harms of treatments. It is therefore important to understand how patients and physicians estimate prognostic risk, and whether and how these estimates can be improved. An online analytical processing (OLAP tool based on pooled data from placebo cohorts of clinical trials offers short-term prognostic estimates that can be used for individual risk counseling. OBJECTIVE: The aim of this study was to clarify if personalized prognostic information as presented by the OLAP tool is considered useful and meaningful by patients. Furthermore, we used the OLAP tool to evaluate patients' and physicians' risk estimates. Within this evaluation process we assessed short-time prognostic risk estimates of patients with MS (final n = 110 and their physicians (n = 6 and compared them with the estimates of OLAP. RESULTS: Patients rated the OLAP tool as understandable and acceptable, but to be only of moderate interest. It turned out that patients, physicians, and the OLAP tool ranked patients similarly regarding their risk of disease progression. Both patients' and physicians' estimates correlated most strongly with those disease covariates that the OLAP tool's estimates also correlated with most strongly. Exposure to the OLAP tool did not change patients' risk estimates. CONCLUSION: While the OLAP tool was rated understandable and acceptable, it was only of modest interest and did not change patients' prognostic estimates. The results suggest, however, that patients had some idea regarding their prognosis and which factors were most important in this regard. Future work with OLAP should assess long-term prognostic

Prognostic risk estimates of patients with multiple sclerosis and their physicians: comparison to an online analytical risk counseling tool.

Science.gov (United States)

Heesen, Christoph; Gaissmaier, Wolfgang; Nguyen, Franziska; Stellmann, Jan-Patrick; Kasper, Jürgen; Köpke, Sascha; Lederer, Christian; Neuhaus, Anneke; Daumer, Martin

2013-01-01

Prognostic counseling in multiple sclerosis (MS) is difficult because of the high variability of disease progression. Simultaneously, patients and physicians are increasingly confronted with making treatment decisions at an early stage, which requires taking individual prognoses into account to strike a good balance between benefits and harms of treatments. It is therefore important to understand how patients and physicians estimate prognostic risk, and whether and how these estimates can be improved. An online analytical processing (OLAP) tool based on pooled data from placebo cohorts of clinical trials offers short-term prognostic estimates that can be used for individual risk counseling. The aim of this study was to clarify if personalized prognostic information as presented by the OLAP tool is considered useful and meaningful by patients. Furthermore, we used the OLAP tool to evaluate patients' and physicians' risk estimates. Within this evaluation process we assessed short-time prognostic risk estimates of patients with MS (final n = 110) and their physicians (n = 6) and compared them with the estimates of OLAP. Patients rated the OLAP tool as understandable and acceptable, but to be only of moderate interest. It turned out that patients, physicians, and the OLAP tool ranked patients similarly regarding their risk of disease progression. Both patients' and physicians' estimates correlated most strongly with those disease covariates that the OLAP tool's estimates also correlated with most strongly. Exposure to the OLAP tool did not change patients' risk estimates. While the OLAP tool was rated understandable and acceptable, it was only of modest interest and did not change patients' prognostic estimates. The results suggest, however, that patients had some idea regarding their prognosis and which factors were most important in this regard. Future work with OLAP should assess long-term prognostic estimates and clarify its usefulness for patients and physicians

[Dyslipidaemia and vascular risk. A new evidence based review].

Science.gov (United States)

Pallarés-Carratalá, V; Pascual-Fuster, V; Godoy-Rocatí, D

2015-01-01

Dyslipidaemia is one of the major risk factors for ischaemic heart disease, the leading cause of death worldwide. Early detection and therapeutic intervention are key elements in the adequate prevention of cardiovascular disease. It is essential to have knowledge of the therapeutic arsenal available for their appropriate use in each of the clinical situations that might be presented in our patients. In the past 3 years, there has been a proliferation of multiple guidelines for the clinical management of patients with dyslipidaemia, with apparent contradictory messages regarding the achievement of the control objectives, which are confusing clinicians. This review aims to provide an updated overview of the situation as regards dyslipidaemia, based on the positioning of both European and American guidelines, through different risk situations and ending with the concept of atherogenic dyslipidaemia as a recognized cardiovascular risk factor. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Homography-based multiple-camera person-tracking

Science.gov (United States)

Turk, Matthew R.

2009-01-01

Multiple video cameras are cheaply installed overlooking an area of interest. While computerized single-camera tracking is well-developed, multiple-camera tracking is a relatively new problem. The main multi-camera problem is to give the same tracking label to all projections of a real-world target. This is called the consistent labelling problem. Khan and Shah (2003) introduced a method to use field of view lines to perform multiple-camera tracking. The method creates inter-camera meta-target associations when objects enter at the scene edges. They also said that a plane-induced homography could be used for tracking, but this method was not well described. Their homography-based system would not work if targets use only one side of a camera to enter the scene. This paper overcomes this limitation and fully describes a practical homography-based tracker. A new method to find the feet feature is introduced. The method works especially well if the camera is tilted, when using the bottom centre of the target's bounding-box would produce inaccurate results. The new method is more accurate than the bounding-box method even when the camera is not tilted. Next, a method is presented that uses a series of corresponding point pairs "dropped" by oblivious, live human targets to find a plane-induced homography. The point pairs are created by tracking the feet locations of moving targets that were associated using the field of view line method. Finally, a homography-based multiple-camera tracking algorithm is introduced. Rules governing when to create the homography are specified. The algorithm ensures that homography-based tracking only starts after a non-degenerate homography is found. The method works when not all four field of view lines are discoverable; only one line needs to be found to use the algorithm. To initialize the system, the operator must specify pairs of overlapping cameras. Aside from that, the algorithm is fully automatic and uses the natural movement of

Stressful life-events in childhood and risk of multiple sclerosis: a Danish nationwide cohort study.

Science.gov (United States)

Nielsen, Nete Munk; Pedersen, Bo V; Stenager, Egon; Koch-Henriksen, Nils; Frisch, Morten

2014-10-01

Current knowledge concerning the association between exposure to stressful life-events (SFLEs) in childhood and later risk of multiple sclerosis (MS) is sparse. We studied the associations between SFLEs in childhood and subsequent risk of MS in a nationwide cohort of 2.9 million Danes born from 1968 to 2011. A SFLE in childhood was defined as exposure before age 18 years to parental divorce, parental death, or death of a sibling, using information from the Danish Civil Registration System. MS cases in the cohort were identified in the Danish Multiple Sclerosis Registry. Associations of SFLE with MS risk were evaluated by incidence rate ratios (RR) of MS obtained in log-linear Poisson regression models. Persons exposed to any SFLE in childhood were at 11% elevated risk of MS (RR = 1.11; 95% confidence interval: 1.03-1.20), compared to non-exposed persons. Stratification by subtype of SFLE showed that parental death and death of a sibling were not associated with MS risk. However, persons exposed to parental divorce were at 13% increased risk of developing MS compared to non-exposed (RR = 1.13; 1.04-1.23). Associations of SFLEs in childhood with risk of MS are weak. However, parental divorce is somehow associated with modestly increased risk of MS. © The Author(s), 2014.

Using Information on Exposure to Characterizing Risks to Human Health from Concurrent Exposures to Multiple Chemicals

NARCIS (Netherlands)

Mr Price, PSP

2012-01-01

This thesis explores the concept of using exposure information to understand, organize, and manage the risks associated with cumulative exposures to chemicals (exposures to multiple chemicals from multiple sources). The issue of cumulative exposures was identified in more than 30 years ago, but in

Psychosocial risks associated with multiple births resulting from assisted reproduction: a Spanish sample.

Science.gov (United States)

Roca de Bes, Montserrat; Gutierrez Maldonado, José; Gris Martínez, José M

2009-09-01

To determine the psychosocial risks associated with multiple births (twins or triplets) resulting from assisted reproductive technology (ART). Transverse study. Infertility units of a university hospital and a private hospital. Mothers and fathers of children between 6 months and 4 years conceived by ART (n = 123). The sample was divided into three groups: parents of singletons (n = 77), twins (n = 37), and triplets (n = 9). The questionnaire was self-administered by patients. It was either completed at the hospital or mailed to participants' homes. Scales measured material needs, quality of life, social stigma, depression, stress, and marital satisfaction. Logistic regression models were applied. Significant odds ratios were obtained for the number of children, material needs, social stigma, quality of life, and marital satisfaction. The results were more significant for data provided by mothers than by fathers. The informed consent form handed out at the beginning of ART should include information on the high risk of conceiving twins and triplets and on the possible psychosocial consequences of multiple births. As soon as a multiple pregnancy is confirmed, it would be useful to provide information on support groups and institutions. Psychological advice should also be given to the parents.

[Retinopathy of prematurity in multiple births: risk analysis for plus disease].

Science.gov (United States)

García-Serrano, J L; Ramírez-García, M C; Piñar-Molina, R

2009-04-01

To analyze the risk factors associated with plus disease in retinopathy of prematurity (ROP). Over a period of 8.5 years we carried out a prospective study of ROP in twins and triplets. Fifty-four multiple-birth infants with low birth weight (large area of avascular retina, low gestational age, low birth weight, a patent ductus arteriosus, length of mechanical ventilation, adverse events increase, low 5 min Apgar scores and poor postnatal weight gain (in the first 4 to 6 weeks of life). Using multiple logistic regression, only the grade of ROP (OR: 5.5; p disease gained an average 3.9 +/- 3.1 g/day in the first 6 weeks of life, compared to a mean of 11.84 +/- 8.3 g/day for those without plus disease (p < 0.0001). Advanced ROP stages and poor weight gain were the most significant factors associated with plus disease. Twins who gained weight at more than 7 g/day in the first 4-6 weeks of life had a significantly reduced risk of plus disease. A good weight gain is an effective strategy against avoidable blindness due to ROP.

Risk-based regulation: Challenges and opportunities

International Nuclear Information System (INIS)

Bari, R.A.

1995-01-01

Over the last twenty years, man has witnessed a gradual but steady movement toward increased usage of risk-based methods and results in the regulatory process. The ''risk perspective'' as a supportive view to existing (non-risk-based or deterministic) information used in decision making has a firm foothold now in most countries that regulate nuclear power. Furthermore, in the areas outside the nuclear power field, such as health risk assessment, risk-based information is used increasingly to make decisions on potential impacts of chemical, biological, and radiological exposures. Some of the principal concepts and issues that are pertinent to risk-based regulation are reviewed. There is a growing interest in most countries in the use of risk-based methods and results to facilitate decision-making associated with regulatory processes. A summary is presented of the challenges and opportunities related to expanded use of risk-based regulation

Associated Risk Factors of STIs and Multiple Sexual Relationships among Youths in Malawi.

Directory of Open Access Journals (Sweden)

Wilson Chialepeh N

Full Text Available Having unprotected sex with multiple sexual partners (MSP is the greatest risk factor for human immunodeficiency virus (HIV and other sexually transmitted infections (STIs among youths. Young people with MSPs are less likely to use a condom and the greater the risk for STIs. This study examines the associated risk factors of STIs and multiple sexual partnerships among youths aged 15-24 years.The Malawi Demographic Health Survey 2010 data was used. Out of a sample of 2,987 males and 9,559 females aged 15-24 years, 2,026 males and 6,470 females were considered in the study. Chi square test and logistic regression techniques were performed. Analysis was performed using Statistical Package for Social Sciences (SPSS version 22.The results indicate that 1,399 (69.0% males and 2,290 (35.4% females reported multiple sexual partnerships (MSP. Within the rural area, females (n = 1779 were more likely to report MSP than males (n = 1082 and within the urban areas, a higher proportion of females (n = 511 still reported MSP, with males (n = 316. About 78% rural females aged 20-24 years, and about 79% rural males aged 15-19 years reported MSP. The likelihood of MSP was higher among females in the poorest households (OR = 1.31, being married (OR = 5.71 and Catholic males (OR = 1.63, who were married (OR = 1.59. Catholic males (OR = 1.82 in the rural areas, who were married (OR = 1.80 and rural females in the northern region (OR = 1.26 were more likely to have MSP. The odds ratios were higher among urban females in the poorest (OR = 3.45 households who were married (OR = 4.22.Having more than one sexual partner increases the risk of STIs and sexuality education programs should be introduced that emphasize the danger that surrounds MSP.

76 FR 1889 - Risk-Based Capital Guidelines: Market Risk

Science.gov (United States)

2011-01-11

... ``three-pillar'' framework that includes (i) risk-based capital requirements for credit risk, market risk... incremental risk capital requirement to capture default and credit quality migration risk for non... (advanced approaches rules) (collectively, the credit risk capital rules) \\8\\ by requiring any bank subject...

Polygenic risk score is associated with increased disease risk in 52 Finnish breast cancer families

OpenAIRE

Muranen, Taru A.; Mavaddat, Nasim; Khan, Sofia; Fagerholm, Rainer; Pelttari, Liisa; Lee, Andrew; Aittom?ki, Kristiina; Blomqvist, Carl; Easton, Douglas F.; Nevanlinna, Heli

2016-01-01

The risk of developing breast cancer is increased in women with family history of breast cancer and particularly in families with multiple cases of breast or ovarian cancer. Nevertheless, many women with a positive family history never develop the disease. Polygenic risk scores (PRSs) based on the risk effects of multiple common genetic variants have been proposed for individual risk assessment on a population level. We investigate the applicability of the PRS for risk prediction within breas...

The East London glaucoma prediction score: web-based validation of glaucoma risk screening tool

Science.gov (United States)

Stephen, Cook; Benjamin, Longo-Mbenza

2013-01-01

AIM It is difficult for Optometrists and General Practitioners to know which patients are at risk. The East London glaucoma prediction score (ELGPS) is a web based risk calculator that has been developed to determine Glaucoma risk at the time of screening. Multiple risk factors that are available in a low tech environment are assessed to provide a risk assessment. This is extremely useful in settings where access to specialist care is difficult. Use of the calculator is educational. It is a free web based service. Data capture is user specific. METHOD The scoring system is a web based questionnaire that captures and subsequently calculates the relative risk for the presence of Glaucoma at the time of screening. Three categories of patient are described: Unlikely to have Glaucoma; Glaucoma Suspect and Glaucoma. A case review methodology of patients with known diagnosis is employed to validate the calculator risk assessment. RESULTS Data from the patient records of 400 patients with an established diagnosis has been captured and used to validate the screening tool. The website reports that the calculated diagnosis correlates with the actual diagnosis 82% of the time. Biostatistics analysis showed: Sensitivity = 88%; Positive predictive value = 97%; Specificity = 75%. CONCLUSION Analysis of the first 400 patients validates the web based screening tool as being a good method of screening for the at risk population. The validation is ongoing. The web based format will allow a more widespread recruitment for different geographic, population and personnel variables. PMID:23550097

Female Gender and Reproductive Factors Affecting Risk, Relapses and Progression in Multiple Sclerosis

NARCIS (Netherlands)

D'hooghe, M. B.; D'Hooghe, T.; De Keyser, J.

2013-01-01

Multiple sclerosis (MS), a chronic inflammatory demyelinating and degenerative disease of the central nervous system, is a frequent cause of neurological disability in young adults. Female predominance has increased over the last decades. Although female gender carries a higher risk of developing

Probabilistic risk assessment framework for structural systems under multiple hazards using Bayesian statistics

Energy Technology Data Exchange (ETDEWEB)

Kwag, Shinyoung [North Carolina State University, Raleigh, NC 27695 (United States); Korea Atomic Energy Research Institute, Daejeon 305-353 (Korea, Republic of); Gupta, Abhinav, E-mail: agupta1@ncsu.edu [North Carolina State University, Raleigh, NC 27695 (United States)

2017-04-15

Highlights: • This study presents the development of Bayesian framework for probabilistic risk assessment (PRA) of structural systems under multiple hazards. • The concepts of Bayesian network and Bayesian inference are combined by mapping the traditionally used fault trees into a Bayesian network. • The proposed mapping allows for consideration of dependencies as well as correlations between events. • Incorporation of Bayesian inference permits a novel way for exploration of a scenario that is likely to result in a system level “vulnerability.” - Abstract: Conventional probabilistic risk assessment (PRA) methodologies (USNRC, 1983; IAEA, 1992; EPRI, 1994; Ellingwood, 2001) conduct risk assessment for different external hazards by considering each hazard separately and independent of each other. The risk metric for a specific hazard is evaluated by a convolution of the fragility and the hazard curves. The fragility curve for basic event is obtained by using empirical, experimental, and/or numerical simulation data for a particular hazard. Treating each hazard as an independently can be inappropriate in some cases as certain hazards are statistically correlated or dependent. Examples of such correlated events include but are not limited to flooding induced fire, seismically induced internal or external flooding, or even seismically induced fire. In the current practice, system level risk and consequence sequences are typically calculated using logic trees to express the causative relationship between events. In this paper, we present the results from a study on multi-hazard risk assessment that is conducted using a Bayesian network (BN) with Bayesian inference. The framework can consider statistical dependencies among risks from multiple hazards, allows updating by considering the newly available data/information at any level, and provide a novel way to explore alternative failure scenarios that may exist due to vulnerabilities.

Probabilistic risk assessment framework for structural systems under multiple hazards using Bayesian statistics

International Nuclear Information System (INIS)

Kwag, Shinyoung; Gupta, Abhinav

2017-01-01

Highlights: • This study presents the development of Bayesian framework for probabilistic risk assessment (PRA) of structural systems under multiple hazards. • The concepts of Bayesian network and Bayesian inference are combined by mapping the traditionally used fault trees into a Bayesian network. • The proposed mapping allows for consideration of dependencies as well as correlations between events. • Incorporation of Bayesian inference permits a novel way for exploration of a scenario that is likely to result in a system level “vulnerability.” - Abstract: Conventional probabilistic risk assessment (PRA) methodologies (USNRC, 1983; IAEA, 1992; EPRI, 1994; Ellingwood, 2001) conduct risk assessment for different external hazards by considering each hazard separately and independent of each other. The risk metric for a specific hazard is evaluated by a convolution of the fragility and the hazard curves. The fragility curve for basic event is obtained by using empirical, experimental, and/or numerical simulation data for a particular hazard. Treating each hazard as an independently can be inappropriate in some cases as certain hazards are statistically correlated or dependent. Examples of such correlated events include but are not limited to flooding induced fire, seismically induced internal or external flooding, or even seismically induced fire. In the current practice, system level risk and consequence sequences are typically calculated using logic trees to express the causative relationship between events. In this paper, we present the results from a study on multi-hazard risk assessment that is conducted using a Bayesian network (BN) with Bayesian inference. The framework can consider statistical dependencies among risks from multiple hazards, allows updating by considering the newly available data/information at any level, and provide a novel way to explore alternative failure scenarios that may exist due to vulnerabilities.

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

Science.gov (United States)

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.

RiskREP: Risk-Based Security Requirements Elicitation and Prioritization

OpenAIRE

Herrmann, Andrea; Morali, A.; Etalle, Sandro; Wieringa, Roelf J.; Niedrite, Laila; Strazdina, Renate; Wangler, Benkt

2011-01-01

Companies are under pressure to be in control of their assets but at the same time they must operate as efficiently as possible. This means that they aim to implement “good-enough security‿ but need to be able to justify their security investment plans. In this paper, we present a Risk-Based Requirements Prioritization method (RiskREP) that extends misuse case-based methods with IT architecture based risk assessment and countermeasure definition and prioritization. Countermeasure prioritizati...

Cattle farmers’ perceptions of risk and risk management strategies

DEFF Research Database (Denmark)

Bishu, Kinfe G.; O'Reilly, Seamus; Lahiff, Edward

2018-01-01

This study analyzes cattle farmers’ perceptions of risk and risk management strategies in Tigray, Northern Ethiopia. We use survey data from a sample of 356 farmers based on multistage random sampling. Factor analysis is employed to classify scores of risk and management strategies, and multiple...... utilization were perceived as the most important strategies for managing risks. Livestock disease and labor shortage were perceived as less of a risk by farmers who adopted the practice of zero grazing compared to other farmers, pointing to the potential of this practice for risk reduction. We find strong...... evidence that farmers engage in multiple risk management practices in order to reduce losses from cattle morbidity and mortality. The results suggest that government strategies that aim at reducing farmers’ risk need to be tailored to specific farm and farmer characteristics. Findings from this study have...

12 CFR 567.6 - Risk-based capital credit risk-weight categories.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Risk-based capital credit risk-weight... CAPITAL Regulatory Capital Requirements § 567.6 Risk-based capital credit risk-weight categories. (a) Risk...)(2) of this section), plus risk-weighted recourse obligations, direct credit substitutes, and certain...

Multiple energy supply risks, optimal reserves, and optimal domestic production capacities

International Nuclear Information System (INIS)

Zweifel, P.; Ferrari, M.

1992-01-01

This study starts from the observation that today's Western trading nations are exposed to multiple risks of energy supplies, e.g. simultaneous shortage of oil and electricity supplies. To cope with these risks, oil can be stockpiled as well as domestic capacity for power production built up. Adopting the viewpoint of a policy maker who aims at minimizing the expected cost of security of supply, optimal simultaneous adjustments of oil stocks and electric production capacities to exogenous changes such as economic growth are derived. Against this benchmark, one-dimensional rules such as 'oil reserves for 90 days' turn out to be not only suboptimal but also to foster adjustments that exacerbate suboptimality. 9 refs., 1 tabs

MICA: Multiple interval-based curve alignment

Science.gov (United States)

Mann, Martin; Kahle, Hans-Peter; Beck, Matthias; Bender, Bela Johannes; Spiecker, Heinrich; Backofen, Rolf

2018-01-01

MICA enables the automatic synchronization of discrete data curves. To this end, characteristic points of the curves' shapes are identified. These landmarks are used within a heuristic curve registration approach to align profile pairs by mapping similar characteristics onto each other. In combination with a progressive alignment scheme, this enables the computation of multiple curve alignments. Multiple curve alignments are needed to derive meaningful representative consensus data of measured time or data series. MICA was already successfully applied to generate representative profiles of tree growth data based on intra-annual wood density profiles or cell formation data. The MICA package provides a command-line and graphical user interface. The R interface enables the direct embedding of multiple curve alignment computation into larger analyses pipelines. Source code, binaries and documentation are freely available at https://github.com/BackofenLab/MICA

Health risks associated with ingesting venison from a uranium enrichment facility with multiple operable units

International Nuclear Information System (INIS)

Duncan, J.; Welsh, C.

1995-01-01

Ingestion of game, including venison, may be a significant exposure pathway in human health risk assessments at hazardous waste sites. The difficulty associated with modeling contaminant tissue concentrations in a wide-ranging herbivorous mammal is compounded when the home range of the mammal extends over multiple operable units (OUs) of varying size and media contaminant concentration. Using biotransfer factors extracted from the literature and species-specific parameter information (e.g., home range size, diet, forage and water ingestion rates) the authors estimate contaminant concentrations in venison based on soil and surface water contaminant concentrations and determine the contribution of individual OUs to modeled venison tissue concentrations. Estimated tissue concentrations are calculated through the use of site foraging factors (SFFS) that adjust exposure contributions from individual OUs to account for the size of the OU in relation to the animals home range. The authors then use the venison tissue concentrations to estimate human health risk associated with ingesting venison under both a current and future exposure scenario

Risk-based maintenance-Techniques and applications

International Nuclear Information System (INIS)

Arunraj, N.S.; Maiti, J.

2007-01-01

Plant and equipment, however well designed, will not remain safe or reliable if it is not maintained. The general objective of the maintenance process is to make use of the knowledge of failures and accidents to achieve the possible safety with the lowest possible cost. The concept of risk-based maintenance was developed to inspect the high-risk components usually with greater frequency and thoroughness and to maintain in a greater manner, to achieve tolerable risk criteria. Risk-based maintenance methodology provides a tool for maintenance planning and decision making to reduce the probability of failure of equipment and the consequences of failure. In this paper, the risk analysis and risk-based maintenance methodologies were identified and classified into suitable classes. The factors affecting the quality of risk analysis were identified and analyzed. The applications, input data and output data were studied to understand their functioning and efficiency. The review showed that there is no unique way to perform risk analysis and risk-based maintenance. The use of suitable techniques and methodologies, careful investigation during the risk analysis phase, and its detailed and structured results are necessary to make proper risk-based maintenance decisions

Biomedical risks of multiple lung lavages in beagle dogs

International Nuclear Information System (INIS)

Muggenburg, B.A.; Mauderly, J.L.; Slauson, D.O.; Halliwell, W.H.

1976-01-01

The biomedical risk of a series of 10 lung lavages was evaluated in 10 Beagle dogs. The dogs were divided into three groups: one group of six dogs was given 10 lung lavages over a 49-day period and sacrificed at 77 days of the study; the second group contained two dogs that were controls that were not treated, but sacrificed on day 77 of the study; and the third group contained two dogs that were control dogs that were sacrificed 56 days into the study. The dogs were evaluated by cardiopulmonary function tests, clinical studies, and studies of the tissues at sacrifice. No significant changes were detected in the cardiopulmonary function tests of the dogs in the study. Clinical studies revealed a very mild, transient reaction to some of the lavage procedures. The reaction was mainly mild, scattered, moist rales heard on auscultation of the chest and a slight rise in body temperature. A mild, scattered tissue reaction was also observed on histologic examination of selected lung tissues. The observed tissue reactions did not appear to be chronic, permanent or progressive. Results of this study indicate that multiple lung lavages carry little biomedical risk and that the primary risk is that associated with general anesthesia

Genetic risk and a primary role for cell-mediated immune mechanisms in multiple sclerosis

DEFF Research Database (Denmark)

Sawcer, Stephen; Hellenthal, Garrett; Pirinen, Matti

2011-01-01

Multiple sclerosis is a common disease of the central nervous system in which the interplay between inflammatory and neurodegenerative processes typically results in intermittent neurological disturbance followed by progressive accumulation of disability. Epidemiological studies have shown...... the greatest individual effect on risk. Modestly powered genome-wide association studies (GWAS) have enabled more than 20 additional risk loci to be identified and have shown that multiple variants exerting modest individual effects have a key role in disease susceptibility. Most of the genetic architecture...... underlying susceptibility to the disease remains to be defined and is anticipated to require the analysis of sample sizes that are beyond the numbers currently available to individual research groups. In a collaborative GWAS involving 9,772 cases of European descent collected by 23 research groups working...

Determining the Relationship between U.S. County-Level Adult Obesity Rate and Multiple Risk Factors by PLS Regression and SVM Modeling Approaches

Directory of Open Access Journals (Sweden)

Chau-Kuang Chen

2015-02-01

Full Text Available Data from the Center for Disease Control (CDC has shown that the obesity rate doubled among adults within the past two decades. This upsurge was the result of changes in human behavior and environment. Partial least squares (PLS regression and support vector machine (SVM models were conducted to determine the relationship between U.S. county-level adult obesity rate and multiple risk factors. The outcome variable was the adult obesity rate. The 23 risk factors were categorized into four domains of the social ecological model including biological/behavioral factor, socioeconomic status, food environment, and physical environment. Of the 23 risk factors related to adult obesity, the top eight significant risk factors with high normalized importance were identified including physical inactivity, natural amenity, percent of households receiving SNAP benefits, and percent of all restaurants being fast food. The study results were consistent with those in the literature. The study showed that adult obesity rate was influenced by biological/behavioral factor, socioeconomic status, food environment, and physical environment embedded in the social ecological theory. By analyzing multiple risk factors of obesity in the communities, may lead to the proposal of more comprehensive and integrated policies and intervention programs to solve the population-based problem.

Patient caries risk assessment

DEFF Research Database (Denmark)

Twetman, Svante; Fontana, Margherita

2009-01-01

Risk assessment is an essential component in the decision-making process for the correct prevention and management of dental caries. Multiple risk factors and indicators have been proposed as targets in the assessment of risk of future disease, varying sometimes based on the age group at which...... they are targeted. Multiple reviews and systematic reviews are available in the literature on this topic. This chapter focusses primarily on results of reviews based on longitudinal studies required to establish the accuracy of caries risk assessment. These findings demonstrate that there is a strong body...... of evidence to support that caries experience is still, unfortunately, the single best predictor for future caries development. In young children, prediction models which include a variety of risk factors seem to increase the accuracy of the prediction, while the usefulness of additional risk factors...

Risk based surveillance for vector borne diseases

DEFF Research Database (Denmark)

Bødker, Rene

of samples and hence early detection of outbreaks. Models for vector borne diseases in Denmark have demonstrated dramatic variation in outbreak risk during the season and between years. The Danish VetMap project aims to make these risk based surveillance estimates available on the veterinarians smart phones...... in Northern Europe. This model approach may be used as a basis for risk based surveillance. In risk based surveillance limited resources for surveillance are targeted at geographical areas most at risk and only when the risk is high. This makes risk based surveillance a cost effective alternative...... sample to a diagnostic laboratory. Risk based surveillance models may reduce this delay. An important feature of risk based surveillance models is their ability to continuously communicate the level of risk to veterinarians and hence increase awareness when risk is high. This is essential for submission...

Target intervention against multiple-risk markers to reduce cardiovascular disease in patients with type 2 diabetes

DEFF Research Database (Denmark)

Gaede, Peter; Pedersen, Oluf

2004-01-01

The risk of cardiovascular disease is markedly increased in patients with type 2 diabetes with a prevalence twice as high compared to the background population. With the recognition of multiple concomitant risk factors for both microvascular as well as cardiovascular disease in type 2 diabetic pa...

A new multicriteria risk mapping approach based on a multiattribute frontier concept.

Science.gov (United States)

Yemshanov, Denys; Koch, Frank H; Ben-Haim, Yakov; Downing, Marla; Sapio, Frank; Siltanen, Marty

2013-09-01

Invasive species risk maps provide broad guidance on where to allocate resources for pest monitoring and regulation, but they often present individual risk components (such as climatic suitability, host abundance, or introduction potential) as independent entities. These independent risk components are integrated using various multicriteria analysis techniques that typically require prior knowledge of the risk components' importance. Such information is often nonexistent for many invasive pests. This study proposes a new approach for building integrated risk maps using the principle of a multiattribute efficient frontier and analyzing the partial order of elements of a risk map as distributed in multidimensional criteria space. The integrated risks are estimated as subsequent multiattribute frontiers in dimensions of individual risk criteria. We demonstrate the approach with the example of Agrilus biguttatus Fabricius, a high-risk pest that may threaten North American oak forests in the near future. Drawing on U.S. and Canadian data, we compare the performance of the multiattribute ranking against a multicriteria linear weighted averaging technique in the presence of uncertainties, using the concept of robustness from info-gap decision theory. The results show major geographic hotspots where the consideration of tradeoffs between multiple risk components changes integrated risk rankings. Both methods delineate similar geographical regions of high and low risks. Overall, aggregation based on a delineation of multiattribute efficient frontiers can be a useful tool to prioritize risks for anticipated invasive pests, which usually have an extremely poor prior knowledge base. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

A developmental screening tool for toddlers with multiple domains based on Rasch analysis.

Science.gov (United States)

Hwang, Ai-Wen; Chou, Yeh-Tai; Hsieh, Ching-Lin; Hsieh, Wu-Shiun; Liao, Hua-Fang; Wong, Alice May-Kuen

2015-01-01

Using multidomain developmental screening tools is a feasible method for pediatric health care professionals to identify children at risk of developmental problems in multiple domains simultaneously. The purpose of this study was to develop a Rasch-based tool for Multidimensional Screening in Child Development (MuSiC) for children aged 0-3 years. The MuSic was developed by constructing items bank based on three commonly used screening tools, validating with developmental status (at risk for delay or not) on five developmental domains. Parents of a convenient sample of 632 children (aged 3-35.5 months) with and without developmental delays responded to items from the three screening tools funded by health authorities in Taiwan. Item bank was determined by item fit of Rasch analysis for each of the five developmental domains (cognitive skills, language skills, gross motor skills, fine motor skills, and socioadaptive skills). Children's performance scores in logits derived in Rasch analysis were validated with developmental status for each domain using the area under receiver operating characteristic curves. MuSiC, a 75-item developmental screening tool for five domains, was derived. The diagnostic validity of all five domains was acceptable for all stages of development, except for the infant stage (≤11 months and 15 days). MuSiC can be applied simultaneously to well-child care visits as a universal screening tool for children aged 1-3 years on multiple domains. Items with sound validity for infants need to be further developed. Copyright © 2014. Published by Elsevier B.V.

Registers of multiple sclerosis in Denmark

DEFF Research Database (Denmark)

Koch-Henriksen, N; Magyari, M; Laursen, B

2015-01-01

between a number of different environmental exposures in the past and the subsequent risk of MS. Some of these studies have been able to exonerate suspected risk factors. The other register, the nationwide Danish Multiple Sclerosis Treatment Register, is a follow-up register for all patients who have......There are two nationwide population-based registers for multiple sclerosis (MS) in Denmark. The oldest register is The Danish Multiple Sclerosis Registry (DMSR), which is an epidemiological register for estimation of prevalence and incidence of MS and survival, and for identifying exposures earlier...... received disease-modifying treatments since 1996. It has, in particular, contributed to the knowledge of the role of antibodies against the biological drugs used for the treatment of MS....

Investigation of Flood Risk Assessment in Inaccessible Regions using Multiple Remote Sensing and Geographic Information Systems

Science.gov (United States)

Lim, J.; Lee, K. S.

2017-12-01

Flooding is extremely dangerous when a river overflows to inundate an urban area. From 1995 to 2016, North Korea (NK) experienced annual extensive damage to life and property almost each year due to a levee breach resulting from typhoons and heavy rainfall during the summer monsoon season. Recently, Hoeryeong City (2016) experienced heavy rainfall during typhoon Lionrock and the resulting flood killed and injured many people (68,900) and destroyed numerous buildings and settlements (11,600). The NK state media described it as the biggest national disaster since 1945. Thus, almost all annual repeat occurrences of floods in NK have had a serious impact, which makes it necessary to figure out the extent of floods in restoring the damaged environment. In addition, traditional hydrological model is impractical to delineate Flood Damaged Areas (FDAs) in NK due to the inaccessibility. Under such a situation, multiple optical Remote Sensing (RS) and radar RS along with a Geographic Information System (GIS)-based spatial analysis were utilized in this study (1) to develop modelling FDA delineation using multiple RS and GIS methods and (2) to conduct flood risk assessment in NK. Interpreting high-resolution web-based satellite imagery were also implemented to confirm the results of the study. From the study result, it was found that (1) on August 30th, 2016, an area of 117.2 km2 (8.6%) at Hoeryeong City was inundated. Most floods occurred in flat areas with a lower and middle stream order. (2) In the binary logistic regression model applied in this study, the distance from the nearest stream map and landform map variables are important factors to delineate FDAs because these two factors reflect heterogeneous mountainous NK topography. (3) Total annual flood risk of study area is estimated to be ₩454.13 million NKW ($504,417.24 USD, and ₩576.53 million SKW). The risk of the confluence of the Tumen River and Hoeryeong stream appears to be the highest. (4) High resolution

A quantitative approach for integrating multiple lines of evidence for the evaluation of environmental health risks

Directory of Open Access Journals (Sweden)

Jerome J. Schleier III

2015-01-01

Full Text Available Decision analysis often considers multiple lines of evidence during the decision making process. Researchers and government agencies have advocated for quantitative weight-of-evidence approaches in which multiple lines of evidence can be considered when estimating risk. Therefore, we utilized Bayesian Markov Chain Monte Carlo to integrate several human-health risk assessment, biomonitoring, and epidemiology studies that have been conducted for two common insecticides (malathion and permethrin used for adult mosquito management to generate an overall estimate of risk quotient (RQ. The utility of the Bayesian inference for risk management is that the estimated risk represents a probability distribution from which the probability of exceeding a threshold can be estimated. The mean RQs after all studies were incorporated were 0.4386, with a variance of 0.0163 for malathion and 0.3281 with a variance of 0.0083 for permethrin. After taking into account all of the evidence available on the risks of ULV insecticides, the probability that malathion or permethrin would exceed a level of concern was less than 0.0001. Bayesian estimates can substantially improve decisions by allowing decision makers to estimate the probability that a risk will exceed a level of concern by considering seemingly disparate lines of evidence.

When no choice of embryos exists, the multiple pregnancy risk is still high.

LENUS (Irish Health Repository)

Wong, V V

2012-10-01

Multiple pregnancies arising from assisted reproduction are known to be associated with increased medical, psychological, economical and social risks. If only two embryos develop after culture, how should the couple be counselled in relation to the risk of multiple pregnancy? We performed a retrospective review of all IVF\\/ICSI treatments performed between 1 January 2005 and 31 December 2007, that resulted in double embryos transfer (DET). We identified 623 cycles with a fortuitous DET (Group I) and 635 cycles with an elective DET (Group II). Group II were significantly more likely to have twins when compared with Group I, irrespective of age. Twin rates in Group I were higher in IVF compared with ICSI; 33.3% vs 16.6% in < 35 years old and 16.2% vs 7.6% in 35-40 years old. Therefore, single embryo transfer should be considered for IVF patients below 35 years old, even if only two good quality embryos are available.

