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Sample records for high risk region

  1. High-risk regions and outbreak modelling of tularemia in humans.

    Science.gov (United States)

    Desvars-Larrive, A; Liu, X; Hjertqvist, M; Sjöstedt, A; Johansson, A; Rydén, P

    2017-02-01

    Sweden reports large and variable numbers of human tularemia cases, but the high-risk regions are anecdotally defined and factors explaining annual variations are poorly understood. Here, high-risk regions were identified by spatial cluster analysis on disease surveillance data for 1984-2012. Negative binomial regression with five previously validated predictors (including predicted mosquito abundance and predictors based on local weather data) was used to model the annual number of tularemia cases within the high-risk regions. Seven high-risk regions were identified with annual incidences of 3·8-44 cases/100 000 inhabitants, accounting for 56·4% of the tularemia cases but only 9·3% of Sweden's population. For all high-risk regions, most cases occurred between July and September. The regression models explained the annual variation of tularemia cases within most high-risk regions and discriminated between years with and without outbreaks. In conclusion, tularemia in Sweden is concentrated in a few high-risk regions and shows high annual and seasonal variations. We present reproducible methods for identifying tularemia high-risk regions and modelling tularemia cases within these regions. The results may help health authorities to target populations at risk and lay the foundation for developing an early warning system for outbreaks.

  2. High Risk Human Papilloma Virus Genotypes in Kurdistan Region in Patients with Vaginal Discharge.

    Science.gov (United States)

    Hussein, Nawfal R; Balatay, Amer A; Assafi, Mahde S; AlMufty, Tamara Abdulezel

    2016-01-01

    The human papilloma virus (HPV) is considered as the major risk factor for the development of cervical cancer. This virus is of different genotypes and generally can be classified into high and low risk types. To determine the rate of high risk HPV genotypes in women with vaginal discharge and lower abdominal pain in Kurdistan region, Iraq. Cervical swabs were taken from 104 women. DNA was extracted and the polymerase chain reaction (PCR) technique was used to determine the presence of high risk genotypes. It was found that 13/104 (12.5%) of the samples were positive for high risk HPV genotypes. Amongst those who were positive, 4/13 (30.7%) were typed as genotype 16 and 7/13 (53.8%) showed mixed genotyping. On the other hand, genotypes 53 and 56 were found in only one sample each. High risk HPV genotypes are not uncommon and further community based study is needed to determine the prevalence of HPV and its genotypes and plan for prevention of infection.

  3. Substance use and regional gray matter volume in individuals at high risk of psychosis

    OpenAIRE

    Stone, James; Bhattacharyya, Sagnik; Barker, Gareth J; McGuire, Philip K; Bhattacharyya, Sagnik

    2012-01-01

    Individuals with an at risk mental state (ARMS) are at greatly increased risk of developing a psychotic illness. Risk of transition to psychosis is associated with regionally reduced cortical gray matter volume. There has been considerable interest in the interaction between psychosis risk and substance use. In this study we investigate the relationship between alcohol, cannabis and nicotine use with gray matter volume in ARMS subjects and healthy volunteers. Twenty seven ARMS subjects and 27...

  4. Human Papillomavirus Cervical Infection and Associated Risk Factors in a Region of Argentina With a High Incidence of Cervical Carcinoma

    Directory of Open Access Journals (Sweden)

    S. A. Tonon

    1999-01-01

    Full Text Available Objective: To assess the prevalence and potential risk factors associated with human papillomavirus (HPV cervical infection among women residing in a region of northeastern Argentina with a high incidence of cervical cancer.

  5. Substance use and regional gray matter volume in individuals at high risk of psychosis.

    Science.gov (United States)

    Stone, James M; Bhattacharyya, Sagnik; Barker, Gareth J; McGuire, Philip K

    2012-02-01

    Individuals with an at risk mental state (ARMS) are at greatly increased risk of developing a psychotic illness. Risk of transition to psychosis is associated with regionally reduced cortical gray matter volume. There has been considerable interest in the interaction between psychosis risk and substance use. In this study we investigate the relationship between alcohol, cannabis and nicotine use with gray matter volume in ARMS subjects and healthy volunteers. Twenty seven ARMS subjects and 27 healthy volunteers took part in the study. All subjects underwent volumetric MRI imaging. The relationship between regional gray matter volume and cannabis use, smoking, and alcohol use in controls and ARMS subjects was analysed using voxel-based morphometry. In any region where a significant relationship with drug was present, data were analysed to determine if there was any group difference in this relationship. Alcohol intake was inversely correlated with gray matter volume in cerebellum, cannabis intake was use was inversely correlated with gray matter volume in prefrontal cortex and tobacco intake was inversely correlated with gray matter volume in left temporal cortex. There were no significant interactions by group in any region. There is no evidence to support the hypothesis of increased susceptibility to harmful effects of drugs and alcohol on regional gray matter in ARMS subjects. However, alcohol, tobacco and cannabis at low to moderate intake may be associated with lower gray matter in both ARMS subjects and healthy volunteers-possibly representing low-level cortical damage or change in neural plasticity. Copyright © 2011 Elsevier B.V. All rights reserved.

  6. Management of women at high risk of hereditary breast cancer in the Veneto Regional Program for Prevention.

    Science.gov (United States)

    Del Sole, Annamaria; Cinquetti, Sandro; Fedato, Chiara; Montagna, Marco; Russo, Francesca; Sbrogiò, Luca Gino; Zorzi, Manuel

    2015-01-01

    Today it is well-known that high risk of genetic breast cancer concerns a very limited part of the population: no more than 2-3 women are affected every thousand and this condition as a whole accounts for no more than 3%-5% of all breast cancers. Following the directions contained in the 2014-2018 National Prevention Plan, Veneto's 2014-2018 Regional Program of Prevention (PRP), approved by Regional Council Resolution (DGR) No. 749 of 14.5.2015, consolidation of a pathway of diagnosis, observation, and prophylaxis for women at high risk of hereditary breast carcinoma is thus proposed. The principal activities of this policy will be the following: creation of a regional working group, survey of currently existing pathways for the identification of women at risk of hereditary breast cancer and adoption of the same, approval and consolidation of a structured regional pathway for women at high risk of hereditary breast and/or ovarian cancer, from paths of oncogenetic consultation and genetic testing to management of disease risk. Subsequent to the recognition of the pathway of diagnosis, observation, and prophylaxis for women at high risk of hereditary breast carcinoma, the Veneto region undertakes to develop a co-ordinated program of information and training on this pathway directed at the population and healthcare workers. It is firmly hoped that with the inclusion of a program for the management of women at high risk of hereditary breast cancer within the Veneto PRP this topic may become more defined and structured in terms of sustainability, integration with the existing regional networks (mammography network, Breast Unit), contrasting inequality, monitoring and evaluation, in this way pursuing the objectives of a reduction of cause-specific mortality and improvement of quality of life.

  7. A multi-region assessment of population rates of cardiac catheterization and yield of high-risk coronary artery disease

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    Clement Fiona M

    2011-11-01

    Full Text Available Abstract Background There is variation in cardiac catheterization utilization across jurisdictions. Previous work from Alberta, Canada, showed no evidence of a plateau in the yield of high-risk disease at cardiac catheterization rates as high as 600 per 100,000 population suggesting that the optimal rate is higher. This work aims 1 To determine if a previously demonstrated linear relationship between the yield of high-risk coronary disease and cardiac catheterization rates persists with contemporary data and 2 to explore whether the linear relationship exists in other jurisdictions. Methods Detailed clinical information on all patients undergoing cardiac catheterization in 3 Canadian provinces was available through the Alberta Provincial Project for Outcomes Assessment in Coronary Heart (APPROACH disease and partner initiatives in British Columbia and Nova Scotia. Population rates of catheterization and high-risk coronary disease detection for each health region in these three provinces, and age-adjusted rates produced using direct standardization. A mixed effects regression analysis was performed to assess the relationship between catheterization rate and high-risk coronary disease detection. Results In the contemporary Alberta data, we found a linear relationship between the population catheterization rate and the high-risk yield. Although the yield was slightly less in time period 2 (2002-2006 than in time period 1(1995-2001, there was no statistical evidence of a plateau. The linear relationship between catheterization rate and high-risk yield was similarly demonstrated in British Columbia and Nova Scotia and appears to extend, without a plateau in yield, to rates over 800 procedures per 100,000 population. Conclusions Our study demonstrates a consistent finding, over time and across jurisdictions, of linearly increasing detection of high-risk CAD as population rates of cardiac catheterization increase. This internationally-relevant finding

  8. Production of high-resolution digital terrain models in mountain regions to support risk assessment

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    Gianfranco Forlani

    2015-07-01

    Full Text Available Demand for high-accuracy digital terrain models (DTMs in the Alpine region has been steadily increasing in recent years in valleys as well as high mountains. In the former, the determination of the geo-mechanical parameters of rock masses is the main objective; global warming, which causes the retreat of glaciers and the reduction of permafrost, is the main drive of the latter. The consequence is the instability of rock masses in high mountains: new cost-effective monitoring techniques are required to deal with the peculiar characteristics of such environment, delivering results at short notice. After discussing the design and execution of photogrammetric surveys in such areas, with particular reference to block orientation and block control, the paper describes the production of DTMs of rock faces and glacier fronts with light instrumentation and data acquisition techniques, allowing highly automated data processing. To this aim, the PhotoGPS technique and structure from motion algorithms are used to speed up the orientation process, while dense matching area-based correlation techniques are used to generate the DTMs.

  9. Distribution of Helicobacter pylori virulence markers in patients with gastroduodenal diseases in a region at high risk of gastric cancer.

    Science.gov (United States)

    Wang, Ming-yi; Chen, Cheng; Gao, Xiao-zhong; Li, Jie; Yue, Jing; Ling, Feng; Wang, Xiao-chun; Shao, Shi-he

    2013-01-01

    Helicobacter pylori (H. pylori) is a major human pathogen that is responsible for various gastroduodenal diseases. We investigated the prevalence of H. pylori virulence markers in a region at high risk of gastric cancer. One hundred and sixteen H. pylori strains were isolated from patients with gastroduodenal diseases. cagA, the cagA 3' variable region, cagPAI genes, vacA, and dupA genotypes were determined by PCR, and some amplicons of the cagA 3' variable region, cagPAI genes and dupA were sequenced. cagA was detected in all strains. The cagA 3' variable region of 85 strains (73.3%) was amplified, and the sequences of 24 strains were obtained including 22 strains possessing the East Asian-type. The partial cagPAI presented at a higher frequency in chronic gastritis (44.4%) than that of the severe clinical outcomes (9.7%, p dupA and sequencing of dupA revealed an ORF of 2449-bp. The prevalence of dupA was significantly higher in strains from patients with the severe clinical outcomes (40.3%) than that from chronic gastritis (20.4%, p = 0.02). The high rate of East Asian-type cagA, intact cagPAI, virulent vacA genotypes, and the intact long-type dupA may underlie the high risk of gastric cancer in the region. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Coordination of Regional Structures’ Interests Concerning Investment Resources of Educational Services of Enterprises under High-Risk Conditions

    Directory of Open Access Journals (Sweden)

    Semchuk Zhanna V.

    2016-02-01

    Full Text Available The development of professional education in the context of interaction with the labor market has been analyzed and inconsistencies of professional and economic nature have been revealed. Reasons for the imbalance in the structure of the market for labor and education have been identified, and it was noted that they have a negative impact on the economic security of educational institutions and cause the accumulation of negative factors as well. Elements of foreign experience in forecasting economic development and associated with it changes in educational services with regard to high-risk conditions have been considered for the purpose of its application in Ukraine. A conceptual model of information technology for coordination of regional structures’ interests concerning investment resources of educational services of enterprises under high-risk conditions has been proposed. The information technology is based on the econometric model for optimizing enterprise Internet payment systems, criterion of hierarchical games theories, multiobjective optimization, active systems, the model for diagnosing internal and external threats to the economic security of the educational institution; means and methodology of the system-value approach; algorithms for recognition of crisis situations; the optimization model for forecasting crisis situations and managing risk as well as the decision-making system for coordination of regional structures’ interests concerning investment resources based on the model of a program-designtarget complex

  11. Preliminary results of an oilspill risk analysis for the Bombay High Region

    Digital Repository Service at National Institute of Oceanography (India)

    Mascarenhas, A.A.M.Q.; Gouveia, A.D.; Sitaraman, R.

    oil were analysed, covering estimates of the time between spill occurrence and contact with resources. The combined results yielded estimates of the overall risks associated with production within the developmental area. Preliminary results...

  12. Regional radiotherapy in high-risk breast cancer: is the issue solved?

    DEFF Research Database (Denmark)

    Krause, M; Petersen, C; Offersen, B V

    2015-01-01

    Adjuvant radiotherapy is the treatment standard for breast cancer with lymph node metastases after breast-conserving surgery or mastectomy. The inclusion of regional lymph nodes into the treatment volumes has been a question in recent clinical trials. Their impact on treatment standards and open...

  13. Neo-adjuvant chemotherapy alone or with regional hyperthermia for localised high-risk soft-tissue sarcoma: a randomised phase 3 multicentre study

    DEFF Research Database (Denmark)

    Issels, Rolf D; Lindner, Lars H; Verweij, Jaap

    2010-01-01

    The optimum treatment for high-risk soft-tissue sarcoma (STS) in adults is unclear. Regional hyperthermia concentrates the action of chemotherapy within the heated tumour region. Phase 2 studies have shown that chemotherapy with regional hyperthermia improves local control compared with chemother...