Multiple transitions and HIV risk among orphaned Kenyan schoolgirls.

Science.gov (United States)

Mojola, Sanyu A

2011-03-01

Why are orphaned girls at particular risk of acquiring HIV infection? Using a transition-to-adulthood framework, this study employs qualitative data from Nyanza Province, Kenya, to explore pathways to HIV risk among orphaned and nonorphaned high-school girls. It shows how simultaneous processes such as leaving their parental home, negotiating financial access, and relationship transitions interact to produce disproportionate risk for orphaned girls. The role of financial provision and parental love in modifying girls' trajectories to risk are also explored. A testable theoretical model is proposed based on the qualitative findings, and policy implications are suggested.

MULTIPLE TRANSITIONS AND HIV RISK AMONG AFRICAN SCHOOL GIRLS

Science.gov (United States)

Mojola, Sanyu A

2012-01-01

Why are orphaned girls at particular risk of contracting HIV? Using a transition to adulthood framework, this paper uses qualitative data from Nyanza province, Kenya to explore pathways to HIV risk among orphaned and non-orphaned high school girls. I show how co-occurring processes such as residential transition out of the parental home, negotiating financial access and relationship transitions interact to produce disproportionate risk for orphan girls. I also explore the role of financial provision and parental love in modifying girls’ trajectories to risk. I propose a testable theoretical model based on the qualitative findings and suggest policy implications. PMID:21500699

Multiple infrared bands absorber based on multilayer gratings

Science.gov (United States)

Liu, Xiaoyi; Gao, Jinsong; Yang, Haigui; Wang, Xiaoyi; Guo, Chengli

2018-03-01

The present study offers an Ag/Si multilayer-grating microstructure based on an Si substrate. The microstructure exhibits designable narrowband absorption in multiple infrared wavebands, especially in mid- and long-wave infrared atmospheric windows. We investigate its resonance mode mechanism, and calculate the resonance wavelengths by the Fabry-Perot and metal-insulator-metal theories for comparison with the simulation results. Furthermore, we summarize the controlling rules of the absorption peak wavelength of the microstructure to provide a new method for generating a Si-based device with multiple working bands in infrared.

Risk estimation of multiple recurrence and progression of non muscle invasive bladder carcinoma using new mathematical models.

Science.gov (United States)

Luján, S; Santamaría, C; Pontones, J L; Ruiz-Cerdá, J L; Trassierra, M; Vera-Donoso, C D; Solsona, E; Jiménez-Cruz, F

2014-12-01

To apply new mathematical models according to Non Muscle Invasive Bladder Carcinoma (NMIBC) biological characteristics and enabling an accurate risk estimation of multiple recurrences and tumor progression. The classical Cox model is not valid for the assessment of this kind of events becausethe time betweenrecurrencesin the same patientmay be stronglycorrelated. These new models for risk estimation of recurrence/progression lead to individualized monitoring and treatment plan. 960 patients with primary NMIBC were enrolled. The median follow-up was 48.1 (3-160) months. Results obtained were validated in 240 patients from other center. Transurethral resection of the bladder (TURB) and random bladder biopsy were performed. Subsequently, adjuvant localized chemotherapy was performed. The variables analyzed were: number and tumor size, age, chemotherapy and histopathology. The endpoints were time to recurrence and time to progression. Cox model and its extensions were used as joint frailty model for multiple recurrence and progression. Model accuracy was calculated using Harrell's concordance index (c-index). 468 (48.8%) patients developed at least one tumor recurrence and tumor progression was reported in 52 (5.4%) patients. Variables for multiple-recurrence risk are: age, grade, number, size, treatment and the number of prior recurrences. All these together with age, stage and grade are the variables for progression risk. Concordance index was 0.64 and 0.85 for multiple recurrence and progression respectively. the high concordance reported besides to the validation process in external source, allow accurate multi-recurrence/progression risk estimation. As consequence, it is possible to schedule a follow-up and treatment individualized plan in new and recurrent NMCB cases. Copyright © 2014 AEU. Published by Elsevier Espana. All rights reserved.

A Risk-based Assessment And Management Framework For Multipollutant Air Quality

Science.gov (United States)

Frey, H. Christopher; Hubbell, Bryan

2010-01-01

The National Research Council recommended both a risk- and performance-based multipollutant approach to air quality management. Specifically, management decisions should be based on minimizing the exposure to, and risk of adverse effects from, multiple sources of air pollution and that the success of these decisions should be measured by how well they achieved this objective. We briefly describe risk analysis and its application within the current approach to air quality management. Recommendations are made as to how current practice could evolve to support a fully risk- and performance-based multipollutant air quality management system. The ability to implement a risk assessment framework in a credible and policy-relevant manner depends on the availability of component models and data which are scientifically sound and developed with an understanding of their application in integrated assessments. The same can be said about accountability assessments used to evaluate the outcomes of decisions made using such frameworks. The existing risk analysis framework, although typically applied to individual pollutants, is conceptually well suited for analyzing multipollutant management actions. Many elements of this framework, such as emissions and air quality modeling, already exist with multipollutant characteristics. However, the framework needs to be supported with information on exposure and concentration response relationships that result from multipollutant health studies. Because the causal chain that links management actions to emission reductions, air quality improvements, exposure reductions and health outcomes is parallel between prospective risk analyses and retrospective accountability assessments, both types of assessment should be placed within a single framework with common metrics and indicators where possible. Improvements in risk reductions can be obtained by adopting a multipollutant risk analysis framework within the current air quality management

Comparison of API 510 pressure vessels inspection planning with API 581 risk-based inspection planning approaches

International Nuclear Information System (INIS)

Shishesaz, Mohammad Reza; Nazarnezhad Bajestani, Mohammad; Hashemi, Seyed Javad; Shekari, Elahe

2013-01-01

To ensure mechanical integrity, all pressure vessels shall be inspected at the intervals provided in inspection codes or based on a risk-based inspection (RBI) assessment. The RBI assessment may allow previously established inspection intervals to be extended. This paper describes the methodology, analysis and results of two RBI studies conducted on 293 pressure vessel components in two crude oil distillation units. Based on API RBI methodology in API 581 (2008), risk target concept was used for determining inspection dates. It was shown that when thinning is the major active damage, the RBI recommended intervals are as long as twice the API 510 intervals. This paper summarizes that, as a fundamental step in the risk calculation, RBI has a more defined methodology for evaluating equipment for multiple damage mechanisms and a more defined approach to specify the use of other inspection technologies beyond the traditional visual, ultrasonic, and radiography tests. -- Highlights: • RBI calculated inspection intervals are as long as twice of API 510 inspection code. • Two case studies verified the advantage of RBI in inspection planning. • RBI is a more reliable methodology when evaluating multiple damage mechanisms. • Damage factor calculations can be used for determining RSFa value in FFS assessments

Using multiple lines of evidence to assess the risk of ecosystem collapse.

Science.gov (United States)

Bland, Lucie M; Regan, Tracey J; Dinh, Minh Ngoc; Ferrari, Renata; Keith, David A; Lester, Rebecca; Mouillot, David; Murray, Nicholas J; Nguyen, Hoang Anh; Nicholson, Emily

2017-09-27

Effective ecosystem risk assessment relies on a conceptual understanding of ecosystem dynamics and the synthesis of multiple lines of evidence. Risk assessment protocols and ecosystem models integrate limited observational data with threat scenarios, making them valuable tools for monitoring ecosystem status and diagnosing key mechanisms of decline to be addressed by management. We applied the IUCN Red List of Ecosystems criteria to quantify the risk of collapse of the Meso-American Reef, a unique ecosystem containing the second longest barrier reef in the world. We collated a wide array of empirical data (field and remotely sensed), and used a stochastic ecosystem model to backcast past ecosystem dynamics, as well as forecast future ecosystem dynamics under 11 scenarios of threat. The ecosystem is at high risk from mass bleaching in the coming decades, with compounding effects of ocean acidification, hurricanes, pollution and fishing. The overall status of the ecosystem is Critically Endangered (plausibly Vulnerable to Critically Endangered), with notable differences among Red List criteria and data types in detecting the most severe symptoms of risk. Our case study provides a template for assessing risks to coral reefs and for further application of ecosystem models in risk assessment. © 2017 The Authors.

Financial crisis and market risk premium: Identifying multiple structural changes

Directory of Open Access Journals (Sweden)

Juan J. García-Machado

2011-03-01

Full Text Available The relationship between macroeconomic variables and stock market returns is, by now, well-documented in the literature. However, in this article we examine the long-run relationship between stock and bond markets returns over the period from 1991:11 to 2009:11, using Bai and Perron’s multiple structural change approach. Findings indicate that while the market risk premium is usually positive, periods with negative values appear only in three periods (1991:1-1993:2, 1998:3-2002:2 and from 2007:1-2009:11 leading to changes in the GDP evolution. Thereby, the study shows the presence of structural breaks in the Spanish market risk premium and its relationship with business cycle. These findings contribute to a better understanding of close linkages between the financial markets and the macroeconomic variables such as GDP. Implications of the study and suggestions for future research are provided.

Risk factors for colorectal cancer in patients with multiple serrated polyps: a cross-sectional case series from genetics clinics.

Directory of Open Access Journals (Sweden)

Daniel D Buchanan

2010-07-01

Full Text Available Patients with multiple serrated polyps are at an increased risk for developing colorectal cancer (CRC. Recent reports have linked cigarette smoking with the subset of CRC that develops from serrated polyps. The aim of this work therefore was to investigate the association between smoking and the risk of CRC in high-risk genetics clinic patients presenting with multiple serrated polyps.We identified 151 Caucasian individuals with multiple serrated polyps including at least 5 outside the rectum, and classified patients into non-smokers, current or former smokers at the time of initial diagnosis of polyposis. Cases were individuals with multiple serrated polyps who presented with CRC. Controls were individuals with multiple serrated polyps and no CRC. Multivariate logistic regression was performed to estimate associations between smoking and CRC with adjustment for age at first presentation, sex and co-existing traditional adenomas, a feature that has been consistently linked with CRC risk in patients with multiple serrated polyps. CRC was present in 56 (37% individuals at presentation. Patients with at least one adenoma were 4 times more likely to present with CRC compared with patients without adenomas (OR = 4.09; 95%CI 1.27 to 13.14; P = 0.02. For females, the odds of CRC decreased by 90% in current smokers as compared to never smokers (OR = 0.10; 95%CI 0.02 to 0.47; P = 0.004 after adjusting for age and adenomas. For males, there was no relationship between current smoking and CRC. There was no statistical evidence of an association between former smoking and CRC for both sexes.A decreased odds for CRC was identified in females with multiple serrated polyps who currently smoke, independent of age and the presence of a traditional adenoma. Investigations into the biological basis for these observations could lead to non-smoking-related therapies being developed to decrease the risk of CRC and colectomy in these patients.

Risk-based and deterministic regulation

International Nuclear Information System (INIS)

Fischer, L.E.; Brown, N.W.

1995-07-01

Both risk-based and deterministic methods are used for regulating the nuclear industry to protect the public safety and health from undue risk. The deterministic method is one where performance standards are specified for each kind of nuclear system or facility. The deterministic performance standards address normal operations and design basis events which include transient and accident conditions. The risk-based method uses probabilistic risk assessment methods to supplement the deterministic one by (1) addressing all possible events (including those beyond the design basis events), (2) using a systematic, logical process for identifying and evaluating accidents, and (3) considering alternative means to reduce accident frequency and/or consequences. Although both deterministic and risk-based methods have been successfully applied, there is need for a better understanding of their applications and supportive roles. This paper describes the relationship between the two methods and how they are used to develop and assess regulations in the nuclear industry. Preliminary guidance is suggested for determining the need for using risk based methods to supplement deterministic ones. However, it is recommended that more detailed guidance and criteria be developed for this purpose

Multiple pregnancies achieved with IVF/ICSI and risk of specific congenital malformations: a meta-analysis of cohort studies.

Science.gov (United States)

Zheng, Zan; Chen, Letao; Yang, Tubao; Yu, Hong; Wang, Hua; Qin, Jiabi

2018-04-01

Studies comparing risk of specific congenital malformations (CM) between multiple pregnancies resulting from IVF/intracytoplasmic sperm injection (ICSI) and those conceived naturally report conflicting results; furthermore, there is a lack of a complete overview. This meta-analysis aimed to address which types of CM are increased in IVF/ICSI multiple pregnancies compared with those conceived naturally. All studies testing the association between IVF/ICSI multiple pregnancies and specific CM identified in various databases were considered. The literature search yielded 856 records, of which 21 cohort studies were included for analysis. Overall, multiple pregnancies achieved with IVF/ICSI experienced a significantly higher risk of chromosomal defects (relative risk [RR] = 1.36; 95% confidence interval [CI]: 1.04-1.77), urogenital (RR = 1.18; 95% CI: 1.03-1.36) and circulatory (RR = 1.22; 95% CI: 1.01-1.47) system malformations. However, the remaining specific CM, such as cleft lip and/or palate, eye, ear, face and neck, respiratory, musculoskeletal, nervous and digestive system malformations, were similar in the two groups. No substantial heterogeneity was observed for most outcomes except for digestive (P = 0.094; I 2 = 38.3%) and circulatory (P = 0.070; I 2 = 35.2%) system malformations. These findings provide additional information on risks of IVF/ICSI for use when counselling patients. Copyright © 2018 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

The Effects of Gain- versus Loss-Framed Messages Following Health Risk Information on Physical Activity in Individuals With Multiple Sclerosis.

Science.gov (United States)

Lithopoulos, Alexander; Bassett-Gunter, Rebecca L; Martin Ginis, Kathleen A; Latimer-Cheung, Amy E

2017-06-01

Few people with multiple sclerosis engage in physical activity. Messaging interventions may motivate more physical activity among these individuals. The purpose of this online study was to evaluate an intervention presenting participants with multiple sclerosis (N = 237) with risk information (i.e., information demonstrating people with multiple sclerosis are more likely to experience certain health issues) or no risk information followed by gain- or loss-framed physical activity messages. Participants completed questionnaires on Days 1, 6, and 28 and received information material on Days 2-5. The dependent variables were as follows: physical activity intentions and behavior, response and task efficacy, perceived threat (i.e., perception of threat to health issues relevant to people with multiple sclerosis), and avoidance (i.e., avoiding thinking about/doing something about the health issues presented in the messages). Analyses indicated physical activity and response efficacy increased over time. Also, participants receiving risk information had higher levels of physical activity and perceived threat. However, manipulation checks showed no differences between participants regarding perceptions of risk information or gain/loss-framed messages. Despite the lack of impact of the framing intervention, this study suggests that a brief informational intervention can positively influence physical activity and certain correlates of physical activity among people with multiple sclerosis.

Area-level poverty and preterm birth risk: A population-based multilevel analysis

Science.gov (United States)

DeFranco, Emily A; Lian, Min; Muglia, Louis A; Schootman, Mario

2008-01-01

Background Preterm birth is a complex disease with etiologic influences from a variety of social, environmental, hormonal, genetic, and other factors. The purpose of this study was to utilize a large population-based birth registry to estimate the independent effect of county-level poverty on preterm birth risk. To accomplish this, we used a multilevel logistic regression approach to account for multiple co-existent individual-level variables and county-level poverty rate. Methods Population-based study utilizing Missouri's birth certificate database (1989–1997). We conducted a multilevel logistic regression analysis to estimate the effect of county-level poverty on PTB risk. Of 634,994 births nested within 115 counties in Missouri, two levels were considered. Individual-level variables included demographics factors, prenatal care, health-related behavioral risk factors, and medical risk factors. The area-level variable included the percentage of the population within each county living below the poverty line (US census data, 1990). Counties were divided into quartiles of poverty; the first quartile (lowest rate of poverty) was the reference group. Results PTB rate of PTB poverty and increased through the 4th quartile (4.9%), p poverty was significantly associated with PTB risk. PTB risk (poverty, adjusted odds ratio (adjOR) 1.18 (95% CI 1.03, 1.35), with a similar effect at earlier gestational ages (birth, above other underlying risk factors. Although the risk increase is modest, it affects a large number of pregnancies. PMID:18793437

A Meta-analysis of Multiple Myeloma Risk Regions in African and European Ancestry Populations Identifies Putatively Functional Loci.

Science.gov (United States)

Rand, Kristin A; Song, Chi; Dean, Eric; Serie, Daniel J; Curtin, Karen; Sheng, Xin; Hu, Donglei; Huff, Carol Ann; Bernal-Mizrachi, Leon; Tomasson, Michael H; Ailawadhi, Sikander; Singhal, Seema; Pawlish, Karen; Peters, Edward S; Bock, Cathryn H; Stram, Alex; Van Den Berg, David J; Edlund, Christopher K; Conti, David V; Zimmerman, Todd; Hwang, Amie E; Huntsman, Scott; Graff, John; Nooka, Ajay; Kong, Yinfei; Pregja, Silvana L; Berndt, Sonja I; Blot, William J; Carpten, John; Casey, Graham; Chu, Lisa; Diver, W Ryan; Stevens, Victoria L; Lieber, Michael R; Goodman, Phyllis J; Hennis, Anselm J M; Hsing, Ann W; Mehta, Jayesh; Kittles, Rick A; Kolb, Suzanne; Klein, Eric A; Leske, Cristina; Murphy, Adam B; Nemesure, Barbara; Neslund-Dudas, Christine; Strom, Sara S; Vij, Ravi; Rybicki, Benjamin A; Stanford, Janet L; Signorello, Lisa B; Witte, John S; Ambrosone, Christine B; Bhatti, Parveen; John, Esther M; Bernstein, Leslie; Zheng, Wei; Olshan, Andrew F; Hu, Jennifer J; Ziegler, Regina G; Nyante, Sarah J; Bandera, Elisa V; Birmann, Brenda M; Ingles, Sue A; Press, Michael F; Atanackovic, Djordje; Glenn, Martha J; Cannon-Albright, Lisa A; Jones, Brandt; Tricot, Guido; Martin, Thomas G; Kumar, Shaji K; Wolf, Jeffrey L; Deming Halverson, Sandra L; Rothman, Nathaniel; Brooks-Wilson, Angela R; Rajkumar, S Vincent; Kolonel, Laurence N; Chanock, Stephen J; Slager, Susan L; Severson, Richard K; Janakiraman, Nalini; Terebelo, Howard R; Brown, Elizabeth E; De Roos, Anneclaire J; Mohrbacher, Ann F; Colditz, Graham A; Giles, Graham G; Spinelli, John J; Chiu, Brian C; Munshi, Nikhil C; Anderson, Kenneth C; Levy, Joan; Zonder, Jeffrey A; Orlowski, Robert Z; Lonial, Sagar; Camp, Nicola J; Vachon, Celine M; Ziv, Elad; Stram, Daniel O; Hazelett, Dennis J; Haiman, Christopher A; Cozen, Wendy

2016-12-01

Genome-wide association studies (GWAS) in European populations have identified genetic risk variants associated with multiple myeloma. We performed association testing of common variation in eight regions in 1,318 patients with multiple myeloma and 1,480 controls of European ancestry and 1,305 patients with multiple myeloma and 7,078 controls of African ancestry and conducted a meta-analysis to localize the signals, with epigenetic annotation used to predict functionality. We found that variants in 7p15.3, 17p11.2, 22q13.1 were statistically significantly (P ancestry and persons of European ancestry, and the variant in 3p22.1 was associated in European ancestry only. In a combined African ancestry-European ancestry meta-analysis, variation in five regions (2p23.3, 3p22.1, 7p15.3, 17p11.2, 22q13.1) was statistically significantly associated with multiple myeloma risk. In 3p22.1, the correlated variants clustered within the gene body of ULK4 Correlated variants in 7p15.3 clustered around an enhancer at the 3' end of the CDCA7L transcription termination site. A missense variant at 17p11.2 (rs34562254, Pro251Leu, OR, 1.32; P = 2.93 × 10 -7 ) in TNFRSF13B encodes a lymphocyte-specific protein in the TNF receptor family that interacts with the NF-κB pathway. SNPs correlated with the index signal in 22q13.1 cluster around the promoter and enhancer regions of CBX7 CONCLUSIONS: We found that reported multiple myeloma susceptibility regions contain risk variants important across populations, supporting the use of multiple racial/ethnic groups with different underlying genetic architecture to enhance the localization and identification of putatively functional alleles. A subset of reported risk loci for multiple myeloma has consistent effects across populations and is likely to be functional. Cancer Epidemiol Biomarkers Prev; 25(12); 1609-18. ©2016 AACR. ©2016 American Association for Cancer Research.

Risk Analysis Based on AHP and Fuzzy Comprehensive Evaluation for Maglev Train Bogie

Directory of Open Access Journals (Sweden)

Chengxin Fan

2016-01-01

Full Text Available The maglev bogie is the key subsystem for maglev train security. To ensure life and property security, it is essential to evaluate its risk level before its operation. In this paper, a combinational method of analytic hierarchy process and fuzzy comprehensive evaluation is proposed to assess hazards in a complex maglev bogie system associated with multiple subsystems’ failures. The very comprehensive identification of risk sources has been done by analyzing the structure of maglev bogie. Furthermore, based on the fuzzy theory, linguistic evaluation set is classified according to risk tolerance. The score of each risk factor is obtained by weighted sum of the result of fuzzy comprehensive evaluation. Our results show that the degree of maglev bogie’s risk is within the range of acceptability. The merits of this work facilitate finding the weak links and determining the maintenance of maglev bogie system.

Risk-based methodology for USNRC inspections

International Nuclear Information System (INIS)

Wong, S.M.; Holahan, G.M.; Chung, J.W.; Johnson, M.R.

1995-01-01

This paper describes the development and trial applications of a risk-based methodology to enhance the inspection processes for US nuclear power plants. Objectives of risk-based methods to complement prescriptive engineering approaches in US Nuclear Regulatory Commission (USNRC) inspection programs are presented. Insights from time-dependent risk profiles of plant configurational from Individual Plant Evaluation (IPE) studies were integrated to develop a framework for optimizing inspection efforts in NRC regulatory initiatives. Lessons learned from NRC pilot applications of the risk-based methodology for evaluation of the effectiveness of operational risk management programs at US nuclear power plant sites are also discussed

The Impact of Five VDR Polymorphisms on Multiple Sclerosis Risk and Progression: a Case-Control and Genotype-Phenotype Study.

Science.gov (United States)

Křenek, Pavel; Benešová, Yvonne; Bienertová-Vašků, Julie; Vašků, Anna

2018-04-01

Vitamin D receptor polymorphisms have been the target of many studies focusing on multiple sclerosis. However, previously reported results have been inconclusive. The objective of this study was to investigate the association between five vitamin D receptor polymorphisms (EcoRV, FokI, ApaI, TaqI, and BsmI) and multiple sclerosis susceptibility and its course. The study was carried out as a case-control and genotype-phenotype study, consisted of 296 Czech multiple sclerosis patients and 135 healthy controls. Genotyping was carried out using polymerase chain reaction and restriction analysis. In multiple sclerosis men, allele and/or genotype distributions differed in EcoRV, TaqI, BsmI, and ApaI polymorphisms as compared to controls (EcoRV, p a = 0.02; Taq, p g = 0.02, p a = 0.02; BsmI, p g = 0.02, p a = 0.04; ApaI, p g = 0.008, p a = 0.005). In multiple sclerosis women, differences in the frequency of alleles and genotypes were found to be significant in ApaI (controls vs multiple sclerosis women: p g = 0.01, p a = 0.05). Conclusive results were observed between multiple sclerosis women in the case of EcoRV [differences in Expanded Disability Status Scale (p = 0.05); CT genotype was found to increase the risk of primary progressive multiple sclerosis 5.5 times (CT vs CC+TT p corr = 0.01, sensitivity 0.833, specificity 0.525, power test 0.823)] and FokI [borderline difference in Multiple Sclerosis Severity Score (p = 0.05)]. Our results indicate that the distribution of investigated vitamin D receptor polymorphisms is a risk factor for multiple sclerosis susceptibility and progression in the Czech population. The association between disease risk and polymorphisms was found to be stronger in men. The association of disease progression with polymorphisms was observed only in women.

Risk-based SMA for Cubesats

Science.gov (United States)

Leitner, Jesse

2016-01-01

This presentation conveys an approach for risk-based safety and mission assurance applied to cubesats. This presentation accompanies a NASA Goddard standard in development that provides guidance for building a mission success plan for cubesats based on the risk tolerance and resources available.

Optical encryption of multiple three-dimensional objects based on multiple interferences and single-pixel digital holography

Science.gov (United States)

Wang, Ying; Liu, Qi; Wang, Jun; Wang, Qiong-Hua

2018-03-01

We present an optical encryption method of multiple three-dimensional objects based on multiple interferences and single-pixel digital holography. By modifying the Mach–Zehnder interferometer, the interference of the multiple objects beams and the one reference beam is used to simultaneously encrypt multiple objects into a ciphertext. During decryption, each three-dimensional object can be decrypted independently without having to decrypt other objects. Since the single-pixel digital holography based on compressive sensing theory is introduced, the encrypted data of this method is effectively reduced. In addition, recording fewer encrypted data can greatly reduce the bandwidth of network transmission. Moreover, the compressive sensing essentially serves as a secret key that makes an intruder attack invalid, which means that the system is more secure than the conventional encryption method. Simulation results demonstrate the feasibility of the proposed method and show that the system has good security performance. Project supported by the National Natural Science Foundation of China (Grant Nos. 61405130 and 61320106015).

A case-control study of risk factors for multiple sclerosis in Iran.

Science.gov (United States)

Alonso, Alvaro; Cook, Stuart D; Maghzi, Amir-Hadi; Divani, Afshin A

2011-05-01

Numerous studies have assessed risk factors for multiple sclerosis (MS), although none have been conducted previously in Iran. The objective of this study was to study lifestyle and environmental risk factors of MS in the Iranian population. A case-control study, including 394 MS cases and 394 matched controls, was conducted in MS clinics in different Iranian cities. Information on lifestyles, environmental exposures, and past medical history was obtained from medical charts and phone interviews. In multivariable analysis, sunlight exposure was associated with a lower risk of MS: the odds ratio (OR) and 95% confidence interval (CI) of MS associated with a 1-h increment in daily sunlight was 0.62 (0.53-0.73). Smoking was associated with MS risk in women (OR: 6.48, 95% CI: 1.46-28.78), but not in men (OR: 0.72, 95% CI: 0.31-1.68) (p=0.002 for interaction). Finally, past history of common surgical procedures, infectious disorders, or exposure to pets and farm animals was not associated with MS risk. Different modifiable lifestyles, including sunlight exposure and smoking, were associated with lower MS risk in Iran. Interventions aimed at promoting smoking cessation and, more importantly, at increasing exposure to sunlight might contribute to the prevention of MS.

Multiple local minima in IMRT optimization based on dose-volume criteria

International Nuclear Information System (INIS)

Wu Qiuwen; Mohan, Radhe

2002-01-01

Multiple local minima traps are known to exist in dose-volume and dose-response objective functions. Nevertheless, their presence and consequences are not considered impediments in finding satisfactory solutions in routine optimization of IMRT plans using gradient methods. However, there is often a concern that a significantly superior solution may exist unbeknownst to the planner and that the optimization process may not be able to reach it. We have investigated the soundness of the assumption that the presence of multiple minima traps can be ignored. To find local minima, we start the optimization process a large number of times with random initial intensities. We investigated whether the occurrence of local minima depends upon the choice of the objective function parameters and the number of variables and whether their existence is an impediment in finding a satisfactory solution. To learn about the behavior of multiple minima, we first used a symmetric cubic phantom containing a cubic target and an organ-at-risk surrounding it to optimize the beam weights of two pairs of parallel-opposed beams using a gradient technique. The phantom studies also served to test our software. Objective function parameters were chosen to ensure that multiple minima would exist. Data for 500 plans, optimized with random initial beam weights, were analyzed. The search process did succeed in finding the local minima and showed that the number of minima depends on the parameters of the objective functions. It was also found that the consequences of local minima depended on the number of beams. We further searched for the multiple minima in intensity-modulated treatment plans for a head-and-neck case and a lung case. In addition to the treatment plan scores and the dose-volume histograms, we examined the dose distributions and intensity patterns. We did not find any evidence that multiple local minima affect the outcome of optimization using gradient techniques in any clinically

A Spatial Framework to Map Heat Health Risks at Multiple Scales.

Science.gov (United States)

Ho, Hung Chak; Knudby, Anders; Huang, Wei

2015-12-18

In the last few decades extreme heat events have led to substantial excess mortality, most dramatically in Central Europe in 2003, in Russia in 2010, and even in typically cool locations such as Vancouver, Canada, in 2009. Heat-related morbidity and mortality is expected to increase over the coming centuries as the result of climate-driven global increases in the severity and frequency of extreme heat events. Spatial information on heat exposure and population vulnerability may be combined to map the areas of highest risk and focus mitigation efforts there. However, a mismatch in spatial resolution between heat exposure and vulnerability data can cause spatial scale issues such as the Modifiable Areal Unit Problem (MAUP). We used a raster-based model to integrate heat exposure and vulnerability data in a multi-criteria decision analysis, and compared it to the traditional vector-based model. We then used the Getis-Ord G(i) index to generate spatially smoothed heat risk hotspot maps from fine to coarse spatial scales. The raster-based model allowed production of maps at spatial resolution, more description of local-scale heat risk variability, and identification of heat-risk areas not identified with the vector-based approach. Spatial smoothing with the Getis-Ord G(i) index produced heat risk hotspots from local to regional spatial scale. The approach is a framework for reducing spatial scale issues in future heat risk mapping, and for identifying heat risk hotspots at spatial scales ranging from the block-level to the municipality level.

Comparison of EHR-based diagnosis documentation locations to a gold standard for risk stratification in patients with multiple chronic conditions.

Science.gov (United States)

Martin, Shelby; Wagner, Jesse; Lupulescu-Mann, Nicoleta; Ramsey, Katrina; Cohen, Aaron; Graven, Peter; Weiskopf, Nicole G; Dorr, David A

2017-08-02

To measure variation among four different Electronic Health Record (EHR) system documentation locations versus 'gold standard' manual chart review for risk stratification in patients with multiple chronic illnesses. Adults seen in primary care with EHR evidence of at least one of 13 conditions were included. EHRs were manually reviewed to determine presence of active diagnoses, and risk scores were calculated using three different methodologies and five EHR documentation locations. Claims data were used to assess cost and utilization for the following year. Descriptive and diagnostic statistics were calculated for each EHR location. Criterion validity testing compared the gold standard verified diagnoses versus other EHR locations and risk scores in predicting future cost and utilization. Nine hundred patients had 2,179 probable diagnoses. About 70% of the diagnoses from the EHR were verified by gold standard. For a subset of patients having baseline and prediction year data (n=750), modeling showed that the gold standard was the best predictor of outcomes on average for a subset of patients that had these data. However, combining all data sources together had nearly equivalent performance for prediction as the gold standard. EHR data locations were inaccurate 30% of the time, leading to improvement in overall modeling from a gold standard from chart review for individual diagnoses. However, the impact on identification of the highest risk patients was minor, and combining data from different EHR locations was equivalent to gold standard performance. The reviewer's ability to identify a diagnosis as correct was influenced by a variety of factors, including completeness, temporality, and perceived accuracy of chart data.

A FTA-based method for risk decision-making in emergency response

DEFF Research Database (Denmark)

Liu, Yang; Li, Hongyan

2014-01-01

Decision-making problems in emergency response are usually risky and uncertain due to the limited decision data and possible evolvement of emergency scenarios. This paper focuses on a risk decisionmaking problem in emergency response with several distinct characteristics including dynamic...... evolvement process of emergency, multiple scenarios, and impact of response actions on the emergency scenarios. A method based on Fault Tree Analysis (FTA) is proposed to solve the problem. By analyzing the evolvement process of emergency, the Fault Tree (FT) is constructed to describe the logical relations...

The Research of Multiple Attenuation Based on Feedback Iteration and Independent Component Analysis

Science.gov (United States)

Xu, X.; Tong, S.; Wang, L.

2017-12-01

How to solve the problem of multiple suppression is a difficult problem in seismic data processing. The traditional technology for multiple attenuation is based on the principle of the minimum output energy of the seismic signal, this criterion is based on the second order statistics, and it can't achieve the multiple attenuation when the primaries and multiples are non-orthogonal. In order to solve the above problems, we combine the feedback iteration method based on the wave equation and the improved independent component analysis (ICA) based on high order statistics to suppress the multiple waves. We first use iterative feedback method to predict the free surface multiples of each order. Then, in order to predict multiples from real multiple in amplitude and phase, we design an expanded pseudo multi-channel matching filtering method to get a more accurate matching multiple result. Finally, we present the improved fast ICA algorithm which is based on the maximum non-Gauss criterion of output signal to the matching multiples and get better separation results of the primaries and the multiples. The advantage of our method is that we don't need any priori information to the prediction of the multiples, and can have a better separation result. The method has been applied to several synthetic data generated by finite-difference model technique and the Sigsbee2B model multiple data, the primaries and multiples are non-orthogonal in these models. The experiments show that after three to four iterations, we can get the perfect multiple results. Using our matching method and Fast ICA adaptive multiple subtraction, we can not only effectively preserve the effective wave energy in seismic records, but also can effectively suppress the free surface multiples, especially the multiples related to the middle and deep areas.

Area-level poverty and preterm birth risk: A population-based multilevel analysis

Directory of Open Access Journals (Sweden)

Muglia Louis A

2008-09-01

Full Text Available Abstract Background Preterm birth is a complex disease with etiologic influences from a variety of social, environmental, hormonal, genetic, and other factors. The purpose of this study was to utilize a large population-based birth registry to estimate the independent effect of county-level poverty on preterm birth risk. To accomplish this, we used a multilevel logistic regression approach to account for multiple co-existent individual-level variables and county-level poverty rate. Methods Population-based study utilizing Missouri's birth certificate database (1989–1997. We conducted a multilevel logistic regression analysis to estimate the effect of county-level poverty on PTB risk. Of 634,994 births nested within 115 counties in Missouri, two levels were considered. Individual-level variables included demographics factors, prenatal care, health-related behavioral risk factors, and medical risk factors. The area-level variable included the percentage of the population within each county living below the poverty line (US census data, 1990. Counties were divided into quartiles of poverty; the first quartile (lowest rate of poverty was the reference group. Results PTB th quartile (4.9%, p adjOR 1.18 (95% CI 1.03, 1.35, with a similar effect at earlier gestational ages (adjOR 1.27 (95% CI 1.06, 1.52. Conclusion Women residing in socioeconomically deprived areas are at increased risk of preterm birth, above other underlying risk factors. Although the risk increase is modest, it affects a large number of pregnancies.

Multiple attribute decision making model and application to food safety risk evaluation.

Science.gov (United States)

Ma, Lihua; Chen, Hong; Yan, Huizhe; Yang, Lifeng; Wu, Lifeng

2017-01-01

Decision making for supermarket food purchase decisions are characterized by network relationships. This paper analyzed factors that influence supermarket food selection and proposes a supplier evaluation index system based on the whole process of food production. The author established the intuitive interval value fuzzy set evaluation model based on characteristics of the network relationship among decision makers, and validated for a multiple attribute decision making case study. Thus, the proposed model provides a reliable, accurate method for multiple attribute decision making.

HOW INTERNAL RISK - BASED AUDIT APPRAISES THE EVALUATION OF RISKS MANAGEMENT

Directory of Open Access Journals (Sweden)

N. Dorosh

2017-09-01

Full Text Available The article deals with the nature and function of the internal risk-based audit process approach to create patterns of risks and methods of evaluation. Deals with the relationship between the level of maturity of the risk of the company and the method of risk-based internal audit. it was emphasized that internal auditing provides an independent and objective opinion to an organization’s management as to whether its risks are being managed to acceptable levels.

Multiple attribute decision making model and application to food safety risk evaluation.

Directory of Open Access Journals (Sweden)

Lihua Ma

Full Text Available Decision making for supermarket food purchase decisions are characterized by network relationships. This paper analyzed factors that influence supermarket food selection and proposes a supplier evaluation index system based on the whole process of food production. The author established the intuitive interval value fuzzy set evaluation model based on characteristics of the network relationship among decision makers, and validated for a multiple attribute decision making case study. Thus, the proposed model provides a reliable, accurate method for multiple attribute decision making.

Periprosthetic joint infection: are patients with multiple prosthetic joints at risk?

Science.gov (United States)

Jafari, S Mehdi; Casper, David S; Restrepo, Camilo; Zmistowski, Benjamin; Parvizi, Javad; Sharkey, Peter F

2012-06-01

Patients who present with a periprosthetic joint infection in a single joint may have multiple prosthetic joints. The risk of these patients developing a subsequent infection in another prosthetic joint is unknown. Our purposes were (1) to identify the risk of developing a subsequent infection in another prosthetic joint and (2) to describe the time span and organism profile to the second prosthetic infection. We retrospectively identified 55 patients with periprosthetic joint infection who had another prosthetic joint in place at the time of presentation. Of the 55 patients, 11 (20%) developed a periprosthetic joint infection in a second joint. The type of organism was the same as the first infection in 4 (36%) of 11 patients. The time to developing a second infection averaged 2.0 years (range, 0-6.9 years). Copyright © 2012 Elsevier Inc. All rights reserved.