  14. Prevalence of metabolic syndrome in Murcia Region, a southern European Mediterranean area with low cardiovascular risk and high obesity

    Directory of Open Access Journals (Sweden)

    Huerta José M

    2011-07-01

    Full Text Available Abstract Background Metabolic syndrome (MS is associated with subsequent appearance of diabetes and cardiovascular disease. As compared to other Spanish regions, Murcia (southern Spain registers increased obesity as well as cardiovascular morbidity and mortality. The aim of this study was to assess the prevalence of MS and its components, awareness of obesity as a health risk and associated lifestyles. Methods A population-based, cross-sectional study was conducted in 2003, covering a sample of 1555 individuals 20 years and over. MS was defined according to the Revised National Cholesterol Education Program Adult Treatment Panel III (R-ATPIII, International Diabetes Federation (IDF and Joint Interim Statement (JIS criteria. Both low (94/80 and high (102/88 waist circumference (WC thresholds were considered. Results Prevalence of MS was 27.2% (95%CI: 25.2-29.2, 32.2% (95%CI: 30.1-34.3 and 33.2% (95%CI: 31.2-35.3 according to the R-ATPIII, IDF and JIS94/80 respectively. It increased with age until reaching 52.6% (R-ATPIII or 60.3% (JIS94/80 among persons aged 70 years and over, and was higher in persons with little or no formal education (51.7% R-ATPIII, 57.3% JIS94/80. The most common risk factors were hypertension (46.6% and central obesity (40.7% and 66.1% according to high and low WC cut-off points respectively. Although most persons were aware that obesity increased health risks, regular exercise was very unusual (13.0% centrally obese, 27.2% non-centrally obese. Adherence to dietary recommendations was similar among centrally obese and non-centrally obese subjects. Conclusions Prevalence of MS is high in our population, is comparable to that found in northern Europe and varies with the definition used. Adherence to preventive recommendations and to adequate weight promotion is very low. In the absence of a specific treatment for MS, integrated intervention based on a sustained increase in physical activity and changes in diet should be

  15. Tourism sector preparedness in zones with a high seismic risk: Case study of the Capital Region of Japan

    Science.gov (United States)

    Lihui, W.; Wang, D.

    2017-12-01

    Japan is a country highly vulnerable to natural disasters, especially earthquakes. Tourism, as a strategic industry in Japan, is especially vulnerable to destructive earthquake disasters owing to the characteristics of vulnerability, sensitivity and substitutability. Here we aim to provide theoretical understanding of the perception and responses of tourism managers towards damaging disasters in tourism destinations with high seismic risks. We conducted surveys among the mangers of tourism businesses in the capital area of Japan in 2014 and applied structural equation modeling techniques to empirically test the proposed model with four latent variables, which are risk perception, threat knowledge, disaster preparedness and earthquake preparedness. Our results show that threat knowledge affects risk perception and disaster preparedness positively. In addition, disaster preparedness positively affects earthquake preparedness. However, the proposed paths from risk perception to disaster preparedness, risk perception to earthquake preparedness, and threat knowledge to earthquake preparedness were not statistically significant. Our results may provide references for policymakers in promoting crisis planning in tourism destination with high seismic risks.

  16. [Prevalence of HPV high-risk serotypes detected by PCR in patients with normal cervical cytology at the Hospital Regional Adolfo López Mateos, ISSSTE].

    Science.gov (United States)

    Martínez-Portilla, R J; López-Velázquez, J L; Martínez-Rojas, G C; Aguilar-Villagómez, M I; De la Torre-Rendón, F E; Villafán-Bernal, J R

    2016-09-01

    Is fundamental to determine the prevalence of human papiloma virus (HVP) high-risk serotypes in local and regional population in order for health providers to offer patients, vaccines and treatments against specific population-based serotypes. To determine the prevalence of HPV High risk serotypes detected by PCR in patients with normal cytology from the ISSSTE Adolfo Lopez Mateos Regional Hospital. An observational, descriptive, prospective study was conducted from cervical cytologies and high risk HPV test by PCR in patients from the Regional Hospital Adolfo López Mateos, ISSSTE, during the period January 2013-December 2015. Cases of patients with negative cervical cytology were included. Information about age, the result of cervical cytology and high risk HPV test by PCR was obtained. The overall prevalence of HPV infection and the most prevalent serotypes by age groups were calculated. A total of 3258 cervical smears were performed, of which 2557 were negative (78.4%), from this, the global prevalence of HPV infection was 10.2% (n=262). We found that 1.8% (n = 45) of negative reports had HPV16 infection, 0.5% (n=13) had HPV18 and 8.9% (n = 227) were infected by Viral Pool of other high-risk serotypes. The prevalence of infection by viral pool of high risk serotypes was 11.5% in women <20 years, 12.9% in women between 20-29 years and 22.2% in women between 30-39 years. This prevalence was lower in patients older than 40 years (p<0.05). A higher prevalence of viral pool high risk serotypes was found in patients with normal cytology, than the HPV16 and HPV-8 prevalence, which was significantly higher in women younger than 40 years.

  17. Targeted cardiopulmonary resuscitation training focused on the family members of high-risk patients at a regional medical center: A comparison between family members of high-risk and no-risk patients.

    Science.gov (United States)

    Han, Kap Su; Lee, Ji Sung; Kim, Su Jin; Lee, Sung Woo

    2018-05-01

    We developed a hospital-based cardiopulmonary resuscitation (CPR) training model focused on the target population (family members of patients with potential risks for cardiac arrest) and compared the outcome of CPR training between target and non-target populations for validity. Family members of patients in training were divided into three groups on the basis of patients' diseases, as follows: 1) the cardio-specific (CS) risk group, including family members of patients with cardiac disease at risk of cardiac arrest; 2) the cardiovascular (CV) risk group, including family members of patients with risk factors for cardiovascular disease; and 3) the no-risk group. Pre- and posttraining surveys and skill tests as well as a post-training 3-month telephone survey were conducted. Educational outcomes were analyzed. A total of 203 family members were enrolled into 21 CPR training classes. The CS group (n=88) included elderly persons and housewives with a lower level of education compared with the CV (n=79) and no-risk groups (n=36). The CS group was motivated by healthcare professionals and participated in the training course. The CS, CV, and no-risk groups showed improvements in knowledge, willingness to perform CPR, and skills. Despite the older age and lower level of education in the CS group, the effects of education were similar to those in the other groups. A high rate of response and secondary propagation of CPR training were observed in the CS group. Family members of patients with heart disease could be an appropriate target population for CPR training, particularly in terms of recruitment and secondary propagation. Targeted intervention may be an effective training strategy to improve bystander CPR rates.

  18. High-Risk List

    Science.gov (United States)

    2017-01-01

    economy. The World Bank has said that “corruption creates an unfavorable business environment by undermining the operation efficiency of firms and... Bank Began as ‘Ponzi Scheme,’” 11/27/2012. 64 Independent Joint Anti-Corruption Monitoring and Evaluation Committee, Unfinished Business : The Follow...HIGH RISK AREA 7: Oversight 51 HIGH-RISK AREA 8: Strategy and Planning 55 CONCLUSION HIGH RISK LIST I JANUARY 11, 2017 2 EXECUTIVE SUMMARY

  19. Creation of RTOG compliant patient CT-atlases for automated atlas based contouring of local regional breast and high-risk prostate cancers.

    Science.gov (United States)

    Velker, Vikram M; Rodrigues, George B; Dinniwell, Robert; Hwee, Jeremiah; Louie, Alexander V

    2013-07-25

    Increasing use of IMRT to treat breast and prostate cancers at high risk of regional nodal spread relies on accurate contouring of targets and organs at risk, which is subject to significant inter- and intra-observer variability. This study sought to evaluate the performance of an atlas based deformable registration algorithm to create multi-patient CT based atlases for automated contouring. Breast and prostate multi-patient CT atlases (n = 50 and 14 respectively) were constructed to be consistent with RTOG consensus contouring guidelines. A commercially available software algorithm was evaluated by comparison of atlas-predicted contours against manual contours using Dice Similarity coefficients. High levels of agreement were demonstrated for prediction of OAR contours of lungs, heart, femurs, and minor editing required for the CTV breast/chest wall. CTVs generated for axillary nodes, supraclavicular nodes, prostate, and pelvic nodes demonstrated modest agreement. Small and highly variable structures, such as internal mammary nodes, lumpectomy cavity, rectum, penile bulb, and seminal vesicles had poor agreement. A method to construct and validate performance of CT-based multi-patient atlases for automated atlas based auto-contouring has been demonstrated, and can be adopted for clinical use in planning of local regional breast and high-risk prostate radiotherapy.

  20. Creation of RTOG compliant patient CT-atlases for automated atlas based contouring of local regional breast and high-risk prostate cancers

    International Nuclear Information System (INIS)

    Velker, Vikram M; Rodrigues, George B; Dinniwell, Robert; Hwee, Jeremiah; Louie, Alexander V

    2013-01-01

    Increasing use of IMRT to treat breast and prostate cancers at high risk of regional nodal spread relies on accurate contouring of targets and organs at risk, which is subject to significant inter- and intra-observer variability. This study sought to evaluate the performance of an atlas based deformable registration algorithm to create multi-patient CT based atlases for automated contouring. Breast and prostate multi-patient CT atlases (n = 50 and 14 respectively) were constructed to be consistent with RTOG consensus contouring guidelines. A commercially available software algorithm was evaluated by comparison of atlas-predicted contours against manual contours using Dice Similarity coefficients. High levels of agreement were demonstrated for prediction of OAR contours of lungs, heart, femurs, and minor editing required for the CTV breast/chest wall. CTVs generated for axillary nodes, supraclavicular nodes, prostate, and pelvic nodes demonstrated modest agreement. Small and highly variable structures, such as internal mammary nodes, lumpectomy cavity, rectum, penile bulb, and seminal vesicles had poor agreement. A method to construct and validate performance of CT-based multi-patient atlases for automated atlas based auto-contouring has been demonstrated, and can be adopted for clinical use in planning of local regional breast and high-risk prostate radiotherapy

  1. Social determinants of common metabolic risk factors (high blood pressure, high blood sugar, high body mass index and high waist-hip ratio) of major non-communicable diseases in South Asia region: a systematic review protocol.

    Science.gov (United States)

    Sharma, Sudesh Raj; Mishra, Shiva Raj; Wagle, Kusum; Page, Rachel; Matheson, Anna; Lambrick, Danielle; Faulkner, James; Lounsbury, David; Vaidya, Abhinav

    2017-09-07

    Prevalence of non-communicable diseases has been increasing at a greater pace in developing countries and, in particular, the South Asia region. Various behavioral, social and environmental factors present in this region perpetuate common metabolic risk factors of non-communicable diseases. This study will identify social determinants of common metabolic risk factors of major non-communicable diseases in the context of the South Asian region and map their causal pathway. A systematic review of selected articles will be carried out following Cochrane guidelines. Review will be guided by Social Determinants of Health Framework developed by the World Health Organization to extract social determinants of metabolic risk factors of non-communicable diseases from studies. A distinct search strategy will be applied using key words to screen relevant studies from online databases. Primary and grey literature published from the year 2000 to 2016 and studies with discussion on proximal and distal determinants of non-communicable risk factors among adults of the South Asia region will be selected. They will be further checked for quality, and a matrix illustrating contents of selected articles will be developed. Thematic content analysis will be done to trace social determinants and their interaction with metabolic risk factors. Findings will be illustrated in causal loop diagrams with social determinants of risk factors along with their interaction (feedback mechanism). The review will describe the interplay of social determinants of common NCD metabolic risk factors in the form of causal loop diagram. Findings will be structured in two parts: the first part will explain the linkage between proximal determinants with the metabolic risk factors and the second part will describe the linkage among the risk factors, proximal determinants and distal determinants. Evidences across different regions will be discussed to compare and validate and/or contrast the findings. Possible

  2. Prevalence and risk factors of underweight, overweight and obesity among a geriatric population living in a high-altitude region of rural Uttarakhand, India.

    Science.gov (United States)

    Gupta, Aakriti; Kapil, Umesh; Khandelwal, Ritika; Khenduja, Preetika; Sareen, Neha; Pandey, Ravindra Mohan; Upadhyay, Ashish Datt

    2018-03-15

    To assess the prevalence and risk factors of underweight, overweight and obesity among a geriatric population living in a high-altitude region of India. Community-based cross-sectional study. Data were collected on sociodemographic profile and anthropometric parameters. Weight and height measurements were utilized for calculation of BMI. Nutrient intake data were collected using 24 h dietary recall. High-altitude region of Nainital District, Uttarakhand State, North India. Community-dwelling geriatric subjects (n 981) aged 60 years or above. We found that 26·6 % of the elderly subjects were underweight (BMI<18·5 kg/m2). Overweight (BMI 25·0-29·9 kg/m2) and obesity (BMI≥30·0 kg/m2) was seen among 18·0 % and 4·6 %, respectively. After controlling for potential cofounders, risk factors such as low level of education and income, chewing problems and lower number of daily meals were found to be associated with underweight. On the other hand, risk factors for overweight/obesity were lower age, high income and unskilled work. There is a need to develop and implement intervention strategies to prevent underweight, overweight and obesity among the geriatric population of India.

  3. Human papillomavirus detection in cervical neoplasia attributed to 12 high-risk human papillomavirus genotypes by region

    DEFF Research Database (Denmark)

    Castellsagué, Xavier; Ault, Kevin A; Bosch, F Xavier

    2016-01-01

    Background: We estimated the proportion of cervical intraepithelial neoplasia (CIN) cases attributed to 14 HPV types, including quadrivalent (qHPV) (6/11/16/18) and 9-valent (9vHPV) (6/11/16/18/31/33/45/52/58) vaccine types, by region. Methods: Women ages 15-26 and 24-45 years from 5 regions were...

  4. A climate-based prediction model in the high-risk clusters of the Mekong Delta region, Vietnam: towards improving dengue prevention and control.

    Science.gov (United States)

    Phung, Dung; Talukder, Mohammad Radwanur Rahman; Rutherford, Shannon; Chu, Cordia

    2016-10-01

    To develop a prediction score scheme useful for prevention practitioners and authorities to implement dengue preparedness and controls in the Mekong Delta region (MDR). We applied a spatial scan statistic to identify high-risk dengue clusters in the MDR and used generalised linear-distributed lag models to examine climate-dengue associations using dengue case records and meteorological data from 2003 to 2013. The significant predictors were collapsed into categorical scales, and the β-coefficients of predictors were converted to prediction scores. The score scheme was validated for predicting dengue outbreaks using ROC analysis. The north-eastern MDR was identified as the high-risk cluster. A 1 °C increase in temperature at lag 1-4 and 5-8 weeks increased the dengue risk 11% (95% CI, 9-13) and 7% (95% CI, 6-8), respectively. A 1% rise in humidity increased dengue risk 0.9% (95% CI, 0.2-1.4) at lag 1-4 and 0.8% (95% CI, 0.2-1.4) at lag 5-8 weeks. Similarly, a 1-mm increase in rainfall increased dengue risk 0.1% (95% CI, 0.05-0.16) at lag 1-4 and 0.11% (95% CI, 0.07-0.16) at lag 5-8 weeks. The predicted scores performed with high accuracy in diagnosing the dengue outbreaks (96.3%). This study demonstrates the potential usefulness of a dengue prediction score scheme derived from complex statistical models for high-risk dengue clusters. We recommend a further study to examine the possibility of incorporating such a score scheme into the dengue early warning system in similar climate settings. © 2016 John Wiley & Sons Ltd.

  5. Geographical Analysis for Detecting High-Risk Areas for Bovine/Human Rabies Transmitted by the Common Hematophagous Bat in the Amazon Region, Brazil.

    Directory of Open Access Journals (Sweden)

    Fernanda A G de Andrade

    Full Text Available The common hematophagous bat, Desmodus rotundus, is one of the main wild reservoirs of rabies virus in several regions in Latin America. New production practices and changed land use have provided environmental features that have been very favorable for D. rotundus bat populations, making this species the main transmitter of rabies in the cycle that involves humans and herbivores. In the Amazon region, these features include a mosaic of environmental, social, and economic components, which together creates areas with different levels of risk for human and bovine infections, as presented in this work in the eastern Brazilian Amazon.We geo-referenced a total of 175 cases of rabies, of which 88% occurred in bovines and 12% in humans, respectively, and related these cases to a number of different geographical and biological variables. The spatial distribution was analyzed using the Kernel function, while the association with independent variables was assessed using a multi-criterion Analytical Hierarchy Process (AHP technique.The spatiotemporal analysis of the occurrence of rabies in bovines and humans found reduction in the number of cases in the eastern state of Pará, where no more cases were recorded in humans, whereas high infection rates were recorded in bovines in the northeastern part of the state, and low rates in the southeast. The areas of highest risk for bovine rabies are found in the proximity of rivers and highways. In the case of human rabies, the highest concentration of high-risk areas was found where the highway network coincides with high densities of rural and indigenous populations.The high-risk areas for human and bovine rabies are patchily distributed, and related to extensive deforested areas, large herds of cattle, and the presence of highways. These findings provide an important database for the generation of epidemiological models that could support the development of effective prevention measures and controls.

  6. Territorial prevention of natural disasters. Campania Region: a high risk territory. Studies by PLINIVS Centre and open issues

    Directory of Open Access Journals (Sweden)

    Giulio Zuccaro

    2013-07-01

    Full Text Available The safety of the territory and the environment is a theme much discussed, but often not in organic and competent way. PLINIVS study centre has been studying for several years the impact of potentially disastrous events on the territory and has produced analysis models and scenery simulation of main natural risks regarding Campania territory (seismic, hydrogeological, volcanic, meteo-marine risks, etc.. Knowing the risk, and quantifying it, is important in order to single out critical aspects of the territory (threats and to intervene through mitigation measures and eventually a modern Plan of Civil Protection. Therefore the plan becomes a dynamic process able to control rhythmically the state of the risk and the safety level of the territory, and spatial planning should avail itself of the fundamental contribution of knowledge offered by these tools.

  7. Human papillomavirus detection in cervical neoplasia attributed to 12 high-risk human papillomavirus genotypes by region

    OpenAIRE

    Castellsagué, Xavier; Ault, Kevin A.; Bosch, F. Xavier; Brown, Darron; Cuzick, Jack; Ferris, Daron G.; Joura, Elmar A.; Garland, Suzanne M.; Giuliano, Anna R; Hernandez-Avila, Mauricio; Huh, Warner; Iversen, Ole-Erik; Kjaer, Susanne K.; Luna, Joaquin; Monsonego, Joseph

    2016-01-01

    Background: We estimated the proportion of cervical intraepithelial neoplasia (CIN) cases attributed to 14 HPV types, including quadrivalent (qHPV) (6/11/16/18) and 9-valent (9vHPV) (6/11/16/18/31/33/45/52/58) vaccine types, by region Methods: Women ages 15–26 and 24–45 years from 5 regions were enrolled in qHPV vaccine clinical trials. Among 10,706 women (placebo arms), 1539 CIN1, 945 CIN2/3, and 24 adenocarcinoma in situ (AIS) cases were diagnosed by pathology panel consensus. Results: Pred...

  8. Human papillomavirus detection in cervical neoplasia attributed to 12 high-risk human papillomavirus genotypes by region.

    Science.gov (United States)

    Castellsagué, Xavier; Ault, Kevin A; Bosch, F Xavier; Brown, Darron; Cuzick, Jack; Ferris, Daron G; Joura, Elmar A; Garland, Suzanne M; Giuliano, Anna R; Hernandez-Avila, Mauricio; Huh, Warner; Iversen, Ole-Erik; Kjaer, Susanne K; Luna, Joaquin; Monsonego, Joseph; Muñoz, Nubia; Myers, Evan; Paavonen, Jorma; Pitisuttihum, Punnee; Steben, Marc; Wheeler, Cosette M; Perez, Gonzalo; Saah, Alfred; Luxembourg, Alain; Sings, Heather L; Velicer, Christine

    2016-12-01

    We estimated the proportion of cervical intraepithelial neoplasia (CIN) cases attributed to 14 HPV types, including quadrivalent (qHPV) (6/11/16/18) and 9-valent (9vHPV) (6/11/16/18/31/33/45/52/58) vaccine types, by region METHODS: Women ages 15-26 and 24-45 years from 5 regions were enrolled in qHPV vaccine clinical trials. Among 10,706 women (placebo arms), 1539 CIN1, 945 CIN2/3, and 24 adenocarcinoma in situ (AIS) cases were diagnosed by pathology panel consensus. Predominant HPV types were 16/51/52/56 (anogenital infection), 16/39/51/52/56 (CIN1), and 16/31/52/58 (CIN2/3). In regions with largest sample sizes, minimal regional variation was observed in 9vHPV type prevalence in CIN1 (~50%) and CIN2/3 (81-85%). Types 31/33/45/52/58 accounted for 25-30% of CIN1 in Latin America and Europe, but 14-18% in North America and Asia. Types 31/33/45/52/58 accounted for 33-38% of CIN2/3 in Latin America (younger women), Europe, and Asia, but 17-18% of CIN2/3 in Latin America (older women) and North America. Non-vaccine HPV types 35/39/51/56/59 had similar or higher prevalence than qHPV types in CIN1 and were attributed to 2-11% of CIN2/3. The 9vHPV vaccine could potentially prevent the majority of CIN1-3, irrespective of geographic region. Notwithstanding, non-vaccine types 35/39/51/56/59 may still be responsible for some CIN1, and to a lesser extent CIN2/3. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  9. Cost-effectiveness analysis of cervical cancer prevention based on a rapid human papillomavirus screening test in a high-risk region of China.

    Science.gov (United States)

    Levin, Carol E; Sellors, John; Shi, Ju-Fang; Ma, Li; Qiao, You-lin; Ortendahl, Jesse; O'Shea, Meredith K H; Goldie, Sue J

    2010-09-01

    This study assessed the cost-effectiveness of a new, rapid human papillomavirus (HPV)-DNA screening test for cervical cancer prevention in the high-risk region of Shanxi, China. Using micro-costing methods, we estimated the resources needed to implement preventive strategies using cervical cytology or HPV-DNA testing, including the Hybrid Capture 2 (hc2) test (QIAGEN Corp., Gaithersburg, MD) and the rapid HPV-DNA careHPV test (QIAGEN). Data were used in a previously published model and empirically calibrated to country-specific epidemiological data. Strategies differed by initial test, targeted age, frequency of screening, number of clinic visits required (1, 2 or 3) and service delivery setting (national, county and township levels). Outcomes included lifetime risk of cancer, years of life saved (YLS), lifetime costs and incremental cost-effectiveness ratios (cost per YLS). For all screening frequencies, the most efficient strategy used 2-visit rapid HPV-DNA testing at the county level, including screening and diagnostics in the first visit, and treatment in the second visit. Screening at ages 35, 40 and 45 reduced cancer risk by 50% among women compliant with all 3 screening rounds, and was US$ 150 per YLS, compared with this same strategy applied twice per lifetime. This would be considered very cost-effective evaluated against China's per-capita gross domestic product (US$ 1,702). By enhancing the linkage between screening and treatment through a reduced number of visits, rapid HPV-DNA testing 3 times per lifetime is more effective than traditional cytology, and is likely to be cost-effective in high-risk regions of China.

  10. Risk assessment: A regional approach

    Energy Technology Data Exchange (ETDEWEB)

    Palecek, M [Occupational Safety Research Institute, Prague (Czech Republic)

    1992-07-01

    An assessment of the region of North Bohemia which suffered from forty years socialist economy and heavy emissions from German and Polish factories and power stations is presented. The case strongly underlines the need for regional and international cooperation both in the assessment of hazards and finding solution to public health and environmental problems.

  11. Risk assessment: A regional approach

    International Nuclear Information System (INIS)

    Palecek, M.

    1992-01-01

    An assessment of the region of North Bohemia which suffered from forty years socialist economy and heavy emissions from German and Polish factories and power stations is presented. The case strongly underlines the need for regional and international cooperation both in the assessment of hazards and finding solution to public health and environmental problems

  12. High-resolution sampling and analysis of ambient particulate matter in the Pearl River Delta region of southern China: source apportionment and health risk implications

    Science.gov (United States)

    Zhou, Shengzhen; Davy, Perry K.; Huang, Minjuan; Duan, Jingbo; Wang, Xuemei; Fan, Qi; Chang, Ming; Liu, Yiming; Chen, Weihua; Xie, Shanju; Ancelet, Travis; Trompetter, William J.

    2018-02-01

    Hazardous air pollutants, such as trace elements in particulate matter (PM), are known or highly suspected to cause detrimental effects on human health. To understand the sources and associated risks of PM to human health, hourly time-integrated major trace elements in size-segregated coarse (PM2.5-10) and fine (PM2.5) particulate matter were collected at the industrial city of Foshan in the Pearl River Delta region, China. Receptor modeling of the data set by positive matrix factorization (PMF) was used to identify six sources contributing to PM2.5 and PM10 concentrations at the site. Dominant sources included industrial coal combustion, secondary inorganic aerosol, motor vehicles and construction dust along with two intermittent sources (biomass combustion and marine aerosol). The biomass combustion source was found to be a significant contributor to peak PM2.5 episodes along with motor vehicles and industrial coal combustion. Conditional probability function (CPF) analysis was applied to estimate the source locations using the PMF-resolved source contribution coupled with the surface wind direction data. Health exposure risk of hazardous trace elements (Pb, As, Si, Cr, Mn and Ni) and source-specific values were estimated. The total hazard quotient (HQ) of PM2.5 was 2.09, higher than the acceptable limit (HQ = 1). The total carcinogenic risk (CR) was 3.37 × 10-3 for PM2.5, which was 3 times higher than the least stringent limit (1.0 × 10-4). Among the selected trace elements, As and Pb posed the highest non-carcinogenic and carcinogenic risks to human health, respectively. In addition, our results show that the industrial coal combustion source is the dominant non-carcinogenic and carcinogenic risk contributor, highlighting the need for stringent control of this source. This study provides new insight for policy makers to prioritize sources in air quality management and health risk reduction.

  13. Tiny Turtles Purchased at Pet Stores are a Potential High Risk for Salmonella Human Infection in the Valencian Region, Eastern Spain.

    Science.gov (United States)

    Marin, Clara; Vega, Santiago; Marco-Jiménez, Francisco

    2016-07-01

    Turtles may be considered unsafe pets, particularly in households with children. This study aimed to assess Salmonella carriage by turtles in pet stores and in private ownership to inform the public of the potential health risk, enabling informed choices around pet selection. During the period between September and October 2013, 24 pet stores and 96 private owners were sampled in the Valencian Region (Eastern Spain). Salmonella identification procedure was based on ISO 6579: 2002 recommendations (Annex D). Salmonella strains were serotyped in accordance with Kauffman-White-Le-Minor technique. The rate of isolation of Salmonella was very high from pet store samples (75.0% ± 8.8%) and moderate for private owners (29.0% ± 4.6%). Serotyping revealed 18 different serotypes among two Salmonella enterica subspecies: S. enterica subsp. enterica and S. enterica subsp. diarizonae. Most frequently isolated serotypes were Salmonella Typhimurium (39.5%, 17/43) and Salmonella Pomona (9.3%, 4/43). Serotypes identified have previously been reported in turtles, and child Salmonella infections associate with pet turtle exposure. The present study clearly demonstrates that turtles in pet stores, as well as in private owners, could be a direct or indirect source of a high risk of human Salmonella infections. In addition, pet stores should advise their customers of the potential risks associated with reptile ownership.

  14. Regional scale ecological risk assessment: using the relative risk model

    National Research Council Canada - National Science Library

    Landis, Wayne G

    2005-01-01

    ...) in the performance of regional-scale ecological risk assessments. The initial chapters present the methodology and the critical nature of the interaction between risk assessors and decision makers...