Cardiovascular risk factors are associated with increased lesion burden and brain atrophy in multiple sclerosis.

Science.gov (United States)

Kappus, Natalie; Weinstock-Guttman, Bianca; Hagemeier, Jesper; Kennedy, Cheryl; Melia, Rebecca; Carl, Ellen; Ramasamy, Deepa P; Cherneva, Mariya; Durfee, Jacqueline; Bergsland, Niels; Dwyer, Michael G; Kolb, Channa; Hojnacki, David; Ramanathan, Murali; Zivadinov, Robert

2016-02-01

Cardiovascular (CV) risk factors have been associated with changes in clinical outcomes in patients with multiple sclerosis (MS). To investigate the frequency of CV risks in patients with MS and their association with MRI outcomes. In a prospective study, 326 patients with relapsing-remitting MS and 163 patients with progressive MS, 61 patients with clinically isolated syndrome (CIS) and 175 healthy controls (HCs) were screened for CV risks and scanned on a 3T MRI scanner. Examined CV risks included hypertension, heart disease, smoking, overweight/obesity and type 1 diabetes. MRI measures assessed lesion volumes (LVs) and brain atrophy. Association between individual or multiple CV risks and MRI outcomes was examined adjusting for age, sex, race, disease duration and treatment status. Patients with MS showed increased frequency of smoking (51.7% vs 36.5%, p = 0.001) and hypertension (33.9% vs 24.7%, p=0.035) compared with HCs. In total, 49.9% of patients with MS and 36% of HCs showed ≥ 2 CV risks (p = 0.003), while the frequency of ≥ 3 CV risks was 18.8% in the MS group and 8.6% in the HCs group (p = 0.002). In patients with MS, hypertension and heart disease were associated with decreased grey matter (GM) and cortical volumes (p < 0.05), while overweight/obesity was associated with increased T1-LV (p < 0.39) and smoking with decreased whole brain volume (p = 0.049). Increased lateral ventricle volume was associated with heart disease (p = 0.029) in CIS. Patients with MS with one or more CV risks showed increased lesion burden and more advanced brain atrophy. 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/

Optical multiple-image encryption based on multiplane phase retrieval and interference

International Nuclear Information System (INIS)

Chen, Wen; Chen, Xudong

2011-01-01

In this paper, we propose a new method for optical multiple-image encryption based on multiplane phase retrieval and interference. An optical encoding system is developed in the Fresnel domain. A phase-only map is iteratively extracted based on a multiplane phase retrieval algorithm, and multiple plaintexts are simultaneously encrypted. Subsequently, the extracted phase-only map is further encrypted into two phase-only masks based on a non-iterative interference algorithm. During image decryption, the advantages and security of the proposed optical cryptosystem are analyzed. Numerical results are presented to demonstrate the validity of the proposed optical multiple-image encryption method

RISK LOAN PORTFOLIO OPTIMIZATION MODEL BASED ON CVAR RISK MEASURE

Directory of Open Access Journals (Sweden)

Ming-Chang LEE

2015-07-01

Full Text Available In order to achieve commercial banks liquidity, safety and profitability objective requirements, loan portfolio risk analysis based optimization decisions are rational allocation of assets.  The risk analysis and asset allocation are the key technology of banking and risk management.  The aim of this paper, build a loan portfolio optimization model based on risk analysis.  Loan portfolio rate of return by using Value-at-Risk (VaR and Conditional Value-at-Risk (CVaR constraint optimization decision model reflects the bank's risk tolerance, and the potential loss of direct control of the bank.  In this paper, it analyze a general risk management model applied to portfolio problems with VaR and CVaR risk measures by using Using the Lagrangian Algorithm.  This paper solves the highly difficult problem by matrix operation method.  Therefore, the combination of this paper is easy understanding the portfolio problems with VaR and CVaR risk model is a hyperbola in mean-standard deviation space.  It is easy calculation in proposed method.

Scientific reporting is suboptimal for aspects that characterize genetic risk prediction studies: a review of published articles based on the Genetic RIsk Prediction Studies statement.

Science.gov (United States)

Iglesias, Adriana I; Mihaescu, Raluca; Ioannidis, John P A; Khoury, Muin J; Little, Julian; van Duijn, Cornelia M; Janssens, A Cecile J W

2014-05-01

Our main objective was to raise awareness of the areas that need improvements in the reporting of genetic risk prediction articles for future publications, based on the Genetic RIsk Prediction Studies (GRIPS) statement. We evaluated studies that developed or validated a prediction model based on multiple DNA variants, using empirical data, and were published in 2010. A data extraction form based on the 25 items of the GRIPS statement was created and piloted. Forty-two studies met our inclusion criteria. Overall, more than half of the evaluated items (34 of 62) were reported in at least 85% of included articles. Seventy-seven percentage of the articles were identified as genetic risk prediction studies through title assessment, but only 31% used the keywords recommended by GRIPS in the title or abstract. Seventy-four percentage mentioned which allele was the risk variant. Overall, only 10% of the articles reported all essential items needed to perform external validation of the risk model. Completeness of reporting in genetic risk prediction studies is adequate for general elements of study design but is suboptimal for several aspects that characterize genetic risk prediction studies such as description of the model construction. Improvements in the transparency of reporting of these aspects would facilitate the identification, replication, and application of genetic risk prediction models. Copyright © 2014 Elsevier Inc. All rights reserved.

Genetic risk and a primary role for cell-mediated immune mechanisms in multiple sclerosis

Science.gov (United States)

Sawcer, Stephen; Hellenthal, Garrett; Pirinen, Matti; Spencer, Chris C.A.; Patsopoulos, Nikolaos A.; Moutsianas, Loukas; Dilthey, Alexander; Su, Zhan; Freeman, Colin; Hunt, Sarah E.; Edkins, Sarah; Gray, Emma; Booth, David R.; Potter, Simon C.; Goris, An; Band, Gavin; Oturai, Annette Bang; Strange, Amy; Saarela, Janna; Bellenguez, Céline; Fontaine, Bertrand; Gillman, Matthew; Hemmer, Bernhard; Gwilliam, Rhian; Zipp, Frauke; Jayakumar, Alagurevathi; Martin, Roland; Leslie, Stephen; Hawkins, Stanley; Giannoulatou, Eleni; D’alfonso, Sandra; Blackburn, Hannah; Boneschi, Filippo Martinelli; Liddle, Jennifer; Harbo, Hanne F.; Perez, Marc L.; Spurkland, Anne; Waller, Matthew J; Mycko, Marcin P.; Ricketts, Michelle; Comabella, Manuel; Hammond, Naomi; Kockum, Ingrid; McCann, Owen T.; Ban, Maria; Whittaker, Pamela; Kemppinen, Anu; Weston, Paul; Hawkins, Clive; Widaa, Sara; Zajicek, John; Dronov, Serge; Robertson, Neil; Bumpstead, Suzannah J.; Barcellos, Lisa F.; Ravindrarajah, Rathi; Abraham, Roby; Alfredsson, Lars; Ardlie, Kristin; Aubin, Cristin; Baker, Amie; Baker, Katharine; Baranzini, Sergio E.; Bergamaschi, Laura; Bergamaschi, Roberto; Bernstein, Allan; Berthele, Achim; Boggild, Mike; Bradfield, Jonathan P.; Brassat, David; Broadley, Simon A.; Buck, Dorothea; Butzkueven, Helmut; Capra, Ruggero; Carroll, William M.; Cavalla, Paola; Celius, Elisabeth G.; Cepok, Sabine; Chiavacci, Rosetta; Clerget-Darpoux, Françoise; Clysters, Katleen; Comi, Giancarlo; Cossburn, Mark; Cournu-Rebeix, Isabelle; Cox, Mathew B.; Cozen, Wendy; Cree, Bruce A.C.; Cross, Anne H.; Cusi, Daniele; Daly, Mark J.; Davis, Emma; de Bakker, Paul I.W.; Debouverie, Marc; D’hooghe, Marie Beatrice; Dixon, Katherine; Dobosi, Rita; Dubois, Bénédicte; Ellinghaus, David; Elovaara, Irina; Esposito, Federica; Fontenille, Claire; Foote, Simon; Franke, Andre; Galimberti, Daniela; Ghezzi, Angelo; Glessner, Joseph; Gomez, Refujia; Gout, Olivier; Graham, Colin; Grant, Struan F.A.; Guerini, Franca Rosa; Hakonarson, Hakon; Hall, Per; Hamsten, Anders; Hartung, Hans-Peter; Heard, Rob N.; Heath, Simon; Hobart, Jeremy; Hoshi, Muna; Infante-Duarte, Carmen; Ingram, Gillian; Ingram, Wendy; Islam, Talat; Jagodic, Maja; Kabesch, Michael; Kermode, Allan G.; Kilpatrick, Trevor J.; Kim, Cecilia; Klopp, Norman; Koivisto, Keijo; Larsson, Malin; Lathrop, Mark; Lechner-Scott, Jeannette S.; Leone, Maurizio A.; Leppä, Virpi; Liljedahl, Ulrika; Bomfim, Izaura Lima; Lincoln, Robin R.; Link, Jenny; Liu, Jianjun; Lorentzen, Åslaug R.; Lupoli, Sara; Macciardi, Fabio; Mack, Thomas; Marriott, Mark; Martinelli, Vittorio; Mason, Deborah; McCauley, Jacob L.; Mentch, Frank; Mero, Inger-Lise; Mihalova, Tania; Montalban, Xavier; Mottershead, John; Myhr, Kjell-Morten; Naldi, Paola; Ollier, William; Page, Alison; Palotie, Aarno; Pelletier, Jean; Piccio, Laura; Pickersgill, Trevor; Piehl, Fredrik; Pobywajlo, Susan; Quach, Hong L.; Ramsay, Patricia P.; Reunanen, Mauri; Reynolds, Richard; Rioux, John D.; Rodegher, Mariaemma; Roesner, Sabine; Rubio, Justin P.; Rückert, Ina-Maria; Salvetti, Marco; Salvi, Erika; Santaniello, Adam; Schaefer, Catherine A.; Schreiber, Stefan; Schulze, Christian; Scott, Rodney J.; Sellebjerg, Finn; Selmaj, Krzysztof W.; Sexton, David; Shen, Ling; Simms-Acuna, Brigid; Skidmore, Sheila; Sleiman, Patrick M.A.; Smestad, Cathrine; Sørensen, Per Soelberg; Søndergaard, Helle Bach; Stankovich, Jim; Strange, Richard C.; Sulonen, Anna-Maija; Sundqvist, Emilie; Syvänen, Ann-Christine; Taddeo, Francesca; Taylor, Bruce; Blackwell, Jenefer M.; Tienari, Pentti; Bramon, Elvira; Tourbah, Ayman; Brown, Matthew A.; Tronczynska, Ewa; Casas, Juan P.; Tubridy, Niall; Corvin, Aiden; Vickery, Jane; Jankowski, Janusz; Villoslada, Pablo; Markus, Hugh S.; Wang, Kai; Mathew, Christopher G.; Wason, James; Palmer, Colin N.A.; Wichmann, H-Erich; Plomin, Robert; Willoughby, Ernest; Rautanen, Anna; Winkelmann, Juliane; Wittig, Michael; Trembath, Richard C.; Yaouanq, Jacqueline; Viswanathan, Ananth C.; Zhang, Haitao; Wood, Nicholas W.; Zuvich, Rebecca; Deloukas, Panos; Langford, Cordelia; Duncanson, Audrey; Oksenberg, Jorge R.; Pericak-Vance, Margaret A.; Haines, Jonathan L.; Olsson, Tomas; Hillert, Jan; Ivinson, Adrian J.; De Jager, Philip L.; Peltonen, Leena; Stewart, Graeme J.; Hafler, David A.; Hauser, Stephen L.; McVean, Gil; Donnelly, Peter; Compston, Alastair

2011-01-01

Multiple sclerosis (OMIM 126200) is a common disease of the central nervous system in which the interplay between inflammatory and neurodegenerative processes typically results in intermittent neurological disturbance followed by progressive accumulation of disability.1 Epidemiological studies have shown that genetic factors are primarily responsible for the substantially increased frequency of the disease seen in the relatives of affected individuals;2,3 and systematic attempts to identify linkage in multiplex families have confirmed that variation within the Major Histocompatibility Complex (MHC) exerts the greatest individual effect on risk.4 Modestly powered Genome-Wide Association Studies (GWAS)5-10 have enabled more than 20 additional risk loci to be identified and have shown that multiple variants exerting modest individual effects play a key role in disease susceptibility.11 Most of the genetic architecture underlying susceptibility to the disease remains to be defined and is anticipated to require the analysis of sample sizes that are beyond the numbers currently available to individual research groups. In a collaborative GWAS involving 9772 cases of European descent collected by 23 research groups working in 15 different countries, we have replicated almost all of the previously suggested associations and identified at least a further 29 novel susceptibility loci. Within the MHC we have refined the identity of the DRB1 risk alleles and confirmed that variation in the HLA-A gene underlies the independent protective effect attributable to the Class I region. Immunologically relevant genes are significantly over-represented amongst those mapping close to the identified loci and particularly implicate T helper cell differentiation in the pathogenesis of multiple sclerosis. PMID:21833088

Component Degradation Susceptibilities As The Bases For Modeling Reactor Aging Risk

International Nuclear Information System (INIS)

Unwin, Stephen D.; Lowry, Peter P.; Toyooka, Michael Y.

2010-01-01

The extension of nuclear power plant operating licenses beyond 60 years in the United States will be necessary if we are to meet national energy needs while addressing the issues of carbon and climate. Characterizing the operating risks associated with aging reactors is problematic because the principal tool for risk-informed decision-making, Probabilistic Risk Assessment (PRA), is not ideally-suited to addressing aging systems. The components most likely to drive risk in an aging reactor - the passives - receive limited treatment in PRA, and furthermore, standard PRA methods are based on the assumption of stationary failure rates: a condition unlikely to be met in an aging system. A critical barrier to modeling passives aging on the wide scale required for a PRA is that there is seldom sufficient field data to populate parametric failure models, and nor is there the availability of practical physics models to predict out-year component reliability. The methodology described here circumvents some of these data and modeling needs by using materials degradation metrics, integrated with conventional PRA models, to produce risk importance measures for specific aging mechanisms and component types. We suggest that these measures have multiple applications, from the risk-screening of components to the prioritization of materials research.

Risk-based inspection of nuclear power plants

International Nuclear Information System (INIS)

Masopust, R.

1995-01-01

A multidiscipline research programme was developed in the USA to establish risk-based inspections for NPP structures and equipment components. Based on this US research effort, the risk-based procedure for developing inspection guidelines for NPPs is described. The procedure includes the definition of systems, qualitative risk assessment, qualitative risk analysis and development of the inspection programme. The method, when adopted and modified, is recommended also for risk-based inspections of structures and equipment of WWER-type NPPs. A pilot application of the method to unit 1 of the Surry NPP is summarized. (Z.S.) 1 tab., 1 fig., 5 refs

Determination of osteoporosis risk factors using a multiple logistic regression model in postmenopausal Turkish women.

Science.gov (United States)

Akkus, Zeki; Camdeviren, Handan; Celik, Fatma; Gur, Ali; Nas, Kemal

2005-09-01

To determine the risk factors of osteoporosis using a multiple binary logistic regression method and to assess the risk variables for osteoporosis, which is a major and growing health problem in many countries. We presented a case-control study, consisting of 126 postmenopausal healthy women as control group and 225 postmenopausal osteoporotic women as the case group. The study was carried out in the Department of Physical Medicine and Rehabilitation, Dicle University, Diyarbakir, Turkey between 1999-2002. The data from the 351 participants were collected using a standard questionnaire that contains 43 variables. A multiple logistic regression model was then used to evaluate the data and to find the best regression model. We classified 80.1% (281/351) of the participants using the regression model. Furthermore, the specificity value of the model was 67% (84/126) of the control group while the sensitivity value was 88% (197/225) of the case group. We found the distribution of residual values standardized for final model to be exponential using the Kolmogorow-Smirnow test (p=0.193). The receiver operating characteristic curve was found successful to predict patients with risk for osteoporosis. This study suggests that low levels of dietary calcium intake, physical activity, education, and longer duration of menopause are independent predictors of the risk of low bone density in our population. Adequate dietary calcium intake in combination with maintaining a daily physical activity, increasing educational level, decreasing birth rate, and duration of breast-feeding may contribute to healthy bones and play a role in practical prevention of osteoporosis in Southeast Anatolia. In addition, the findings of the present study indicate that the use of multivariate statistical method as a multiple logistic regression in osteoporosis, which maybe influenced by many variables, is better than univariate statistical evaluation.

Derailment-based Fault Tree Analysis on Risk Management of Railway Turnout Systems

Science.gov (United States)

Dindar, Serdar; Kaewunruen, Sakdirat; An, Min; Gigante-Barrera, Ángel

2017-10-01

Railway turnouts are fundamental mechanical infrastructures, which allow a rolling stock to divert one direction to another. As those are of a large number of engineering subsystems, e.g. track, signalling, earthworks, these particular sub-systems are expected to induce high potential through various kind of failure mechanisms. This could be a cause of any catastrophic event. A derailment, one of undesirable events in railway operation, often results, albeit rare occurs, in damaging to rolling stock, railway infrastructure and disrupt service, and has the potential to cause casualties and even loss of lives. As a result, it is quite significant that a well-designed risk analysis is performed to create awareness of hazards and to identify what parts of the systems may be at risk. This study will focus on all types of environment based failures as a result of numerous contributing factors noted officially as accident reports. This risk analysis is designed to help industry to minimise the occurrence of accidents at railway turnouts. The methodology of the study relies on accurate assessment of derailment likelihood, and is based on statistical multiple factors-integrated accident rate analysis. The study is prepared in the way of establishing product risks and faults, and showing the impact of potential process by Boolean algebra.

A population-based study on alcohol and high-risk sexual behaviors in Botswana.

Directory of Open Access Journals (Sweden)

Sheri D Weiser

2006-10-01

Full Text Available In Botswana, an estimated 24% of adults ages 15-49 years are infected with HIV. While alcohol use is strongly associated with HIV infection in Africa, few population-based studies have characterized the association of alcohol use with specific high-risk sexual behaviors.We conducted a cross-sectional, population-based study of 1,268 adults from five districts in Botswana using a stratified two-stage probability sample design. Multivariate logistic regression was used to assess correlates of heavy alcohol consumption (>14 drinks/week for women, and >21 drinks/week for men as a dependent variable. We also assessed gender-specific associations between alcohol use as a primary independent variable (categorized as none, moderate, problem and heavy drinking and several risky sex outcomes including: (a having unprotected sex with a nonmonogamous partner; (b having multiple sexual partners; and (c paying for or selling sex in exchange for money or other resources. Criteria for heavy drinking were met by 31% of men and 17% of women. Adjusted correlates of heavy alcohol use included male gender, intergenerational relationships (age gap > or =10 y, higher education, and living with a sexual partner. Among men, heavy alcohol use was associated with higher odds of all risky sex outcomes examined, including unprotected sex (AOR = 3.48; 95% confidence interval [CI], 1.65 to 7.32, multiple partners (AOR = 3.08; 95% CI, 1.95 to 4.87, and paying for sex (AOR = 3.65; 95% CI, 2.58 to 12.37. Similarly, among women, heavy alcohol consumption was associated with higher odds of unprotected sex (AOR = 3.28; 95% CI, 1.71 to 6.28, multiple partners (AOR = 3.05; 95% CI, 1.83 to 5.07, and selling sex (AOR = 8.50; 95% CI, 3.41 to 21.18. A dose-response relationship was seen between alcohol use and risky sexual behaviors, with moderate drinkers at lower risk than both problem and heavy drinkers.Alcohol use is associated with multiple risks for HIV transmission among both men

The residues and environmental risks of multiple veterinary antibiotics in animal faeces.

Science.gov (United States)

Li, Yan-Xia; Zhang, Xue-Lian; Li, Wei; Lu, Xiao-Fei; Liu, Bei; Wang, Jing

2013-03-01

To understand the residues and ecological risks of veterinary antibiotics (VAs) in animal faeces from concentrated animal feeding operations in northeastern China, 14 VAs were identified by high performance liquid chromatography, and the preliminary risks of six antibiotics were assessed using the hazard quotient (HQ). The investigated VAs occurred in 7.41 to 57.41 % of the 54 samples, and the levels ranged from 0.08 to 56.81 mg kg(-1). Tetracyclines were predominant with a maximum level of 56.81 mg kg(-1) mostly detected in pig faeces. Sulfonamides were common and detected with the highest concentration of 7.11 mg kg(-1). Fluoroquinolones were more widely detected in chicken faeces rather than in pig or cow faeces, which contained the dominant antibiotic enrofloxacin. In comparison, the residue of tylosin was less frequently found. The risk evaluations of the six antibiotics revealed that tetracyclines, especially oxytetracycline, displayed the greatest ecological risk because of its high HQ value of 15.75. The results of this study imply that multiple kinds of VAs were jointly used in animal feeding processes in the study area. These medicine residues in animal faeces may potentially bring ecological risks if the animal manure is not treated effectively.

Risk-based remediation: Approach and application

International Nuclear Information System (INIS)

Frishmuth, R.A.; Benson, L.A.

1995-01-01

The principle objective of remedial actions is to protect human health and the environment. Risk assessments are the only defensible tools available to demonstrate to the regulatory community and public that this objective can be achieved. Understanding the actual risks posed by site-related contamination is crucial to designing cost-effective remedial strategies. All to often remedial actions are overdesigned, resulting in little to no increase in risk reduction while increasing project cost. Risk-based remedial actions have recently been embraced by federal and state regulators, industry, government, the scientific community, and the public as a mechanism to implement rapid and cost-effective remedial actions. Emphasizing risk reduction, rather than adherence to ambiguous and generic standards, ensures that only remedial actions required to protect human health and the environment at a particular site are implemented. Two sites are presented as case studies on how risk-based approaches are being used to remediate two petroleum hydrocarbon contaminated sites. The sites are located at two US Air Force Bases, Wurtsmith Air Force Base (AFB) in Oscoda, Michigan and Malmstrom AFB in Great Falls, Montana

Developing points-based risk-scoring systems in the presence of competing risks.

Science.gov (United States)

Austin, Peter C; Lee, Douglas S; D'Agostino, Ralph B; Fine, Jason P

2016-09-30

Predicting the occurrence of an adverse event over time is an important issue in clinical medicine. Clinical prediction models and associated points-based risk-scoring systems are popular statistical methods for summarizing the relationship between a multivariable set of patient risk factors and the risk of the occurrence of an adverse event. Points-based risk-scoring systems are popular amongst physicians as they permit a rapid assessment of patient risk without the use of computers or other electronic devices. The use of such points-based risk-scoring systems facilitates evidence-based clinical decision making. There is a growing interest in cause-specific mortality and in non-fatal outcomes. However, when considering these types of outcomes, one must account for competing risks whose occurrence precludes the occurrence of the event of interest. We describe how points-based risk-scoring systems can be developed in the presence of competing events. We illustrate the application of these methods by developing risk-scoring systems for predicting cardiovascular mortality in patients hospitalized with acute myocardial infarction. Code in the R statistical programming language is provided for the implementation of the described methods. © 2016 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd. © 2016 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd.

A scenario-based modeling approach for emergency evacuation management and risk analysis under multiple uncertainties

Energy Technology Data Exchange (ETDEWEB)

Lv, Y., E-mail: lvyying@hotmail.com [School of Traffic and Transportation, Beijing Jiaotong University, Beijing 100044 (China); Faculty of Engineering and Applied Science, University of Regina, Regina, Saskatchewan S4S 0A2 (Canada); Huang, G.H., E-mail: huang@iseis.org [Faculty of Engineering and Applied Science, University of Regina, Regina, Saskatchewan S4S 0A2 (Canada); Guo, L., E-mail: guoli8658@hotmail.com [Faculty of Engineering and Applied Science, University of Regina, Regina, Saskatchewan S4S 0A2 (Canada); Li, Y.P., E-mail: yongping.li@iseis.org [MOE Key Laboratory of Regional Energy and Environmental Systems Optimization, Resources and Environmental Research Academy, North China Electric Power University, Beijing 102206 (China); Dai, C., E-mail: daichao321@gmail.com [College of Environmental Sciences and Engineering, Peking University, Beijing 100871 (China); Wang, X.W., E-mail: wangxingwei0812@gamil.com [State Key Laboratory of Water Environment Simulation, School of Environment, Beijing Normal University, Beijing 100875 (China); Sun, W., E-mail: sunwei@iseis.org [Faculty of Engineering and Applied Science, University of Regina, Regina, Saskatchewan S4S 0A2 (Canada)

2013-02-15

Highlights: ► An interval-parameter joint-probabilistic integer programming method is developed. ► It is useful for nuclear emergency management practices under uncertainties. ► It can schedule optimal routes with maximizing evacuees during a finite time. ► Scenario-based analysis enhances robustness in controlling system risk. ► The method will help to improve the capability of disaster responses. -- Abstract: Nuclear emergency evacuation is important to prevent radioactive harms by hazardous materials and to limit the accidents’ consequences; however, uncertainties are involved in the components and processes of such a management system. In the study, an interval-parameter joint-probabilistic integer programming (IJIP) method is developed for emergency evacuation management under uncertainties. Optimization techniques of interval-parameter programming (IPP) and joint-probabilistic constrained (JPC) programming are incorporated into an integer linear programming framework, so that the approach can deal with uncertainties expressed as joint probability and interval values. The IJIP method can schedule the optimal routes to guarantee the maximum population evacuated away from the effected zone during a finite time. Furthermore, it can also facilitate post optimization analysis to enhance robustness in controlling system violation risk imposed on the joint-probabilistic constraints. The developed method has been applied to a case study of nuclear emergency management; meanwhile, a number of scenarios under different system conditions have been analyzed. It is indicated that the solutions are useful for evacuation management practices. The result of the IJIP method can not only help to raise the capability of disaster responses in a systematic manner, but also provide an insight into complex relationships among evacuation planning, resources utilizations, policy requirements and system risks.

Effectiveness of a Web-Based Computer-Tailored Multiple-Lifestyle Intervention for People Interested in Reducing their Cardiovascular Risk: A Randomized Controlled Trial.

Science.gov (United States)

Storm, Vera; Dörenkämper, Julia; Reinwand, Dominique Alexandra; Wienert, Julian; De Vries, Hein; Lippke, Sonia

2016-04-11

Web-based computer-tailored interventions for multiple health behaviors can improve the strength of behavior habits in people who want to reduce their cardiovascular risk. Nonetheless, few randomized controlled trials have tested this assumption to date. The study aim was to test an 8-week Web-based computer-tailored intervention designed to improve habit strength for physical activity and fruit and vegetable consumption among people who want to reduce their cardiovascular risk. In a randomized controlled design, self-reported changes in perceived habit strength, self-efficacy, and planning across different domains of physical activity as well as fruit and vegetable consumption were evaluated. This study was a randomized controlled trial involving an intervention group (n=403) and a waiting control group (n=387). Web-based data collection was performed in Germany and the Netherlands during 2013-2015. The intervention content was based on the Health Action Process Approach and involved personalized feedback on lifestyle behaviors, which indicated whether participants complied with behavioral guidelines for physical activity and fruit and vegetable consumption. There were three Web-based assessments: baseline (T0, N=790), a posttest 8 weeks after the baseline (T1, n=206), and a follow-up 3 months after the baseline (T2, n=121). Data analysis was conducted by analyzing variances and structural equation analysis. Significant group by time interactions revealed superior treatment effects for the intervention group, with substantially higher increases in self-reported habit strength for physical activity (F1,199=7.71, P=.006, Cohen's d=0.37) and fruit and vegetable consumption (F1,199=7.71, P=.006, Cohen's d=0.30) at posttest T1 for the intervention group. Mediation analyses yielded behavior-specific sequential mediator effects for T1 planning and T1 self-efficacy between the intervention and habit strength at follow-up T2 (fruit and vegetable consumption: beta=0.12, 95

Nuclear insurance risk assessment using risk-based methodology

International Nuclear Information System (INIS)

Wendland, W.G.

1992-01-01

This paper presents American Nuclear Insurers' (ANI's) and Mutual Atomic Energy Liability Underwriters' (MAELU's) process and experience for conducting nuclear insurance risk assessments using a risk-based methodology. The process is primarily qualitative and uses traditional insurance risk assessment methods and an approach developed under the auspices of the American Society of Mechanical Engineers (ASME) in which ANI/MAELU is an active sponsor. This process assists ANI's technical resources in identifying where to look for insurance risk in an industry in which insurance exposure tends to be dynamic and nonactuarial. The process is an evolving one that also seeks to minimize the impact on insureds while maintaining a mutually agreeable risk tolerance

13 CFR 120.1000 - Risk-Based Lender Oversight.

Science.gov (United States)

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Risk-Based Lender Oversight. 120.1000 Section 120.1000 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Risk-Based Lender Oversight Supervision § 120.1000 Risk-Based Lender Oversight. (a) Risk-Based Lender...

The risk of fracture in patients with multiple sclerosis: The UK general practice research database

DEFF Research Database (Denmark)

Bazelier, Marloes T; van Staa, Tjeerd; Uitdehaag, Bernard Mj

2011-01-01

Patients with multiple sclerosis (MS) may be at an increased risk of fracture owing to a greater risk of falling and decreased bone mineral density when compared with the general population. This study was designed to estimate the relative and absolute risk of fracture in patients with MS. We...... were used to derive adjusted hazard ratios (HRs) for fracture associated with MS. Time-dependent adjustments were made for age, comorbidity, and drug use. Absolute 5- and 10-year risks of fracture were estimated for MS patients as a function of age. Compared with controls, MS patients had an almost...... threefold increased risk of hip fracture [HR = 2.79,95% confidence interval (CI) 1.83-4.26] and a risk of osteoporotic fracture that was increased 1.4-fold (HR = 1.35,95% CI 1.13-1.62). Risk was greater in patients who had been prescribed oral/intravenous glucocorticoids (GCs; HR = 1.85, 95% CI 1...

20 CFR 345.403 - Multiple base year employers.

Science.gov (United States)

2010-04-01

..., benefits will be charged in reverse chronological order, but the amount charged to each base year employer...) In all other cases, benefits will be charged in the same ratio as the compensation paid to such... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Multiple base year employers. 345.403 Section...

Synthesizing Risk from Summary Evidence Across Multiple Risk Factors.

Science.gov (United States)

Shrier, Ian; Colditz, Graham A; Steele, Russell J

2018-07-01

Although meta-analyses provide summary effect estimates that help advise patient care, patients often want to compare their overall health to the general population. The Harvard Cancer Risk Index was published in 2004 and uses risk ratio estimates and prevalence estimates from original studies across many risk factors to provide an answer to this question. However, the published version of the formula only uses dichotomous risk factors and its derivation was not provided. The objective of this brief report was to provide the derivation of a more general form of the equation that allows the incorporation of risk factors with three or more levels.

Multiple risk factors during pregnancy in South Africa: the need for a horizontal approach to perinatal care.

Science.gov (United States)

Tomlinson, Mark; O'Connor, Mary J; le Roux, Ingrid M; Stewart, Jacqueline; Mbewu, Nokwanele; Harwood, Jessica; Rotheram-Borus, Mary Jane

2014-06-01

South African children's long-term health and well-being is jeopardized during their mothers' pregnancies by the intersecting epidemics of HIV, alcohol use, low birth weight (LBW; alcohol prior to knowing that they were pregnant, and 15 % had a previous childbirth with a LBW infant. Approximately 27 % of women had more than one risk factor: depressed mood was significantly associated with alcohol use and LBW, with a trend to significance with HIV+. In addition, alcohol use was significantly related to HIV+. These results suggest the importance of intervening across multiple risks to maternal and child health, and particularly with depression and alcohol use, to positively impact multiple maternal and infant outcomes.

Combined adaptive multiple subtraction based on optimized event tracing and extended wiener filtering

Science.gov (United States)

Tan, Jun; Song, Peng; Li, Jinshan; Wang, Lei; Zhong, Mengxuan; Zhang, Xiaobo

2017-06-01

The surface-related multiple elimination (SRME) method is based on feedback formulation and has become one of the most preferred multiple suppression methods used. However, some differences are apparent between the predicted multiples and those in the source seismic records, which may result in conventional adaptive multiple subtraction methods being barely able to effectively suppress multiples in actual production. This paper introduces a combined adaptive multiple attenuation method based on the optimized event tracing technique and extended Wiener filtering. The method firstly uses multiple records predicted by SRME to generate a multiple velocity spectrum, then separates the original record to an approximate primary record and an approximate multiple record by applying the optimized event tracing method and short-time window FK filtering method. After applying the extended Wiener filtering method, residual multiples in the approximate primary record can then be eliminated and the damaged primary can be restored from the approximate multiple record. This method combines the advantages of multiple elimination based on the optimized event tracing method and the extended Wiener filtering technique. It is an ideal method for suppressing typical hyperbolic and other types of multiples, with the advantage of minimizing damage of the primary. Synthetic and field data tests show that this method produces better multiple elimination results than the traditional multi-channel Wiener filter method and is more suitable for multiple elimination in complicated geological areas.

Risk management for sulfur dioxide abatement under multiple uncertainties

Science.gov (United States)

Dai, C.; Sun, W.; Tan, Q.; Liu, Y.; Lu, W. T.; Guo, H. C.

2016-03-01

In this study, interval-parameter programming, two-stage stochastic programming (TSP), and conditional value-at-risk (CVaR) were incorporated into a general optimization framework, leading to an interval-parameter CVaR-based two-stage programming (ICTP) method. The ICTP method had several advantages: (i) its objective function simultaneously took expected cost and risk cost into consideration, and also used discrete random variables and discrete intervals to reflect uncertain properties; (ii) it quantitatively evaluated the right tail of distributions of random variables which could better calculate the risk of violated environmental standards; (iii) it was useful for helping decision makers to analyze the trade-offs between cost and risk; and (iv) it was effective to penalize the second-stage costs, as well as to capture the notion of risk in stochastic programming. The developed model was applied to sulfur dioxide abatement in an air quality management system. The results indicated that the ICTP method could be used for generating a series of air quality management schemes under different risk-aversion levels, for identifying desired air quality management strategies for decision makers, and for considering a proper balance between system economy and environmental quality.

Risks of falls in subjects with multiple sclerosis.

Science.gov (United States)

Cattaneo, Davide; De Nuzzo, Carmela; Fascia, Teresa; Macalli, Marco; Pisoni, Ivana; Cardini, Roldano

2002-06-01

To quantify fall risk among patients with multiple sclerosis (MS) and to report the importance of variables associated with falls. Retrospective case-control study design with a 2-group sample of convenience. A hospital and home settings in Italy. A convenience sample of 50 people with MS divided into 2 groups according to their reports of falls. Not applicable. Subjects were assessed with questionnaires for cognitive ability and were measured on their ability to maintain balance, to walk, and to perform daily life activities. Data regarding patients' strength, spasticity, and transfer skills impairment were also collected. No statistical differences were found between groups of fallers and nonfallers using variables pertaining to years after onset, age, gender, and Mini-Mental State Examination. Near statistically significant differences were found in activities of daily living and transfer skills (Pfall status: balance, ability to walk, and use of a cane (Pcane differed between fallers and nonfallers groups and the incidence of those variables can be used as a predictive model to quantify fall risk in patients suffering from MS. These findings emphasize the multifactorial nature of falls in this patient population. Assessment of different aspects of motor impairment and the accurate determination of factors contributing to falls are necessary for individual patient management and therapy and for the development of a prevention program for falls. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Risk analysis for roadways subjected to multiple landslide-related hazards

Science.gov (United States)

Corominas, Jordi; Mavrouli, Olga

2014-05-01

Roadways through mountainous terrain often involve cuts and landslide areas whose stability is precarious and require protection and stabilization works. To optimize the allocation of resources, government and technical offices are increasingly interested in both the risk analysis and assessment. Risk analysis has to consider the hazard occurrence and the consequences. The consequences can be both direct and indirect. The former include the costs regarding the repair of the roadway, the damage of vehicles and the potential fatalities, while the latter refer to the costs related to the diversion of vehicles, the excess of distance travelled, the time differences, and tolls. The type of slope instabilities that may affect a roadway may vary and its effects as well. Most current approaches either consider a single hazardous phenomenon each time, or if applied at small (for example national) scale, they do not take into account local conditions at each section of the roadway. The objective of this work is the development of a simple and comprehensive methodology for the assessment of the risk due to multiple hazards along roadways, integrating different landslide types that include rockfalls, debris flows and considering as well the potential failure of retaining walls. To quantify risk, all hazards are expressed with a common term: their probability of occurrence. The methodology takes into consideration the specific local conditions along the roadway. For rockfalls and debris flow a variety of methods for assessing the probability of occurrence exists. To assess the annual probability of failure of retaining walls we use an indicator-based model that provides a hazard index. The model parameters consist in the design safety factor, and further anchorage design and construction parameters. The probability of failure is evaluated in function of the hazard index and next corrected (in terms of order of magnitude) according to in situ observations for increase of two

Management of high-risk Myeloma: an evidence-based review of treatment strategies.

Science.gov (United States)

Lehners, Nicola; Hayden, Patrick J; Goldschmidt, Hartmut; Raab, Marc-Steffen

2016-08-01

Despite the progress made in the treatment of patients with multiple myeloma over recent decades, a significant cohort with high-risk disease as defined by specific clinical and genetic criteria continue to respond poorly to standard treatment. These patients represent a particular challenge to the treating physician and require early identification as well as personalized treatment strategies. In this review, we discuss the prognostic impact of adverse clinical, radiological and genetic factors, evaluate available scoring systems and highlight key aspects of the therapeutic management of high-risk myeloma. MEDLINE and recent scientific meetings' databases were searched for the keywords 'high-risk' and 'multiple myeloma' and relevant studies relating to both diagnostic and therapeutic approaches were identified. Expert commentary: A case is made for intensive induction using combinations of novel agents, early high-dose therapy supported by autologous stem cell transplantation and the widespread use of maintenance therapies. Novel therapeutic options, especially in the field of immunotherapy, are currently explored in clinical trials and have the potential to further improve outcomes for patients with high-risk multiple myeloma.

Efficacy and toxicity profile of carfilzomib based regimens for treatment of multiple myeloma: A systematic review.

Science.gov (United States)

Mushtaq, Adeela; Kapoor, Vikas; Latif, Azka; Iftikhar, Ahmad; Zahid, Umar; McBride, Ali; Abraham, Ivo; Riaz, Irbaz Bin; Anwer, Faiz

2018-05-01

Standard induction therapy for multiple myeloma is three-drug combination based on following classes of drugs: proteasome inhibitors, immunomodulators and steroids. Despite its notable efficacy, bortezomib has side effects like peripheral neuropathy (PNP) with reported incidence of grade ≥3 PNP between 2%-23% Schlafer et al., 2017. Carfilzomib (CFZ) has high selectivity and minimal off-target adverse effects including lower rates of PNP. CFZ is already approved for treatment of relapsed and refractory multiple myeloma (RRMM) as single agent as well as in combination with lenalidomide and/or dexamethasone. Extensive literature search identified a total of 1839 articles. Twenty-six articles (n = 5980) met the inclusion criteria, 15 in newly diagnosed multiple myeloma (NDMM) and 11 in RRMM group. CFZ demonstrates comparable or even better efficacy to bortezomib with much favorable AE profile. Deep, rapid and sustainable response using KRd with safer toxicity profile supports extension of KRd therapy to frontline therapy for all risk categories of MM. High incidence of grade ≥3 HTN underscores the importance of serial BP monitoring. In RRMM, CFZ has documented efficacy with standard 20-27mg/m2 dose. Further large-scale trials are needed to study benefit-to-risk profile of 20-56 and 20-70 mg/m2 dose of CFZ vs standard 20-27 mg/m2 dose in NDMM and RRMM. Copyright © 2018 Elsevier B.V. All rights reserved.

INCORPORATING NONCHEMICAL STRESSORS INTO CUMMULATIVE RISK ASSESSMENTS

Science.gov (United States)

The risk assessment paradigm has begun to shift from assessing single chemicals using "reasonable worst case" assumptions for individuals to considering multiple chemicals and community-based models. Inherent in community-based risk assessment is examination of all stressors a...

Population-based studies on risk of fracture in patients with neurological disorders

NARCIS (Netherlands)

Pouwels, S.

2014-01-01

Introduction Patients with neurological disorders may be at an increased risk of fracture via multiple causal pathways, including increases in the risk of falls, changes in bone mineral density and quality of bone microarchitecture. Risk of fracture may be increased by the disease itself, by

Retinal thickness measured with optical coherence tomography and risk of disability worsening in multiple sclerosis

DEFF Research Database (Denmark)

Martinez-Lapiscina, Elena H; Arnow, Sam; Wilson, James A

2016-01-01

of disability worsening in a cohort of patients with multiple sclerosis who had at least one eye without optic neuritis available. METHODS: In this multicentre, cohort study, we collected data about patients (age ≥16 years old) with clinically isolated syndrome, relapsing-remitting multiple sclerosis...... with the risk of subsequent disability worsening by use of proportional hazards models that included OCT metrics and age, disease duration, disability, presence of previous unilateral optic neuritis, and use of disease-modifying therapies as covariates. FINDINGS: 879 patients with clinically isolated syndrome...

Wavelet based multicarrier code division multiple access ...

African Journals Online (AJOL)

This paper presents the study on Wavelet transform based Multicarrier Code Division Multiple Access (MC-CDMA) system for a downlink wireless channel. The performance of the system is studied for Additive White Gaussian Noise Channel (AWGN) and slowly varying multipath channels. The bit error rate (BER) versus ...

A model-based risk management framework

Energy Technology Data Exchange (ETDEWEB)

Gran, Bjoern Axel; Fredriksen, Rune

2002-08-15

The ongoing research activity addresses these issues through two co-operative activities. The first is the IST funded research project CORAS, where Institutt for energiteknikk takes part as responsible for the work package for Risk Analysis. The main objective of the CORAS project is to develop a framework to support risk assessment of security critical systems. The second, called the Halden Open Dependability Demonstrator (HODD), is established in cooperation between Oestfold University College, local companies and HRP. The objective of HODD is to provide an open-source test bed for testing, teaching and learning about risk analysis methods, risk analysis tools, and fault tolerance techniques. The Inverted Pendulum Control System (IPCON), which main task is to keep a pendulum balanced and controlled, is the first system that has been established. In order to make risk assessment one need to know what a system does, or is intended to do. Furthermore, the risk assessment requires correct descriptions of the system, its context and all relevant features. A basic assumption is that a precise model of this knowledge, based on formal or semi-formal descriptions, such as UML, will facilitate a systematic risk assessment. It is also necessary to have a framework to integrate the different risk assessment methods. The experiences so far support this hypothesis. This report presents CORAS and the CORAS model-based risk management framework, including a preliminary guideline for model-based risk assessment. The CORAS framework for model-based risk analysis offers a structured and systematic approach to identify and assess security issues of ICT systems. From the initial assessment of IPCON, we also believe that the framework is applicable in a safety context. Further work on IPCON, as well as the experiences from the CORAS trials, will provide insight and feedback for further improvements. (Author)

Risk Evaluation of Multiple Hazards during Sediment and Water Related Disasters in a Small Basin

Science.gov (United States)

Yamanoi, Kazuki; Fujita, Masaharu

2016-04-01

To reduce human damage due to sediment and water related disasters induced by heavy rainfall, warning and evacuation system is very important. In Japan, the Meteorological Agency issues the sediment disaster alert when the potential of sediment disaster increases. Following the alert, local government issues evacuation advisory considering the alert and premonitory phenomena. However, it is very difficult for local people to perceive the dangerousness around them because the alert and advisory do not contain any definite information. Therefore, they sometimes misjudge the evacuation action. One reason of this is not only crucial hazards but also relatively small-scale multiple hazards take place and rise evacuation difficulties during sediment and water related disaster. Examples of small-scale hazards include: rainfall-associated hazards such as poor visibility or road submergence; landslide-associated hazards such as slope failure or sediment inflow; and flood-associated hazards such as overtopping of river dike, inundation, or destruction of bridges. The purpose of this study was to estimate the risk of multiple hazards during disaster events by numerical simulation. We applied the integrated sediment runoff model on unit channels, unit slopes, and slope units to an actual sediment and water related disaster occurred in a small basin in Tamba city, Hyogo, Japan. The maximum rainfall per hour was 91 mm (17/09/2014 2:00˜3:00) and the maximum daily precipitation was 414mm. The integrated model contains semi-physical based landslide prediction (sediment production) model, rainfall runoff model employing the kinematic wave method, model of sediment supply to channels, and bedload and suspended sediment transport model. We evaluated the risk of rainfall-associated hazards in each slope unit into 4 levels (Level I ˜ IV) using the rainfall intensity Ir [mm/hour]. The risk of flood- associated hazards were also estimated using the ratio of calculated water level and

Principal axis-based correspondence between multiple cameras for people tracking.

Science.gov (United States)

Hu, Weiming; Hu, Min; Zhou, Xue; Tan, Tieniu; Lou, Jianguang; Maybank, Steve

2006-04-01

Visual surveillance using multiple cameras has attracted increasing interest in recent years. Correspondence between multiple cameras is one of the most important and basic problems which visual surveillance using multiple cameras brings. In this paper, we propose a simple and robust method, based on principal axes of people, to match people across multiple cameras. The correspondence likelihood reflecting the similarity of pairs of principal axes of people is constructed according to the relationship between "ground-points" of people detected in each camera view and the intersections of principal axes detected in different camera views and transformed to the same view. Our method has the following desirable properties: 1) Camera calibration is not needed. 2) Accurate motion detection and segmentation are less critical due to the robustness of the principal axis-based feature to noise. 3) Based on the fused data derived from correspondence results, positions of people in each camera view can be accurately located even when the people are partially occluded in all views. The experimental results on several real video sequences from outdoor environments have demonstrated the effectiveness, efficiency, and robustness of our method.

Does vagotomy protect against multiple sclerosis?

Science.gov (United States)

Sundbøll, Jens; Horváth-Puhó, Erzsébet; Adelborg, Kasper; Svensson, Elisabeth

2017-07-01

To examine the association between vagotomy and multiple sclerosis. We conducted a matched cohort study of all patients who underwent truncal or super-selective vagotomy and a comparison cohort, by linking Danish population-based medical registries (1977-1995). Hazard ratios (HRs) for multiple sclerosis, adjusting for potential confounders were computed by means of Cox regression analysis. Median age of multiple sclerosis onset corresponded to late onset multiple sclerosis. No association with multiple sclerosis was observed for truncal vagotomy (0-37 year adjusted HR=0.91, 95% confidence interval [CI]: 0.48-1.74) or super-selective vagotomy (0-37 year adjusted HR=1.28, 95% CI: 0.79-2.09) compared with the general population. We found no association between vagotomy and later risk of late onset multiple sclerosis. Copyright © 2017 Elsevier B.V. All rights reserved.

Risk Probability Estimating Based on Clustering

DEFF Research Database (Denmark)

Chen, Yong; Jensen, Christian D.; Gray, Elizabeth

2003-01-01

of prior experiences, recommendations from a trusted entity or the reputation of the other entity. In this paper we propose a dynamic mechanism for estimating the risk probability of a certain interaction in a given environment using hybrid neural networks. We argue that traditional risk assessment models...... from the insurance industry do not directly apply to ubiquitous computing environments. Instead, we propose a dynamic mechanism for risk assessment, which is based on pattern matching, classification and prediction procedures. This mechanism uses an estimator of risk probability, which is based...

Multiple regression as a preventive tool for determining the risk of Legionella spp.

Directory of Open Access Journals (Sweden)

Enrique Gea-Izquierdo

2012-04-01

Full Text Available To determine the interrelationship between health & hygiene conditions for prevention of legionellosis, the compositionof materials used in water distribution systems, the water origin and Legionella pneumophila risk. Material and methods. Include adescriptive study and multiple regression analysis on a sample of golf course sprinkler irrigation systems (n=31 pertaining to hotelslocated on the Costa del Sol (Malaga, Spain. The study was carried out in 2009. Results. Presented a significant lineal relation, withall the independent variables contributing significantly (p<0.05 to the model’s fit. The relationship between water type and the risk ofLegionella, as well as the material composition and the latter, is lineal and positive. In contrast, the relationship between health-hygieneconditions and Legionella risk is lineal and negative. Conclusion. The characterization of Legionella pneumophila concentration, asdefined by the risk in water and through use of the predictive method, can contribute to the consideration of new influence variables inthe development of the agent, resulting in improved control and prevention of the disease.

Risk-based security cost-benefit analysis: method and example applications - 59381

International Nuclear Information System (INIS)

Wyss, Gregory; Hinton, John; Clem, John; Silva, Consuelo; Duran, Felicia A.

2012-01-01

Document available in abstract form only. Full text of publication follows: Decision makers wish to use risk-based cost-benefit analysis to prioritize security investments. However, understanding security risk requires estimating the likelihood of attack, which is extremely uncertain and depends on unquantifiable psychological factors like dissuasion and deterrence. In addition, the most common performance metric for physical security systems, probability of effectiveness at the design basis threat [P(E)], performs poorly in cost-benefit analysis. It is extremely sensitive to small changes in adversary characteristics when the threat is near a systems breaking point, but very insensitive to those changes under other conditions. This makes it difficult to prioritize investment options on the basis of P(E), especially across multiple targets or facilities. To overcome these obstacles, a Sandia National Laboratories Laboratory Directed Research and Development project has developed a risk-based security cost-benefit analysis method. This approach characterizes targets by how difficult it would be for adversaries to exploit each targets vulnerabilities to induce consequences. Adversaries generally have success criteria (e.g., adequate or desired consequences and thresholds for likelihood of success), and choose among alternative strategies that meet these criteria while considering their degree of difficulty in achieving their successful outcome. Investments reduce security risk as they reduce the severity of consequences available and/or increase the difficulty for an adversary to successfully accomplish their most advantageous attack

Multiple access chaotic digital communication based on generalized synchronization

International Nuclear Information System (INIS)

Lu Junguo

2005-01-01

A novel method for multiple access chaotic digital communication based on the concept of chaos generalized synchronization and the on-line least square method is proposed. This method can be used for transmitting multiple digital information signals concurrently. We illustrate the method using a Lorenz system driving a Chua's circuit and then examine the robustness of the proposed method with respect to noise in communication channel

Impact of shutdown risk on risk-based assessment of technical specifications

International Nuclear Information System (INIS)

Deriot, S.

1992-10-01

This paper describes the current work performed by the Research and Development Division of EDF concerning risk-based assessment of Operating Technical Specifications (OTS). The current risk-based assessment of OTS at EDF is presented. Then, the level 1 Probabilistic Safety Assessment of unit 3 of the Paluel nuclear power station (called PSA 1300) is described. It is fully computerized and takes into account the risk in shutdown states. A case study is presented. It shows that the fact of considering shutdown risk suggests that the current OTS should be modified

Risk-based decisionmaking (Panel)

Energy Technology Data Exchange (ETDEWEB)

Smith, T.H.

1995-12-31

By means of a panel discussion and extensive audience interaction, explore the current challenges and progress to date in applying risk considerations to decisionmaking related to low-level waste. This topic is especially timely because of the proposed legislation pertaining to risk-based decisionmaking and because of the increased emphasis placed on radiological performance assessments of low-level waste disposal.

Risk Governance of Multiple Natural Hazards: Centralized versus Decentralized Approach in Europe

Science.gov (United States)

Komendantova, Nadejda; Scolobig, Anna; Vinchon, Charlotte

2014-05-01

The multi-risk approach is a relatively new field and its definition includes the need to consider multiple hazards and vulnerabilities in their interdependency (Selva, 2013) and the current multi-hazards disasters, such as the 2011 Tohoku earthquake, tsunami and nuclear catastrophe, showed the need for a multi-risk approach in hazard mitigation and management. Our knowledge about multi-risk assessment, including studies from different scientific disciplines and developed assessment tools, is constantly growing (White et al., 2001). However, the link between scientific knowledge, its implementation and the results in terms of improved governance and decision-making have gained significantly less attention (IRGC, 2005; Kappes et al., 2012), even though the interest to risk governance, in general, has increased significantly during the last years (Verweiy and Thompson, 2006). Therefore, the key research question is how risk assessment is implemented and what is the potential for the implementation of a multi-risk approach in different governance systems across Europe. More precisely, how do the characteristics of risk governance, such as the degree of centralization versus decentralization, influence the implementation of a multi-risk approach. The methodology of this research includes comparative case study analysis of top-down and bottom-up interactions in governance in the city of Naples, (Italy), where the institutional landscape is marked by significant autonomy of Italian regions in decision-making processes for assessing the majority of natural risks, excluding volcanic, and in Guadeloupe, French West Indies, an overseas department of France, where the decision-making process is marked by greater centralization in decision making associated with a well established state governance within regions, delegated to the prefect and decentralised services of central ministries. The research design included documentary analysis and extensive empirical work involving

Development of new risk based regulations

International Nuclear Information System (INIS)

Nielsen, L.

1999-01-01

A short presentation of the oil and gas industry in Norway, and a brief overview of the regulatory regime in the petroleum sector in Norway is given. Risk analysis has been performed in Norway since 1981 and the various applications will be described. These risk analyses are quite different from a nuclear PSA and some of these differences will be commented. Risk based optimisation techniques such as RCM (Reliability Centred Maintenance) and Risk Based Inspection is used in the industry, with very limited support from the risk analysis. Some of the limitation that exist when such techniques are imported from other industries will be commented on. NPD (Norwegian Petroleum Directorate) is revising our regulations and some of the future plants when it comes to risk informed regulatory requirements will be presented. (au)

MFAM: Multiple Frequency Adaptive Model-Based Indoor Localization Method.

Science.gov (United States)

Tuta, Jure; Juric, Matjaz B

2018-03-24

This paper presents MFAM (Multiple Frequency Adaptive Model-based localization method), a novel model-based indoor localization method that is capable of using multiple wireless signal frequencies simultaneously. It utilizes indoor architectural model and physical properties of wireless signal propagation through objects and space. The motivation for developing multiple frequency localization method lies in the future Wi-Fi standards (e.g., 802.11ah) and the growing number of various wireless signals present in the buildings (e.g., Wi-Fi, Bluetooth, ZigBee, etc.). Current indoor localization methods mostly rely on a single wireless signal type and often require many devices to achieve the necessary accuracy. MFAM utilizes multiple wireless signal types and improves the localization accuracy over the usage of a single frequency. It continuously monitors signal propagation through space and adapts the model according to the changes indoors. Using multiple signal sources lowers the required number of access points for a specific signal type while utilizing signals, already present in the indoors. Due to the unavailability of the 802.11ah hardware, we have evaluated proposed method with similar signals; we have used 2.4 GHz Wi-Fi and 868 MHz HomeMatic home automation signals. We have performed the evaluation in a modern two-bedroom apartment and measured mean localization error 2.0 to 2.3 m and median error of 2.0 to 2.2 m. Based on our evaluation results, using two different signals improves the localization accuracy by 18% in comparison to 2.4 GHz Wi-Fi-only approach. Additional signals would improve the accuracy even further. We have shown that MFAM provides better accuracy than competing methods, while having several advantages for real-world usage.

MFAM: Multiple Frequency Adaptive Model-Based Indoor Localization Method

Directory of Open Access Journals (Sweden)

Jure Tuta

2018-03-01

Full Text Available This paper presents MFAM (Multiple Frequency Adaptive Model-based localization method, a novel model-based indoor localization method that is capable of using multiple wireless signal frequencies simultaneously. It utilizes indoor architectural model and physical properties of wireless signal propagation through objects and space. The motivation for developing multiple frequency localization method lies in the future Wi-Fi standards (e.g., 802.11ah and the growing number of various wireless signals present in the buildings (e.g., Wi-Fi, Bluetooth, ZigBee, etc.. Current indoor localization methods mostly rely on a single wireless signal type and often require many devices to achieve the necessary accuracy. MFAM utilizes multiple wireless signal types and improves the localization accuracy over the usage of a single frequency. It continuously monitors signal propagation through space and adapts the model according to the changes indoors. Using multiple signal sources lowers the required number of access points for a specific signal type while utilizing signals, already present in the indoors. Due to the unavailability of the 802.11ah hardware, we have evaluated proposed method with similar signals; we have used 2.4 GHz Wi-Fi and 868 MHz HomeMatic home automation signals. We have performed the evaluation in a modern two-bedroom apartment and measured mean localization error 2.0 to 2.3 m and median error of 2.0 to 2.2 m. Based on our evaluation results, using two different signals improves the localization accuracy by 18% in comparison to 2.4 GHz Wi-Fi-only approach. Additional signals would improve the accuracy even further. We have shown that MFAM provides better accuracy than competing methods, while having several advantages for real-world usage.

Demonstration of risk-based decision analysis in remedial alternative selection and design

International Nuclear Information System (INIS)

Evans, E.K.; Duffield, G.M.; Massmann, J.W.; Freeze, R.A.; Stephenson, D.E.

1993-01-01

This study demonstrates the use of risk-based decision analysis (Massmann and Freeze 1987a, 1987b) in the selection and design of an engineering alternative for groundwater remediation at a waste site at the Savannah River Site, a US Department of Energy facility in South Carolina. The investigation focuses on the remediation and closure of the H-Area Seepage Basins, an inactive disposal site that formerly received effluent water from a nearby production facility. A previous study by Duffield et al. (1992), which used risk-based decision analysis to screen a number of ground-water remediation alternatives under consideration for this site, indicated that the most attractive remedial option is ground-water extraction by wells coupled with surface water discharge of treated effluent. The aim of the present study is to demonstrate the iterative use of risk-based decision analysis throughout the design of a particular remedial alternative. In this study, we consider the interaction between two episodes of aquifer testing over a 6-year period and the refinement of a remedial extraction well system design. Using a three-dimensional ground-water flow model, this study employs (1) geostatistics and Monte Carlo techniques to simulate hydraulic conductivity as a stochastic process and (2) Bayesian updating and conditional simulation to investigate multiple phases of aquifer testing. In our evaluation of a remedial alternative, we compute probabilistic costs associated with the failure of an alternative to completely capture a simulated contaminant plume. The results of this study demonstrate the utility of risk-based decision analysis as a tool for improving the design of a remedial alternative through the course of phased data collection at a remedial site

Multiple imputation for estimating the risk of developing dementia and its impact on survival.

Science.gov (United States)

Yu, Binbing; Saczynski, Jane S; Launer, Lenore

2010-10-01

Dementia, Alzheimer's disease in particular, is one of the major causes of disability and decreased quality of life among the elderly and a leading obstacle to successful aging. Given the profound impact on public health, much research has focused on the age-specific risk of developing dementia and the impact on survival. Early work has discussed various methods of estimating age-specific incidence of dementia, among which the illness-death model is popular for modeling disease progression. In this article we use multiple imputation to fit multi-state models for survival data with interval censoring and left truncation. This approach allows semi-Markov models in which survival after dementia depends on onset age. Such models can be used to estimate the cumulative risk of developing dementia in the presence of the competing risk of dementia-free death. Simulations are carried out to examine the performance of the proposed method. Data from the Honolulu Asia Aging Study are analyzed to estimate the age-specific and cumulative risks of dementia and to examine the effect of major risk factors on dementia onset and death.

Multiple exciton generation in quantum dot-based solar cells

Science.gov (United States)

Goodwin, Heather; Jellicoe, Tom C.; Davis, Nathaniel J. L. K.; Böhm, Marcus L.

2018-01-01

Multiple exciton generation (MEG) in quantum-confined semiconductors is the process by which multiple bound charge-carrier pairs are generated after absorption of a single high-energy photon. Such charge-carrier multiplication effects have been highlighted as particularly beneficial for solar cells where they have the potential to increase the photocurrent significantly. Indeed, recent research efforts have proved that more than one charge-carrier pair per incident solar photon can be extracted in photovoltaic devices incorporating quantum-confined semiconductors. While these proof-of-concept applications underline the potential of MEG in solar cells, the impact of the carrier multiplication effect on the device performance remains rather low. This review covers recent advancements in the understanding and application of MEG as a photocurrent-enhancing mechanism in quantum dot-based photovoltaics.

Computed tomography imaging of early coronary artery lesions in stable individuals with multiple cardiovascular risk factors

Directory of Open Access Journals (Sweden)

Xi Yang

2015-04-01

Full Text Available OBJECTIVES: To investigate the prevalence, extent, severity, and features of coronary artery lesions in stable patients with multiple cardiovascular risk factors. METHODS: Seventy-seven patients with more than 3 cardiovascular risk factors were suspected of having coronary artery disease. Patients with high-risk factors and 39 controls with no risk factors were enrolled in the study. The related risk factors included hypertension, impaired glucose tolerance, dyslipidemia, smoking history, and overweight. The characteristics of coronary lesions were identified and evaluated by 64-slice coronary computed tomography angiography. RESULTS: The incidence of coronary atherosclerosis was higher in the high-risk group than in the no-risk group. The involved branches of the coronary artery, the diffusivity of the lesion, the degree of stenosis, and the nature of the plaques were significantly more severe in the high-risk group compared with the no-risk group (all p < 0.05. CONCLUSION: Among stable individuals with high-risk factors, early coronary artery lesions are common and severe. Computed tomography has promising value for the early screening of coronary lesions.

Mortgage Default Risk

DEFF Research Database (Denmark)

Chauvet, Marcelle; Gabriel, Stuart; Lutz, Chandler

2016-01-01

We use Google search query data to develop a broad-based and real-time index of mortgage default risk. Unlike established indicators, our Mortgage Default Risk Index (MDRI) directly reflects households’concerns regarding their risk of mortgage default. The MDRI predicts housing returns, mortgage ...... delinquency indicators, and subprime credit default swaps. These results persist both in- and out-of-sample and at multiple data frequencies. Together, research findings suggest internet search queries yield valuable new insights into household mortgage default risk....

Implementation of Multiple Intelligences Supported Project-Based Learning in EFL/ESL Classrooms

Science.gov (United States)

Bas, Gokhan

2008-01-01

This article deals with the implementation of Multiple Intelligences supported Project-Based learning in EFL/ESL Classrooms. In this study, after Multiple Intelligences supported Project-based learning was presented shortly, the implementation of this learning method into English classrooms. Implementation process of MI supported Project-based…

People with multiple tattoos and/or piercings are not at increased risk for HBV or HCV in The Netherlands

NARCIS (Netherlands)

Urbanus, Anouk T.; van den Hoek, Anneke; Boonstra, Albert; van Houdt, Robin; de Bruijn, Lotte J.; Heijman, Titia; Coutinho, Roel A.; Prins, Maria

2011-01-01

Although published results are inconsistent, it has been suggested that tattooing and piercing are risk factors for HBV and HCV infections. To examine whether tattooing and piercing do indeed increase the risk of infection, we conducted a study among people with multiple tattoos and/or piercings in

Lowering risk score profile during PCI in multiple vessel disease is associated with low adverse events: The ERACI risk score.

Science.gov (United States)

Rodriguez, Alfredo E; Fernandez-Pereira, Carlos; Mieres, Juan; Pavlovsky, Hernan; Del Pozo, Juan; Rodriguez-Granillo, Alfredo M; Antoniucci, David

2018-02-13

In recent years angiographic risk scores have been introduced in clinical practice to stratify different levels of risk after percutaneous coronary interventions (PCI). The SYNTAX score included all intermediate lesions in vessels ≥1.5 mm, consequently, multiple stent implantation was required. Four years ago, we built a new angiographic score in order to guide PCI strategy avoiding stent deployment both in intermediate stenosis as in small vessels, therefore these were not scored (ERACI risk score). The purpose of this mini review is to validate the strategy of PCI guided by this scoring, taking into account long term follow up outcomes of two observational and prospective registries where this policy was used. With this new risk score we have modified risk profile of our patient's candidates for PCI or coronary artery bypass surgery lowering the risk and PCI. The simple exclusion of small vessels and intermediate stenosis from the revascularization approach resulted in clinical outcome comparable with the one of fractional flow reserve guided revascularization. Low events rate at late follow up observed in both studies was also in agreement with guided PCI by functional lesion assessment observed by Syntax II registry, where investigators found lower events rate in spite of a few number of stents implanted per patient. use of ERACI risk scores may significantly reclassify patients into a lower risk category and be associated with low adverse events rate. Copyright © 2018. Published by Elsevier Inc.

Connection-based and object-based grouping in multiple-object tracking: A developmental study.

Science.gov (United States)

Van der Hallen, Ruth; Reusens, Julie; Evers, Kris; de-Wit, Lee; Wagemans, Johan

2018-03-30

Developmental research on Gestalt laws has previously revealed that, even as young as infancy, we are bound to group visual elements into unitary structures in accordance with a variety of organizational principles. Here, we focus on the developmental trajectory of both connection-based and object-based grouping, and investigate their impact on object formation in participants, aged 9-21 years old (N = 113), using a multiple-object tracking paradigm. Results reveal a main effect of both age and grouping type, indicating that 9- to 21-year-olds are sensitive to both connection-based and object-based grouping interference, and tracking ability increases with age. In addition to its importance for typical development, these results provide an informative baseline to understand clinical aberrations in this regard. Statement of contribution What is already known on this subject? The origin of the Gestalt principles is still an ongoing debate: Are they innate, learned over time, or both? Developmental research has revealed how each Gestalt principle has its own trajectory and unique relationship to visual experience. Both connectedness and object-based grouping play an important role in object formation during childhood. What does this study add? The study identifies how sensitivity to connectedness and object-based grouping evolves in individuals, aged 9-21 years old. Using multiple-object tracking, results reveal that the ability to track multiple objects increases with age. These results provide an informative baseline to understand clinical aberrations in different types of grouping. © 2018 The Authors. British Journal of Developmental Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.

Multiple risk-behavior profiles of smokers with serious mental illness and motivation for change.

Science.gov (United States)

Prochaska, Judith J; Fromont, Sebastien C; Delucchi, Kevin; Young-Wolff, Kelly C; Benowitz, Neal L; Hall, Stephen; Bonas, Thomas; Hall, Sharon M

2014-12-01

Individuals with serious mental illness (SMI) are dying on average 25 years prematurely. The leading causes are chronic preventable diseases. In the context of a tobacco-treatment trial, this exploratory study examined the behavioral risk profiles of adults with SMI to identify broader interventional needs. Recruited from five acute inpatient psychiatry units, participants were 693 adult smokers (recruitment rate = 76%, 50% male, 45% Caucasian, age M = 39, 49% had income change 11 health behaviors, referencing the period prior to acute hospitalization. Participants averaged 5.2 (SD = 2.1) risk behaviors, including smoking (100%), high-fat diet (68%), inadequate fruits/vegetables (67%), poor sleep (53%), physical inactivity (52%), and marijuana use (46%). The percent prepared to change ranged from 23% for tobacco and marijuana to 76% for depression management. Latent class analysis differentiated three risk groups: the global higher risk group included patients elevated on all risk behaviors; the global lower risk group was low on all risks; and a mood and metabolic risk group, characterized by inactivity, unhealthy diet, sleep problems, and poor stress and depression management. The global higher risk group (11% of sample) was younger, largely male, and had the greatest number of risk behaviors and mental health diagnoses; had the most severe psychopathologies, addiction-treatment histories, and nicotine dependence; and the lowest confidence for quitting smoking and commitment to abstinence. Most smokers with SMI engaged in multiple risks. Expanding targets to treat co-occurring risks and personalizing treatment to individuals' multibehavioral profiles may increase intervention relevance, interest, and impact on health.

Multiple sclerosis decreases explicit counterfactual processing and risk taking in decision making.

Science.gov (United States)

Simioni, Samanta; Schluep, Myriam; Bault, Nadège; Coricelli, Giorgio; Kleeberg, Joerg; Du Pasquier, Renaud A; Gschwind, Markus; Vuilleumier, Patrik; Annoni, Jean-Marie

2012-01-01

Deficits in decision making (DM) are commonly associated with prefrontal cortical damage, but may occur with multiple sclerosis (MS). There are no data concerning the impact of MS on tasks evaluating DM under explicit risk, where different emotional and cognitive components can be distinguished. We assessed 72 relapsing-remitting MS (RRMS) patients with mild to moderate disease and 38 healthy controls in two DM tasks involving risk with explicit rules: (1) The Wheel of Fortune (WOF), which probes the anticipated affects of decisions outcomes on future choices; and (2) The Cambridge Gamble Task (CGT) which measures risk taking. Participants also underwent a neuropsychological and emotional assessment, and skin conductance responses (SCRs) were recorded. In the WOF, RRMS patients showed deficits in integrating positive counterfactual information (paffect than controls (disappointment: p = 0.007; regret: p = 0.01), although their implicit emotional reactions as measured by post-choice SCRs did not differ. In the CGT, RRMS patients differed from controls in quality of DM (p = 0.01) and deliberation time (p = 0.0002), the latter difference being correlated with attention scores. Such changes did not result in overall decreases in performance (total gains). The quality of DM under risk was modified by MS in both tasks. The reduction in the expression of disappointment coexisted with an increased risk aversion in the WOF and alexithymia features. These concomitant emotional alterations may have implications for better understanding the components of explicit DM and for the clinical support of MS patients.

Vehicle coordinated transportation dispatching model base on multiple crisis locations

Science.gov (United States)

Tian, Ran; Li, Shanwei; Yang, Guoying

2018-05-01

Many disastrous events are often caused after unconventional emergencies occur, and the requirements of disasters are often different. It is difficult for a single emergency resource center to satisfy such requirements at the same time. Therefore, how to coordinate the emergency resources stored by multiple emergency resource centers to various disaster sites requires the coordinated transportation of emergency vehicles. In this paper, according to the problem of emergency logistics coordination scheduling, based on the related constraints of emergency logistics transportation, an emergency resource scheduling model based on multiple disasters is established.

Cellular Proliferation by Multiplex Immunohistochemistry Identifies High-Risk Multiple Myeloma in Newly Diagnosed, Treatment-Naive Patients.

Science.gov (United States)

Ely, Scott; Forsberg, Peter; Ouansafi, Ihsane; Rossi, Adriana; Modin, Alvin; Pearse, Roger; Pekle, Karen; Perry, Arthur; Coleman, Morton; Jayabalan, David; Di Liberto, Maurizio; Chen-Kiang, Selina; Niesvizky, Ruben; Mark, Tomer M

2017-12-01

Therapeutic options for multiple myeloma (MM) are growing, yet clinical outcomes remain heterogeneous. Cytogenetic analysis and disease staging are mainstays of risk stratification, but data suggest a complex interplay between numerous abnormalities. Myeloma cell proliferation is a metric shown to predict outcomes, but available methods are not feasible in clinical practice. Multiplex immunohistochemistry (mIHC), using multiple immunostains simultaneously, is universally available for clinical use. We tested mIHC as a method to calculate a plasma cell proliferation index (PCPI). By mIHC, marrow trephine core biopsy samples were costained for CD138, a plasma cell-specific marker, and Ki-67. Myeloma cells (CD138 + ) were counted as proliferating if coexpressing Ki-67. Retrospective analysis was performed on 151 newly diagnosed, treatment-naive patients divided into 2 groups on the basis of myeloma cell proliferation: low (PCPI ≤ 5%, n = 87), and high (PCPI > 5%, n = 64). Median overall survival (OS) was not reached versus 78.9 months (P = .0434) for the low versus high PCPI groups. Multivariate analysis showed that only high-risk cytogenetics (hazard ratio [HR] = 2.02; P = .023), International Staging System (ISS) stage > I (HR = 2.30; P = .014), and PCPI > 5% (HR = 1.70; P = .041) had independent effects on OS. Twenty-three (36%) of the 64 patients with low-risk disease (ISS stage 1, without high-risk cytogenetics) were uniquely reidentified as high risk by PCPI. PCPI is a practical method that predicts OS in newly diagnosed myeloma and facilitates broader use of MM cell proliferation for risk stratification. Copyright © 2017 Elsevier Inc. All rights reserved.

A Multi-Risk Approach to Climate Change Adaptation, Based on an Analysis of South Korean Newspaper Articles

Directory of Open Access Journals (Sweden)

Youngeun Kang

2018-05-01

Full Text Available The risks caused by climate change are worsening worldwide, and it is recognized that national and regional responses to climate change are essential. This study therefore explores climate change risks that have been recognized as fatal to people and the environment by analyzing multi-influence factors that appear in multiple risk indicators. The climate change risks in this study are based on 73 existing risk indicators; the frame data for multi-influence risk factors are based on 3098 newspaper articles published over 24 years on the impact of climate change in South Korea. The main outcomes for this study were finding climate change risk trend from newspaper articles regarding climate change impacts through text-mining, and figuring out the multi-risk indicators that are likely to occur at the same time with other risk indicators using network analysis. From the network analysis, we found that the major risk indicators have a high degree of interrelationship among risk indicators, including “increase in mortality rate from disaster”, “increase in flood areas due to coastal flooding”, and “destruction of repair facilities due to flooding (river bank, etc.”. The main risk indicators derived from this study can therefore be used as a reasonable standard when identifying the main risks posed by climate change and defining future adaptation planning priorities.