  15. A canine purgation study and risk factor analysis for echinococcosis in a high endemic region of the Tibetan plateau.

    NARCIS (Netherlands)

    Budke, C.M.; Campos Ponce, M.; Qian, B.F.; Torgerson, P.R.

    2005-01-01

    The Tibetan plateau of western China has been shown to have a very high prevalence of human cystic echinococcosis (CE) caused by Echinococcus granulosus and human alveolar echinococcosis (AE) caused by Echinococcus multilocularis. The domestic dog is suspected to be the primary definitive host for

  16. [Detecting high risk pregnancy].

    Science.gov (United States)

    Doret, Muriel; Gaucherand, Pascal

    2009-12-20

    Antenatal care is aiming to reduce maternal land foetal mortality and morbidity. Maternal and foetal mortality can be due to different causes. Their knowledge allows identifying pregnancy (high risk pregnancy) with factors associated with an increased risk for maternal and/or foetal mortality and serious morbidity. Identification of high risk pregnancies and initiation of appropriate treatment and/or surveillance should improve maternal and/or foetal outcome. New risk factors are continuously described thanks to improvement in antenatal care and development in biology and cytopathology, increasing complexity in identifying high risk pregnancies. Level of risk can change all over the pregnancy. Ideally, it should be evaluated prior to the pregnancy and at each antenatal visit. Clinical examination is able to screen for intra-uterin growth restriction, pre-eclampsia, threatened for preterm labour; ultrasounds help in the diagnosis of foetal morphological anomalies, foetal chromosomal anomalies, placenta praevia and abnormal foetal growth; biological exams are used to screen for pre-eclampsia, gestational diabetes, trisomy 21 (for which screening method just changed), rhesus immunisation, seroconversion for toxoplasmosis or rubeola, unknown infectious disease (syphilis, hepatitis B, VIH). During pregnancy, most of the preventive strategies have to be initiated during the first trimester or even before conception. Prevention for neural-tube defects, neonatal hypocalcemia and listeriosis should be performed for all women. On the opposite, some measures are concerning only women with risk factors such as prevention for toxoplasmosis, rhesus immunization (which recently changed), tobacco complications and pre-eclampsia and intra-uterine growth factor restriction.

  17. Deficient Suppression of Default Mode Regions during Working Memory in Individuals with Early Psychosis and at Clinical High-Risk for Psychosis.

    Science.gov (United States)

    Fryer, Susanna L; Woods, Scott W; Kiehl, Kent A; Calhoun, Vince D; Pearlson, Godfrey D; Roach, Brian J; Ford, Judith M; Srihari, Vinod H; McGlashan, Thomas H; Mathalon, Daniel H

    2013-01-01

    The default mode network (DMN) is a set of brain regions typically activated at rest and suppressed during extrinsic cognition. Schizophrenia has been associated with deficient DMN suppression, though the extent to which DMN dysfunction predates psychosis onset is unclear. This study examined DMN suppression during working memory (WM) performance in youth at clinical high-risk (CHR) for psychosis, early schizophrenia (ESZ) patients, and healthy controls (HC). We hypothesized that the DMN would show load-dependent suppression during WM retrieval in HC but not in ESZ, with CHR participants showing an intermediate pattern. fMRI data were collected from CHR (n = 32), ESZ (n = 22), and HC (n = 54) participants, ages 12-30. DMN regions were defined via seed-based connectivity analysis of resting-state fMRI data from an independent HC sample. Load-dependent deactivations of these DMN regions in response to WM probes were interrogated. Healthy controls showed linear load-dependent increases in DMN deactivation. Significant Group-by-Load interactions were observed in DMN regions including medial prefrontal and lateral posterior parietal cortices. Group-by-Load effects in posterior DMN nodes resulted from less suppression at higher WM loads in ESZ relative to HC, with CHR differing from neither group. In medial prefrontal cortex, suppression of activity at higher WM loads was significantly diminished in both CHR and ESZ groups, relative to HC. In addition, investigation of dorsolateral prefrontal cortex (DLPFC) activations revealed that ESZ activated right DLPFC significantly more than HC, with CHR differing from neither group. While HC showed WM load-dependent modulation of DMN suppression, CHR individuals had deficient higher-load DMN suppression that was similar to, but less pronounced than, the distributed suppression deficits evident in ESZ patients. These results suggest that DMN dysregulation associated with schizophrenia predates psychosis onset.

  18. High-resolution sampling and analysis of air particulate matter in the Pear River Delta region of Southern China: source apportionment and health risk assessment

    Science.gov (United States)

    Zhou, S.; Day, P. K.; Wang, X.

    2017-12-01

    Hazardous air pollutants, such as trace elements in particulate matters (PM), are known or highly suspected to cause detrimental effects on human health. To understand the sources and associated risks of PM to human health, hourly time-integrated major trace elements in size-segregated coarse (PM10-2.5) and fine (PM2.5) particulate matter were collected and examined in an industrial city of Foshan in the Pearl River Delta region, China. Receptor modeling of the dataset by positive matrix factorization (PMF) was used to identify six sources contributing to PM2.5 and PM10 concentrations at the site. Dominant sources included industrial coal combustion, secondary inorganic aerosol, motor vehicles and construction dust along with two intermittent sources, biomass combustion and marine aerosol. The biomass combustion source was found to be a significant contributor to peak PM2.5 episodes along with motor vehicles and industrial coal combustion. Conditional probability function (CPF) was applied to estimate the local source effects from wind direction using the PMF-resolved source contribution coupled with the surface wind direction data. Health exposure risk for hazardous trace elements (Pb, As, Cr, Ni, Zn, V, Cu, Mn, Fe) and source-specific values were estimated. The total hazard quotient (total HQ =HI) of PM2.5 was 2.09, which is two times higher than the acceptable limit (HQ = 1). The total carcinogenic risk was 3.37*10-3 for PM2.5, which was three orders higher than the acceptable limit (i.e. 1.0*10-6). Among the selected trace elements, As and Pb posed the highest non-carcinogenic and carcinogenic risks for human health, respectively. In additional, our results showed that industrial coal combustion source was the dominant non-carcinogenic and carcinogenic risks contributor, highlighting the need for stringent control of this source. This study can provide new insight for policy makers to prioritize sources in air quality management and health risk reduction.

  19. High-resolution sampling and analysis of ambient particulate matter in the Pearl River Delta region of southern China: source apportionment and health risk implications

    Directory of Open Access Journals (Sweden)

    S. Zhou

    2018-02-01

    Full Text Available Hazardous air pollutants, such as trace elements in particulate matter (PM, are known or highly suspected to cause detrimental effects on human health. To understand the sources and associated risks of PM to human health, hourly time-integrated major trace elements in size-segregated coarse (PM2.5–10 and fine (PM2.5 particulate matter were collected at the industrial city of Foshan in the Pearl River Delta region, China. Receptor modeling of the data set by positive matrix factorization (PMF was used to identify six sources contributing to PM2.5 and PM10 concentrations at the site. Dominant sources included industrial coal combustion, secondary inorganic aerosol, motor vehicles and construction dust along with two intermittent sources (biomass combustion and marine aerosol. The biomass combustion source was found to be a significant contributor to peak PM2.5 episodes along with motor vehicles and industrial coal combustion. Conditional probability function (CPF analysis was applied to estimate the source locations using the PMF-resolved source contribution coupled with the surface wind direction data. Health exposure risk of hazardous trace elements (Pb, As, Si, Cr, Mn and Ni and source-specific values were estimated. The total hazard quotient (HQ of PM2.5 was 2.09, higher than the acceptable limit (HQ = 1. The total carcinogenic risk (CR was 3.37 × 10−3 for PM2.5, which was 3 times higher than the least stringent limit (1.0 × 10−4. Among the selected trace elements, As and Pb posed the highest non-carcinogenic and carcinogenic risks to human health, respectively. In addition, our results show that the industrial coal combustion source is the dominant non-carcinogenic and carcinogenic risk contributor, highlighting the need for stringent control of this source. This study provides new insight for policy makers to prioritize sources in air quality management and health risk reduction.

  20. CYP1A1 gene polymorphisms increase lung cancer risk in a high-incidence region of Spain: a case control study

    Directory of Open Access Journals (Sweden)

    San Jose Carmen

    2010-08-01

    Full Text Available Abstract Background A rural region in south-west Spain has one of the highest lung cancer incidence rates of the country, as revealed by a previous epidemiological 10-year follow-up study. The present work was undertaken to ascertain the role of CYP1A1 gene polymorphisms and their interaction with tobacco smoking in the development of the disease in this location. Methods One-hundred-and-three cases of lung cancer and 265 controls participated in the study. The participants were screened for the presence of four CYP1A1 polymorphisms, namely MspI, Ile462Val, T3205C, and Thr461Asn. Lung cancer risk was estimated as odds ratios (OR and 95% confidence intervals (CI using unconditional logistic regression models adjusting for age, sex, and smoking. Results The distribution of the variant CYP1A1 alleles was different from that described for other Caucasian populations, with CYP1A1*2A showing an uncommonly high frequency (p CYP1A1*2B allele (carrying MspI and Ile462Val mutations was strongly associated with high lung cancer risk (OR = 4.59, CI:1.4-12.6, p p p = 0.04. Moreover, the Thr461Asn polymorphism was found to be associated with SCLC in a Caucasian population for the first time to our knowledge (OR = 8.33, CI: 1.3-15.2, p = 0.04. Conclusion The results suggest that CYP1A1 polymorphisms contribute to increase lung cancer susceptibility in an area with an uncommon high incidence rate.

  1. Use of support services in a sample of patients with high-risk primary melanomas in urban, regional and rural Queensland.

    Science.gov (United States)

    von Schuckmann, Lena A; Smithers, Bernhard M; Khosrotehrani, Kiarash; Beesley, Vanessa L; van der Pols, Jolieke C; Hughes, Maria B; Green, Adele C

    2017-06-01

    To characterise use of support services in patients diagnosed with high-risk primary melanoma by their location of residence. In a cross-sectional study of 787 patients with histologically-confirmed clinical stage 1B-2 melanoma, we estimated odds ratios (ORs) using regression models to assess the association of support service use with residence in rural, regional or urban areas. We also evaluated demographic and clinical correlates of support service use. Among 113 rural patients, 33 (29%) used support services around time of diagnosis compared to 88 (39%) of 224 regional participants and 164 of 448 (37%) urban participants. Regional participants more commonly used support services compared to rural participants (OR 1.84; CI 1.09-3.10), but there was no association with urban versus rural residence (OR 1.32; CI 0.82-2.13). As well, females (OR 1.58; CI 1.15-2.18), those <65 years (OR 1.96; CI 1.42-2.71), or with higher education (OR 2.30; CI 1.53-3.44), or those with T-stage 4B (OR 2.69; CI 1.36-5.32) were more likely to use support services than other patients. Use of support services is lower among rural patients and other sub-groups of primary melanoma patients who have poorer prognoses than others. Implications for public health: Appropriate triage to support services is required for rural and other vulnerable patient groups to ensure optimal patient care. © 2017 The Authors.

  2. Hazard-to-Risk: High-Performance Computing Simulations of Large Earthquake Ground Motions and Building Damage in the Near-Fault Region

    Science.gov (United States)

    Miah, M.; Rodgers, A. J.; McCallen, D.; Petersson, N. A.; Pitarka, A.

    2017-12-01

    We are running high-performance computing (HPC) simulations of ground motions for large (magnitude, M=6.5-7.0) earthquakes in the near-fault region (steel moment frame buildings throughout the near-fault domain. For ground motions, we are using SW4, a fourth order summation-by-parts finite difference time-domain code running on 10,000-100,000's of cores. Earthquake ruptures are generated using the Graves and Pitarka (2017) method. We validated ground motion intensity measurements against Ground Motion Prediction Equations. We considered two events (M=6.5 and 7.0) for vertical strike-slip ruptures with three-dimensional (3D) basin structures, including stochastic heterogeneity. We have also considered M7.0 scenarios for a Hayward Fault rupture scenario which effects the San Francisco Bay Area and northern California using both 1D and 3D earth structure. Dynamic, inelastic response of canonical buildings is computed with the NEVADA, a nonlinear, finite-deformation finite element code. Canonical buildings include 3-, 9-, 20- and 40-story steel moment frame buildings. Damage potential is tracked by the peak inter-story drift (PID) ratio, which measures the maximum displacement between adjacent floors of the building and is strongly correlated with damage. PID ratios greater 1.0 generally indicate non-linear response and permanent deformation of the structure. We also track roof displacement to identify permanent deformation. PID (damage) for a given earthquake scenario (M, slip distribution, hypocenter) is spatially mapped throughout the SW4 domain with 1-2 km resolution. Results show that in the near fault region building damage is correlated with peak ground velocity (PGV), while farther away (> 20 km) it is better correlated with peak ground acceleration (PGA). We also show how simulated ground motions have peaks in the response spectra that shift to longer periods for larger magnitude events and for locations of forward directivity, as has been reported by

  3. A methodology for modeling regional terrorism risk.

    Science.gov (United States)

    Chatterjee, Samrat; Abkowitz, Mark D

    2011-07-01

    Over the past decade, terrorism risk has become a prominent consideration in protecting the well-being of individuals and organizations. More recently, there has been interest in not only quantifying terrorism risk, but also placing it in the context of an all-hazards environment in which consideration is given to accidents and natural hazards, as well as intentional acts. This article discusses the development of a regional terrorism risk assessment model designed for this purpose. The approach taken is to model terrorism risk as a dependent variable, expressed in expected annual monetary terms, as a function of attributes of population concentration and critical infrastructure. This allows for an assessment of regional terrorism risk in and of itself, as well as in relation to man-made accident and natural hazard risks, so that mitigation resources can be allocated in an effective manner. The adopted methodology incorporates elements of two terrorism risk modeling approaches (event-based models and risk indicators), producing results that can be utilized at various jurisdictional levels. The validity, strengths, and limitations of the model are discussed in the context of a case study application within the United States. © 2011 Society for Risk Analysis.

  4. [Clinical features, care pathways and behaviors of patients with high level of cardiovascular risk: transversal study in south-west region of France].

    Science.gov (United States)

    Gay, Bernard; Couffinhal, Thierry; Saillour-Glénisson, Florence; Sevin, Floriane; Kret, Marion; Michel, Philippe

    2013-11-01

    To screen and to follow-up the patients with high cardiovascular risk in general practice may amplify the decrease of the cardiovascular morbi-mortality observed since a few years. The objective of this study is to identify the patients with high cardiovascular risk and to describe the management of these patients by general practitioners in Aquitaine. Transversal study of a sample of patients from 18 to 70 years old with high cardiovascular risk (combining at least 3 factors), included by voluntary general practitioners (GP). Forty-seven GP included 102 patients, presenting on average 3.7 risk factors among which 2.6 modifiable. The target values were reached for 59 % of patients with high blood pressure, 56 % of patients with diabetes and 53 % of patients with high cholesterol level. The analysis of care pathways identified the cardiologist as the privileged interlocutor. The doctors thought that seven patients out of 10 could change their risk behaviors. For the patients, the scale of declared importance to change was 6.6 on 10 for tobacco, 6.0 for food habits and 6.2 for physical activity. The confidence in their capacity to change was 3.8 on 10 for the tobacco, 5.2 for the food habits and 4.7 for the physical activity. Although doctors' sample is not representative, these results give an original overview of the management of patients with high cardiovascular risk and their care pathways. Medical treatments were globally in accordance with guidelines. The difficulty to change risk behaviors illustrates the necessity of patient therapeutic education. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  5. Assessment of genetic mutations in the XRCC2 coding region by high resolution melting curve analysis and the risk of differentiated thyroid carcinoma in Iran

    Directory of Open Access Journals (Sweden)

    Shima Fayaz

    2012-01-01

    Full Text Available Homologous recombination (HR is the major pathway for repairing double strand breaks (DSBs in eukaryotes and XRCC2 is an essential component of the HR repair machinery. To evaluate the potential role of mutations in gene repair by HR in individuals susceptible to differentiated thyroid carcinoma (DTC we used high resolution melting (HRM analysis, a recently introduced method for detecting mutations, to examine the entire XRCC2 coding region in an Iranian population. HRM analysis was used to screen for mutations in three XRCC2 coding regions in 50 patients and 50 controls. There was no variation in the HRM curves obtained from the analysis of exons 1 and 2 in the case and control groups. In exon 3, an Arg188His polymorphism (rs3218536 was detected as a new melting curve group (OR: 1.46; 95%CI: 0.432-4.969; p = 0.38 compared with the normal melting curve. We also found a new Ser150Arg polymorphism in exon 3 of the control group. These findings suggest that genetic variations in the XRCC2 coding region have no potential effects on susceptibility to DTC. However, further studies with larger populations are required to confirm this conclusion.

  6. Non-detection of Epstein-Barr virus and human papillomavirus in a region of high gastric cancer risk indicates a lack of a role for these viruses in gastric carcinomas

    Directory of Open Access Journals (Sweden)

    Xiao-yan Yuan

    2013-01-01

    Full Text Available Gastric mucosa tissue was collected from patients with gastroduodenal diseases in a region of norrteastern China showing a high risk of gastric cancer incidence. The presence of EBV and HPV were assayed to investigate the relationship between gastric carcinomas and virus infection. Neither EBV nor HPV DNA was detected in tissue from the patients. The role of EBV and HPV in gastric cancer is not well understood and still needs to be clarified.

  7. Estimation of extreme risk regions under multivariate regular variation

    NARCIS (Netherlands)

    Cai, J.; Einmahl, J.H.J.; de Haan, L.F.M.

    2011-01-01

    When considering d possibly dependent random variables, one is often interested in extreme risk regions, with very small probability p. We consider risk regions of the form {z ∈ Rd : f (z) ≤ β}, where f is the joint density and β a small number. Estimation of such an extreme risk region is difficult

  8. [Regional atmospheric environment risk source identification and assessment].

    Science.gov (United States)

    Zhang, Xiao-Chun; Chen, Wei-Ping; Ma, Chun; Zhan, Shui-Fen; Jiao, Wen-Tao

    2012-12-01

    Identification and assessment for atmospheric environment risk source plays an important role in regional atmospheric risk assessment and regional atmospheric pollution prevention and control. The likelihood exposure and consequence assessment method (LEC method) and the Delphi method were employed to build a fast and effective method for identification and assessment of regional atmospheric environment risk sources. This method was applied to the case study of a large coal transportation port in North China. The assessment results showed that the risk characteristics and the harm degree of regional atmospheric environment risk source were in line with the actual situation. Fast and effective identification and assessment of risk source has laid an important foundation for the regional atmospheric environmental risk assessment and regional atmospheric pollution prevention and control.

  9. New information on high risk breast screening

    International Nuclear Information System (INIS)

    Riedl, C.C.; Ponhold, L.; Gruber, R.; Pinker, K.; Helbich, T.H.

    2010-01-01

    Women with an elevated risk for breast cancer require intensified screening beginning at an early age. Such high risk screening differs considerably from screening in the general population. After an expert has evaluated the exact risk a breast MRI examination should be offered at least once a year and beginning latest at the age of 30 depending on the patients risk category. Complementary mammograms should not be performed before the age of 35. An additional ultrasound examination is no longer recommended. To ensure a high sensitivity and specificity high risk screening should be performed only at a nationally or regionally approved and audited service. Adequate knowledge about the phenotypical characteristics of familial breast cancer is essential. Besides the common malignant phenotypes, benign morphologies (round or oval shape and smooth margins) as well as a low prevalence of calcifications have been described. Using MRI benign contrast media kinetics as well as non-solid lesions with focal, regional and segmental enhancement can often be visualized. (orig.) [de

  10. An Overview. High Risk Series.

    Science.gov (United States)

    General Accounting Office, Washington, DC.

    This report provides an overview of efforts undertaken by the U.S. General Accounting Office (GAO) in 1990 to review and report on federal program areas its work identified as high risk because of vulnerabilities to waste, fraud, abuse, and mismanagement. It reviews the current status of efforts to address these concerns. The six categories of…

  11. [Incentive for Regional Risk Selection in the German Risk Structure Compensation Scheme].

    Science.gov (United States)

    Wende, Danny

    2017-10-01

    The introduction of the new law GKV-FQWG strengthens the competition between statutory health insurance. If incentives for risk selection exist, they may force a battle for cheap customers. This study aims to document and discuss incentives for regional risk selection in the German risk structure compensation scheme. Identify regional autocorrelation with Moran's l on financial parameters of the risk structure compensation schema. Incentives for regional risk selection do indeed exist. The risk structure compensation schema reduces 91% of the effect and helps to reduce risk selection. Nevertheless, a connection between regional situation and competition could be shown (correlation: 69.5%). Only the integration of regional control variables into the risk compensation eliminates regional autocorrelation. The actual risk structure compensation is leading to regional inequalities and as a consequence to risk selection and distortion in competition. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Karst risk assessment for engineering in Nizhny Novgorod region, Russia

    Directory of Open Access Journals (Sweden)

    Tolmachev Vladimir

    2013-01-01

    Full Text Available Federal Standards of the Russian include the requirement of mandatory assessment of the risks induced by natural processes in order to make sure their values do not exceed acceptable limits. To meet the requirement a number of karst risk assessment methods have been developed for the regions of the country where the most significant hazard is presented by karst sinkholes. For this particular application karst risk is understood as specific probability of sinkhole development on a unit area per a unit time span with account of probable economic, social and environmental components of damage. The probability of sinkhole development is evaluated by specialists in engineering karstology and designers. They make use of the acceptable data on the environmental conditions and apply stochastic laws of sinkhole development in time and space, alongside with focusing on all other relevant specificity of the building or facility to be built. Acceptable limits of karst risks should be specified by a multidisciplinary team including designers, lawyers, economists, insurers, environmentalists, engineering karstologists and other specialists on the basis of their expert knowledge. It has been demonstrated that a ratio between predicted and acceptable karst risk values can serve a practically meaningful karst risk level indicator for the purposes of building on karst. This ratio can be used with a rather high degree of objectiveness to develop a programme of antikarst activities during both facilities construction and operation.

  13. Comparative evaluation of risks at regional level

    International Nuclear Information System (INIS)

    Aigueperse, J.; Anguenot, F.; Hardy, S.

    1990-01-01

    In this paper we give the risks for the population of the South-East part of France. The risks are given, in case of chronic intake for energy production (coal and uranium mines, oil refineries, electricity production), for natural and medical irradiation (X-ray radiography-radiotherapy) and for domestic risks (use of chemical products). In case of accidents, the risks are studied in the optic of territorial gestion: transport of dangerous products (natural gas-fuel-chemical products) fires or explosions in chemical manufactories, water pollution by manufactories and agricultural uses [fr

  14. A modified SINTACS method for groundwater vulnerability and pollution risk assessment in highly anthropized regions based on NO3- and SO42- concentrations.

    Science.gov (United States)

    Busico, Gianluigi; Kazakis, Nerantzis; Colombani, Nicolò; Mastrocicco, Micòl; Voudouris, Konstantinos; Tedesco, Dario

    2017-12-31

    Groundwater vulnerability and risk assessment are worldwide tools in supporting groundwater protection and land planning. In this study, we used three of these different methodologies applied to the Campanian Plain located in southern Italy: SINTACS, AVI and LOS. However, their capability to describe the observed chemical pollution of the area has resulted quite poor. For such a reason, a modified SINTACS method has been then implemented in the area in order to get a more reliable view of groundwater vulnerability. NO 3 - and SO 4 2- from more than 400 monitoring wells were used for specific vulnerability assessment. Land use was chosen as key parameter to infer the risk of groundwater pollution in our area. The new methodology seems to show a higher correlation with observed NO 3 - concentrations and a more reliable identification of aquifer's pollution hot spots. The main sources of NO 3 - were found in sub-urban areas, where vulnerability and risk are higher than in other areas. Otherwise due to reducing conditions triggered by the presence of elevated sedimentary organic matter and peat, concentrations below agricultural areas were lower than in sub-urban areas. The SO 4 2- specific vulnerability map showed a positive correlation with observed concentrations, due to geogenic and anthropogenic SO 4 2- sources present in the area. The combination of both NO 3 - and SO 4 2- derived risk maps becomes essential to improve the conceptual model of aquifer pollution in this severely anthropized area. The application of this new and original approach shed light on the strengths and weaknesses of each of the described previous methods and clearly showed how anthropogenic activities have to be taken into account in the assessment process. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. A Comparison of the Diabetes Risk Score in HIV/AIDS Patients on Highly Active Antiretroviral Therapy (HAART and HAART-Naïve Patients at the Limbe Regional Hospital, Cameroon.

    Directory of Open Access Journals (Sweden)

    Christian Akem Dimala

    Full Text Available Highly active antiretroviral therapy (HAART has been associated with dysglycaemia. However, there is scarce data on the risk of developing diabetes mellitus (DM in HIV/AIDS patients in Africa.Primarily to quantify and compare the risk of having diabetes mellitus in HIV/AIDS patients on HAART and HAART-naïve patients in Limbe, Cameroon; and secondarily to determine if there is an association between HAART and increased DM risk.A cross-sectional study was conducted at the Limbe Regional Hospital HIV treatment center between April and June 2013, involving 200 HIV/AIDS patients (100 on first-line HAART regimens for at least 12 months matched by age and gender to 100 HAART-naïve patients. The Diabetes Risk Score (DRS was calculated using a clinically validated model based on routinely recorded primary care parameters. A DRS ≥ 7% was considered as indicative of an increased risk of developing DM.The median DRS was significantly higher in patients on HAART (2.30% than in HAART-naïve patients (1.62%, p = 0.002. The prevalence of the increased DM risk (DRS ≥ 7% was significantly higher in patients on HAART, 31% (95% CI: 22.13-41.03 than in HAART-naïve patients, 17% (95% CI: 10.23-25.82, p = 0.020. HAART was significantly associated with an increased DM risk, the odds ratio of the HAART group compared to the HAART-naïve group was 2.19 (95% CI: 1.12-4.30, p = 0.020. However, no association was found after adjusting for BMI-defined overweight, hypertension, age, sex, family history of DM and smoking (Odds ratio = 1.22, 95% CI: 0.42-3.59, p = 0.708. Higher BMI and hypertension accounted for the increased risk of DM in patients on HAART. Also, more than 82% of the participants were receiving or had ever used Zidovudine based HAART regimens.HIV/AIDS patients on HAART could be at a greater risk of having DM than HAART-naïve patients as a result of the effect of HAART on risk factors of DM such as BMI and blood pressure.