Risk Factors for Pneumonia in Ventilated Trauma Patients with Multiple Rib Fractures

Directory of Open Access Journals (Sweden)

Hyun Oh Park

2017-10-01

Full Text Available Background: Ventilator-associated pneumonia (VAP is a common disease that may contribute to morbidity and mortality among trauma patients in the intensive care unit (ICU. This study evaluated the associations between trauma factors and the development of VAP in ventilated patients with multiple rib fractures. Methods: We retrospectively and consecutively evaluated 101 patients with multiple rib fractures who were ventilated and managed at our hospital between January 2010 and December 2015, analyzing the associations between VAP and trauma factors in these patients. Trauma factors included sternal fracture, flail chest, diaphragm injury, traumatic aortic dissection, combined cardiac injury, pulmonary contusion, pneumothorax, hemothorax, hemopneumothorax, abbreviated injury scale score, thoracic trauma severity score, and injury severity score. Results: Forty-six patients (45.5% had at least 1 episode of VAP, 10 (21.7% of whom died in the ICU. Of the 55 (54.5% patients who did not have pneumonia, 9 (16.4% died in the ICU. Using logistic regression analysis, we found that VAP was associated with severe lung contusion (odds ratio, 3.07; 95% confidence interval, 1.12 to 8.39; p=0.029. Conclusion: Severe pulmonary contusion (pulmonary lung contusion score 6–12 is an independent risk factor for VAP in ventilated trauma patients with multiple rib fractures.

Clustering of Multiple Lifestyle Behaviours and Its Association to Cardiovascular Risk Factors in Children

DEFF Research Database (Denmark)

Bel-Serrat, Silvia; Mouratidou, Theodora; Santaliestra-Pasías, Alba María

2013-01-01

ratio, triglycerides, sum of two skinfolds and systolic blood pressure (SBP) z-scores were summed to compute a CVD risk score. Cluster analyses stratified by sex and age groups (2 to ...) consumption, PA performance and television video/DVD viewing. RESULTS: Five clusters were identified. Associations between CVD risk factors and score, and clusters were obtained by multiple linear regression using cluster 5 (‘low beverages consumption and low sedentary’) as the reference cluster. SBP...... association was observed between CVD risk score and clusters 2 (β=0.60; 95% CI: 0.20, 1.01), 3 (β=0.55; 95% CI: 0.14, 0.97) and 4 (β=0.60, 95% CI: 0.18, 1.02) in older boys. CONCLUSIONS: Low television/video/DVD viewing levels and low SSB consumption may result in a healthier CVD profile rather than having...

Designing and evaluating risk-based surveillance systems

DEFF Research Database (Denmark)

Willeberg, Preben; Nielsen, Liza Rosenbaum; Salman, Mo

2012-01-01

Risk-based surveillance systems reveal occurrence of disease or infection in a sample of population units, which are selected on the basis of risk factors for the condition under study. The purpose of such systems for supporting practical animal disease policy formulations and management decisions...... with prudent use of resources while maintaining acceptable system performance. High-risk category units are selected for testing by identification of the presence of specific high-risk factor(s), while disregarding other factors that might also influence the risk. On this basis we argue that the most...... applicable risk estimate for use in designing and evaluating a risk-based surveillance system would be a crude (unadjusted) relative risk, odds ratio or apparent prevalence. Risk estimates found in the published literature, however, are often the results of multivariable analyses implicitly adjusting...

Cost effectiveness of risk-based closures at UST sites

International Nuclear Information System (INIS)

Scruton, K.M.; Baker, J.N.

1995-01-01

Risk-based closures have been achieved at Underground Storage Tank (UST) sites throughout the country for a major transportation company. The risk-based closures were cost-effective because a streamlined risk-based approach was used instead of the generic baseline risk assessment approach. USEPA has recently provided guidance encouraging the use of risk-based methodology for achieving closure at UST sites. The risk-based approach used in achieving the site closures involved an identification of potential human and ecological receptors and exposure pathways, and a comparison of maximum onsite chemical concentrations to applicable or relevant and appropriate requirements (ARARs). The ARARs used in the evaluation included Federal and/or State Maximum Contaminant Levels (MCLs) for groundwater and risk-based screening levels for soils. If the maximum concentrations were above the screening levels, a baseline risk assessment was recommended. In several instances, however, the risk-based approach resulted in a regulatory agency acceptance of a ''no further action'' alternative at UST sites which did not pose a significant threat to human health and the environment. The cost of the streamlined risk-based approach is approximately $3,500, while a baseline risk assessment for the same UST site could cost up to $10,000 or more. The use of the streamlined risk-based approach has proven to be successful for achieving a ''no further action'' outcome for the client at a reasonable cost

Prediction of breast cancer risk based on profiling with common genetic variants

DEFF Research Database (Denmark)

Mavaddat, Nasim; Pharoah, Paul D P; Michailidou, Kyriaki

2015-01-01

BACKGROUND: Data for multiple common susceptibility alleles for breast cancer may be combined to identify women at different levels of breast cancer risk. Such stratification could guide preventive and screening strategies. However, empirical evidence for genetic risk stratification is lacking. M...

Prediction of breast cancer risk based on profiling with common genetic variants

NARCIS (Netherlands)

N. Mavaddat (Nasim); P.D.P. Pharoah (Paul); K. Michailidou (Kyriaki); J.P. Tyrer (Jonathan); M.N. Brook (Mark N.); M.K. Bolla (Manjeet); Q. Wang (Qing); J. Dennis (Joe); A.M. Dunning (Alison); M. Shah (Mitul); R.N. Luben (Robert); J. Brown (Judith); S.E. Bojesen (Stig); B.G. Nordestgaard (Børge); S.F. Nielsen (Sune F.); H. Flyger (Henrik); K. Czene (Kamila); H. Darabi (Hatef); M. Eriksson (Mikael); J. Peto (Julian); I. dos Santos Silva (Isabel); F. Dudbridge (Frank); N. Johnson (Nichola); M.K. Schmidt (Marjanka); A. Broeks (Annegien); S. Verhoef; E.J. Rutgers (Emiel J.); A.J. Swerdlow (Anthony ); A. Ashworth (Alan); N. Orr (Nick); M. Schoemaker (Minouk); J.D. Figueroa (Jonine); S.J. Chanock (Stephen); L.A. Brinton (Louise); J. Lissowska (Jolanta); F.J. Couch (Fergus); J.E. Olson (Janet); C. Vachon (Celine); V.S. Pankratz (Shane); D. Lambrechts (Diether); H. Wildiers (Hans); C. van Ongeval (Chantal); E. van Limbergen (Erik); V. Kristensen (Vessela); G. Grenaker Alnæs (Grethe); S. Nord (Silje); A.-L. Borresen-Dale (Anne-Lise); H. Nevanlinna (Heli); T.A. Muranen (Taru); K. Aittomäki (Kristiina); C. Blomqvist (Carl); J. Chang-Claude (Jenny); A. Rudolph (Anja); P. Seibold (Petra); D. Flesch-Janys (Dieter); P.A. Fasching (Peter); L. Haeberle (Lothar); A.B. Ekici (Arif); M.W. Beckmann (Matthias); B. Burwinkel (Barbara); F. Marme (Federick); A. Schneeweiss (Andreas); C. Sohn (Christof); A. Trentham-Dietz (Amy); P. Newcomb (Polly); L. Titus (Linda); K.M. Egan (Kathleen M.); D. Hunter (David); S. Lindstrom (Stephen); R. Tamimi (Rulla); P. Kraft (Peter); N. Rahman (Nazneen); C. Turnbull (Clare); A. Renwick (Anthony); S. Seal (Sheila); J. Li (Jingmei); J. Liu (Jianjun); M.K. Humphreys (Manjeet); J. Benítez (Javier); M.P. Zamora (Pilar); J.I. Arias Pérez (José Ignacio); P. Menéndez (Primitiva); A. Jakubowska (Anna); J. Lubinski (Jan); K. Jaworska-Bieniek (Katarzyna); K. Durda (Katarzyna); N.V. Bogdanova (Natalia); N.N. Antonenkova (Natalia); T. Dörk (Thilo); H. Anton-Culver (Hoda); S.L. Neuhausen (Susan); A. Ziogas (Argyrios); L. Bernstein (Leslie); P. Devilee (Peter); R.A.E.M. Tollenaar (Rob); C.M. Seynaeve (Caroline); C.J. van Asperen (Christi); A. Cox (Angela); S.S. Cross (Simon); M.W.R. Reed (Malcolm); E.K. Khusnutdinova (Elza); M. Bermisheva (Marina); D. Prokofyeva (Darya); Z. Takhirova (Zalina); A. Meindl (Alfons); R.K. Schmutzler (Rita); C. Sutter (Christian); R. Yang (Rongxi); P. Schürmann (Peter); M. Bremer (Michael); H. Christiansen (Hans); T.-W. Park-Simon; P. Hillemanns (Peter); P. Guénel (Pascal); T. Truong (Thérèse); F. Menegaux (Florence); M. Sanchez (Marie); P. Radice (Paolo); P. Peterlongo (Paolo); S. Manoukian (Siranoush); V. Pensotti (Valeria); J. Hopper (John); H. Tsimiklis (Helen); C. Apicella (Carmel); M.C. Southey (Melissa); H. Brauch (Hiltrud); T. Brüning (Thomas); Y.-D. Ko (Yon-Dschun); A.J. Sigurdson (Alice); M.M. Doody (Michele M.); U. Hamann (Ute); D. Torres (Diana); H.U. Ulmer (Hans); A. Försti (Asta); E.J. Sawyer (Elinor); I.P. Tomlinson (Ian); M. Kerin (Michael); N. Miller (Nicola); I.L. Andrulis (Irene); J.A. Knight (Julia); G. Glendon (Gord); A. Marie Mulligan (Anna); G. Chenevix-Trench (Georgia); R. Balleine (Rosemary); G.G. Giles (Graham); R.L. Milne (Roger); C.A. McLean (Catriona Ann); A. Lindblom (Annika); S. Margolin (Sara); C.A. Haiman (Christopher); B.E. Henderson (Brian); F. Schumacher (Fredrick); L. Le Marchand (Loic); U. Eilber (Ursula); S. Wang-Gohrke (Shan); M.J. Hooning (Maartje); A. Hollestelle (Antoinette); A.M.W. van den Ouweland (Ans); L.B. Koppert (Lisa); J. Carpenter (Jane); C. Clarke (Christine); R.J. Scott (Rodney J.); A. Mannermaa (Arto); V. Kataja (Vesa); V-M. Kosma (Veli-Matti); J.M. Hartikainen (J.); H. Brenner (Hermann); V. Arndt (Volker); C. Stegmaier (Christa); A. Karina Dieffenbach (Aida); R. Winqvist (Robert); K. Pykäs (Katri); A. Jukkola-Vuorinen (Arja); M. Grip (Mervi); K. Offit (Kenneth); J. Vijai (Joseph); M. Robson (Mark); R. Rau-Murthy (Rohini); M. Dwek (Miriam); R. Swann (Ruth); K. Annie Perkins (Katherine); M.S. Goldberg (Mark); F. Labrèche (France); M. Dumont (Martine); D. Eccles (Diana); W. Tapper (William); M. Rafiq (Meena); E.M. John (Esther M.); A.S. Whittemore (Alice); S. Slager (Susan); D. Yannoukakos (Drakoulis); A.E. Toland (Amanda); S. Yao (Song); W. Zheng (Wei); S.L. Halverson (Sandra L.); A. González-Neira (Anna); G. Pita (Guillermo); M. Rosario Alonso; N. Álvarez (Nuria); D. Herrero (Daniel); D.C. Tessier (Daniel C.); D. Vincent (Daniel); F. Bacot (Francois); C. Luccarini (Craig); C. Baynes (Caroline); S. Ahmed (Shahana); M. Maranian (Melanie); S. Healey (Sue); J. Simard (Jacques); P. Hall (Per); D.F. Easton (Douglas); M. García-Closas (Montserrat)

2015-01-01

textabstractBackground: Data for multiple common susceptibility alleles for breast cancer may be combined to identify women at different levels of breast cancer risk. Such stratification could guide preventive and screening strategies. However, empirical evidence for genetic risk stratification is

Managing Multiple Risk Factors

National Research Council Canada - National Science Library

Lollis, Charlie

1998-01-01

...) contribute to the racial differences in cardiovascular risk and events among women. High levels of socioeconomic stress, higher dietary fat intake and sedentary lifestyle are more prevalent among black than white women...

Prostate cancer risk locus at 8q24 as a regulatory hub by physical interactions with multiple genomic loci across the genome.

Science.gov (United States)

Du, Meijun; Yuan, Tiezheng; Schilter, Kala F; Dittmar, Rachel L; Mackinnon, Alexander; Huang, Xiaoyi; Tschannen, Michael; Worthey, Elizabeth; Jacob, Howard; Xia, Shu; Gao, Jianzhong; Tillmans, Lori; Lu, Yan; Liu, Pengyuan; Thibodeau, Stephen N; Wang, Liang

2015-01-01

Chromosome 8q24 locus contains regulatory variants that modulate genetic risk to various cancers including prostate cancer (PC). However, the biological mechanism underlying this regulation is not well understood. Here, we developed a chromosome conformation capture (3C)-based multi-target sequencing technology and systematically examined three PC risk regions at the 8q24 locus and their potential regulatory targets across human genome in six cell lines. We observed frequent physical contacts of this risk locus with multiple genomic regions, in particular, inter-chromosomal interaction with CD96 at 3q13 and intra-chromosomal interaction with MYC at 8q24. We identified at least five interaction hot spots within the predicted functional regulatory elements at the 8q24 risk locus. We also found intra-chromosomal interaction genes PVT1, FAM84B and GSDMC and inter-chromosomal interaction gene CXorf36 in most of the six cell lines. Other gene regions appeared to be cell line-specific, such as RRP12 in LNCaP, USP14 in DU-145 and SMIN3 in lymphoblastoid cell line. We further found that the 8q24 functional domains more likely interacted with genomic regions containing genes enriched in critical pathways such as Wnt signaling and promoter motifs such as E2F1 and TCF3. This result suggests that the risk locus may function as a regulatory hub by physical interactions with multiple genes important for prostate carcinogenesis. Further understanding genetic effect and biological mechanism of these chromatin interactions will shed light on the newly discovered regulatory role of the risk locus in PC etiology and progression. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Risk based inspection for atmospheric storage tank

Science.gov (United States)

Nugroho, Agus; Haryadi, Gunawan Dwi; Ismail, Rifky; Kim, Seon Jin

2016-04-01

Corrosion is an attack that occurs on a metallic material as a result of environment's reaction.Thus, it causes atmospheric storage tank's leakage, material loss, environmental pollution, equipment failure and affects the age of process equipment then finally financial damage. Corrosion risk measurement becomesa vital part of Asset Management at the plant for operating any aging asset.This paper provides six case studies dealing with high speed diesel atmospheric storage tank parts at a power plant. A summary of the basic principles and procedures of corrosion risk analysis and RBI applicable to the Process Industries were discussed prior to the study. Semi quantitative method based onAPI 58I Base-Resource Document was employed. The risk associated with corrosion on the equipment in terms of its likelihood and its consequences were discussed. The corrosion risk analysis outcome used to formulate Risk Based Inspection (RBI) method that should be a part of the atmospheric storage tank operation at the plant. RBI gives more concern to inspection resources which are mostly on `High Risk' and `Medium Risk' criteria and less on `Low Risk' shell. Risk categories of the evaluated equipment were illustrated through case study analysis outcome.

High-risk and multiple human papillomavirus infections among married women in Can Tho, Viet Nam.

Science.gov (United States)

Vu, Lan Thi Hoang

2012-07-01

The two currently licensed human papillomavirus (HPV) vaccines are highly efficacious in preventing cervical pre-cancers related to HPV 6, 11, 16 and 18. Before implementing a large-scale HPV vaccine campaign in Viet Nam, information about the prevalence of infection with the HPV vaccine types is required. This study was done in Can Tho, the province with the highest prevalence of cervical cancer in the south of Viet Nam, to explore the distribution of other high-risk types of HPV among married women in this province. The study employed a cross-sectional design with multistage sampling. A total of 1000 participants were randomly selected, interviewed and given gynaecological examinations. HPV infection status and HPV genotyping test were completed for all participants. A broad spectrum of HPV types was reported in this study. The prevalence of cases infected with HPV 16 and/or 18 was 7%; the prevalence of cases infected with other high-risk HPV types was 6%. The highest prevalence for single and multiple infections, as well as for high-risk infections, was reported for the youngest age group (less than 30 years). While it is relevant to implement an HPV vaccine campaign in Viet Nam due to the high prevalence of infection with HPV 16 and/or 18, it is important to note that one can be infected with multiple types of HPV. Vaccination does not protect against all types of high-risk HPV. Future vaccine campaigns should openly disclose this information to women receiving vaccines.

A risk-based microbiological criterion that uses the relative risk as the critical limit

DEFF Research Database (Denmark)

Andersen, Jens Kirk; Nørrung, Birgit; da Costa Alves Machado, Simone

2015-01-01

A risk-based microbiological criterion is described, that is based on the relative risk associated to the analytical result of a number of samples taken from a food lot. The acceptable limit is a specific level of risk and not a specific number of microorganisms, as in other microbiological...... criteria. The approach requires the availability of a quantitative microbiological risk assessment model to get risk estimates for food products from sampled food lots. By relating these food lot risk estimates to the mean risk estimate associated to a representative baseline data set, a relative risk...... estimate can be obtained. This relative risk estimate then can be compared with a critical value, defined by the criterion. This microbiological criterion based on a relative risk limit is particularly useful when quantitative enumeration data are available and when the prevalence of the microorganism...

The Theory-based Influence of Map Features on Risk Beliefs: Self-reports of What is Seen and Understood for Maps Depicting an Environmental Health Hazard

OpenAIRE

Severtson, Dolores J.; Vatovec, Christine

2012-01-01

Theory-based research is needed to understand how maps of environmental health risk information influence risk beliefs and protective behavior. Using theoretical concepts from multiple fields of study including visual cognition, semiotics, health behavior, and learning and memory supports a comprehensive assessment of this influence. We report results from thirteen cognitive interviews that provide theory-based insights into how visual features influenced what participants saw ...

Redefining high-risk patients with stage II colon cancer by risk index and microRNA-21: results from a population-based cohort

DEFF Research Database (Denmark)

Hansen, T F; Kjær-Frifeldt, S; Christensen, R D

2014-01-01

Background:The aim of the present study was to analyse the prognostic value of microRNA-21 (miRNA-21) in patients with stage II colon cancer aiming at a risk index for this group of patients.Methods:A population-based cohort of 554 patients was included. MicroRNA-21 was analysed by qPCR based...... on tumour tissue. An index was created using the coefficients obtained from a collective multiple Cox regression. The entire procedure was cross-validated (10-fold). The performance of the index was quantified by time-dependent receiver operating characteristics curves.Results:High miRNA-21 expression...... was associated with an unfavourable recurrence-free cancer-specific survival (RF-CSS), hazard ratio 1.35 (95% confidence interval, 1.03-1.76) (P=0.028). The generated RF-CSS index divided the traditional high-risk patients into subgroups with 5-year RF-CSS rates of 87% and 73%, respectively (P...

Multiple sclerosis, brain radiotherapy, and risk of neurotoxicity: The Mayo Clinic experience

International Nuclear Information System (INIS)

Miller, Robert C.; Lachance, Daniel H.; Lucchinetti, Claudia F.; Keegan, B. Mark; Gavrilova, Ralitza H.; Brown, Paul D.; Weinshenker, Brian G.; Rodriguez, Moses

2006-01-01

Purpose: The aim of this study was a retrospective assessment of neurotoxicity in patients with multiple sclerosis (MS) receiving external beam radiotherapy (EBRT) to the brain. Methods and Materials: We studied 15 consecutively treated patients with MS who received brain EBRT. Neurologic toxicity was assessed with the Common Toxicity Criteria v.3.0. Results: Median follow-up for the 5 living patients was 6.0 years (range, 3.3-27.4 years). No exacerbation of MS occurred in any patient during EBRT. Five patients had Grade 4 neurologic toxicity and 1 had possible Grade 5 toxicity. Kaplan-Meier estimated risk of neurotoxicity greater than Grade 4 at 5 years was 57% (95% confidence interval, 27%-82%). Toxicity occurred at 37.5 to 54.0 Gy at a median of 1.0 year (range, 0.2-4.3 years) after EBRT. Univariate analysis showed an association between opposed-field irradiation of the temporal lobes, central white matter, and brainstem and increased risk of neurotoxicity (p < 0.04). Three of 6 cases of toxicity occurred in patients treated before 1986. Conclusions: External beam radiotherapy of the brain in patients with MS may be associated with an increased risk of neurotoxicity compared with patients without demyelinating illnesses. However, this risk is associated with treatment techniques that may not be comparable to modern, conformal radiotherapy

Multiple sclerosis decreases explicit counterfactual processing and risk taking in decision making.

Directory of Open Access Journals (Sweden)

Samanta Simioni

Full Text Available INTRODUCTION: Deficits in decision making (DM are commonly associated with prefrontal cortical damage, but may occur with multiple sclerosis (MS. There are no data concerning the impact of MS on tasks evaluating DM under explicit risk, where different emotional and cognitive components can be distinguished. METHODS: We assessed 72 relapsing-remitting MS (RRMS patients with mild to moderate disease and 38 healthy controls in two DM tasks involving risk with explicit rules: (1 The Wheel of Fortune (WOF, which probes the anticipated affects of decisions outcomes on future choices; and (2 The Cambridge Gamble Task (CGT which measures risk taking. Participants also underwent a neuropsychological and emotional assessment, and skin conductance responses (SCRs were recorded. RESULTS: In the WOF, RRMS patients showed deficits in integrating positive counterfactual information (p<0.005 and greater risk aversion (p<0.001. They reported less negative affect than controls (disappointment: p = 0.007; regret: p = 0.01, although their implicit emotional reactions as measured by post-choice SCRs did not differ. In the CGT, RRMS patients differed from controls in quality of DM (p = 0.01 and deliberation time (p = 0.0002, the latter difference being correlated with attention scores. Such changes did not result in overall decreases in performance (total gains. CONCLUSIONS: The quality of DM under risk was modified by MS in both tasks. The reduction in the expression of disappointment coexisted with an increased risk aversion in the WOF and alexithymia features. These concomitant emotional alterations may have implications for better understanding the components of explicit DM and for the clinical support of MS patients.

Backtesting for Risk-Based Regulatory Capital

NARCIS (Netherlands)

Kerkhof, F.L.J.; Melenberg, B.

2002-01-01

In this paper we present a framework for backtesting all currently popular risk measurement methods (including value-at-risk and expected shortfall) using the functional delta method.Estimation risk can be taken explicitly into account.Based on a simulation study we provide evidence that tests for

Reproduction and the risk of multiple sclerosis

DEFF Research Database (Denmark)

Magyari, Melinda; Koch-Henriksen, Nils Iørgen; Pfleger, Claudia Christina

2013-01-01

The incidence of multiple sclerosis (MS) in Denmark has doubled in women since 1970, whereas it has been almost unchanged in men.......The incidence of multiple sclerosis (MS) in Denmark has doubled in women since 1970, whereas it has been almost unchanged in men....

In vitro fertilization and multiple pregnancies: an evidence-based analysis.

Science.gov (United States)

2006-01-01

The objective of this health technology policy assessment was to determine the clinical effectiveness and cost-effectiveness of IVF for infertility treatment, as well as the role of IVF in reducing the rate of multiple pregnancies. TARGET POPULATION AND CONDITION Typically defined as a failure to conceive after a year of regular unprotected intercourse, infertility affects 8% to 16% of reproductive age couples. The condition can be caused by disruptions at various steps of the reproductive process. Major causes of infertility include abnormalities of sperm, tubal obstruction, endometriosis, ovulatory disorder, and idiopathic infertility. Depending on the cause and patient characteristics, management options range from pharmacologic treatment to more advanced techniques referred to as assisted reproductive technologies (ART). ART include IVF and IVF-related procedures such as intra-cytoplasmic sperm injection (ICSI) and, according to some definitions, intra-uterine insemination (IUI), also known as artificial insemination. Almost invariably, an initial step in ART is controlled ovarian stimulation (COS), which leads to a significantly higher rate of multiple pregnancies after ART compared with that following natural conception. Multiple pregnancies are associated with a broad range of negative consequences for both mother and fetuses. Maternal complications include increased risk of pregnancy-induced hypertension, pre-eclampsia, polyhydramnios, gestational diabetes, fetal malpresentation requiring Caesarean section, postpartum haemorrhage, and postpartum depression. Babies from multiple pregnancies are at a significantly higher risk of early death, prematurity, and low birth weight, as well as mental and physical disabilities related to prematurity. Increased maternal and fetal morbidity leads to higher perinatal and neonatal costs of multiple pregnancies, as well as subsequent lifelong costs due to disabilities and an increased need for medical and social support

Risk based limits for Operational Safety Requirements

International Nuclear Information System (INIS)

Cappucci, A.J. Jr.

1993-01-01

OSR limits are designed to protect the assumptions made in the facility safety analysis in order to preserve the safety envelope during facility operation. Normally, limits are set based on ''worst case conditions'' without regard to the likelihood (frequency) of a credible event occurring. In special cases where the accident analyses are based on ''time at risk'' arguments, it may be desirable to control the time at which the facility is at risk. A methodology has been developed to use OSR limits to control the source terms and the times these source terms would be available, thus controlling the acceptable risk to a nuclear process facility. The methodology defines a new term ''gram-days''. This term represents the area under a source term (inventory) vs time curve which represents the risk to the facility. Using the concept of gram-days (normalized to one year) allows the use of an accounting scheme to control the risk under the inventory vs time curve. The methodology results in at least three OSR limits: (1) control of the maximum inventory or source term, (2) control of the maximum gram-days for the period based on a source term weighted average, and (3) control of the maximum gram-days at the individual source term levels. Basing OSR limits on risk based safety analysis is feasible, and a basis for development of risk based limits is defensible. However, monitoring inventories and the frequencies required to maintain facility operation within the safety envelope may be complex and time consuming

Risk-based decision analysis for groundwater operable units

International Nuclear Information System (INIS)

Chiaramonte, G.R.

1995-01-01

This document proposes a streamlined approach and methodology for performing risk assessment in support of interim remedial measure (IRM) decisions involving the remediation of contaminated groundwater on the Hanford Site. This methodology, referred to as ''risk-based decision analysis,'' also supports the specification of target cleanup volumes and provides a basis for design and operation of the groundwater remedies. The risk-based decision analysis can be completed within a short time frame and concisely documented. The risk-based decision analysis is more versatile than the qualitative risk assessment (QRA), because it not only supports the need for IRMs, but also provides criteria for defining the success of the IRMs and provides the risk-basis for decisions on final remedies. For these reasons, it is proposed that, for groundwater operable units, the risk-based decision analysis should replace the more elaborate, costly, and time-consuming QRA

Multiple traumatisation as a risk factor of post-traumatic stress disorder

Directory of Open Access Journals (Sweden)

Savjak Nadežda

2003-01-01

Full Text Available Paper presents a part of results obtained in 1998 within action study of the psychological effects of war traumatisation in Republika Srpska. Special attention is paid to the additional impact of multiple exposure to war sufferings regarding the degree of the traumatisation (the loss of loved ones, direct life threat, the participation in combats, and the testimony of the death of other people. 229 persons were assessed in 8 towns of Republika Srpska. The comparison of the results of refugees and domicile persons at the Reaction Index - Revised speaks in favour of their significantly higher vulnerability even after three years after the end of war. Total degree of the traumatisation, as well as the symptoms of intrusion, avoidance, and hyper-arousal are significantly more frequent. In 42.5% of refugees (in relation to 26.7% of domicile persons there is PTSP risk. The intensification of criteria proves that 17% of refugees are at high risk (in relation to 5.2% of the domiciled. It is obvious, that refuge presents traumatic event for many people, and not only chronic burden. The results suggest that the effect of direct jeopardy, combat stress, and the testimony of somebody else’s death are fading in time, but that the culmination of tangible, social, and human losses in refuge is serious risk factor for mental health.

Risk-based investment trade-off related to building facility management

Energy Technology Data Exchange (ETDEWEB)

Taillandier, F. [Departement TIDS, Centre Scientifique et Technique du Batiment, 06904 Sophia Antipolis (France); Laboratoire Optimisation de la conception et Ingenierie de l' environnement, Polytech' Savoie, Universite de Savoie, 73376 Le Bourget du lac (France)], E-mail: franck.taillandier@univ-savoie.fr; Sauce, G. [Laboratoire Optimisation de la conception et Ingenierie de l' environnement, Polytech' Savoie, Universite de Savoie, 73376 Le Bourget du lac (France); Bonetto, R. [Departement TIDS, Centre Scientifique et Technique du Batiment, 06904 Sophia Antipolis (France)

2009-04-15

Due to his or her profession, any building facility manager has to face many decision-making situations. One of the most important to be mentioned is the arbitration of a multi-year maintenance plan for buildings. Deciding between proposed maintenance actions, according to several constraints, so as to aim at satisfying corporate strategy is a complex choice. Risk approaches can be particularly effective because of their ability to handle complexity and uncertainties. The problem is then to be able to propose a method considering risks, adapted to the specific context of building facility management. Our method, regarded as a traditional approach, includes needed resources (i.e. costs) according to constraints (i.e. budget), but it also considers several risk domains (safety, technical preservation, client satisfaction, etc.), through the consequences (gain and loss). It proposes an ergonomic arbitration system based on filters following two complementary approaches: a selection of the fundamental actions and then an optimization of the plan (in a global view). The aim, for decision-makers, is to build their own solution by testing multiple angles of vision in simulation logic. This article presents the principles of the method, illustrated by an example of a real case conducted for a leading French company.

Risk-based investment trade-off related to building facility management

International Nuclear Information System (INIS)

Taillandier, F.; Sauce, G.; Bonetto, R.

2009-01-01

Due to his or her profession, any building facility manager has to face many decision-making situations. One of the most important to be mentioned is the arbitration of a multi-year maintenance plan for buildings. Deciding between proposed maintenance actions, according to several constraints, so as to aim at satisfying corporate strategy is a complex choice. Risk approaches can be particularly effective because of their ability to handle complexity and uncertainties. The problem is then to be able to propose a method considering risks, adapted to the specific context of building facility management. Our method, regarded as a traditional approach, includes needed resources (i.e. costs) according to constraints (i.e. budget), but it also considers several risk domains (safety, technical preservation, client satisfaction, etc.), through the consequences (gain and loss). It proposes an ergonomic arbitration system based on filters following two complementary approaches: a selection of the fundamental actions and then an optimization of the plan (in a global view). The aim, for decision-makers, is to build their own solution by testing multiple angles of vision in simulation logic. This article presents the principles of the method, illustrated by an example of a real case conducted for a leading French company

Risk-based analysis and decision making in multi-disciplinary environments

Science.gov (United States)

Feather, Martin S.; Cornford, Steven L.; Moran, Kelly

2003-01-01

A risk-based decision-making process conceived of and developed at JPL and NASA, has been used to help plan and guide novel technology applications for use on spacecraft. These applications exemplify key challenges inherent in multi-disciplinary design of novel technologies deployed in mission-critical settings. 1) Cross-disciplinary concerns are numerous (e.g., spacecraft involve navigation, propulsion, telecommunications). These concems are cross-coupled and interact in multiple ways (e.g., electromagnetic interference, heat transfer). 2) Time and budget pressures constrain development, operational resources constrain the resulting system (e.g., mass, volume, power). 3) Spacecraft are critical systems that must operate correctly the first time in only partially understood environments, with no chance for repair. 4) Past experience provides only a partial guide: New mission concepts are enhanced and enabled by new technologies, for which past experience is lacking. The decision-making process rests on quantitative assessments of the relationships between three classes of information - objectives (the things the system is to accomplish and constraints on its operation and development), risks (whose occurrence detracts from objectives), and mitigations (options for reducing the likelihood and or severity of risks). The process successfully guides experts to pool their knowledge, using custom-built software to support information gathering and decision-making.

Vulnerability and risk of deltaic social-ecological systems exposed to multiple hazards.

Science.gov (United States)

Hagenlocher, Michael; Renaud, Fabrice G; Haas, Susanne; Sebesvari, Zita

2018-08-01

Coastal river deltas are hotspots of global change impacts. Sustainable delta futures are increasingly threatened due to rising hazard exposure combined with high vulnerabilities of deltaic social-ecological systems. While the need for integrated multi-hazard approaches has been clearly articulated, studies on vulnerability and risk in deltas either focus on local case studies or single hazards and do not apply a social-ecological systems perspective. As a result, vulnerabilities and risks in areas with strong social and ecological coupling, such as coastal deltas, are not fully understood and the identification of risk reduction and adaptation strategies are often based on incomplete assumptions. To overcome these limitations, we propose an innovative modular indicator library-based approach for the assessment of multi-hazard risk of social-ecological systems across and within coastal deltas globally, and apply it to the Amazon, Ganges-Brahmaputra-Meghna (GBM), and Mekong deltas. Results show that multi-hazard risk is highest in the GBM delta and lowest in the Amazon delta. The analysis reveals major differences between social and environmental vulnerability across the three deltas, notably in the Mekong and the GBM deltas where environmental vulnerability is significantly higher than social vulnerability. Hotspots and drivers of risk vary spatially, thus calling for spatially targeted risk reduction and adaptation strategies within the deltas. Ecosystems have been identified as both an important element at risk as well as an entry point for risk reduction and adaptation strategies. Copyright © 2018. Published by Elsevier B.V.

Multiple lifestyle behaviours and mortality, findings from a large population-based Norwegian cohort study - The HUNT Study

Directory of Open Access Journals (Sweden)

Steinar Krokstad

2017-01-01

Full Text Available Abstract Background Lifestyle risk behaviours are responsible for a large proportion of disease burden and premature mortality worldwide. Risk behaviours tend to cluster in populations. We developed a new lifestyle risk index by including emerging risk factors (sleep, sitting time, and social participation and examine unique risk combinations and their associations with all-cause and cardio-metabolic mortality. Methods Data are from a large population-based cohort study in a Norway, the Nord-Trøndelag Health Study (HUNT, with an average follow-up time of 14.1 years. Baseline data from 1995–97 were linked to the Norwegian Causes of Death Registry. The analytic sample comprised 36 911 adults aged 20–69 years. Cox regression models were first fitted for seven risk factors (poor diet, excessive alcohol consumption, current smoking, physical inactivity, excessive sitting, too much/too little sleep, and poor social participation separately and then adjusted for socio-demographic covariates. Based on these results, a lifestyle risk index was developed. Finally, we explored common combinations of the risk factors in relation to all-cause and cardio-metabolic mortality outcomes. Results All single risk factors, except for diet, were significantly associated with both mortality outcomes, and were therefore selected to form a lifestyle risk index. Risk of mortality increased as the index score increased. The hazard ratio for all-cause mortality increased from 1.37 (1.15-1.62 to 6.15 (3.56-10.63 as the number of index risk factors increased from one to six respectively. Among the most common risk factor combinations the association with mortality was particularly strong when smoking and/or social participation were included. Conclusions This study adds to previous research on multiple risk behaviours by incorporating emerging risk factors. Findings regarding social participation and prolonged sitting suggest new components of healthy lifestyles and

Contributions of vitamin D response elements and HLA promoters to multiple sclerosis risk.

Science.gov (United States)

Nolan, David; Castley, Alison; Tschochner, Monika; James, Ian; Qiu, Wei; Sayer, David; Christiansen, Frank T; Witt, Campbell; Mastaglia, Frank; Carroll, William; Kermode, Allan

2012-08-07

The identification of a vitamin D-responsive (VDRE) motif within the HLA-DRB1*15:01 promoter region provides an attractive explanation for the combined effects of HLA-DR inheritance and vitamin D exposure on multiple sclerosis (MS) risk. We therefore sought to incorporate HLA-DRB1 promoter variation, including the VDRE motif, in an assessment of HLA-DRB1-associated MS risk. We utilized 32 homozygous HLA cell lines (covering 17 DRB1 alleles) and 53 heterozygote MS samples (20 DRB1 alleles) for HLA-DRB1 promoter sequencing. The influence of HLA-DRB1 variation on MS risk was then assessed among 466 MS cases and 498 controls. The majority of HLA*DRB1 alleles (including HLA-DRB1*15:01) express the functional VDRE motif, apart from HLA-DRB1*04, *07, and *09 alleles that comprise the HLA-DR53 serologic group. Allele-specific variation within functional X-box and Y-box motifs was also associated with serologically defined HLA-DR haplotypes. Incorporating these results in an analysis of MS risk, we identified a strong protective effect of HLA-DRB1*04, *07, and *09 (DR53) alleles (p = 10(-12)) and elevated risk associated with DRB1*15 and *16 (DR51) and *08 (DR8) alleles (p < 10(-18)). HLA-DRB1 groups corresponding to serologic HLA-DR profiles as well as promoter polymorphism haplotypes effectively stratified MS risk over an 11-fold range, suggesting functional relationships between risk-modifying HLA-DRB1 alleles. An independent contribution of VDRE motif variation to increase MS risk was not discernible, although vitamin D-dependent regulation of HLA-DR expression may still play an important role given that HLA-DRB1*04/*07/*09 (DR53) alleles that express the "nonresponsive" VDRE motif were associated with significantly reduced risk of MS.