  16. Correlation Assessment of Tax System Risk and Profitability in the Russian Regions

    Directory of Open Access Journals (Sweden)

    Marina Yuryevna Malkina

    2015-09-01

    Full Text Available The subject of the article is the risk, returnm and efficiency of the tax systems in the regions of the Russian Federation. Research methods: deflating GRP and tax revenues at regional level; calculating the standard deviations; G. Markowitz portfolio approach; W. Sharpe ratio calculating; correlation and regression analysis. Results obtained: 1 comparative risk profile of various taxes and their groups in the Russian Federation; 2 clustering the Russian regions in terms of risk and return of tax systems; 3 regression between the risk of regional tax systems, relative scale of regional economics and tax return based on panel data of the Russian regions in 2006-2012; 4 ranking of the RF regions on the effectiveness of their tax systems, estimated by W. Sharpe ratio. In the paper, the authors have concluded: 1 all taxes (tax group collected in the Russian regions demonstrate a positive statistical relationship between return and risk, but with different correlation; 2 the risk of regional tax system depends on the structure of tax revenues in given region, the risks of collected taxes and the covariance of different taxes revenues to each other, and joint effect of these factors is estimated by means of portfolio approach by G. Markowitz; 3 the correlation between return and risk of the tax systems of the subjects of Russian Federation considering the scale of regional economics accounts for 75 %; 4 the risk of the Russian tax system is significantly provided by 19 major high-risk regions with more than 65 share in the total state tax revenues; 5 the effectiveness of regional tax systems estimated by the Sharpe ratio depends on both the objective and subjective factors affecting the yield and volatility of tax revenues in a region. Obtained results can be used by researchers in further dynamic and comparative analysis of regional tax systems’ risk and return, as well as in identifying the reserves for increasing the regional tax policy

  17. Clinical high risk for psychosis

    DEFF Research Database (Denmark)

    van der Steen, Y; Gimpel-Drees, J; Lataster, T

    2017-01-01

    OBJECTIVE: The aim of this study was to assess associations between momentary stress and both affective and psychotic symptoms in everyday life of individuals at clinical high risk (CHR), compared to chronic psychotic patients and healthy controls, in search for evidence of early stress...... and 26 healthy controls. RESULTS: Multilevel models showed significantly larger associations between negative affect (NA) and activity-related stress for CHR patients than for psychotic patients (P = 0.008) and for CHR compared to controls (P

  18. Postoperative radiotherapy appeared to improve the disease free survival rate of patients with extrahepatic bile duct cancer at high risk of loco-regional recurrence

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Young; Kim, Jin Hee; Kim, Yong Hoon [Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of); Byun, Sang Jun [Dept. of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2016-12-15

    To investigate the outcomes of postoperative radiotherapy (RT), in patients with extrahepatic bile duct (EHBD) cancer by comparing the survival rate between patients undergoing surgery alone or surgery plus postoperative RT, and to identify the prognostic factors affecting survival. Between 2000 and 2013, 52 patients with EHBD cancer underwent surgical resection. Of these, 33 patients did not receive postoperative RT (group I), and 19 patients did (group II). R1 resection was significantly more frequent in group II. The median radiation dose was 5,040 cGy. The 3-year overall survival (OS) rate for group I and group II was 38% and 56%, respectively (p = 0.274). The 3-year disease free survival (DFS) rate for group I and group II was 20% and 31%, respectively (p = 0.049), and the 3-year loco-regional recurrence free survival (LRFS) rates were 19% and 58%, respectively (p = 0.002). Multivariate analyses showed that postoperative RT and lymphovascular invasion were independent prognostic factors for DFS and LRFS. Overall, 42 patients (80%) experienced treatment failure. Distant metastasis was the predominant pattern of failure in group II. Postoperative RT after surgical resection appeared to improve the loco-regional control and DFS rate. More effort is needed to reduce distant metastasis, the major pattern of failure, in patients who receive postoperative RT.

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

    Science.gov (United States)

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

    2017-11-01

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

  20. Regional risk associated with the transport of hazardous materials

    OpenAIRE

    Nardini, L.; Aparicio, L.; Bandoni, A.; Tonelli, S. M.

    2003-01-01

    An increasing concern over the level of risk associated with hazardous materials transportation has led international efforts to focus on risk assessment at regional level. Following this trend, the aim of this work is to review the latest procedures for analysing the regional risks resulting from hazardous materials transportation by means of road and rail. In particular, two methodologies are reviewed and discussed, a method recently developed at Swiss Federal Institute of Technology [1] an...

  1. Adopting the new World Health Organization diagnostic criteria for gestational diabetes: How the prevalence changes in a high-risk region in Australia.

    Science.gov (United States)

    Wong, Vincent W; Lin, Andrew; Russell, Hamish

    2017-07-01

    In this study, we assessed changes in prevalence of gestational diabetes mellitus (GDM) in a region with diverse cultural backgrounds in Australia under the new World Health Organization (WHO) diagnostic criteria, with reference to the woman's ethnicity, age and pre-pregnant body mass index (BMI). We recorded results of all 75-gram oral glucose tolerance tests (OGTTs) performed on pregnant women between February and December 2015 together with their demographic details, and determined the prevalence of GDM based on the old Australian Diabetes in Pregnancy Society (ADIPS) and the new WHO criteria respectively. Over that period, 2140 OGTTs were performed in 1725 pregnant women. The prevalence of GDM was 14.8% (255/1725 women) under old ADIPS criteria, but went up to 29.6% (510/1725) when using WHO criteria. An increase in prevalence was observed in all ethnic groups. Women from East/South-East Asia had the lowest increment (from 19.2 to 22.3%) while those from South Asia had the highest (from 22.0 to 44.4%). Prevalence of GDM was 45.9% amongst women with BMI>30kg/m 2 . For women from South Asia with BMI>30kg/m 2 , 70.0% would have GDM. Birth outcomes were similar between women who would have GDM under WHO but not the old ADIPS criteria (untreated), and those who were treated for GDM under old criteria. In parts of Australia, adoption of WHO diagnostic criteria could result in doubling of the prevalence of GDM, depending on the women's demographic characteristics. Women from South Asia or those with obesity should be targeted for pre-pregnant lifestyle intervention. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Integrated, regional approach to risk management of industrial systems

    International Nuclear Information System (INIS)

    Chakraborty, S.

    1992-01-01

    This paper focuses on the following four main issues: (1) necessity for an integrated, regional approach to risk management of industrial systems; (2) principles of risk management; (3) integrated approach and overall methodology; and (4) implementation of risk management strategies on a regional basis. The U.N. Interagency project on risk management for large industrial areas, which is a pioneer type of international initiative for an integrated approach to risk management, is discussed in this context. Another encouraging activity for further development of overall methodologies for risk management is the ongoing project on the risk and safety of technical systems at the Swiss Federal Institute of Technology in Aurich. The concept of integral risk management takes into account multidimensional factors including technical, economic, political, social, and ethical considerations to allow a well-balanced decision-making process

  3. Desertification risk in Kakheti Region, East Georgia.

    Science.gov (United States)

    Basialashvili, Tsisana; Matchavariani, Lia; Lagidze, Lamzira

    2015-01-01

    Desertification or land degradation in drylands is caused by various factors. The most important of these is climate change, a significant global ecological problem. Desertification, like erosion, as an environmental process of ecosystem degradation, is often caused by human activity. It is a common misconception that droughts cause desertification. Well-managed lands can recover from drought if the rains return. These practices help to control erosion and maintain productivity during periods when moisture is available. Traditionally, the most vulnerable territories considered under the threat of desertification in Georgia is Kakheti region (East Georgia), which has been selected as one of the priority investigation area. In Eastern Georgia, intervals of atmospheric precipitation do not coincide with the phases of water demand of plants. In recent decades as a result of more frequent droughts in Kakheti, the region has already lost hundreds, thousands of hectares of fertile land. Based on the contemporary climate warming projections, the temperature is expected to increase and precipitation to decrease. This will lead to an increase in evaporation and reduction of river flow. Under such conditions the danger of desertification is evident. To mitigate the negative effects of desertification, it is recommended to put forward set of adaptation activities through rehabilitation of water use systems, prevention of loss of water, reconstruction and expansion of irrigation canals, accumulation of unused autumn-winter river water and spring floods in reservoirs, developing an optimal scheme of distributing water resources among water users, device windbreaks and work on breeding of drought resistant varieties, preparation of water volume forecasts of rivers and their role in planning of water use; application of apply drip and sprinkler irrigation, using artificial precipitation following increase as a result of active influence on clouds. All these activities will provide

  4. Petroleum business of high risk

    International Nuclear Information System (INIS)

    Carta Petrolera

    2001-01-01

    The paper is about the economic risk and of the geologic risk that assist the industry of the petroleum; an analysis of these types of risk, possibilities of success and investments to carry out in the search of hydrocarbons are made

  5. Methodical Approaches to Risk Management in a Regional Commercial Bank

    Directory of Open Access Journals (Sweden)

    Elena Vladimirovna Altukhova

    2016-03-01

    Full Text Available The article presents the results of the research of the methodological and information infrastructure of the integrated risk management in a regional commercial bank. Within the study of the general development tendencies of the regional banking services market, the most significant risks for a regional bank are revealed. The analysis is carried out on the basis of the stress testing technique developed at the Plekhanov Russian University of Economics. It is based on a technique of dynamic economic and mathematical modeling with the application of information technologies. The created combination of the methodological and instrumental tools allows to carry out the dynamic scenario analysis of the activity of a commercial bank for the identification of potential risks and for the development of the strategy of financial management reducing the potential risks and leveling the consequences of their realization. The received tool allows during the computer test to watch the predicted dynamics of the condition of the key indicators of the activity of a regional commercial bank changing under the influence of the exogenous regulatory measures and instruments of bank management applied to decrease risk and at the same time to introduce adjustments in the perspective strategy of management. As the result of the analysis, the universal management model of the main bank risks in a regional commercial bank within three alternative scenarios is created. The software product allowing to develop and acquire the practical skills of the students in banking is developed. It also may help to develop the methodological support for the regulation of the organizational procedures of risk management in a regional commercial bank. The received software product may be used in a system of the improving the professional skills, and also for obtaining the expected data in a risk management system in a regional commercial bank.

  6. Animal Fascioliasis: Perspectives from high altitudinal regions.

    Science.gov (United States)

    Lyngdoh, Damanbha; Sharma, Sunil; Roy, Bishnupada; Tandon, Veena

    2016-12-15

    The parasitic flukes of the genus Fasciola (Platyhelminthes: Trematoda: Digenea) cause fascioliasis or liver-rot disease in ruminant livestock in tropical and sub-tropical regions of the world. Classically, two species of Fasciola- F. hepatica and F. gigantica, are universally recognized as taxonomically valid species. Our survey studies on ovid and bovid animals including yak and mithun from high altitudinal mountainous regions in Northeast India revealed the occurrence of Fasciola gigantica and also Fasciola sp.- an intermediate form, at altitudes between 5000 and 14,085 feet above sea level (asl). Two morphotypes- F. hepatica - like and F. gigantica - like, of Fasciola species were reported from the high altitudinal areas of Northeast India; most of these locales constitute new-locality and first records for the occurrence of these liver flukes. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Highlighting High Performance: Whitman Hanson Regional High School; Whitman, Massachusetts

    Energy Technology Data Exchange (ETDEWEB)

    2006-06-01

    This brochure describes the key high-performance building features of the Whitman-Hanson Regional High School. The brochure was paid for by the Massachusetts Technology Collaborative as part of their Green Schools Initiative. High-performance features described are daylighting and energy-efficient lighting, indoor air quality, solar and wind energy, building envelope, heating and cooling systems, water conservation, and acoustics. Energy cost savings are also discussed.

  8. Serological evaluation of Crimean-Congo hemorrhagic fever in humans with high-risk professions living in enzootic regions of Isfahan province of Iran and genetic analysis of circulating strains.

    Science.gov (United States)

    Chinikar, Sadegh; Ghiasi, Seyed M; Naddaf, Saeed; Piazak, Norair; Moradi, Maryam; Razavi, Mohammad R; Afzali, Neda; Haeri, Ali; Mostafavizadeh, Kamyar; Ataei, Behrouz; Khalilifard-Brojeni, Mohammad; Husseini, Sayed M; Bouloy, Michele

    2012-09-01

    Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic viral disease that is asymptomatic in infected livestock, but causes a serious threat to humans with a mortality rate up to 50%. Although the CCHF virus (CCHFV) is often transmitted by ticks, livestock-to-human and human-to-human transmission also occurs. In the current study, we focused on CCHF in the province of Isfahan, located in the center of Iran and deemed to be the second most infected province. Human and livestock sera and resident ticks in the livestock are collected from different regions of the province and analyzed with specific IgG ELISA and RT-PCR tests. Overall, 12% and 12.7% of studied human and livestock populations were IgG positive, respectively. The genome of CCHFV was detected in 9% of ticks resident in livestock involved in this survey. The CCHFV isolates from infected ticks were genetically examined. Nucleotide sequence of the S-segment revealed that the different isolates were closely related to each other, with nucleotide sequence identities higher than 98%. Phylogenetic analysis demonstrated that a variant isolate clustered with the Iraq strain. This high proportion of IgG-positive sera and nearly high proportion of infected ticks increases the risk of CCHF outbreaks in the province and probably posits a great danger to other provinces.

  9. Case Study of Cardiovascular Risk Reduction in the Northwest Region and TRICARE Region 11

    National Research Council Canada - National Science Library

    Murphy, Rosemary

    2003-01-01

    ... and TRICARE Lead Agent Region 11. The outcomes management team developed a cardiovascular risk reduction scorecard and metrics in which to evaluate the care being given to the TRICARE prime enrollees with a cardiovascular disease diagnosis...

  10. An economic assessment of population health risk in region

    Directory of Open Access Journals (Sweden)

    Nina Vladimirovna Zaytseva

    2012-06-01

    Full Text Available This paper proposes a method of economic assessment of population health risk as a tool of life qualitymanagement and qualityof labor resources in the region (as factors of a region’s economic security. The technique is based on the cost of reducing the period of disability in the implementation of population health risk and takes into account the effects of risk prevention on levels of the budgetary system of the Russian Federation. The method intends to support making decisions on planning measures to reduce population health risk at the level of regions, territories and separate objects to assess their cost-performance, optimization of investment and operating costs to reduce the population health risk and sustainable development of the territory

  11. Regional approaches in high-rise construction

    Science.gov (United States)

    Iconopisceva, O. G.; Proskurin, G. A.

    2018-03-01

    The evolutionary process of high-rise construction is in the article focus. The aim of the study was to create a retrospective matrix reflecting the tasks of the study such as: structuring the most iconic high-rise objects within historic boundaries. The study is based on contemporary experience of high-rise construction in different countries. The main directions and regional specifics in the field of high-rise construction as well as factors influencing the further evolution process are analyzed. The main changes in architectural stylistics, form-building, constructive solutions that focus on the principles of energy efficiency and bio positivity of "sustainable buildings", as well as the search for a new typology are noted. The most universal constructive methods and solutions that turned out to be particularly popular are generalized. The new typology of high-rises and individual approach to urban context are noted. The results of the study as a graphical scheme made it possible to represent the whole high-rise evolution. The new spatial forms of high-rises lead them to new role within the urban environments. Futuristic hyperscalable concepts take the autonomous urban space functions itself and demonstrate us how high-rises can replace multifunctional urban fabric, developing it inside their shells.

  12. Risk perception in women with high-risk pregnancies

    OpenAIRE

    Lee, S.

    2014-01-01

    Risk perception in women with high risk pregnancies affects the decisions they make about antenatal care and so may therefore influence the wellbeing of mother and baby. This article addresses the factors which influence women when making risk assessments and how these assessments may differ from those of healthcare professionals.\\ud \\ud Women use multiple sources of information to determine their risk status including advice from professionals, from other trusted sources, and their own intui...

  13. High-intensification regions of gravitational lenses

    International Nuclear Information System (INIS)

    Benson, J.R.; Cooke, J.H.

    1979-01-01

    We examine the intensification, I, near the singular points in the object plane of an extended spherical gravitational lens. Geometrical optics predicts an infinite I for a point object located on a singularity. The function I, however, turns out to be integrable over the object plane. We make a detailed physical optics calculation for I. No singularities appear, and there are some interesting, marginally detectable diffraction phenomena. The two types of bright regions, the ''halo'' and the ''spike,'' behave very differently. Simple order-of-magnitude expressions give estimates for the brightness and duration of a high-intensification event

  14. High resolution fire risk mapping in Italy

    Science.gov (United States)

    Fiorucci, Paolo; Biondi, Guido; Campo, Lorenzo; D'Andrea, Mirko

    2014-05-01

    The high topographic and vegetation heterogeneity makes Italy vulnerable to forest fires both in the summer and in winter. In particular, northern regions are predominantly characterized by a winter fire regime, mainly due to frequent extremely dry winds from the north, while southern and central regions and the large islands are characterized by a severe summer fire regime, because of the higher temperatures and prolonged lack of precipitation. The threat of wildfires in Italy is not confined to wooded areas as they extend to agricultural areas and urban-forest interface areas. The agricultural and rural areas, in the last century, have been gradually abandoned, especially in areas with complex topography. Many of these areas were subject to reforestation, leading to the spread of pioneer species mainly represented by Mediterranean conifer, which are highly vulnerable to fire. Because of the frequent spread of fire, these areas are limited to the early successional stages, consisting mainly of shrub vegetation; its survival in the competition with the climax species being ensured by the spread of fire itself. Due to the frequency of fire ignition — almost entirely man caused — the time between fires on the same area is at least an order of magnitude less than the time that would allow the establishment of forest climax species far less vulnerable to fire. In view of the limited availability of fire risk management resources, most of which are used in the management of national and regional air services, it is necessary to precisely identify the areas most vulnerable to fire risk. The few resources available can thus be used on a yearly basis to mitigate problems in the areas at highest risk by defining a program of forest management interventions, which is expected to make a significant contribution to the problem in a few years' time. The goal of such detailed planning is to dramatically reduce the costs associated with water bombers fleet management and fire

  15. List of High risk countries

    International Development Research Centre (IDRC) Digital Library (Canada)

    Francine Sinzinkayo

    2013-07-26

    Higher Risk Countries and Territories. Reviewed regularly. Last update: July 26, 2013. Country/Territory. Note (1). Sources of Concern. Canadian. Law or. Policy. Knowledge of research setting. Ability to monitor research activities. (Note 2). Operational. Issues. (Note 3). Banking. Restrictions. (Note 4). Afghanistan. X. X.

  16. Basic Practices Aiding High-Performance Homeland Security Regional Partnerships

    National Research Council Canada - National Science Library

    Caudle, Sharon

    2006-01-01

    ....1 A national priority under the Goal is the use of geographic regions across the nation to share risk, engage in joint planning, and share resources to develop and sustain risk-based capability levels...

  17. A regional approach to the environmental risk assessment in the Campania region

    Science.gov (United States)

    Minolfi, Giulia; Albanese, Stefano; Lima, Annamaria; De Vivo, Benedetto

    2016-04-01

    Environmental risk assessment and analysis has a crucial role for guaranteeing the safety of the population, especially in intensive urbanized and industrialized areas, such as the Campania region (Italy). In Italy, since 2006, the human health risk assessment has become mandatory for contaminated soil and waters at contaminated sites. While traditional risk assessment procedures are usually run at site specific level (brownfields), with this work we would like to introduce a freshly developed method to assess risks at regional level by means of GIS, considering the hazard due to the presence in the environment of a contaminated media, the land use variability and the actual distribution of the population. 3535 top soils were collected across the whole Campania region (Italy) with a sampling density of 1 sample/4 km2. Samples were analyzed at ACME Analytical Lab. Ltd (Vancouver, Canada), to determine the concentration of 52 elements, with a combined methods of ICP-MS and ICP-ES following an aqua regia digestion. After a detailed statistical data analysis and geochemical mapping, we reclassified the interpolated maps of some potentially toxic elements (Sb, As, Be, Cd, Co, Cr, Hg, Ni, Pb, Se, Sn, Tl, V, Zn), in accordance with the Italian environmental law (D.Lgs 152/2006), on the base of the trigger and action limits (CSC) for human safety established by this latter. The obtained maps were summed up in the GIS environment in order to get a cumulative map of the potential hazard for the topsoils of Campania region. Considering that environmental risk for the population is strongly influenced by the exposure pathways followed by contaminants to reach the human target, in the case of Campania region we evaluated as relevant pathways both the soil/dust and food ingestion. Furthermore to consider the influence of the land use in the onset of the risk, each land use type was associated with a specific value of a Land Use Risk Coefficient (LURC) which is also dependent on

  18. Improving of State Regional Policy Mechanism at Risks` Conditions

    Directory of Open Access Journals (Sweden)

    Roman Tarasovich Lukysha

    2015-10-01

    Full Text Available Modernization and innovatization were defined as the ways of improvement of the state policy of regional development from the safety perspective. They stipulate the following: 1 avoidance of the possible risks of the development of regions providing for the refusal of the unreliable programs and projects, unreasonable taking on credit and other kinds of loans; 2 risk sharing and convergence, as well as the reduction of their influence on the results of administrative activity; 3 determination and prevention of negative effect of risks. It was offered to carry out the improvement of the state policy of the development of regions with the help of the forming of stable organizational and informational network and system. It was specified that the difference between the latter is in the fact that the organizational and informational system concerns the financial side of administrative activity in regions. This means that it ensures the observance of the principle of transparency. While the organizational and informational network reflects its procedural side with the concept of openness being the basis of such activity. The improvement of the procedure of the organization of state administration of risks of the regional development was proved. It was established that organization of the state administration of the risks of regions development has a form of a chain: “provision of power and powers to the public authority → establishment of the new structural unit or addition of the existing administrative formations, approval of the functional regulations, official duties, etc. → competitive selection of the officials, their training, retraining, consulting → performance by them of the direct tasks on the detection and the prevention of the negative influence of dangers and threats.”

  19. Qualitative analysis of Adenomatous Polyposis Coli promoter: Hypermethylation, engagement and effects on survival of patients with esophageal cancer in a high risk region of the world, a potential molecular marker

    International Nuclear Information System (INIS)

    Zare, Maryam; Jazii, Ferdous Rastgar; Alivand, Mohammad Reza; Nasseri, Negin Karimi; Malekzadeh, Reza; Yazdanbod, Mansour

    2009-01-01

    survival for patients with methylated APC promoter following their treatment. Further investigation into the association between promoter hypermethylation and tumor differentiation status indicated that patients with well differentiated tumors were more likely to develop promoter hypermethylation. Observing similar level of APC promoter hypermethylation in patients with SCCE in this high risk region and comparing it with other parts of the world could support the hypothesis that a common molecular mechanism might be involved in tumorigenesis of SCCE. In addition, the higher rate of two-year survival for patients with unmethylated APC promoter as well as its relationship with tumor differentiation would suggest that this tumor suppressor could be an appropriate candidate molecular marker for evaluating tumor malignancy and predicting survival of patients subsequent to treatment

  20. Qualitative analysis of Adenomatous Polyposis Coli promoter: Hypermethylation, engagement and effects on survival of patients with esophageal cancer in a high risk region of the world, a potential molecular marker

    Directory of Open Access Journals (Sweden)

    Nasseri Negin

    2009-01-01

    to promoter hypermethylation showed a lower rate of survival for patients with methylated APC promoter following their treatment. Further investigation into the association between promoter hypermethylation and tumor differentiation status indicated that patients with well differentiated tumors were more likely to develop promoter hypermethylation. Conclusion Observing similar level of APC promoter hypermethylation in patients with SCCE in this high risk region and comparing it with other parts of the world could support the hypothesis that a common molecular mechanism might be involved in tumorigenesis of SCCE. In addition, the higher rate of two-year survival for patients with unmethylated APC promoter as well as its relationship with tumor differentiation would suggest that this tumor suppressor could be an appropriate candidate molecular marker for evaluating tumor malignancy and predicting survival of patients subsequent to treatment.

  1. Collateral Determinats In Bank Risk Mananagement: The Regional Case

    Directory of Open Access Journals (Sweden)

    A. M. Karminsky

    2018-01-01

    Full Text Available Regional banks are struggling with significant obstacles in the modern Russian economy. Among them are strong competition with major big banks, strong resource restrictions, tightening the Bank of Russia’s requirements, and quite rapid expansion of financial technologies. Thus, the reduction of regional banks occurs, that produces both a negative impact on the development of small and medium enterprises (SMEs and challenges for balanced competition on the Russian market. Basically, these banks provide the settlement of region’s social and economic problems while maintaining local companies and enterprises. Collateral, as a source for losses covering, became the essential element of credit risk management in banks. Providing lenders to implement such instruments, it helps to reduce bank losses under borrower’s default. The purpose of the article relates to revealing of collateral determinants with higher impact on bank risk with the application of empirical methods (including regional level. This study is based on linear regression models evaluated by the least square method. Private data of secured small and medium business loans is used. This article presents LTV (loan-to-value as a major collateral determinant. The empirical evidence of interlinkage between collateral requirements, by the means of LTV, and risk premium is provided for loan portfolio of Russian regional banks. The hypothesis that LTV conversely correlates with risk premium is statistically proved.

  2. Risk Diagnostics and Management for Welfare in Regions (in the Example of the Ural Federal District

    Directory of Open Access Journals (Sweden)

    Aleksandr Anatolyevich Kuklin

    2018-06-01

    Full Text Available Welfare is one of the indicators that characterizes the functioning of socio-economic system at any level, which is influenced by many factors. It increases the importance of necessity of choice, estimating risks that affect welfare, and managing their influence. The authors view welfare in the region from two viewpoints: an individual and a territory, which implies definition and estimation of risks for each of them. The goal of the study is to estimate the risks to welfare of an individual and a territory, which means solving the following tasks: 1 defining the category ‘risk to welfare of an individual and a territory’; 2 estimating integral risks for the Ural Federal District’s territories; 3 estimating the probability of integral risk reaching critical zone. The methods of study used by the authors: indicative analysis, integration of objective function through Monte Carlo statistical trials method. The object of the study is the regions of the Ural Federal District (subjects of the Russian Federation, timeframe – 2001–2016, information mass – official data of Russian Federal State Statistics Service. Based on the calculations, the authors conclude the following: all regions of the Ural Federal District are in the high-risk zone and have low probability of reaching critical risk zone. The results can be used in managing the risks through development of roadmaps on minimization of risk and probability of aggravation. The proposed measures allow decreasing the integral risk and increasing welfare level of an individual and a territory

  3. [A model list of high risk drugs].

    Science.gov (United States)

    Cotrina Luque, J; Guerrero Aznar, M D; Alvarez del Vayo Benito, C; Jimenez Mesa, E; Guzman Laura, K P; Fernández Fernández, L

    2013-12-01

    «High-risk drugs» are those that have a very high «risk» of causing death or serious injury if an error occurs during its use. The Institute for Safe Medication Practices (ISMP) has prepared a high-risk drugs list applicable to the general population (with no differences between the pediatric and adult population). Thus, there is a lack of information for the pediatric population. The main objective of this work is to develop a high-risk drug list adapted to the neonatal or pediatric population as a reference model for the pediatric hospital health workforce. We made a literature search in May 2012 to identify any published lists or references in relation to pediatric and/or neonatal high-risk drugs. A total of 15 studies were found, from which 9 were selected. A model list was developed mainly based on the ISMP one, adding strongly perceived pediatric risk drugs and removing those where the pediatric use was anecdotal. There is no published list that suits pediatric risk management. The list of pediatric and neonatal high-risk drugs presented here could be a «reference list of high-risk drugs » for pediatric hospitals. Using this list and training will help to prevent medication errors in each drug supply chain (prescribing, transcribing, dispensing and administration). Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  4. Regional risk assessment approaches to land planning for industrial polluted areas in China: the Hulunbeier region case study.