Risk Aversion and Effort in an Incentive Pay Scheme with Multiplicative Noise: Theory and Experimental Evidence

NARCIS (Netherlands)

N.V. Zubanov (Nick)

2012-01-01

textabstractThe application of the classical "linear" model of incentive pay to the case when the noise is multiplicative to effort generates two predictions for a given strength of incentives: 1) more risk-averse workers will put in less effort, and 2) setting a performance target will weaken the

Adequacy of relative and absolute risk models for lifetime risk estimate of radiation-induced cancer

International Nuclear Information System (INIS)

McBride, M.; Coldman, A.J.

1988-03-01

This report examines the applicability of the relative (multiplicative) and absolute (additive) models in predicting lifetime risk of radiation-induced cancer. A review of the epidemiologic literature, and a discussion of the mathematical models of carcinogenesis and their relationship to these models of lifetime risk, are included. Based on the available data, the relative risk model for the estimation of lifetime risk is preferred for non-sex-specific epithelial tumours. However, because of lack of knowledge concerning other determinants of radiation risk and of background incidence rates, considerable uncertainty in modelling lifetime risk still exists. Therefore, it is essential that follow-up of exposed cohorts be continued so that population-based estimates of lifetime risk are available

Suicide risk in relation to psychiatric hospitalization: evidence based on longitudinal registers

DEFF Research Database (Denmark)

Qin, Ping; Nordentoft, Merete

2005-01-01

history increases suicide risk relatively more in women than in men; and suicide risk is substantial for substance disorders and for multiple admissions in women but not in men. CONCLUSIONS: Suicide risk peaks in periods immediately after admission and discharge. The risk is particularly high in persons...... with affective disorders and in persons with short hospital treatment. These findings should lead to systematic evaluation of suicide risk among inpatients before discharge and corresponding outpatient treatment, and family support should be initiated immediately after the discharge...

Low-Frequency Synonymous Coding Variation in CYP2R1 Has Large Effects on Vitamin D Levels and Risk of Multiple Sclerosis

NARCIS (Netherlands)

Manousaki, Despoina; Dudding, Tom; Haworth, Simon; Hsu, Yi Hsiang; Liu, Ching Ti; Medina-Gómez, Carolina; Voortman, Trudy; Velde, Van Der Nathalie; Melhus, Håkan; Vandenput, Liesbeth; Noordam, Raymond; Forgetta, Vincenzo; Greenwood, Celia M.T.; Biggs, Mary L.; Psaty, Bruce M.; Rotter, Jerome I.; Zemel, Babette S.; Mitchell, Jonathan A.; Taylor, Bruce; Lorentzon, Mattias; Karlsson, Magnus; Jaddoe, Vincent W.V.; Tiemeier, Henning; Campos-Obando, Natalia; Franco, Oscar H.; Utterlinden, Andre G.; Broer, Linda; Schoor, van Natasja M.; Ham, Annelies C.; Ikram, Arfan M.A.; Karasik, David; Mutsert, De Renée; Rosendaal, Frits R.; Heijer, den Martin; Wang, Thomas J.; Lind, Lars; Orwoll, Eric S.; Mook-Kanamori, Dennis O.; Michaëlsson, Karl; Kestenbaum, Bryan; Ohlsson, Claes; Mellström, Dan; Groot, de Lisette C.P.G.M.; Grant, Struan F.A.; Kiel, Douglas P.; Zillikens, M.C.; Rivadeneira, Fernando; Sawcer, Stephen; Timpson, Nicholas J.; Richards, J.B.

2017-01-01

Vitamin D insufficiency is common, correctable, and influenced by genetic factors, and it has been associated with risk of several diseases. We sought to identify low-frequency genetic variants that strongly increase the risk of vitamin D insufficiency and tested their effect on risk of multiple

Foraging Value, Risk Avoidance, and Multiple Control Signals: How the Anterior Cingulate Cortex Controls Value-based Decision-making.

Science.gov (United States)

Brown, Joshua W; Alexander, William H

2017-10-01

Recent work on the role of the ACC in cognition has focused on choice difficulty, action value, risk avoidance, conflict resolution, and the value of exerting control among other factors. A main underlying question is what are the output signals of ACC, and relatedly, what is their effect on downstream cognitive processes? Here we propose a model of how ACC influences cognitive processing in other brain regions that choose actions. The model builds on the earlier Predicted Response Outcome model and suggests that ACC learns to represent specifically the states in which the potential costs or risks of an action are high, on both short and long timescales. It then uses those cost signals as a basis to bias decisions to minimize losses while maximizing gains. The model simulates both proactive and reactive control signals and accounts for a variety of empirical findings regarding value-based decision-making.

Multiple cardiovascular risk factors in Kenya: evidence from a health and demographic surveillance system using the WHO STEPwise approach to chronic disease risk factor surveillance.

Science.gov (United States)

Bloomfield, Gerald S; Mwangi, Ann; Chege, Patrick; Simiyu, Chrispinus J; Aswa, Daniel F; Odhiambo, David; Obala, Andrew A; Ayuo, Paul; Khwa-Otsyula, Barasa O

2013-09-01

To describe the distribution of cardiovascular risk factors in western Kenya using a Health and Demographic Surveillance System (HDSS). Population based survey of residents in an HDSS. Webuye Division in Bungoma East District, Western Province of Kenya. 4037 adults ≥ 18 years of age. Home based survey using the WHO STEPwise approach to chronic disease risk factor surveillance. Self-report of high blood pressure, high blood sugar, tobacco use, alcohol use, physical activity, and fruit/vegetable intake. The median age of the population was 35 years (IQR 26-50). Less than 6% of the population reported high blood pressure or blood sugar. Tobacco and alcohol use were reported in 7% and 16% of the population, respectively. The majority of the population (93%) was physically active. The average number of days per week that participants reported intake of fruits (3.1 ± 0.1) or vegetables (1.6 ± 0.1) was low. In multiple logistic regression analyses, women were more likely to report a history of high blood pressure (OR 2.72, 95% CI 1.9 to 3.9), less likely to report using tobacco (OR 0.08, 95% CI 0.06 to 0.11), less likely to report alcohol use (OR 0.18, 95% CI 0.15 to 0.21) or eat ≥ 5 servings per day of fruits or vegetables (OR 0.87, 95% CI 0.76 to 0.99) compared to men. The most common cardiovascular risk factors in peri-urban western Kenya are tobacco use, alcohol use, and inadequate intake of fruits and vegetables. Our data reveal locally relevant subgroup differences that could inform future prevention efforts.

Research needs for risk-informed, performance-based regulations

International Nuclear Information System (INIS)

Thadani, A.C.

1997-01-01

This article summarizes the activities of the Office of Research of the NRC, both from a historical aspect as well as it applies to the application of risk-based decision making. The office has been actively involved in problems related to understanding risks related to core accidents, to understanding the problem of aging of reactor components and materials from years of service, and toward the understanding and analysis of severe accidents. In addition new policy statements regarding the role of risk assessment in regulatory applications has given focus for the need of further work. The NRC has used risk assessment in regulatory questions in the past but in a fairly ad hoc sort of manner. The new policies will clearly require a better defined application of risk assessment, and help for people evaluating applications in judging the applicability of such applications when a component of them is based on risk-based decision making. To address this, standard review plans are being prepared to serve as guides for such questions. In addition, with regulatory decisions being allowed to be based upon risk-based decisions, it is necessary to have an adequate data base prepared, and made publically available, to support such a position

Risk of Debt-Based Financing in Indonesian Islamic Banking

Directory of Open Access Journals (Sweden)

Kharisya Ayu Effendi

2017-05-01

Full Text Available The purpose of this study is to know the risk of debt-based financing in Islamic banking in Indonesia by using an accounting based calculation, those are NPF analysis, Credit risk Z-score and Altman Z-score. This study is telling about the risk of debt-based finacing on Indonesian Islamic banking using an accounting based measurement, those are NPF analysis, Credit Risk Z-score analysis and Altman Z-score analysis. The data was obtained from 2011 to 2015 from the website of each bank. The result is a risk on debt-based financing on Indonesian Islamic banking is low. The measurement using 3 accounting based measurement tool gives a consistent result, that is Indonesian Islamic banking use a debt-based financing have a high financial stability and a low risk.DOI: 10.15408/aiq.v9i2.4821

A Novel CSR-Based Sparse Matrix-Vector Multiplication on GPUs

Directory of Open Access Journals (Sweden)

Guixia He

2016-01-01

Full Text Available Sparse matrix-vector multiplication (SpMV is an important operation in scientific computations. Compressed sparse row (CSR is the most frequently used format to store sparse matrices. However, CSR-based SpMVs on graphic processing units (GPUs, for example, CSR-scalar and CSR-vector, usually have poor performance due to irregular memory access patterns. This motivates us to propose a perfect CSR-based SpMV on the GPU that is called PCSR. PCSR involves two kernels and accesses CSR arrays in a fully coalesced manner by introducing a middle array, which greatly alleviates the deficiencies of CSR-scalar (rare coalescing and CSR-vector (partial coalescing. Test results on a single C2050 GPU show that PCSR fully outperforms CSR-scalar, CSR-vector, and CSRMV and HYBMV in the vendor-tuned CUSPARSE library and is comparable with a most recently proposed CSR-based algorithm, CSR-Adaptive. Furthermore, we extend PCSR on a single GPU to multiple GPUs. Experimental results on four C2050 GPUs show that no matter whether the communication between GPUs is considered or not PCSR on multiple GPUs achieves good performance and has high parallel efficiency.

Carfilzomib significantly improves the progression-free survival of high-risk patients in multiple myeloma.

Science.gov (United States)

Avet-Loiseau, Hervé; Fonseca, Rafael; Siegel, David; Dimopoulos, Meletios A; Špička, Ivan; Masszi, Tamás; Hájek, Roman; Rosiñol, Laura; Goranova-Marinova, Vesselina; Mihaylov, Georgi; Maisnar, Vladimír; Mateos, Maria-Victoria; Wang, Michael; Niesvizky, Ruben; Oriol, Albert; Jakubowiak, Andrzej; Minarik, Jiri; Palumbo, Antonio; Bensinger, William; Kukreti, Vishal; Ben-Yehuda, Dina; Stewart, A Keith; Obreja, Mihaela; Moreau, Philippe

2016-09-01

The presence of certain high-risk cytogenetic abnormalities, such as translocations (4;14) and (14;16) and deletion (17p), are known to have a negative impact on survival in multiple myeloma (MM). The phase 3 study ASPIRE (N = 792) demonstrated that progression-free survival (PFS) was significantly improved with carfilzomib, lenalidomide, and dexamethasone (KRd), compared with lenalidomide and dexamethasone (Rd) in relapsed MM. This preplanned subgroup analysis of ASPIRE was conducted to evaluate KRd vs Rd by baseline cytogenetics according to fluorescence in situ hybridization. Of 417 patients with known cytogenetic risk status, 100 patients (24%) were categorized with high-risk cytogenetics (KRd, n = 48; Rd, n = 52) and 317 (76%) were categorized with standard-risk cytogenetics (KRd, n = 147; Rd, n = 170). For patients with high-risk cytogenetics, treatment with KRd resulted in a median PFS of 23.1 months, a 9-month improvement relative to treatment with Rd. For patients with standard-risk cytogenetics, treatment with KRd led to a 10-month improvement in median PFS vs Rd. The overall response rates for KRd vs Rd were 79.2% vs 59.6% (high-risk cytogenetics) and 91.2% vs 73.5% (standard-risk cytogenetics); approximately fivefold as many patients with high- or standard-risk cytogenetics achieved a complete response or better with KRd vs Rd (29.2% vs 5.8% and 38.1% vs 6.5%, respectively). KRd improved but did not abrogate the poor prognosis associated with high-risk cytogenetics. This regimen had a favorable benefit-risk profile in patients with relapsed MM, irrespective of cytogenetic risk status, and should be considered a standard of care in these patients. This trial was registered at www.clinicaltrials.gov as #NCT01080391. © 2016 by The American Society of Hematology.

Relationship Between Physiological and Perceived Fall Risk in People With Multiple Sclerosis: Implications for Assessment and Management.

Science.gov (United States)

Gunn, Hilary; Cameron, Michelle; Hoang, Phu; Lord, Stephen; Shaw, Steve; Freeman, Jennifer

2018-04-24

This study evaluated the relationship between physiological and perceived fall risk in people with multiple sclerosis (MS). Secondary analysis of data from prospective cohort studies undertaken in Australia, the United Kingdom, and the United States. Community. Ambulatory people with MS (N=416) (age 51.5±12.0 years; 73% female; 62% relapsing-remitting MS; 13.7±9.9 years disease duration). Not applicable. All participants completed measures of physiological (Physiological Profile Assessment [PPA]) and perceived (Falls Efficacy Scale-international [FESi]) fall risk and prospectively recorded falls for 3 months. 155 (37%) of the participants were recurrent fallers (≥2 falls). Mean PPA and FESi scores were high (PPA 2.14±1.87, FESi 34.27±11.18). The PPA and the FESi independently predicted faller classification in logistic regression, which indicated that the odds of being classified as a recurrent faller significantly increased with increasing scores (PPA odds ratio [OR] 1.30 [95% CI 1.17-1.46], FESi OR 1.05 [95% CI 1.03-1.07]). Classification and regression tree analysis divided the sample into four groups based on cutoff values for the PPA: (1) low physiological/low perceived risk (PPA 27.5), (3) high physiological/low perceived risk (PPA >2.83, FESi 35.5). Over 50% of participants had a disparity between perceived and physiological fall risk; most were in group 2. It is possible that physiological risk factors not detected by the PPA may also be influential. This study highlights the importance of considering both physiological and perceived fall risk in MS and the need for further research to explore the complex interrelationships of perceptual and physiological risk factors in this population. This study also supports the importance of developing behavioral and physical interventions that can be tailored to the individual's needs. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Season of infectious mononucleosis as a risk factor for multiple sclerosis: A UK primary care case-control study.

Science.gov (United States)

Downham, Christina; Visser, Elizabeth; Vickers, Mark; Counsell, Carl

2017-10-01

Infectious mononucleosis (IM) and vitamin D deficiency are both risk factors for multiple sclerosis (MS). We wished to establish if IM in the winter months when vitamin D levels are low may be a greater risk factor for MS than IM in the summer months. We identified all patients with MS diagnosed aged 16-60 in a large primary care database in the United Kingdom and matched each by age, sex, general practice and observation period with up to six controls. We identified a coded diagnosis of IM prior to the index date (date of diagnosis). Logistic regression was used to calculate the odds ratio for prior IM exposure in cases versus controls and for winter versus summer exposure in cases and controls with prior IM exposure. Based on 9247 cases and 55,033 matched controls (246 and 846 with prior IM respectively), IM was associated with the development of MS (OR 1.77, 95%CI 1.53-2.05) but there was no evidence that IM in the winter as opposed to summer was associated with developing MS (OR 1.09, 95%CI 0.72-1.66). We found no evidence that the season of IM influences the risk of subsequent MS. Copyright © 2017 Elsevier B.V. All rights reserved.

Sexual behavior, risk perception, and HIV transmission can respond to HIV antiviral drugs and vaccines through multiple pathways

Science.gov (United States)

Tully, Stephen; Cojocaru, Monica; Bauch, Chris T.

2015-01-01

There has been growing use of highly active antiretroviral treatment (HAART) for HIV and significant progress in developing prophylactic HIV vaccines. The simplest theories of counterproductive behavioral responses to such interventions tend to focus on single feedback mechanisms: for instance, HAART optimism makes infection less scary and thus promotes risky sexual behavior. Here, we develop an agent based, age-structured model of HIV transmission, risk perception, and partner selection in a core group to explore behavioral responses to interventions. We find that interventions can activate not one, but several feedback mechanisms that could potentially influence decision-making and HIV prevalence. In the model, HAART increases the attractiveness of unprotected sex, but it also increases perceived risk of infection and, on longer timescales, causes demographic impacts that partially counteract HAART optimism. Both HAART and vaccination usually lead to lower rates of unprotected sex on the whole, but intervention effectiveness depends strongly on whether individuals over- or under-estimate intervention coverage. Age-specific effects cause sexual behavior and HIV prevalence to change in opposite ways in old and young age groups. For complex infections like HIV—where interventions influence transmission, demography, sexual behavior and risk perception—we conclude that evaluations of behavioral responses should consider multiple feedback mechanisms. PMID:26507957

Shift work at young age is associated with increased risk of multiple sclerosis in a Danish population.

Science.gov (United States)

Gustavsen, S; Søndergaard, H B; Oturai, D B; Laursen, B; Laursen, J H; Magyari, M; Ullum, H; Larsen, M H; Sellebjerg, F; Oturai, A B

2016-09-01

Epidemiological studies suggest an important role for environmental factors in developing multiple sclerosis (MS). Furthermore several studies have indicated that the effect of environmental factors may be especially pronounced in adolescents. Recently only one study investigated and found that shift work at young age is associated with an increased risk of developing MS. In this study we focused on the effect of shift work in the vulnerable period between 15-19 years. The aim of this study was to investigate the association between shift work at young age and the risk of developing MS. We performed a large case-control study including 1723 patients diagnosed with MS and 4067 controls. MS patients were recruited from the Danish Multiple Sclerosis Biobank and controls from The Danish Blood Donor Study. Information on working patterns and lifestyle factors was obtained using a comprehensive lifestyle-environmental factor questionnaire with participants enrolled between 2009 and 2014. Logistic regression models were used to investigate the association between shift work at age 15-19 years and the subsequent risk of MS and were controlled for effects due to established MS risk factors. We found a statistically significant association when total numbers of night shifts were compared with non-shift workers. For every additional 100 night shifts the odds ratio (OR) for MS was 1.20 (95% confidence interval (CI), 1.08-1.34, p=0.001). Increasing intensity of shift work also increased MS risk. For every additional night per month the OR was 1.04 (95% CI, 1.01-1.06, p=0.002). Duration of shift work in years was not associated with risk of MS. This study supports a statistically significant association between shift work at age 15-19 years and MS risk. Copyright © 2016 Elsevier B.V. All rights reserved.

Using impedance cardiography to detect subclinical cardiovascular disease in women with multiple risk factors: a pilot study.

Science.gov (United States)

Demarzo, Arthur P

2009-01-01

Early detection of cardiovascular disease (CVD) could initiate appropriate treatment and prevent progression. This study used impedance cardiography (ICG) waveform analysis with postural change to detect functional CVD in women older than 40 years with no history of CVD and >or=2 of the following risk factors: cigarette smoking, poor diet, physical inactivity, central adiposity, family history of premature CVD, hypertension, and dyslipidemia. A study group of 32 women underwent ICG in standing and supine positions. An age-matched control group had 20 women with an active lifestyle, no risk factors, and no history of CVD. All women in the control group had normal ICG data. All women in the study group had some abnormal ICG data, with 28 (87.5%) having multiple ICG abnormalities. ICG data indicated that 13 (40.6%) had ventricular dysfunction, 14 (43.8%) had high vascular resistive load, and 30 (93.8%) had elevated vascular pulsatile load. The data suggest that subclinical CVD, detectable by ICG, is prevalent in women older than 40 years with multiple risk factors. Abnormal ICG results could expedite the initiation of customized treatment as part of a preventive approach to CVD. (c) 2009 Wiley Periodicals, Inc.

Redefining high-risk patients with stage II colon cancer by risk index and microRNA-21: results from a population-based cohort

DEFF Research Database (Denmark)

Hansen, T F; Kjær-Frifeldt, S; Christensen, R D

2014-01-01

Background:The aim of the present study was to analyse the prognostic value of microRNA-21 (miRNA-21) in patients with stage II colon cancer aiming at a risk index for this group of patients.Methods:A population-based cohort of 554 patients was included. MicroRNA-21 was analysed by qPCR based.......001). The overall survival (OS) index identified three different subgroups (Pcolon cancer. Furthermore...... on tumour tissue. An index was created using the coefficients obtained from a collective multiple Cox regression. The entire procedure was cross-validated (10-fold). The performance of the index was quantified by time-dependent receiver operating characteristics curves.Results:High miRNA-21 expression...

Perception of mobile phone and base station risks.

Science.gov (United States)

Siegrist, Michael; Earle, Timothy C; Gutscher, Heinz; Keller, Carmen

2005-10-01

Perceptions of risks associated with mobile phones, base stations, and other sources of electromagnetic fields (EMF) were examined. Data from a telephone survey conducted in the German- and French-speaking parts of Switzerland are presented (N = 1,015). Participants assessed both risks and benefits associated with nine different sources of EMF. Trust in the authorities regulating these hazards was assessed as well. In addition, participants answered a set of questions related to attitudes toward EMF and toward mobile phone base stations. According to respondents' assessments, high-voltage transmission lines are the most risky source of EMF. Mobile phones and mobile phone base stations received lower risk ratings. Results showed that trust in authorities was positively associated with perceived benefits and negatively associated with perceived risks. People who use their mobile phones frequently perceived lower risks and higher benefits than people who use their mobile phones infrequently. People who believed they lived close to a base station did not significantly differ in their level of risks associated with mobile phone base stations from people who did not believe they lived close to a base station. Regarding risk regulation, a majority of participants were in favor of fixing limiting values based on the worst-case scenario. Correlations suggest that belief in paranormal phenomena is related to level of perceived risks associated with EMF. Furthermore, people who believed that most chemical substances cause cancer also worried more about EMF than people who did not believe that chemical substances are that harmful. Practical implications of the results are discussed.

Risk-benefit considerations in the treatment of relapsing-remitting multiple sclerosis

Directory of Open Access Journals (Sweden)

Lugaresi A

2013-06-01

Full Text Available Alessandra Lugaresi,1 Maria di Ioia,1 Daniela Travaglini,1 Erika Pietrolongo,1 Eugenio Pucci,2 Marco Onofrj11Department of Neuroscience and Imaging, University “G d’Annunzio”, Chieti, 2Operative Unit Neurologia ASUR Marche Area Vasta 3, Macerata, ItalyAbstract: Multiple sclerosis (MS is a chronic demyelinating disease of the central nervous system and mainly affects young adults. Its natural history has changed in recent years with the advent of disease-modifying drugs, which have been available since the early 1990s. The increasing number of first-line and second-line treatment options, together with the variable course of the disease and patient lifestyles and expectations, makes the therapeutic decision a real challenge. The aim of this review is to give a comprehensive overview of the main present and some future drugs for relapsing-remitting MS, including risk-benefit considerations, to enable readers to draw their own conclusions regarding the risk-benefit assessment of personalized treatment strategies, taking into account not only treatment-related but also disease-related risks. We performed a Medline literature search to identify studies on the treatment of MS with risk stratification and risk-benefit considerations. We focused our attention on studies of disease-modifying, immunomodulating, and immunosuppressive drugs, including monoclonal antibodies. Here we offer personal considerations, stemming from long-term experience in the treatment of MS and thorough discussions with other neurologists closely involved in the care of patients with the disease. MS specialists need to know not only the specific risks and benefits of single drugs, but also about drug interactions, either in simultaneous or serial combination therapy, and patient comorbidities, preferences, and fears. This has to be put into perspective, considering also the risks of untreated disease in patients with different clinical and radiological characteristics

Risk-based inspection--Development of guidelines

International Nuclear Information System (INIS)

1993-07-01

Effective inservice inspection programs can play a significant role in minimizing equipment and structural failures. Most of the current inservice inspection programs for light water reactor (LWR) nuclear power plant components are based on experience and engineers' qualitative judgment. These programs include only an implicit consideration of risk, which combines the probability of failure of a component under its operation and loading conditions and the consequences of such failure, if it occurs. This document recommends appropriate methods for establishing a risk-based inspection program for LWR nuclear power plant components. The process has been built from a general methodology (Volume 1) and has been expanded to involve five major steps: defining the system; evaluating qualitative risk assessment results; using this and information from plant probabilistic risk assessments to perform a quantitative risk analysis; selecting target failure probabilities; and developing an inspection program for components using economic decision analysis and structural reliability assessment methods

Risk-based zoning for urbanizing floodplains.

Science.gov (United States)

Porse, Erik

2014-01-01

Urban floodplain development brings economic benefits and enhanced flood risks. Rapidly growing cities must often balance the economic benefits and increased risks of floodplain settlement. Planning can provide multiple flood mitigation and environmental benefits by combining traditional structural measures such as levees, increasingly popular landscape and design features (green infrastructure), and non-structural measures such as zoning. Flexibility in both structural and non-structural options, including zoning procedures, can reduce flood risks. This paper presents a linear programming formulation to assess cost-effective urban floodplain development decisions that consider benefits and costs of development along with expected flood damages. It uses a probabilistic approach to identify combinations of land-use allocations (residential and commercial development, flood channels, distributed runoff management) and zoning regulations (development zones in channel) to maximize benefits. The model is applied to a floodplain planning analysis for an urbanizing region in the Baja Sur peninsula of Mexico. The analysis demonstrates how (1) economic benefits drive floodplain development, (2) flexible zoning can improve economic returns, and (3) cities can use landscapes, enhanced by technology and design, to manage floods. The framework can incorporate additional green infrastructure benefits, and bridges typical disciplinary gaps for planning and engineering.

Cryptanalysis of the public key encryption based on multiple chaotic systems

International Nuclear Information System (INIS)

Zhang Linhua

2008-01-01

Recently, Ranjan proposed a novel public key encryption technique based on multiple chaotic systems [Phys Lett 2005;95]. Unfortunately, Wang soon gave a successful attack on its special case based on Parseval's theorem [Wang K, Pei W, Zhou L, et al. Security of public key encryption technique based on multiple chaotic system. Phys Lett A, in press]. In this letter, we give an improved example which can avoid the attack and point out that Wang cannot find the essential drawback of the technique. However, further experimental result shows Ruanjan's encryption technique is inefficient, and detailed theoretic analysis shows that the complexity to break the cryptosystem is overestimated

Multi-lane detection based on multiple vanishing points detection

Science.gov (United States)

Li, Chuanxiang; Nie, Yiming; Dai, Bin; Wu, Tao

2015-03-01

Lane detection plays a significant role in Advanced Driver Assistance Systems (ADAS) for intelligent vehicles. In this paper we present a multi-lane detection method based on multiple vanishing points detection. A new multi-lane model assumes that a single lane, which has two approximately parallel boundaries, may not parallel to others on road plane. Non-parallel lanes associate with different vanishing points. A biological plausibility model is used to detect multiple vanishing points and fit lane model. Experimental results show that the proposed method can detect both parallel lanes and non-parallel lanes.

Serum Parathyroid Hormone Is a New Potential Risk Factor in Multiple Myeloma

Directory of Open Access Journals (Sweden)

Min-Gu Kang

2014-01-01

Full Text Available We hypothesized that serum PTH might be associated with various clinicopathological parameters in multiple myeloma (MM. So we investigated the implications of serum PTH in MM patients and the relationship with other risk factors of MM. A total of 115 patients who were newly diagnosed with MM were enrolled. Serum PTH level was 24.7 ± 34.9 (ranged 0.0–284.1 pg/mL. Serum levels of IgG, IgM, FLC-lambda, albumin, and LDH were in positive correlation with serum PTH. Compared to non-high PTH (<68.3 pg/mL group, the hazard ratio (HR for overall survival was higher for group with high PTH level (≥68.3 pg/mL (HR, 1.710. Furthermore, the patient group with high PTH level showed inferior progression-free survival than non-high PTH group (P=0.056. Interestingly, subgroup analysis showed that serum PTH level at diagnosis was associated with risk factors and clinical outcome in MM patients, especially in complete remission group, transplantation cases, ISS stage II cases, and cases without chromosome abnormality. In conclusion, this study showed that blood PTH level in MM at diagnosis was associated with risk factors and clinical outcome in MM patients.

Homocyst(e)ine and risk of cardiovascular disease in the multiple risk factor intervention trial.

Science.gov (United States)

Evans, R W; Shaten, B J; Hempel, J D; Cutler, J A; Kuller, L H

2000-01-01

A nested case-control study was undertaken involving men participating in the Multiple Risk Factor Intervention Trial (MRFIT). Serum samples from 712 men, stored for upto 20 years, were analysed for homocyst(e)ine. Cases involved non-fatal myocardial infractions, identified through the active phase of the study, which ended on February 28, 1982, and deaths due to coronary heart disease, monitored through 1990. The non-fatal myocardial infarction occurred within 7 years of sample collection, whereas the majority of coronary heart disease deaths occurred more than 11 years after sample collection. Mean homocyst(e)ine concentrations were in the expected range and did not differ significantly between case patients and control subjects: myocardial infarction cases, 12.6 micromol/L; myocardial infarction controls, 13.1 micromol/L; coronary heart disease death cases, 12.8 micromol/L; and coronary heart disease controls, 12.7 micromol/L. Odds ratios versus quartile 1 for coronary heart disease deaths and myocardial infarctions combined were as follows: quartile 2, 1.03; quartile 3, 0.84; and quartile 4, 0.92. Thus, in this prospective study, no association of homocyst(e)ine concentration with heart disease was detected. Homocyst(e)ine levels were weakly associated with the acute-phase (C-reactive) protein. These results are discussed with respect to the suggestion that homocyst(e)ine is an independent risk factor for heart disease.

Application of REVEAL-W to risk-based configuration control

International Nuclear Information System (INIS)

Dezfuli, H.; Meyer, J.; Modarres, M.

1994-01-01

Over the past two years, the concept of risk-based configuration control has been introduced to the US Nuclear Regulatory Commission and the nuclear industry. Converting much of the current, deterministically based regulation of nuclear power plants to risk-based regulation can result in lower levels of risk while relieving unnecessary burdens on power plant operators and regulatory staff. To achieve the potential benefits of risk-based configuration control, the risk models developed for nuclear power plants should be (1) flexible enough to effectively support necessary risk calculations, and (2) transparent enough to encourage their use by all parties. To address these needs, SCIENTECH, Inc., has developed the PC-based REVEAL W (formerly known as SMART). This graphic-oriented and user-friendly application software allows the user to develop transparent complex logic models based on the concept of the master plant logic diagram. The logic model is success-oriented and compact. The analytical capability built into REVEAL W is generic, so the software can support different types of risk-based evaluations, such as probabilistic safety assessment, accident sequence precursor analysis, design evaluation and configuration management. In this paper, we focus on the application of REVEAL W to support risk-based configuration control of nuclear power plants. (author)

Effects of a risk-based online mammography intervention on accuracy of perceived risk and mammography intentions.

Science.gov (United States)

Seitz, Holli H; Gibson, Laura; Skubisz, Christine; Forquer, Heather; Mello, Susan; Schapira, Marilyn M; Armstrong, Katrina; Cappella, Joseph N

2016-10-01

This experiment tested the effects of an individualized risk-based online mammography decision intervention. The intervention employs exemplification theory and the Elaboration Likelihood Model of persuasion to improve the match between breast cancer risk and mammography intentions. 2918 women ages 35-49 were stratified into two levels of 10-year breast cancer risk (<1.5%; ≥1.5%) then randomly assigned to one of eight conditions: two comparison conditions and six risk-based intervention conditions that varied according to a 2 (amount of content: brief vs. extended) x 3 (format: expository vs. untailored exemplar [example case] vs. tailored exemplar) design. Outcomes included mammography intentions and accuracy of perceived breast cancer risk. Risk-based intervention conditions improved the match between objective risk estimates and perceived risk, especially for high-numeracy women with a 10-year breast cancer risk ≤1.5%. For women with a risk≤1.5%, exemplars improved accuracy of perceived risk and all risk-based interventions increased intentions to wait until age 50 to screen. A risk-based mammography intervention improved accuracy of perceived risk and the match between objective risk estimates and mammography intentions. Interventions could be applied in online or clinical settings to help women understand risk and make mammography decisions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Multiplicative interaction of functional inflammasome genetic variants in determining the risk of gout.

Science.gov (United States)

McKinney, Cushla; Stamp, Lisa K; Dalbeth, Nicola; Topless, Ruth K; Day, Richard O; Kannangara, Diluk Rw; Williams, Kenneth M; Janssen, Matthijs; Jansen, Timothy L; Joosten, Leo A; Radstake, Timothy R; Riches, Philip L; Tausche, Anne-Kathrin; Lioté, Frederic; So, Alexander; Merriman, Tony R

2015-10-13

The acute gout flare results from a localised self-limiting innate immune response to monosodium urate (MSU) crystals deposited in joints in hyperuricaemic individuals. Activation of the caspase recruitment domain-containing protein 8 (CARD8) NOD-like receptor pyrin-containing 3 (NLRP3) inflammasome by MSU crystals and production of mature interleukin-1β (IL-1β) is central to acute gouty arthritis. However very little is known about genetic control of the innate immune response involved in acute gouty arthritis. Therefore our aim was to test functional single nucleotide polymorphism (SNP) variants in the toll-like receptor (TLR)-inflammasome-IL-1β axis for association with gout. 1,494 gout cases of European and 863 gout cases of New Zealand (NZ) Polynesian (Māori and Pacific Island) ancestry were included. Gout was diagnosed by the 1977 ARA gout classification criteria. There were 1,030 Polynesian controls and 10,942 European controls including from the publicly-available Atherosclerosis Risk in Communities (ARIC) and Framingham Heart (FHS) studies. The ten SNPs were either genotyped by Sequenom MassArray or by Affymetrix SNP array or imputed in the ARIC and FHS datasets. Allelic association was done by logistic regression adjusting by age and sex with European and Polynesian data combined by meta-analysis. Sample sets were pooled for multiplicative interaction analysis, which was also adjusted by sample set. Eleven SNPs were tested in the TLR2, CD14, IL1B, CARD8, NLRP3, MYD88, P2RX7, DAPK1 and TNXIP genes. Nominally significant (P gout were detected at CARD8 rs2043211 (OR = 1.12, P = 0.007), IL1B rs1143623 (OR = 1.10, P = 0.020) and CD14 rs2569190 (OR = 1.08; P = 0.036). There was significant multiplicative interaction between CARD8 and IL1B (P = 0.005), with the IL1B risk genotype amplifying the risk effect of CARD8. There is evidence for association of gout with functional variants in CARD8, IL1B and CD14. The gout-associated allele of IL1B increases

DOA Estimation of Multiple LFM Sources Using a STFT-based and FBSS-based MUSIC Algorithm

Directory of Open Access Journals (Sweden)

K. B. Cui

2017-12-01

Full Text Available Direction of arrival (DOA estimation is an important problem in array signal processing. An effective multiple signal classification (MUSIC method based on the short-time Fourier transform (STFT and forward/ backward spatial smoothing (FBSS techniques for the DOA estimation problem of multiple time-frequency (t-f joint LFM sources is addressed. Previous work in the area e. g. STFT-MUSIC algorithm cannot resolve the t-f completely or largely joint sources because they can only select the single-source t-f points. The proposed method con¬structs the spatial t-f distributions (STFDs by selecting the multiple-source t-f points and uses the FBSS techniques to solve the problem of rank loss. In this way, the STFT-FBSS-MUSIC algorithm can resolve the t-f largely joint or completely joint LFM sources. In addition, the proposed algorithm also owns pretty low computational complexity when resolving multiple LFM sources because it can reduce the times of the feature decomposition and spectrum search. The performance of the proposed method is compared with that of the existing t-f based MUSIC algorithms through computer simulations and the results show its good performance.

Trends and risk factors of stillbirths and neonatal deaths in Eastern Uganda (1982-2011): a cross-sectional, population-based study.

Science.gov (United States)

Kujala, Sanni; Waiswa, Peter; Kadobera, Daniel; Akuze, Joseph; Pariyo, George; Hanson, Claudia

2017-01-01

To identify mortality trends and risk factors associated with stillbirths and neonatal deaths 1982-2011. Population-based cross-sectional study based on reported pregnancy history in Iganga-Mayuge Health and Demographic Surveillance Site (HDSS) in Uganda. A pregnancy history survey was conducted among women aged 15-49 years living in the HDSS during May-July 2011 (n = 10 540). Time trends were analysed with cubic splines and linear regression. Potential risk factors were examined with multilevel logistic regression with adjusted odds ratios (AOR) and 95% confidence intervals (CI). 34 073 births from 1982 to 2011 were analysed. The annual rate of decrease was 0.9% for stillbirths and 1.8% for neonatal mortality. Stillbirths were associated with several risk factors: multiple births (AOR 2.57, CI 1.66-3.99), previous adverse outcome (AOR 6.16, CI 4.26-8.88) and grand multiparity among 35- to 49-year-olds (AOR 1.97, CI 1.32-2.89). Neonatal deaths were associated with multiple births (AOR 6.16, CI 4.80-7.92) and advanced maternal age linked with parity of 1-4 (AOR 2.34, CI 1.28-4.25) and grand multiparity (AOR 1.44, CI 1.09-1.90). Education, marital status and household wealth were not associated with the outcomes. The slow decline in mortality rates and easily identifiable risk factors calls for improving quality of care at birth and a rethinking of how to address obstetric risks, potentially a revival of the risk approach in antenatal care. © 2016 John Wiley & Sons Ltd.

New approach for risk based inspection of H2S based Process Plants

International Nuclear Information System (INIS)

Vinod, Gopika; Sharma, Pavan K.; Santosh, T.V.; Hari Prasad, M.; Vaze, K.K.

2014-01-01

Highlights: • Study looks into improving the consequence evaluation in risk based inspection. • Ways to revise the quantity factors used in qualitative approach. • New approach based on computational fluid dynamics along with probit mathematics. • Demonstrated this methodology along with a suitable case study for the said issue. - Abstract: Recent trend in risk informed and risk based approaches in life management issues have certainly put the focus on developing estimation methods for real risk. Idea of employing risk as an optimising measure for in-service inspection, termed as risk based inspection, was accepted in principle from late 80s. While applying risk based inspection, consequence of failure from each component needs to be assessed. Consequence evaluation in a Process Plant is a crucial task. It may be noted that, in general, the number of components to be considered for life management is very large and hence the consequence evaluation resulting from their failures (individually) is a laborious task. Screening of critical components is usually carried out using simplified qualitative approach, which primarily uses influence factors for categorisation. This necessitates logical formulation of influence factors and their ranges with a suitable technical basis for acceptance from regulators. This paper describes application of risk based inspection for H 2 S based Process Plant along with the approach devised for handling the influence factor related to the quantity of H 2 S released

Cell-based therapeutic strategies for multiple sclerosis

DEFF Research Database (Denmark)

Scolding, Neil J; Pasquini, Marcelo; Reingold, Stephen C

2017-01-01

and none directly promotes repair. Cell-based therapies, including immunoablation followed by autologous haematopoietic stem cell transplantation, mesenchymal and related stem cell transplantation, pharmacologic manipulation of endogenous stem cells to enhance their reparative capabilities......, and transplantation of oligodendrocyte progenitor cells, have generated substantial interest as novel therapeutic strategies for immune modulation, neuroprotection, or repair of the damaged central nervous system in multiple sclerosis. Each approach has potential advantages but also safety concerns and unresolved...

Single-visit or multiple-visit root canal treatment: systematic review, meta-analysis and trial sequential analysis.

Science.gov (United States)

Schwendicke, Falk; Göstemeyer, Gerd

2017-02-01

Single-visit root canal treatment has some advantages over conventional multivisit treatment, but might increase the risk of complications. We systematically evaluated the risk of complications after single-visit or multiple-visit root canal treatment using meta-analysis and trial-sequential analysis. Controlled trials comparing single-visit versus multiple-visit root canal treatment of permanent teeth were included. Trials needed to assess the risk of long-term complications (pain, infection, new/persisting/increasing periapical lesions ≥1 year after treatment), short-term pain or flare-up (acute exacerbation of initiation or continuation of root canal treatment). Electronic databases (PubMed, EMBASE, Cochrane Central) were screened, random-effects meta-analyses performed and trial-sequential analysis used to control for risk of random errors. Evidence was graded according to GRADE. 29 trials (4341 patients) were included, all but 6 showing high risk of bias. Based on 10 trials (1257 teeth), risk of complications was not significantly different in single-visit versus multiple-visit treatment (risk ratio (RR) 1.00 (95% CI 0.75 to 1.35); weak evidence). Based on 20 studies (3008 teeth), risk of pain did not significantly differ between treatments (RR 0.99 (95% CI 0.76 to 1.30); moderate evidence). Risk of flare-up was recorded by 8 studies (1110 teeth) and was significantly higher after single-visit versus multiple-visit treatment (RR 2.13 (95% CI 1.16 to 3.89); very weak evidence). Trial-sequential analysis revealed that firm evidence for benefit, harm or futility was not reached for any of the outcomes. There is insufficient evidence to rule out whether important differences between both strategies exist. Dentists can provide root canal treatment in 1 or multiple visits. Given the possibly increased risk of flare-ups, multiple-visit treatment might be preferred for certain teeth (eg, those with periapical lesions). Published by the BMJ Publishing Group Limited

A quantitative risk assessment of multiple factors influencing HIV/AIDS transmission through unprotected sex among HIV-seropositive men.

Science.gov (United States)

Gerbi, Gemechu B; Habtemariam, Tsegaye; Tameru, Berhanu; Nganwa, David; Robnett, Vinaida

2012-01-01

The objective of this study is to conduct a quantitative risk assessment of multiple factors influencing HIV/AIDS transmission through unprotected sexual practices among HIV-seropositive men. A knowledgebase was developed by reviewing different published sources. The data were collected from different sources including Centers for Disease Control and Prevention, selected journals, and reports. The risk pathway scenario tree was developed based on a comprehensive review of published literature. The variables are organized into nine major parameter categories. Monte Carlo simulations for the quantitative risk assessment of HIV/AIDS transmission was executed with the software @Risk 4.0 (Palisade Corporation). Results show that the value for the likelihood of unprotected sex due to having less knowledge about HIV/AIDS and negative attitude toward condom use and safer sex ranged from 1.24 × 10(-5) to 8.47 × 10(-4) with the mean and standard deviation of 1.83 × 10(-4) and 8.63 × 10(-5), respectively. The likelihood of unprotected sex due to having greater anger-hostility, anxiety, less satisfied with aspects of life, and greater depressive symptoms ranged from 2.76 × 10(-9) to 5.34 × 10(-7) with the mean and standard deviation of 5.23 × 10(-8) and 3.58 × 10(-8), respectively. The findings suggest that HIV/AIDS research and intervention programs must be focused on behavior, and the broader setting within which individual risky behaviors occur.

Improved seismic risk estimation for Bucharest, based on multiple hazard scenarios, analytical methods and new techniques

Science.gov (United States)

Toma-Danila, Dragos; Florinela Manea, Elena; Ortanza Cioflan, Carmen

2014-05-01

Bucharest, capital of Romania (with 1678000 inhabitants in 2011), is one of the most exposed big cities in Europe to seismic damage. The major earthquakes affecting the city have their origin in the Vrancea region. The Vrancea intermediate-depth source generates, statistically, 2-3 shocks with moment magnitude >7.0 per century. Although the focal distance is greater than 170 km, the historical records (from the 1838, 1894, 1908, 1940 and 1977 events) reveal severe effects in the Bucharest area, e.g. intensities IX (MSK) for the case of 1940 event. During the 1977 earthquake, 1420 people were killed and 33 large buildings collapsed. The nowadays building stock is vulnerable both due to construction (material, age) and soil conditions (high amplification, generated within the weak consolidated Quaternary deposits, their thickness is varying 250-500m throughout the city). A number of 373 old buildings, out of 2563, evaluated by experts are more likely to experience severe damage/collapse in the next major earthquake. The total number of residential buildings, in 2011, was 113900. In order to guide the mitigation measures, different studies tried to estimate the seismic risk of Bucharest, in terms of buildings, population or economic damage probability. Unfortunately, most of them were based on incomplete sets of data, whether regarding the hazard or the building stock in detail. However, during the DACEA Project, the National Institute for Earth Physics, together with the Technical University of Civil Engineering Bucharest and NORSAR Institute managed to compile a database for buildings in southern Romania (according to the 1999 census), with 48 associated capacity and fragility curves. Until now, the developed real-time estimation system was not implemented for Bucharest. This paper presents more than an adaptation of this system to Bucharest; first, we analyze the previous seismic risk studies, from a SWOT perspective. This reveals that most of the studies don't use

Bioassay-based risk assessment of complex mixtures

International Nuclear Information System (INIS)

Donnelly, K.C.; Huebner, H.J.

1996-01-01

The baseline risk assessment often plays an integral role in various decision-making processes at Superfund sites. The present study reports on risk characterizations prepared for seven complex mixtures using biological and chemical analysis. Three of the samples (A, B, and C) were complex mixtures of polycyclic aromatic hydrocarbons (PAHs) extracted from coal tar; while four samples extracted from munitions-contaminated soil contained primarily nitroaromatic hydrocarbons. The chemical-based risk assessment ranked sample C as least toxic, while the risk associated with samples A and B was approximately equal. The microbial bioassay was in general agreement for the coal tar samples. The weighted activity of the coal tar extracts in Salmonella was 4,960 for sample C, and 162,000 and 206,000 for samples A and B, respectively. The bacterial mutagenicity of 2,4,6-trinitrotoluene contaminated soils exhibited an indirect correlation with chemical-based risk assessment. The aqueous extract of sample 004 induced 1,292 net revertants in Salmonella, while the estimated risk to ingestion and dermal adsorption was 2E-9. The data indicate that the chemical-based risk assessment accurately predicted the genotoxicity of the PAHs, while the accuracy of the risk assessment for munitions contaminated soils was limited due to the presence of metabolites of TNT degradation. The biological tests used in this research provide a valuable compliment to chemical analysis for characterizing the genotoxic risk of complex mixtures

Incentivising flood risk adaptation through risk based insurance premiums : Trade-offs between affordability and risk reduction

NARCIS (Netherlands)

Hudson, Paul F.; Botzen, W.J.W.; Feyen, L.; Aerts, Jeroen C.J.H.

2016-01-01

The financial incentives offered by the risk-based pricing of insurance can stimulate policyholder adaptation to flood risk while potentially conflicting with affordability. We examine the trade-off between risk reduction and affordability in a model of public-private flood insurance in France and

12 CFR 652.70 - Risk-based capital level.

Science.gov (United States)

2010-01-01

... risk-based capital level is the sum of the following amounts: (a) Credit and interest rate risk. The... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Risk-based capital level. 652.70 Section 652.70 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM FEDERAL AGRICULTURAL MORTGAGE...

Assessing interactions between HLA-DRB1*15 and infectious mononucleosis on the risk of multiple sclerosis.

Science.gov (United States)

Disanto, Giulio; Hall, Carolina; Lucas, Robyn; Ponsonby, Anne-Louise; Berlanga-Taylor, Antonio J; Giovannoni, Gavin; Ramagopalan, Sreeram V

2013-09-01

Gene-environment interactions may shed light on the mechanisms underlying multiple sclerosis (MS). We pooled data from two case-control studies on incident demyelination and used different methods to assess interaction between HLA-DRB1*15 (DRB1-15) and history of infectious mononucleosis (IM). Individuals exposed to both factors were at substantially increased risk of disease (OR=7.32, 95% CI=4.92-10.90). In logistic regression models, DRB1-15 and IM status were independent predictors of disease while their interaction term was not (DRB1-15*IM: OR=1.35, 95% CI=0.79-2.23). However, interaction on an additive scale was evident (Synergy index=2.09, 95% CI=1.59-2.59; excess risk due to interaction=3.30, 95%CI=0.47-6.12; attributable proportion due to interaction=45%, 95% CI=22-68%). This suggests, if the additive model is appropriate, the DRB1-15 and IM may be involved in the same causal process leading to MS and highlights the benefit of reporting gene-environment interactions on both a multiplicative and additive scale.

Additivity of Feature-based and Symmetry-based Grouping Effects in Multiple Object Tracking

Directory of Open Access Journals (Sweden)

Chundi eWang

2016-05-01

Full Text Available Multiple object tracking (MOT is an attentional process wherein people track several moving targets among several distractors. Symmetry, an important indicator of regularity, is a general spatial pattern observed in natural and artificial scenes. According to the laws of perceptual organization proposed by Gestalt psychologists, regularity is a principle of perceptual grouping, such as similarity and closure. A great deal of research reported that feature-based similarity grouping (e.g., grouping based on color, size, or shape among targets in MOT tasks can improve tracking performance. However, no additive feature-based grouping effects have been reported where the tracking objects had two or more features. Additive effect refers to a greater grouping effect produced by grouping based on multiple cues instead of one cue. Can spatial symmetry produce a similar grouping effect similar to that of feature similarity in MOT tasks? Are the grouping effects based on symmetry and feature similarity additive? This study includes four experiments to address these questions. The results of Experiments 1 and 2 demonstrated the automatic symmetry-based grouping effects. More importantly, an additive grouping effect of symmetry and feature similarity was observed in Experiments 3 and 4. Our findings indicate that symmetry can produce an enhanced grouping effect in MOT and facilitate the grouping effect based on color or shape similarity. The where and what pathways might have played an important role in the additive grouping effect.

A risk-based sensor placement methodology

International Nuclear Information System (INIS)

Lee, Ronald W.; Kulesz, James J.

2008-01-01

A risk-based sensor placement methodology is proposed to solve the problem of optimal location of sensors to protect population against the exposure to, and effects of, known and/or postulated chemical, biological, and/or radiological threats. Risk is calculated as a quantitative value representing population at risk from exposure at standard exposure levels. Historical meteorological data are used to characterize weather conditions as the frequency of wind speed and direction pairs. The meteorological data drive atmospheric transport and dispersion modeling of the threats, the results of which are used to calculate risk values. Sensor locations are determined via an iterative dynamic programming algorithm whereby threats detected by sensors placed in prior iterations are removed from consideration in subsequent iterations. In addition to the risk-based placement algorithm, the proposed methodology provides a quantification of the marginal utility of each additional sensor. This is the fraction of the total risk accounted for by placement of the sensor. Thus, the criteria for halting the iterative process can be the number of sensors available, a threshold marginal utility value, and/or a minimum cumulative utility achieved with all sensors

Ecological correlates of multiple sexual partnerships among adolescents and young adults in urban Cape Town: a cumulative risk factor approach.

Science.gov (United States)

Muchiri, Evans; Odimegwu, Clifford; Banda, Pamela; Ntoimo, Lorreta; Adedini, Sunday

2017-07-01

Studies in South Africa have reported unsafe levels of risky sexual behvaiours among adolescents and young adults, with the country reporting the highest burden of HIV/AIDS globally, as well as a high rate of teenage pregnancy. While determinants of risky sexual behaviours have been investigated for factors occurring at the individual and household levels, not fully explored in the literature is the effect of community level factors. Furthermore, it is unclear whether risk factors occurring within the ecology of adolescents and young adults act cumulatively to influence their sexual practices. This article aims to address this knowledge gap using a case study of the Cape Area Panel Study of adolescents and young adults in urban Cape Town, South Africa. The ecological framework was adopted to guide the selection of risk factors at the individual, household, and community levels. Multivariate linear discriminant function analyses were used to select significant risk factors for multiple sexual partnerships and used to produce risk indices for the respondents. The cumulative risk approach was applied to test whether significant risk factors acted cumulatively. Findings point to the importance of ecological factors in influencing outcomes of multiple sexual partnerships among respondents and further demonstrate that ecological risk factors may act cumulatively. These findings are important for South Africa that is grappling with teenage pregnancy and disproportionate HIV epidemic among the youth.

Risk-based configuration control system: Analysis and approaches

International Nuclear Information System (INIS)

Samanta, P.K.; Kim, I.S.; Vesely, W.E.; Lofgren, E.V.

1989-01-01

This paper presents an evaluation of the configuration risks associated with the operation of a nuclear power plant and the approaches to control these risks using risk-based configuration control considerations. In that context, the actual and maximum potential configuration risks at a plant are analyzed and the alternative types criteria for a risk-based configuration control systems are described. The risk-based configuration calculations which are studied here focus on the core-melt frequency impacts from given plant configurations. By calculating the core-melt frequency for given configurations, the configurations which cause large core-melt frequency increases can be identified and controlled. The duration time in which the configuration can exist can then be limited or the core-melt frequency level associated with the configuration can be reduced by various actions. Furthermore, maintenances and tests can be scheduled to avoid the configurations which cause large core-melt frequency increases. Present technical specifications do not control many of these configurations which can cause large core-melt frequency increases but instead focus on many risk-unimportant allowed outage times. Hence, risk-based configuration management can be effectively used to reduce core-melt frequency associated risks at a plant and at the same time can provide flexibility in plant operation. The alternative strategies for controlling the core-melt frequency and other risk contributions include: (1) controlling the increased risk level which is associated with the configuration; (2) controlling the individual configuration risk which is associated with a given duration of a configuration; (3) controlling the time period configuration risk from configurations which occur in a time period

Iodine-based contrast media, multiple myeloma and monoclonal gammopathies

DEFF Research Database (Denmark)

Stacul, Fulvio; Bertolotto, Michele; Thomsen, Henrik S

2018-01-01

OBJECTIVES: Many radiologists and clinicians still consider multiple myeloma (MM) and monoclonal gammopathies (MG) a contraindication for using iodine-based contrast media. The ESUR Contrast Media Safety Committee performed a systematic review of the incidence of post-contrast acute kidney injury...

Risk assessment of Giardia in rivers of southern China based on continuous monitoring

Institute of Scientific and Technical Information of China (English)

Wei An; Dongqing Zhang; Shumin Xiao; Jianwei Yu; Min Yang

2012-01-01

The occurrence and risks of Giardia in China have been unclear to date,which has made it difficult to properly manage source water as well as to create reasonable drinking water standards.The levels of Giardia in river networks of several cities in Zhejiang Province,China were found to be in the range of 0-5 oocysts/10 L in the rainy season in 2008.The mortality due to Giardia infection for people in this region was calculated to be from 0 to 1.95 × 10-s persons using a conditional probability equation.Based on multiple unboiled water intake routes,the disability-adjusted life years (DALYs) due to Giardia infection for people who consumed conventionally treated water was 0.625 (95% CI:0.137-2.05) per 105 persons,with the symptom of hospitalization making the highest contribution to total DALYs (0.56 per 105 persons; 95% CI:0.122-1.84).The DALYs decreased to 0.425 (95% CI:0.137-2.05) per 105 persons per year for those consuming water treated with advanced technology.These values were lower than the acceptable risk (1.97 × 10-5 DALYs per year).This study revealed the risk of Giardia infection to the people in river networks of Zhejiang Province for the first time,and provides a method to evaluate the risk of Giardia infection.The results are useful for the modification of drinking water quality standards based on cost-benefit analysis.

Multiple constant multiplication optimizations for field programmable gate arrays

CERN Document Server

Kumm, Martin

2016-01-01

This work covers field programmable gate array (FPGA)-specific optimizations of circuits computing the multiplication of a variable by several constants, commonly denoted as multiple constant multiplication (MCM). These optimizations focus on low resource usage but high performance. They comprise the use of fast carry-chains in adder-based constant multiplications including ternary (3-input) adders as well as the integration of look-up table-based constant multipliers and embedded multipliers to get the optimal mapping to modern FPGAs. The proposed methods can be used for the efficient implementation of digital filters, discrete transforms and many other circuits in the domain of digital signal processing, communication and image processing. Contents Heuristic and ILP-Based Optimal Solutions for the Pipelined Multiple Constant Multiplication Problem Methods to Integrate Embedded Multipliers, LUT-Based Constant Multipliers and Ternary (3-Input) Adders An Optimized Multiple Constant Multiplication Architecture ...

A 2:1 MUX Based on Multiple MEMS Resonators

KAUST Repository

Hafiz, Md Abdullah Al

2017-01-09

Micro/nano-electromechanical resonator based mechanical computing has recently attracted significant attention. This paper reports a realization of a 2:1 MUX, a concatenable digital logic element, based on electrothermal frequency tuning of electrically connected multiple arch resonators. Toward this, shallow arch shaped microresonators are electrically connected and their resonance frequencies are tuned based on an electrothermal frequency modulation scheme. This study demonstrates that by reconfiguring the same basic building block, the arch microresonator, complex logic circuits can be realized.

A 2:1 MUX Based on Multiple MEMS Resonators

KAUST Repository

Hafiz, Md Abdullah Al; Kosuru, Lakshmoji; Younis, Mohammad I.; Fariborzi, Hossein

2017-01-01

Micro/nano-electromechanical resonator based mechanical computing has recently attracted significant attention. This paper reports a realization of a 2:1 MUX, a concatenable digital logic element, based on electrothermal frequency tuning of electrically connected multiple arch resonators. Toward this, shallow arch shaped microresonators are electrically connected and their resonance frequencies are tuned based on an electrothermal frequency modulation scheme. This study demonstrates that by reconfiguring the same basic building block, the arch microresonator, complex logic circuits can be realized.

High EDSS can predict risk for upper urinary tract damage in patients with multiple sclerosis.

Science.gov (United States)

Ineichen, Benjamin V; Schneider, Marc P; Hlavica, Martin; Hagenbuch, Niels; Linnebank, Michael; Kessler, Thomas M

2018-04-01

Neurogenic lower urinary tract dysfunction (NLUTD) is very common in patients with multiple sclerosis (MS), and it might jeopardize renal function and thereby increase mortality. Although there are well-known urodynamic risk factors for upper urinary tract damage, no clinical prediction parameters are available. We aimed to assess clinical parameters potentially predicting urodynamic risk factors for upper urinary tract damage. A consecutive series of 141 patients with MS referred from neurologists for primary neuro-urological work-up including urodynamics were prospectively evaluated. Clinical parameters taken into account were age, sex, duration, and clinical course of MS and Expanded Disability Status Scale (EDSS). Multivariate modeling revealed EDSS as a clinical parameter significantly associated with urodynamic risk factors for upper urinary tract damage (odds ratio = 1.34, 95% confidence interval (CI) = 1.06-1.71, p = 0.02). Using receiver operator characteristic (ROC) curves, an EDSS of 5.0 as cutoff showed a sensitivity of 86%-87% and a specificity of 52% for at least one urodynamic risk factor for upper urinary tract damage. High EDSS is significantly associated with urodynamic risk factors for upper urinary tract damage and allows a risk-dependent stratification in daily neurological clinical practice to identify MS patients requiring further neuro-urological assessment and treatment.

Comprehensive transportation risk assessment system based on unit-consequence factors

International Nuclear Information System (INIS)

Biwer, B.M.; Monette, F.A.; LePoire, D.J.; Chen, S.Y.

1994-01-01

The U.S. Department of Energy (DOE) Environmental Restoration and Waste Management Programmatic Environmental Impact Statement requires a comprehensive transportation risk analysis of radioactive waste shipments for large shipping campaigns. Thousands of unique shipments involving truck and rail transport must be analyzed; a comprehensive risk analysis is impossible with currently available methods. Argonne National Laboratory developed a modular transportation model that can handle the demands imposed by such an analysis. The modular design of the model facilitates the simple addition/updating of transportation routes and waste inventories, as required, and reduces the overhead associated with file maintenance and quality assurance. The model incorporates unit-consequences factors generated with the RADTRAN 4 transportation risk analysis code that are combined with an easy-to-use, menu-driven interface on IBM-compatible computers running under DOS. User selection of multiple origin/destination site pairs for the shipment of multiple radioactive waste inventories is permitted from pop-up lists. Over 800 predefined routes are available among more than 30 DOE sites and waste inventories that include high-level waste, spent nuclear fuel, transuranic waste, low-level waste, low-level mixed waste, and greater-than-Class C waste

Medical Assistant-based care management for high risk patients in small primary care practices

DEFF Research Database (Denmark)

Freund, Tobias; Peters-Klimm, Frank; Boyd, Cynthia M.

2016-01-01

Background: Patients with multiple chronic conditions are at high risk of potentially avoidable hospital admissions, which may be reduced by care coordination and self-management support. Medical assistants are an increasingly available resource for patient care in primary care practices. Objective......: To determine whether protocol-based care management delivered by medical assistants improves patient care in patients at high risk of future hospitalization in primary care. Design: Two-year cluster randomized clinical trial. Setting: 115 primary care practices in Germany. Patients: 2,076 patients with type 2......, and monitoring delivered by medical assistants with usual care. Measurements: All-cause hospitalizations at 12 months (primary outcome) and quality of life scores (Short Form 12 Health Questionnaire [SF-12] and the Euroqol instrument [EQ-5D]). Results: Included patients had, on average, four co-occurring chronic...

Integrating scientific and local knowledge to inform risk-based management approaches for climate adaptation

Directory of Open Access Journals (Sweden)

Nathan P. Kettle

2014-01-01

Full Text Available Risk-based management approaches to climate adaptation depend on the assessment of potential threats, and their causes, vulnerabilities, and impacts. The refinement of these approaches relies heavily on detailed local knowledge of places and priorities, such as infrastructure, governance structures, and socio-economic conditions, as well as scientific understanding of climate projections and trends. Developing processes that integrate local and scientific knowledge will enhance the value of risk-based management approaches, facilitate group learning and planning processes, and support the capacity of communities to prepare for change. This study uses the Vulnerability, Consequences, and Adaptation Planning Scenarios (VCAPS process, a form of analytic-deliberative dialogue, and the conceptual frameworks of hazard management and climate vulnerability, to integrate scientific and local knowledge. We worked with local government staff in an urbanized barrier island community (Sullivan’s Island, South Carolina to consider climate risks, impacts, and adaptation challenges associated with sea level rise and wastewater and stormwater management. The findings discuss how the process increases understanding of town officials’ views of risks and climate change impacts to barrier islands, the management actions being considered to address of the multiple impacts of concern, and the local tradeoffs and challenges in adaptation planning. We also comment on group learning and specific adaptation tasks, strategies, and needs identified.

Variable Speed Wind Turbine Based on Multiple Generators Drive-Train Configuration

DEFF Research Database (Denmark)

Deng, Fujin; Chen, Zhe

2010-01-01

A variable speed wind turbine is presented in this paper, where multiple permanent magnet synchronous generators (MPMSGs) drive-train configuration is employed in the wind turbine. A cascaded multilevel converter interface based on the MPMSGs is developed to synthesize a desired high ac sinusoidal...... output voltage, which could be directly connected to the grids. What is more, such arrangement has been made so that the output ac voltage having a selected phase angle difference among the stator windings of multiple generators. A phase angle shift strategy is proposed in this paper, which effectively...... reduce the fluctuation of the electromagnetic torque sum and results in a good performance for the MPMSGs structure. The simulation study is conducted using PSCAD/EMTDC, and the results verify the feasibility of this variable speed wind turbine based on multiple generators drive-train configuration....

Multiple-Strain Approach and Probabilistic Modeling of Consumer Habits in Quantitative Microbial Risk Assessment: A Quantitative Assessment of Exposure to Staphylococcal Enterotoxin A in Raw Milk.

Science.gov (United States)

Crotta, Matteo; Rizzi, Rita; Varisco, Giorgio; Daminelli, Paolo; Cunico, Elena Cosciani; Luini, Mario; Graber, Hans Ulrich; Paterlini, Franco; Guitian, Javier

2016-03-01

Quantitative microbial risk assessment (QMRA) models are extensively applied to inform management of a broad range of food safety risks. Inevitably, QMRA modeling involves an element of simplification of the biological process of interest. Two features that are frequently simplified or disregarded are the pathogenicity of multiple strains of a single pathogen and consumer behavior at the household level. In this study, we developed a QMRA model with a multiple-strain approach and a consumer phase module (CPM) based on uncertainty distributions fitted from field data. We modeled exposure to staphylococcal enterotoxin A in raw milk in Lombardy; a specific enterotoxin production module was thus included. The model is adaptable and could be used to assess the risk related to other pathogens in raw milk as well as other staphylococcal enterotoxins. The multiplestrain approach, implemented as a multinomial process, allowed the inclusion of variability and uncertainty with regard to pathogenicity at the bacterial level. Data from 301 questionnaires submitted to raw milk consumers were used to obtain uncertainty distributions for the CPM. The distributions were modeled to be easily updatable with further data or evidence. The sources of uncertainty due to the multiple-strain approach and the CPM were identified, and their impact on the output was assessed by comparing specific scenarios to the baseline. When the distributions reflecting the uncertainty in consumer behavior were fixed to the 95th percentile, the risk of exposure increased up to 160 times. This reflects the importance of taking into consideration the diversity of consumers' habits at the household level and the impact that the lack of knowledge about variables in the CPM can have on the final QMRA estimates. The multiple-strain approach lends itself to use in other food matrices besides raw milk and allows the model to better capture the complexity of the real world and to be capable of geographical

Risk-based performance indicators

International Nuclear Information System (INIS)

Azarm, M.A.; Boccio, J.L.; Vesely, W.E.; Lofgren, E.

1987-01-01

The purpose of risk-based indicators is to monitor plant safety. Safety is measured by monitoring the potential for core melt (core-melt frequency) and the public risk. Targets for these measures can be set consistent with NRC safety goals. In this process, the performance of safety systems, support systems, major components, and initiating events can be monitored using measures such as unavailability, failure or occurrence frequency. The changes in performance measures and their trends are determined from the time behavior of monitored measures by differentiation between stochastical and actual variations. Therefore, degradation, as well as improvement in the plant safety performance, can be determined. The development of risk-based performance indicators will also provide the means to trace a change in the safety measures to specific problem areas which are amenable to root cause analysis and inspection audits. In addition, systematic methods will be developed to identify specific improvement policies using the plant information system for the identified problem areas. The final product of the performance indicator project will be a methodology, and an integrated and validated set of software packages which, if properly interfaced with the logic model software of a plant, can monitor the plant performance as plant information is provided as input

Multiple health behavior change in adults with or at risk for cancer: a systematic review.

Science.gov (United States)

Green, Amanda C; Hayman, Laura L; Cooley, Mary E

2015-05-01

To identify components of efficacious interventions for multiple health behavior change (MHBC) in adult cancer survivors or adults at high risk for cancer. A systematic review of MHBC interventions was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. Ten studies met inclusion criteria. Most studies changed at least 2 health behaviors. Diet, exercise, and smoking cessation were consistently changed with in-person interventions. Longer duration interventions using phone or mail contact had a positive association with changing diet and exercise. MHBC interventions positively influenced behavior change in adults with cancer and those at high risk for cancer. Future studies should focus on increasing dissemination and implementation of efficacious interventions.

Fatal accidents among Danes with multiple sclerosis

DEFF Research Database (Denmark)

Brønnum-Hansen, Henrik; Hansen, Thomas; Koch-Henriksen, Nils

2006-01-01

We compared the rate of fatal accidents among Danes with multiple sclerosis (MS) with that of the general population. The study was based on linkage of the Danish Multiple Sclerosis Registry to the Cause of Death Registry and covered all 10174 persons in whom MS was diagnosed during the period 19...... for deaths from burns (SMR = 8.90) and suffocation (SMR = 5.57). We conclude that persons with MS are more prone to fatal accidents than the general population. The excess risk is due not to traffic accidents but to burns and suffocation.......-1996. The end of follow-up was 1 January 1999. We calculated standardized mortality ratios (SMRs) for various types of fatal accidents. A total of 76 persons (48 men and 28 women) died from accidents, whereas the expected number of fatalities from such causes was 55.7 (31.4 men and 24.3 women). Thus, the risk...... for death from accidents among persons with MS was 37% higher than that of the general population (SMR = 1.37). We found no significant excess risk for fatal road accidents (SMR = 0.80). The risk for falls was elevated (SMR = 1.29) but not statistically significantly so. The risks were particularly high...

Ranking ecological risks of multiple chemical stressors on amphibians.

Science.gov (United States)

Fedorenkova, Anastasia; Vonk, J Arie; Lenders, H J Rob; Creemers, Raymond C M; Breure, Anton M; Hendriks, A Jan

2012-06-01

Populations of amphibians have been declining worldwide since the late 1960s. Despite global concern, no studies have quantitatively assessed the major causes of this decline. In the present study, species sensitivity distributions (SSDs) were developed to analyze the sensitivity of anurans for ammonium, nitrate, heavy metals (cadmium, copper), pesticides (18 compounds), and acidification (pH) based on laboratory toxicity data. Ecological risk (ER) was calculated as the probability that a measured environmental concentration of a particular stressor in habitats where anurans were observed would exceed the toxic effect concentrations derived from the species sensitivity distributions. The assessment of ER was used to rank the stressors according to their potential risk to anurans based on a case study of Dutch freshwater bodies. The derived ERs revealed that threats to populations of anurans decreased in the sequence of pH, copper, diazinon, ammonium, and endosulfan. Other stressors studied were of minor importance. The method of deriving ER by combining field observation data and laboratory data provides insight into potential threats to species in their habitats and can be used to prioritize stressors, which is necessary to achieve effective management in amphibian conservation. Copyright © 2012 SETAC.

No evidence that polymorphisms of the vanishing white matter disease genes are risk factors in multiple sclerosis

NARCIS (Netherlands)

Pronk, J.C.; Scheper, G.C.; Andel, R.J.; van Berkel, C.G.M.; Polman, C.H.; Uitdehaag, B.M.J.; van der Knaap, M.S.

2008-01-01

Febrile infections are known to cause exacerbations in the white matter disorders 'vanishing white matter' (VWM) and multiple sclerosis (MS). We hypothesized that polymorphisms in EIF2B1-5, the genes involved in VWM, might be risk factors for the development of MS or temperature sensitivity in

Multiple kernel boosting framework based on information measure for classification

International Nuclear Information System (INIS)

Qi, Chengming; Wang, Yuping; Tian, Wenjie; Wang, Qun

2016-01-01

The performance of kernel-based method, such as support vector machine (SVM), is greatly affected by the choice of kernel function. Multiple kernel learning (MKL) is a promising family of machine learning algorithms and has attracted many attentions in recent years. MKL combines multiple sub-kernels to seek better results compared to single kernel learning. In order to improve the efficiency of SVM and MKL, in this paper, the Kullback–Leibler kernel function is derived to develop SVM. The proposed method employs an improved ensemble learning framework, named KLMKB, which applies Adaboost to learning multiple kernel-based classifier. In the experiment for hyperspectral remote sensing image classification, we employ feature selected through Optional Index Factor (OIF) to classify the satellite image. We extensively examine the performance of our approach in comparison to some relevant and state-of-the-art algorithms on a number of benchmark classification data sets and hyperspectral remote sensing image data set. Experimental results show that our method has a stable behavior and a noticeable accuracy for different data set.

Type 2 diabetes-related variants influence the risk of developing multiple myeloma

DEFF Research Database (Denmark)

Ríos, Rafael; Lupiañez, Carmen Belén; Campa, Daniele

2015-01-01

Type 2 diabetes (T2D) has been suggested to be a risk factor for multiple myeloma (MM), but the relationship between the two traits is still not well understood. The aims of this study were to evaluate whether 58 genome-wide-association-studies (GWAS)-identified common variants for T2D influence...... genetic information (area under the curve (AUC)=0.645 vs AUC=0.629; P=4.05×10(-) (06)). A gender-stratified analysis also revealed a significant gender effect modification for ADAM30rs2641348 and NOTCH2rs10923931 variants (Pinteraction=0.001 and 0.0004, respectively). Men carrying the ADAM30rs2641348C...... carrying the KCNQ1rs2237892T allele or the CDKN2A-2Brs2383208G/G, IGF1rs35767T/T and MADDrs7944584T/T genotypes had a significantly increased risk of MM (odds ratio (OR)=1.32-2.13) whereas those carrying the KCNJ11rs5215C, KCNJ11rs5219T and THADArs7578597C alleles or the FTOrs8050136A/A and LTArs1041981C...

Risk-based decision making for terrorism applications.

Science.gov (United States)

Dillon, Robin L; Liebe, Robert M; Bestafka, Thomas

2009-03-01

This article describes the anti-terrorism risk-based decision aid (ARDA), a risk-based decision-making approach for prioritizing anti-terrorism measures. The ARDA model was developed as part of a larger effort to assess investments for protecting U.S. Navy assets at risk and determine whether the most effective anti-terrorism alternatives are being used to reduce the risk to the facilities and war-fighting assets. With ARDA and some support from subject matter experts, we examine thousands of scenarios composed of 15 attack modes against 160 facility types on two installations and hundreds of portfolios of 22 mitigation alternatives. ARDA uses multiattribute utility theory to solve some of the commonly identified challenges in security risk analysis. This article describes the process and documents lessons learned from applying the ARDA model for this application.

Strategies and criteria for risk-based configuration control

International Nuclear Information System (INIS)

Samanta, P.K.; Kim, I.S.; Vesely, W.E.

1991-01-01

A configuration, as used here, is a set of component operability or statuses that define the state of a nuclear power plant. Risk-based configuration control is the management of component configurations using a risk perspective to control risk and assure safety. If the component configurations that have high risk implications do not occur then the risk from the operation of nuclear power plants would be minimal. The control of component configurations, i.e., the management of component statuses, so that the risk from components being unavailable is minimized, becomes difficult because the status of a standby safety system component is often not apparent unless it is tested. In this paper, we discuss the strategies and criteria for risk-based configuration control in nuclear power plants. In developing these strategies and criteria, the primary objective is to obtain more direct risk control but the added benefit is the effective use of plant resources. Implementation of such approaches can result in replacement/modification of parts of Technical Specifications. Specifically, the risk impact or safety impact of a configuration depends upon four factors: (1) The configuration components which are simultaneously down (i.e., inoperable); (2) the backup components which are known to be up (i.e., operable); (3) the duration of time the configuration exists (the outage time); and (4) the frequency at which the configuration occurs. Risk-based configuration control involves managing these factors using risk analyses and risk insights. In this paper, we discuss each of the factors and illustrate how they can be controlled. The information and the tools needed in implementing configuration control are also discussed. The risk-based calculation requirements in achieving the control are also delineated. 4 refs., 4 figs., 1 tab

Risk-based decision making and risk management of European Union regional programs

Directory of Open Access Journals (Sweden)

Michalopoulos Evangelos

2008-01-01

Full Text Available This paper presents a generalized method for management decision making incorporating risk assessment techniques. The risk based decision making methodology is applied to European Union expenditure programs used to implement its regional policy, such as the community support framework, community initiatives, special initiatives and other European policies. An example is presented for the development of an audit (inspection program in the region of West Macedonia, Greece, during the implementation of the 3rd Community Structural Support Framework Operational Program. The generic nature of the method permits its use in the management of similar European regional programs in Greece and other European countries. It is also applicable to many other industries interested in applying risk-based management decisions to physical or process based systems. .

No association between dietary sodium intake and the risk of multiple sclerosis.

Science.gov (United States)

Cortese, Marianna; Yuan, Changzheng; Chitnis, Tanuja; Ascherio, Alberto; Munger, Kassandra L

2017-09-26

To prospectively investigate the association between dietary sodium intake and multiple sclerosis (MS) risk. In this cohort study, we assessed dietary sodium intake by a validated food frequency questionnaire administered every 4 years to 80,920 nurses in the Nurses' Health Study (NHS) (1984-2002) and to 94,511 in the Nurses' Health Study II (NHSII) (1991-2007), and calibrated it using data from a validation study. There were 479 new MS cases during follow-up. We used Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the effect of energy-adjusted dietary sodium on MS risk, adjusting also for age, latitude of residence at age 15, ancestry, body mass index at age 18, supplemental vitamin D intake, cigarette smoking, and total energy intake in each cohort. The results in both cohorts were pooled using fixed effects models. Total dietary intake of sodium at baseline was not associated with MS risk (highest [medians: 3.2 g/d NHS; 3.5 g/d NHSII] vs lowest [medians: 2.5 g/d NHS; 2.8 g/d NHSII] quintile: HR pooled 0.98, 95% CI 0.74-1.30, p for trend = 0.75). Cumulative average sodium intake during follow-up was also not associated with MS risk (highest [medians: 3.3 g/d NHS; 3.4 g/d NHSII] vs lowest [medians: 2.7 g/d NHS; 2.8 g/d NHSII] quintile: HR pooled 1.02, 95% CI 0.76-1.37, p for trend = 0.76). Comparing more extreme sodium intake in deciles yielded similar results ( p for trend = 0.95). Our findings suggest that higher dietary sodium intake does not increase the risk of developing MS. © 2017 American Academy of Neurology.

Multiple brain atlas database and atlas-based neuroimaging system.

Science.gov (United States)

Nowinski, W L; Fang, A; Nguyen, B T; Raphel, J K; Jagannathan, L; Raghavan, R; Bryan, R N; Miller, G A

1997-01-01

For the purpose of developing multiple, complementary, fully labeled electronic brain atlases and an atlas-based neuroimaging system for analysis, quantification, and real-time manipulation of cerebral structures in two and three dimensions, we have digitized, enhanced, segmented, and labeled the following print brain atlases: Co-Planar Stereotaxic Atlas of the Human Brain by Talairach and Tournoux, Atlas for Stereotaxy of the Human Brain by Schaltenbrand and Wahren, Referentially Oriented Cerebral MRI Anatomy by Talairach and Tournoux, and Atlas of the Cerebral Sulci by Ono, Kubik, and Abernathey. Three-dimensional extensions of these atlases have been developed as well. All two- and three-dimensional atlases are mutually preregistered and may be interactively registered with an actual patient's data. An atlas-based neuroimaging system has been developed that provides support for reformatting, registration, visualization, navigation, image processing, and quantification of clinical data. The anatomical index contains about 1,000 structures and over 400 sulcal patterns. Several new applications of the brain atlas database also have been developed, supported by various technologies such as virtual reality, the Internet, and electronic publishing. Fusion of information from multiple atlases assists the user in comprehensively understanding brain structures and identifying and quantifying anatomical regions in clinical data. The multiple brain atlas database and atlas-based neuroimaging system have substantial potential impact in stereotactic neurosurgery and radiotherapy by assisting in visualization and real-time manipulation in three dimensions of anatomical structures, in quantitative neuroradiology by allowing interactive analysis of clinical data, in three-dimensional neuroeducation, and in brain function studies.

RiskREP: Risk-Based Security Requirements Elicitation and Prioritization (extended version)

NARCIS (Netherlands)

Herrmann, Andrea; Morali, A.

2010-01-01

Today, companies are required to be in control of the security of their IT assets. This is especially challenging in the presence of limited budgets and conflicting requirements. Here, we present Risk-Based Requirements Elicitation and Prioritization (RiskREP), a method for managing IT security

Multiple and concurrent sexual partnerships among men who have sex with men in Viet Nam: results from a National Internet-based Cross-sectional Survey.

Science.gov (United States)

García, M C; Duong, Q L; Meyer, S B; Ward, P R

2016-03-01

Men who have sex with men (MSM) are one of the largest HIV risk groups in Viet Nam and have been understudied. Sexual concurrency and multiple sex partnerships may contribute to high HIV incidence among MSM in Viet Nam. Limited information is available on concurrency and multiple sexual partnerships among MSM in Viet Nam or on the extent to which this population engages in concurrent and multiple unprotected anal intercourse. Data are from a self-administered Internet-based survey of Vietnamese MSM aged 18 years or older, having sex with male partner(s) in the last 12 months and recruited from social networking MSM-specific websites in Viet Nam. Multiple partnerships and concurrency were measured using the UNAIDS-recommended sexual partner matrix, a key component in the questionnaire. Concurrent and multiple sexual partnerships were analyzed at the individual level. Logistic regression analyses were conducted to assess the demographic characteristics and behaviors associated with multiple sexual partnerships. A total of 1695 MSM reported on multiple sexual partnerships; 69.5% indicated multiple sexual partnerships in the last 6 months. A total of 257 MSM reported on concurrent sexual partnerships, with 51.0% reporting penetrative sex with concurrent partners in the last 6 months. Respondents were more likely to engage in multiple sexual partnerships if they were no longer a student, consumed alcohol before and/or during sex, used the Internet to meet casual sex partners and had never participated in a behavioral HIV intervention. Multiple sexual partnerships in the previous 6 months were common among MSM surveyed, as was sexual concurrency. High levels of multiple and concurrent sexual partnerships may be catalyzing the transmission of HIV among MSM in Viet Nam. Given the high prevalence of this high-risk sexual behavior, our findings underscore the urgent need for targeted prevention efforts, focusing on the reduction of multiple and concurrent sexual partners

Type 1 diabetes and multiple sclerosis

DEFF Research Database (Denmark)

Nielsen, N.M.; Westergaard, T.; Frisch, M.

2006-01-01

BACKGROUND: Type 1 diabetes mellitus (T1D) and multiple sclerosis (MS) contribute considerably to the burden of autoimmune diseases in young adults. Although HLA patterns of T1D and MS are considered mutually exclusive, individual and familial co-occurrence of the 2 diseases has been reported...... Multiple Sclerosis Register were used to identify patients with T1D, defined as patients in whom diabetes was diagnosed before age 20 years (N = 6078), and patients with MS (N = 11 862). First-degree relatives (N = 14,771) of patients with MS were identified from family information in the Danish Civil....... OBJECTIVE: To assess the co-occurrence of T1D and MS by estimating the risk for MS in patients with T1D and the risk for T1D in first-degree relatives of patients with MS. DESIGN, SETTING, AND PARTICIPANTS: Two population-based disease registers, the Danish Hospital Discharge Register and the Danish...

Historical Perspective and Risk of Multiple Neglected Tropical Diseases in Coastal Tanzania: Compositional and Contextual Determinants of Disease Risk.

Science.gov (United States)

Armah, Frederick Ato; Quansah, Reginald; Luginaah, Isaac; Chuenpagdee, Ratana; Hambati, Herbert; Campbell, Gwyn

2015-01-01

In the past decade, research on neglected tropical diseases (NTDs) has intensified in response to the need to enhance community participation in health delivery, establish monitoring and surveillance systems, and integrate existing disease-specific treatment programs to control overlapping NTD burdens and detrimental effects. In this paper, we evaluated the geographical distribution of NTDs in coastal Tanzania. We also assessed the collective (compositional and contextual) factors that currently determine risks to multiple NTDs using a cross sectional survey of 1253 individuals in coastal Tanzania. The results show that the effect size in decreasing order of magnitude for non-binary predictors of NTD risks is as follows: NTD comorbidities > poverty > educational attainment > self-reported household quality of life > ethnicity. The multivariate analysis explained 95% of the variance in the relationship between NTD risks and the theoretically-relevant covariates. Compositional (biosocial and sociocultural) factors explained more variance at the neighbourhood level than at the regional level, whereas contextual factors, such as access to health services and household quality, in districts explained a large proportion of variance at the regional level but individually had modest statistical significance, demonstrating the complex interactions between compositional and contextual factors in generating NTD risks. NTD risks were inequitably distributed over geographic space, which has several important policy implications. First, it suggests that localities of high burden of NTDs are likely to diminish within statistical averages at higher (regional or national) levels. Second, it indicates that curative or preventive interventions will become more efficient provided they can be focused on the localities, particularly as populations in these localities are likely to be burdened by several NTDs simultaneously, further increasing the imperative of multi

12 CFR 932.3 - Risk-based capital requirement.

Science.gov (United States)

2010-01-01

... credit risk capital requirement, its market risk capital requirement, and its operations risk capital... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Risk-based capital requirement. 932.3 Section 932.3 Banks and Banking FEDERAL HOUSING FINANCE BOARD FEDERAL HOME LOAN BANK RISK MANAGEMENT AND...

SDG and qualitative trend based model multiple scale validation

Science.gov (United States)

Gao, Dong; Xu, Xin; Yin, Jianjin; Zhang, Hongyu; Zhang, Beike

2017-09-01

Verification, Validation and Accreditation (VV&A) is key technology of simulation and modelling. For the traditional model validation methods, the completeness is weak; it is carried out in one scale; it depends on human experience. The SDG (Signed Directed Graph) and qualitative trend based multiple scale validation is proposed. First the SDG model is built and qualitative trends are added to the model. And then complete testing scenarios are produced by positive inference. The multiple scale validation is carried out by comparing the testing scenarios with outputs of simulation model in different scales. Finally, the effectiveness is proved by carrying out validation for a reactor model.

Selecting a risk-based tool to aid in decision making

Energy Technology Data Exchange (ETDEWEB)

Bendure, A.O.

1995-03-01

Selecting a risk-based tool to aid in decision making is as much of a challenge as properly using the tool once it has been selected. Failure to consider customer and stakeholder requirements and the technical bases and differences in risk-based decision making tools will produce confounding and/or politically unacceptable results when the tool is used. Selecting a risk-based decisionmaking tool must therefore be undertaken with the same, if not greater, rigor than the use of the tool once it is selected. This paper presents a process for selecting a risk-based tool appropriate to a set of prioritization or resource allocation tasks, discusses the results of applying the process to four risk-based decision-making tools, and identifies the ``musts`` for successful selection and implementation of a risk-based tool to aid in decision making.

Risk Classification and Risk-based Safety and Mission Assurance

Science.gov (United States)

Leitner, Jesse A.

2014-01-01

Recent activities to revamp and emphasize the need to streamline processes and activities for Class D missions across the agency have led to various interpretations of Class D, including the lumping of a variety of low-cost projects into Class D. Sometimes terms such as Class D minus are used. In this presentation, mission risk classifications will be traced to official requirements and definitions as a measure to ensure that projects and programs align with the guidance and requirements that are commensurate for their defined risk posture. As part of this, the full suite of risk classifications, formal and informal will be defined, followed by an introduction to the new GPR 8705.4 that is currently under review.GPR 8705.4 lays out guidance for the mission success activities performed at the Classes A-D for NPR 7120.5 projects as well as for projects not under NPR 7120.5. Furthermore, the trends in stepping from Class A into higher risk posture classifications will be discussed. The talk will conclude with a discussion about risk-based safety and mission assuranceat GSFC.

Connection-based and object-based grouping in multiple-object tracking: A developmental study

OpenAIRE

Hallen, Ruth; Reusens, J. (Julie); Evers, K. (Kris); de-Wit, Lee; Wagemans, Johan

2018-01-01

textabstractDevelopmental research on Gestalt laws has previously revealed that, even as young as infancy, we are bound to group visual elements into unitary structures in accordance with a variety of organizational principles. Here, we focus on the developmental trajectory of both connection-based and object-based grouping, and investigate their impact on object formation in participants, aged 9-21 years old (N = 113), using a multiple-object tracking paradigm. Results reveal a main effect o...

[Multiple meningiomas].

Science.gov (United States)

Terrier, L-M; François, P

2016-06-01

Multiple meningiomas (MMs) or meningiomatosis are defined by the presence of at least 2 lesions that appear simultaneously or not, at different intracranial locations, without the association of neurofibromatosis. They present 1-9 % of meningiomas with a female predominance. The occurrence of multiple meningiomas is not clear. There are 2 main hypotheses for their development, one that supports the independent evolution of these tumors and the other, completely opposite, that suggests the propagation of tumor cells of a unique clone transformation, through cerebrospinal fluid. NF2 gene mutation is an important intrinsic risk factor in the etiology of multiple meningiomas and some exogenous risk factors have been suspected but only ionizing radiation exposure has been proven. These tumors can grow anywhere in the skull but they are more frequently observed in supratentorial locations. Their histologic types are similar to unique meningiomas of psammomatous, fibroblastic, meningothelial or transitional type and in most cases are benign tumors. The prognosis of these tumors is eventually good and does not differ from the unique tumors except for the cases of radiation-induced multiple meningiomas, in the context of NF2 or when diagnosed in children where the outcome is less favorable. Each meningioma lesion should be dealt with individually and their multiple character should not justify their resection at all costs. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Modeling Freedom From Progression for Standard-Risk Medulloblastoma: A Mathematical Tumor Control Model With Multiple Modes of Failure

International Nuclear Information System (INIS)

Brodin, N. Patrik; Vogelius, Ivan R.; Björk-Eriksson, Thomas; Munck af Rosenschöld, Per; Bentzen, Søren M.

2013-01-01

Purpose: As pediatric medulloblastoma (MB) is a relatively rare disease, it is important to extract the maximum information from trials and cohort studies. Here, a framework was developed for modeling tumor control with multiple modes of failure and time-to-progression for standard-risk MB, using published pattern of failure data. Methods and Materials: Outcome data for standard-risk MB published after 1990 with pattern of relapse information were used to fit a tumor control dose-response model addressing failures in both the high-dose boost volume and the elective craniospinal volume. Estimates of 5-year event-free survival from 2 large randomized MB trials were used to model the time-to-progression distribution. Uncertainty in freedom from progression (FFP) was estimated by Monte Carlo sampling over the statistical uncertainty in input data. Results: The estimated 5-year FFP (95% confidence intervals [CI]) for craniospinal doses of 15, 18, 24, and 36 Gy while maintaining 54 Gy to the posterior fossa was 77% (95% CI, 70%-81%), 78% (95% CI, 73%-81%), 79% (95% CI, 76%-82%), and 80% (95% CI, 77%-84%) respectively. The uncertainty in FFP was considerably larger for craniospinal doses below 18 Gy, reflecting the lack of data in the lower dose range. Conclusions: Estimates of tumor control and time-to-progression for standard-risk MB provides a data-driven setting for hypothesis generation or power calculations for prospective trials, taking the uncertainties into account. The presented methods can also be applied to incorporate further risk-stratification for example based on molecular biomarkers, when the necessary data become available

Study of operational risk-based configuration control

Energy Technology Data Exchange (ETDEWEB)

Vesely, W E [Science Applications International Corp., Dublin, OH (United States); Samanta, P K; Kim, I S [Brookhaven National Lab., Upton, NY (United States)

1991-08-01

This report studies aspects of a risk-based configuration control system to detect and control plant configurations from a risk perspective. Configuration control, as the term is used here, is the management of component configurations to achieve specific objectives. One important objective is to control risk and safety. Another is to operate efficiently and make effective use of available resources. PSA-based evaluations are performed to study configuration to core-melt frequency and core-melt probability for two plants. Some equipment configurations can cause large core-melt frequency and there are a number of such configurations that are not currently controlled by technical specifications. However, the expected frequency of occurrence of the impacting configurations is small and the core-melt probability contributions are also generally small. The insights from this evaluation are used to develop the framework for an effective risk-based configuration control system. The focal points of such a system and the requirements for tools development for implementing the system are defined. The requirements of risk models needed for the system, and the uses of plant-specific data are also discussed. 18 refs., 25 figs., 10 tabs.

III: Use of biomarkers as Risk Indicators in Environmental Risk Assessment of oil based discharges offshore.

Science.gov (United States)

Sanni, Steinar; Lyng, Emily; Pampanin, Daniela M

2017-06-01

Offshore oil and gas activities are required not to cause adverse environmental effects, and risk based management has been established to meet environmental standards. In some risk assessment schemes, Risk Indicators (RIs) are parameters to monitor the development of risk affecting factors. RIs have not yet been established in the Environmental Risk Assessment procedures for management of oil based discharges offshore. This paper evaluates the usefulness of biomarkers as RIs, based on their properties, existing laboratory biomarker data and assessment methods. Data shows several correlations between oil concentrations and biomarker responses, and assessment principles exist that qualify biomarkers for integration into risk procedures. Different ways that these existing biomarkers and methods can be applied as RIs in a probabilistic risk assessment system when linked with whole organism responses are discussed. This can be a useful approach to integrate biomarkers into probabilistic risk assessment related to oil based discharges, representing a potential supplement to information that biomarkers already provide about environmental impact and risk related to these kind of discharges. Copyright © 2016 Elsevier Ltd. All rights reserved.

Exposure to Multiple Pesticides and Risk of Non-Hodgkin Lymphoma in Men from Six Canadian Provinces

Science.gov (United States)

Hohenadel, Karin; Harris, Shelley A.; McLaughlin, John R.; Spinelli, John J.; Pahwa, Punam; Dosman, James A.; Demers, Paul A.; Blair, Aaron

2011-01-01

Non-Hodgkin lymphoma (NHL) has been linked to several agricultural exposures, including some commonly used pesticides. Although there is a significant body of literature examining the effects of exposure to individual pesticides on NHL, the impact of exposure to multiple pesticides or specific pesticide combinations has not been explored in depth. Data from a six-province Canadian case-control study conducted between 1991 and 1994 were analyzed to investigate the relationship between NHL, the total number of pesticides used and some common pesticide combinations. Cases (n = 513) were identified through hospital records and provincial cancer registries and controls (n = 1,506), frequency matched to cases by age and province of residence, were obtained through provincial health records, telephone listings, or voter lists. In multiple logistic regression analyses, risk of NHL increased with the number of pesticides used. Similar results were obtained in analyses restricted to herbicides, insecticides and several pesticide classes. Odds ratios increased further when only ‘potentially carcinogenic’ pesticides were considered (OR[one pesticide] = 1.30, 95% CI = 0.90–1.88; OR[two to four] = 1.54, CI = 1.11–2.12; OR[five or more] = 1.94, CI = 1.17–3.23). Elevated risks were also found among those reporting use of malathion in combination with several other pesticides. These analyses support and extend previous findings that the risk of NHL increases with the number of pesticides used and some pesticide combinations. PMID:21776232

Risk-based Regulatory Evaluation Program methodology

International Nuclear Information System (INIS)

DuCharme, A.R.; Sanders, G.A.; Carlson, D.D.; Asselin, S.V.

1987-01-01

The objectives of this DOE-supported Regulatory Evaluation Progrwam are to analyze and evaluate the safety importance and economic significance of existing regulatory guidance in order to assist in the improvement of the regulatory process for current generation and future design reactors. A risk-based cost-benefit methodology was developed to evaluate the safety benefit and cost of specific regulations or Standard Review Plan sections. Risk-based methods can be used in lieu of or in combination with deterministic methods in developing regulatory requirements and reaching regulatory decisions

Study of a risk-based piping inspection guideline system.

Science.gov (United States)

Tien, Shiaw-Wen; Hwang, Wen-Tsung; Tsai, Chih-Hung

2007-02-01

A risk-based inspection system and a piping inspection guideline model were developed in this study. The research procedure consists of two parts--the building of a risk-based inspection model for piping and the construction of a risk-based piping inspection guideline model. Field visits at the plant were conducted to develop the risk-based inspection and strategic analysis system. A knowledge-based model had been built in accordance with international standards and local government regulations, and the rational unified process was applied for reducing the discrepancy in the development of the models. The models had been designed to analyze damage factors, damage models, and potential damage positions of piping in the petrochemical plants. The purpose of this study was to provide inspection-related personnel with the optimal planning tools for piping inspections, hence, to enable effective predictions of potential piping risks and to enhance the better degree of safety in plant operations that the petrochemical industries can be expected to achieve. A risk analysis was conducted on the piping system of a petrochemical plant. The outcome indicated that most of the risks resulted from a small number of pipelines.

Feasibility assessment of a risk-based approach to technical specifications

International Nuclear Information System (INIS)

Atefi, B.; Gallagher, D.W.

1991-05-01

To assess the potential use of risk and reliability techniques for improving the effectiveness of the technical specifications to control plant operational risk, the Technical Specifications Branch of the Nuclear Regulatory Commission initiated an effort to identify and evaluate alternative risk-based approaches that could bring greater risk perspective to these requirements. In the first phase four alternative approaches were identified and their characteristics were analyzed. Among these, the risk-based approach to technical specifications is the most promising approach for controlling plant operational risk using technical specifications. The second phase of the study concentrated on detailed characteristics of the real time risk-based approach. It is concluded that a real time risk-based approach to technical specifications has the potential to improve both plant safety and availability. 33 figs., 5 figs., 6 tabs

Water shortage risk assessment considering large-scale regional transfers: a copula-based uncertainty case study in Lunan, China.

Science.gov (United States)

Gao, Xueping; Liu, Yinzhu; Sun, Bowen

2018-06-05

The risk of water shortage caused by uncertainties, such as frequent drought, varied precipitation, multiple water resources, and different water demands, brings new challenges to the water transfer projects. Uncertainties exist for transferring water and local surface water; therefore, the relationship between them should be thoroughly studied to prevent water shortage. For more effective water management, an uncertainty-based water shortage risk assessment model (UWSRAM) is developed to study the combined effect of multiple water resources and analyze the shortage degree under uncertainty. The UWSRAM combines copula-based Monte Carlo stochastic simulation and the chance-constrained programming-stochastic multiobjective optimization model, using the Lunan water-receiving area in China as an example. Statistical copula functions are employed to estimate the joint probability of available transferring water and local surface water and sampling from the multivariate probability distribution, which are used as inputs for the optimization model. The approach reveals the distribution of water shortage and is able to emphasize the importance of improving and updating transferring water and local surface water management, and examine their combined influence on water shortage risk assessment. The possible available water and shortages can be calculated applying the UWSRAM, also with the corresponding allocation measures under different water availability levels and violating probabilities. The UWSRAM is valuable for mastering the overall multi-water resource and water shortage degree, adapting to the uncertainty surrounding water resources, establishing effective water resource planning policies for managers and achieving sustainable development.

Evidence-based evaluation of treatment strategy for multiple sclerosis

Directory of Open Access Journals (Sweden)

LI Meng-qiu

2012-04-01

Full Text Available Objective To formulate the best treatment plan for multiple sclerosis (MS patients by evaluating the therapeutic efficacy and side effect of various evidence-based programs. Methods Key words were defined as multiple sclerosis, immunomodulatory therapy and therapy, etc. We searched MEDLINE, Cochrane Library, Wanfang data bases for Scientific Journals in China and National Knowledge Infrastructure for Chinese Scientific Journals Database. Additionally, we applied manual searching and screened out conference paper and academic dissertation, etc, from various references. After that we obtained and evaluated by Jadad scales on systematic reviews, randomized controlled trials, controlled clinical trials and observational study cases about glucocorticoids, plasmapheresis, intravenous immunoglobulin, IFN-β, glatiramer acetate, mitoxantrone, natalizumab, fingolimod. Results After screening, all seventeen selected resources included systematic reviews 6 articles, randomized controlled trials 7 articles, controlled clinical trials 2 articles, observational study cases 2 articles, among which fifteen articles were proved to be high quality (according to Jadad scoring system, five score 4, six score 5, four score 7, two chapters were judged to be low quality scoring 3. Finally, we summerize that: 1 The first choice of treatment for acute relapses is glucocorticoids and we suggest that plasmapheresis or intravenous immunoglobulin may be tried as an alternative therapy in acute MS relapse, especially in case of contraindications to intravenous methylprednisolone. 2 Immunomodulatory or immunosuppressive treatment (IFN-β, glatiramer acetate, mitoxantrone, natalizumab can be an option to prevent new relapses and progression of disability. 3 Fingolimod is an oral treatment for multiple sclerosis to improve treatment adherence. Conclusion Using evidence-based medicine methods can provide us best clinical evidence on MS treatment.

Risk-based rules for crane safety systems

Energy Technology Data Exchange (ETDEWEB)

Ruud, Stian [Section for Control Systems, DNV Maritime, 1322 Hovik (Norway)], E-mail: Stian.Ruud@dnv.com; Mikkelsen, Age [Section for Lifting Appliances, DNV Maritime, 1322 Hovik (Norway)], E-mail: Age.Mikkelsen@dnv.com

2008-09-15

The International Maritime Organisation (IMO) has recommended a method called formal safety assessment (FSA) for future development of rules and regulations. The FSA method has been applied in a pilot research project for development of risk-based rules and functional requirements for systems and components for offshore crane systems. This paper reports some developments in the project. A method for estimating target reliability for the risk-control options (safety functions) by means of the cost/benefit decision criterion has been developed in the project and is presented in this paper. Finally, a structure for risk-based rules is proposed and presented.

Risk-based rules for crane safety systems

International Nuclear Information System (INIS)

Ruud, Stian; Mikkelsen, Age

2008-01-01

The International Maritime Organisation (IMO) has recommended a method called formal safety assessment (FSA) for future development of rules and regulations. The FSA method has been applied in a pilot research project for development of risk-based rules and functional requirements for systems and components for offshore crane systems. This paper reports some developments in the project. A method for estimating target reliability for the risk-control options (safety functions) by means of the cost/benefit decision criterion has been developed in the project and is presented in this paper. Finally, a structure for risk-based rules is proposed and presented

Novel pedigree analysis implicates DNA repair and chromatin remodeling in multiple myeloma risk.

Science.gov (United States)

Waller, Rosalie G; Darlington, Todd M; Wei, Xiaomu; Madsen, Michael J; Thomas, Alun; Curtin, Karen; Coon, Hilary; Rajamanickam, Venkatesh; Musinsky, Justin; Jayabalan, David; Atanackovic, Djordje; Rajkumar, S Vincent; Kumar, Shaji; Slager, Susan; Middha, Mridu; Galia, Perrine; Demangel, Delphine; Salama, Mohamed; Joseph, Vijai; McKay, James; Offit, Kenneth; Klein, Robert J; Lipkin, Steven M; Dumontet, Charles; Vachon, Celine M; Camp, Nicola J

2018-02-01

The high-risk pedigree (HRP) design is an established strategy to discover rare, highly-penetrant, Mendelian-like causal variants. Its success, however, in complex traits has been modest, largely due to challenges of genetic heterogeneity and complex inheritance models. We describe a HRP strategy that addresses intra-familial heterogeneity, and identifies inherited segments important for mapping regulatory risk. We apply this new Shared Genomic Segment (SGS) method in 11 extended, Utah, multiple myeloma (MM) HRPs, and subsequent exome sequencing in SGS regions of interest in 1063 MM / MGUS (monoclonal gammopathy of undetermined significance-a precursor to MM) cases and 964 controls from a jointly-called collaborative resource, including cases from the initial 11 HRPs. One genome-wide significant 1.8 Mb shared segment was found at 6q16. Exome sequencing in this region revealed predicted deleterious variants in USP45 (p.Gln691* and p.Gln621Glu), a gene known to influence DNA repair through endonuclease regulation. Additionally, a 1.2 Mb segment at 1p36.11 is inherited in two Utah HRPs, with coding variants identified in ARID1A (p.Ser90Gly and p.Met890Val), a key gene in the SWI/SNF chromatin remodeling complex. Our results provide compelling statistical and genetic evidence for segregating risk variants for MM. In addition, we demonstrate a novel strategy to use large HRPs for risk-variant discovery more generally in complex traits.

Novel pedigree analysis implicates DNA repair and chromatin remodeling in multiple myeloma risk.

Directory of Open Access Journals (Sweden)

Rosalie G Waller

2018-02-01

Full Text Available The high-risk pedigree (HRP design is an established strategy to discover rare, highly-penetrant, Mendelian-like causal variants. Its success, however, in complex traits has been modest, largely due to challenges of genetic heterogeneity and complex inheritance models. We describe a HRP strategy that addresses intra-familial heterogeneity, and identifies inherited segments important for mapping regulatory risk. We apply this new Shared Genomic Segment (SGS method in 11 extended, Utah, multiple myeloma (MM HRPs, and subsequent exome sequencing in SGS regions of interest in 1063 MM / MGUS (monoclonal gammopathy of undetermined significance-a precursor to MM cases and 964 controls from a jointly-called collaborative resource, including cases from the initial 11 HRPs. One genome-wide significant 1.8 Mb shared segment was found at 6q16. Exome sequencing in this region revealed predicted deleterious variants in USP45 (p.Gln691* and p.Gln621Glu, a gene known to influence DNA repair through endonuclease regulation. Additionally, a 1.2 Mb segment at 1p36.11 is inherited in two Utah HRPs, with coding variants identified in ARID1A (p.Ser90Gly and p.Met890Val, a key gene in the SWI/SNF chromatin remodeling complex. Our results provide compelling statistical and genetic evidence for segregating risk variants for MM. In addition, we demonstrate a novel strategy to use large HRPs for risk-variant discovery more generally in complex traits.

Event-based historical value-at-risk

NARCIS (Netherlands)

Hogenboom, F.P.; Winter, Michael; Hogenboom, A.C.; Jansen, Milan; Frasincar, F.; Kaymak, U.

2012-01-01

Value-at-Risk (VaR) is an important tool to assess portfolio risk. When calculating VaR based on historical stock return data, we hypothesize that this historical data is sensitive to outliers caused by news events in the sampled period. In this paper, we research whether the VaR accuracy can be

Risk-based audit selection of dairy farms.

Science.gov (United States)

van Asseldonk, M A P M; Velthuis, A G J

2014-02-01

Dairy farms are audited in the Netherlands on numerous process standards. Each farm is audited once every 2 years. Increasing demands for cost-effectiveness in farm audits can be met by introducing risk-based principles. This implies targeting subpopulations with a higher risk of poor process standards. To select farms for an audit that present higher risks, a statistical analysis was conducted to test the relationship between the outcome of farm audits and bulk milk laboratory results before the audit. The analysis comprised 28,358 farm audits and all conducted laboratory tests of bulk milk samples 12 mo before the audit. The overall outcome of each farm audit was classified as approved or rejected. Laboratory results included somatic cell count (SCC), total bacterial count (TBC), antimicrobial drug residues (ADR), level of butyric acid spores (BAB), freezing point depression (FPD), level of free fatty acids (FFA), and cleanliness of the milk (CLN). The bulk milk laboratory results were significantly related to audit outcomes. Rejected audits are likely to occur on dairy farms with higher mean levels of SCC, TBC, ADR, and BAB. Moreover, in a multivariable model, maxima for TBC, SCC, and FPD as well as standard deviations for TBC and FPD are risk factors for negative audit outcomes. The efficiency curve of a risk-based selection approach, on the basis of the derived regression results, dominated the current random selection approach. To capture 25, 50, or 75% of the population with poor process standards (i.e., audit outcome of rejected), respectively, only 8, 20, or 47% of the population had to be sampled based on a risk-based selection approach. Milk quality information can thus be used to preselect high-risk farms to be audited more frequently. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Managing Disease Risks from Trade: Strategic Behavior with Many Choices and Price Effects.

Science.gov (United States)

Chitchumnong, Piyayut; Horan, Richard D

2018-03-16

An individual's infectious disease risks, and hence the individual's incentives for risk mitigation, may be influenced by others' risk management choices. If so, then there will be strategic interactions among individuals, whereby each makes his or her own risk management decisions based, at least in part, on the expected decisions of others. Prior work has shown that multiple equilibria could arise in this setting, with one equilibrium being a coordination failure in which individuals make too few investments in protection. However, these results are largely based on simplified models involving a single management choice and fixed prices that may influence risk management incentives. Relaxing these assumptions, we find strategic interactions influence, and are influenced by, choices involving multiple management options and market price effects. In particular, we find these features can reduce or eliminate concerns about multiple equilibria and coordination failure. This has important policy implications relative to simpler models.

Laboratory-based and office-based risk scores and charts to predict 10-year risk of cardiovascular disease in 182 countries

DEFF Research Database (Denmark)

Ueda, Peter; Woodward, Mark; Lu, Yuan

2017-01-01

BACKGROUND: Worldwide implementation of risk-based cardiovascular disease (CVD) prevention requires risk prediction tools that are contemporarily recalibrated for the target country and can be used where laboratory measurements are unavailable. We present two cardiovascular risk scores, with and ...

A trace ratio maximization approach to multiple kernel-based dimensionality reduction.

Science.gov (United States)

Jiang, Wenhao; Chung, Fu-lai

2014-01-01

Most dimensionality reduction techniques are based on one metric or one kernel, hence it is necessary to select an appropriate kernel for kernel-based dimensionality reduction. Multiple kernel learning for dimensionality reduction (MKL-DR) has been recently proposed to learn a kernel from a set of base kernels which are seen as different descriptions of data. As MKL-DR does not involve regularization, it might be ill-posed under some conditions and consequently its applications are hindered. This paper proposes a multiple kernel learning framework for dimensionality reduction based on regularized trace ratio, termed as MKL-TR. Our method aims at learning a transformation into a space of lower dimension and a corresponding kernel from the given base kernels among which some may not be suitable for the given data. The solutions for the proposed framework can be found based on trace ratio maximization. The experimental results demonstrate its effectiveness in benchmark datasets, which include text, image and sound datasets, for supervised, unsupervised as well as semi-supervised settings. Copyright © 2013 Elsevier Ltd. All rights reserved.

Developing an objective evaluation method to estimate diabetes risk in community-based settings.

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Kenya, Sonjia; He, Qing; Fullilove, Robert; Kotler, Donald P

2011-05-01

Exercise interventions often aim to affect abdominal obesity and glucose tolerance, two significant risk factors for type 2 diabetes. Because of limited financial and clinical resources in community and university-based environments, intervention effects are often measured with interviews or questionnaires and correlated with weight loss or body fat indicated by body bioimpedence analysis (BIA). However, self-reported assessments are subject to high levels of bias and low levels of reliability. Because obesity and body fat are correlated with diabetes at different levels in various ethnic groups, data reflecting changes in weight or fat do not necessarily indicate changes in diabetes risk. To determine how exercise interventions affect diabetes risk in community and university-based settings, improved evaluation methods are warranted. We compared a noninvasive, objective measurement technique--regional BIA--with whole-body BIA for its ability to assess abdominal obesity and predict glucose tolerance in 39 women. To determine regional BIA's utility in predicting glucose, we tested the association between the regional BIA method and blood glucose levels. Regional BIA estimates of abdominal fat area were significantly correlated (r = 0.554, P < 0.003) with fasting glucose. When waist circumference and family history of diabetes were added to abdominal fat in multiple regression models, the association with glucose increased further (r = 0.701, P < 0.001). Regional BIA estimates of abdominal fat may predict fasting glucose better than whole-body BIA as well as provide an objective assessment of changes in diabetes risk achieved through physical activity interventions in community settings.

Exploring change in a group-based psychological intervention for multiple sclerosis patients.

Science.gov (United States)

Borghi, Martina; Bonino, Silvia; Graziano, Federica; Calandri, Emanuela

2018-07-01

The study is focused on a group-based cognitive behavioral intervention aimed at promoting the quality of life and psychological well-being of multiple sclerosis patients. The study investigates how the group intervention promoted change among participants and fostered their adjustment to the illness. The intervention involved six groups of patients (a total of 41 patients) and included four consecutive sessions and a 6-month follow-up. To explore change, verbatim transcripts of the intervention sessions were analyzed using a mixed-methods content analysis with qualitative data combined with descriptive statistics. The categories of resistance and openness to change were used to describe the process of change. Resistance and openness to change coexisted during the intervention. Only in the first session did resistance prevail over openness to change; thereafter, openness to change gradually increased and stabilized over time, and openness to change was then always stronger than resistance. The study builds on previous research on the effectiveness of group-based psychological interventions for multiple sclerosis patients and gives methodological and clinical suggestions to health care professionals working with multiple sclerosis patients. Implications for rehabilitation The study suggests that a group-based cognitive behavioral intervention for multiple sclerosis patients focused on the promotion of identity redefinition, a sense of coherence and self-efficacy in dealing with multiple sclerosis fosters the process of change and may be effective in promoting patients' adjustment to their illness. Health care professionals leading group-based psychological interventions for multiple sclerosis patients should be aware that resistance and openness to change coexist in the process of change. The study suggests that the duration of the intervention is a crucial factor: a minimum of three sessions appears to be necessary for group participants to develop greater openness