    Science.gov (United States)

    Li, Daiqing; Zhang, Chen; Pizzol, Lisa; Critto, Andrea; Zhang, Haibo; Lv, Shihai; Marcomini, Antonio

    2014-04-01

    The rapid industrial development and urbanization processes that occurred in China over the past 30years has increased dramatically the consumption of natural resources and raw materials, thus exacerbating the human pressure on environmental ecosystems. In result, large scale environmental pollution of soil, natural waters and urban air were recorded. The development of effective industrial planning to support regional sustainable economy development has become an issue of serious concern for local authorities which need to select safe sites for new industrial settlements (i.e. industrial plants) according to assessment approaches considering cumulative impacts, synergistic pollution effects and risks of accidental releases. In order to support decision makers in the development of efficient and effective regional land-use plans encompassing the identification of suitable areas for new industrial settlements and areas in need of intervention measures, this study provides a spatial regional risk assessment methodology which integrates relative risk assessment (RRA) and socio-economic assessment (SEA) and makes use of spatial analysis (GIS) methodologies and multicriteria decision analysis (MCDA) techniques. The proposed methodology was applied to the Chinese region of Hulunbeier which is located in eastern Inner Mongolia Autonomous Region, adjacent to the Republic of Mongolia. The application results demonstrated the effectiveness of the proposed methodology in the identification of the most hazardous and risky industrial settlements, the most vulnerable regional receptors and the regional districts which resulted to be the most relevant for intervention measures since they are characterized by high regional risk and excellent socio-economic development conditions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Social and economic factors of the natural risk increasing: estimation of the Russian regions

    Directory of Open Access Journals (Sweden)

    E. Petrova

    2004-01-01

    Full Text Available This study is an attempt to assess quantitatively social and economic factors that determine vulnerability of Russian regions to natural risk, to trace the space differences of the considered factors, and to group the regions by their similarity. In order to indicate the regional differences in social and economic development, equipment condition, dangerous substances accumulation, and social trouble four the most suitable parameters were estimated, including the per capita production of Gross Regional Product (GRP, capital consumption, volume of total toxic waste, and crime rate. Increase of the first parameter causes vulnerability reducing, the increase of the last three causes its increasing. Using multidimensional cluster analysis five types of regions were found for Russia according to similarity of the considered parameters. These types are characterized with higher value of a single (rarely two chosen parameter, which seems to be sufficient enough to affect natural risks increasing in these regions in near future. Only few regions belonging to the fifth type proved to have rather high value of GRP and relatively low values of the other parameters. The negative correlation was found between a number of natural disasters (ND and the per capita GRP in case when some parameters reached anomalously high value. The distinctions between regions by prevailing different parameters, which result in natural risk increasing, help risk management to find directions where to focus on.

  6. Resuscitation of newborn in high risk deliveries

    International Nuclear Information System (INIS)

    Yousaf, U.F.; Hayat, S.

    2015-01-01

    High risk deliveries are usually associated with increased neonatal mortality and morbidity. Neonatal resuscitation can appreciably affect the outcome in these types of deliveries. Presence of personnel trained in basic neonatal resuscitation at the time of delivery can play an important role in reducing perinatal complications in neonates at risk. The study was carried out to evaluate the effects of newborn resuscitation on neonatal outcome in high risk deliveries. Methods: This descriptive case series was carried out at the Department of Obstetrics and Gynecology, Jinnah Hospital, Lahore. Ninety consecutive high risk deliveries were included and attended by paediatricians trained in newborn resuscitation. Babies delivered by elective Caesarean section, normal spontaneous vaginal deliveries and still births were excluded. Neonatal resuscitation was performed in babies who failed to initiate breathing in the first minute after birth. Data was analyzed using SPSS-16.0. Results: A total of 90 high risk deliveries were included in the study. Emergency caesarean section was the mode of delivery in 94.4% (n=85) cases and spontaneous vaginal delivery in 5.6% (n=5). Preterm pregnancy was the major high risk factor. Newborn resuscitation was required in 37.8% (n=34) of all high risk deliveries (p=0.013). All the new-borns who required resuscitation survived. Conclusion: New-born resuscitation is required in high risk pregnancies and personnel trained in newborn resuscitation should be available at the time of delivery. (author)

  7. Risk factors control in patients with cardiovascular diseases in Ivanovo region: possibilities of a regional registry

    Directory of Open Access Journals (Sweden)

    Belova O.A.

    2016-03-01

    Conclusion ― In primary care units of Ivanovo region in 2015 patients were insufficiently asked about their lifestyle (smoking, physical activity, eating habits, as well as their body weight was measured. If a patient had a risk factor he usually receive a proper advice. For BP, weight and blood lipids the goals were achieved rare.

  8. Improving antenatal risk assessment in women exposed to high risks.

    Science.gov (United States)

    Perry, Natasha; Newman, Louise K; Hunter, Mick; Dunlop, Adrian

    2015-01-01

    Antenatal substance use and related psychosocial risk factors are known to increase the likelihood of child protection involvement; less is known about the predictive nature of maternal reflective functioning (RF) in this population. This preliminary study assessed psychosocial and psychological risk factors for a group of substance dependent women exposed to high risks in pregnancy, and their impact on child protection involvement. Pregnant women on opiate substitution treatment (n = 11) and a comparison group (n = 15) were recruited during their third trimester to complete measures of RF (Pregnancy Interview), childhood trauma, mental health and psychosocial assessments. At postnatal follow-up, RF was reassessed (Parent Development Interview - Revised Short Version) and mother-infant dyads were videotaped to assess emotional availability (EA). Child protection services were contacted to determine if any concerns had been raised for infant safety. Significant between-group differences were observed for demographics, psychosocial factors, trauma and mental health symptoms. Unexpectedly, no significant differences were found for RF or EA between groups. Eight women in the 'exposed to high risks' group became involved with child protection services. Reflective functioning was not significantly associated with psychosocial risk factors, and therefore did not mediate the outcome of child protection involvement. Women 'exposed to high risks' were equally able to generate a model of their own and their infants' mental states and should not be seen within a deficit perspective. Further research is required to better understand the range of risk factors that predict child protection involvement in high risk groups. © The Author(s) 2013.

  9. High prevalence of suicide risk in people living with HIV: who is at higher risk?

    Science.gov (United States)

    Passos, Susane Müller Klug; Souza, Luciano Dias de Mattos; Spessato, Bárbara Coiro

    2014-01-01

    A cross-sectional study was developed to evaluate suicide risk and associated factors in HIV/AIDS patients at a regional reference center for the treatment of HIV/AIDS in southern Brazil. We assessed 211 patients in regard to suicide risk, clinical and sociodemographic characteristics, drug use, depression, and anxiety. Suicide risk was assessed with Mini International Neuropsychiatric Interview, Module C. Multivariate analysis was performed using Poisson regression. Of the total sample, 34.1% were at risk of suicide. In the multivariate analysis, the following variables were independently associated with suicide risk: female gender; age up to 47 years; unemployment; indicative of anxiety; indicative of depression; and abuse or addiction on psychoactive substances. Suicide risk is high in this population. Psychosocial factors should be included in the physical and clinical evaluation, given their strong association with suicide risk.

  10. Postmastectomy irradiation in high-risk breast cancer patients

    International Nuclear Information System (INIS)

    Overgaard, M.; Juul Christensen, J.; Johansen, H.; Nybo-Rasmussen, A.; Brincker, H.; Kooy, P. van der; Frederiksen, P.L.; Laursen, F.; Panduro, J.; Soerensen, N.E.; Gadeberg, C.C.; Hjelm-Hansen, M.; Overgaard, J.; West Andersen, K.; Zedeler, K.

    1988-01-01

    All pre- and postmenopausal high-risk breast cancer patients in the protocols DBCG 77 of the Danish Breast Cancer Cooperative Group received postmastectomy irradiation before randomization to either adjuvant systemic therapy or no such treatment. The actuarial loco-regional recurrence rate at 9 years was 6-17%, with the lowest rate in patients who also received additional adjuvant chemotherapy or tamoxifen. In a subsequent study (DBCG 82) the role of postmastectomy irradiation together with systemic treatment was evaluated in high-risk patients. Pre- and menopausal patients were randomized to postmastectomy irradiation+CMF (cyclophosphamide, methotrexate, 5-fluorouracil), CMF alone or CMF+TAM (tamoxifen). Postmenopausal patients were randomized to postmastectomy irradiation+TAM, TAM or CMF+TAM. At 4 years the loco-regional recurrence rate was significantly lower in the irradiated patients (5-7% vs. 23-33%). Further, disease-free survival was significantly improved in both pre- and postmenopausal irradiated patients compared with those who had only systemic treatment. At present, there are no significant differences between survival in the treatment groups. Thus, adjuvant systemic treatment alone (chemotherapy and/or tamoxifen) did not prevent loco-regional recurrences in high-risk patients after mastectomy and axillary lymph node sampling. However, a longer observation time is necessary to evaluate the consequence of primary optimal loco-regional tumour control in high-risk breast cancer patients with respect to survival. (orig.)

  11. Highly Enhanced Risk Management Emergency Satellite

    DEFF Research Database (Denmark)

    Dalmeir, Michael; Gataullin, Yunir; Indrajit, Agung

    HERMES (Highly Enhanced Risk Management Emergency Satellite) is potential European satellite mission for global flood management, being implemented by Technical University Munich and European Space Agency. With its main instrument - a reliable and precise Synthetic Aperture Radar (SAR) antenna...

  12. The high-risk plaque initiative

    DEFF Research Database (Denmark)

    Falk, Erling; Sillesen, Henrik; Muntendam, Pieter

    2011-01-01

    The High-Risk Plaque (HRP) Initiative is a research and development effort to advance the understanding, recognition, and management of asymptomatic individuals at risk for a near-term atherothrombotic event such as myocardial infarction or stroke. Clinical studies using the newest technologies...... have been initiated, including the BioImage Study in which novel approaches are tested in a typical health plan population. Asymptomatic at-risk individuals were enrolled, including a survey-only group (n = 865), a group undergoing traditional risk factor scoring (n = 718), and a group in which all...

  13. Global Natural Disaster Risk Hotspots: Transition to a Regional Approach

    Science.gov (United States)

    Lerner-Lam, A.; Chen, R.; Dilley, M.

    2005-12-01

    The "Hotspots Project" is a collaborative study of the global distribution and occurrence of multiple natural hazards and the associated exposures of populations and their economic output. In this study we assess the global risks of two disaster-related outcomes: mortality and economic losses. We estimate risk levels by combining hazard exposure with historical vulnerability for two indicators of elements at risk-gridded population and Gross Domestic Product (GDP) per unit area - for six major natural hazards: earthquakes, volcanoes, landslides, floods, drought, and cyclones. By calculating relative risks for each grid cell rather than for countries as a whole, we are able to estimate risk levels at sub-national scales. These can then be used to estimate aggregate relative multiple hazard risk at regional and national scales. Mortality-related risks are assessed on a 2.5' x 2.5' latitude-longitude grid of global population (GPW Version 3). Economic risks are assessed at the same resolution for gridded GDP per unit area, using World Bank estimates of GDP based on purchasing power parity. Global hazard data were compiled from multiple sources. The project collaborated directly with UNDP and UNEP, the International Research Institute for Climate Prediction (IRI) at Columbia, and the Norwegian Geotechnical Institute (NGI) in the creation of data sets for several hazards for which global data sets did not previously exist. Drought, flood and volcano hazards are characterized in terms of event frequency, storms by frequency and severity, earthquakes by frequency and ground acceleration exceedance probability, and landslides by an index derived from probability of occurrence. The global analysis undertaken in this project is clearly limited by issues of scale as well as by the availability and quality of data. For some hazards, there exist only 15- to 25-year global records with relatively crude spatial information. Data on historical disaster losses, and particularly on

  14. 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. .

  15. Risk-adaptive optimization: Selective boosting of high-risk tumor subvolumes

    International Nuclear Information System (INIS)

    Kim, Yusung; Tome, Wolfgang A.

    2006-01-01

    Background and Purpose: A tumor subvolume-based, risk-adaptive optimization strategy is presented. Methods and Materials: Risk-adaptive optimization employs a biologic objective function instead of an objective function based on physical dose constraints. Using this biologic objective function, tumor control probability (TCP) is maximized for different tumor risk regions while at the same time minimizing normal tissue complication probability (NTCP) for organs at risk. The feasibility of risk-adaptive optimization was investigated for a variety of tumor subvolume geometries, risk-levels, and slopes of the TCP curve. Furthermore, the impact of a correlation parameter, δ, between TCP and NTCP on risk-adaptive optimization was investigated. Results: Employing risk-adaptive optimization, it is possible in a prostate cancer model to increase the equivalent uniform dose (EUD) by up to 35.4 Gy in tumor subvolumes having the highest risk classification without increasing predicted normal tissue complications in organs at risk. For all tumor subvolume geometries investigated, we found that the EUD to high-risk tumor subvolumes could be increased significantly without increasing normal tissue complications above those expected from a treatment plan aiming for uniform dose coverage of the planning target volume. We furthermore found that the tumor subvolume with the highest risk classification had the largest influence on the design of the risk-adaptive dose distribution. The parameter δ had little effect on risk-adaptive optimization. However, the clinical parameters D 5 and γ 5 that represent the risk classification of tumor subvolumes had the largest impact on risk-adaptive optimization. Conclusions: On the whole, risk-adaptive optimization yields heterogeneous dose distributions that match the risk level distribution of different subvolumes within the tumor volume

  16. A procedure for seismic risk reduction in Campania Region

    Science.gov (United States)

    Zuccaro, G.; Palmieri, M.; Maggiò, F.; Cicalese, S.; Grassi, V.; Rauci, M.

    2008-07-01

    The Campania Region has set and performed a peculiar procedure in the field of seismic risk reduction. Great attention has been paid to public strategic buildings such as town halls, civil protection buildings and schools. The Ordinance 3274 promulgate in the 2004 by the Italian central authority obliged the owners of strategic buildings to perform seismic analyses within 2008 in order to check the safety of the structures and the adequacy to the use. In the procedure the Campania region, instead of the local authorities, ensure the complete drafting of seismic checks through financial resources of the Italian Government. A regional scientific technical committee has been constituted, composed of scientific experts, academics in seismic engineering. The committee has drawn up guidelines for the processing of seismic analyses. At the same time, the Region has issued a public competition to select technical seismic engineering experts to appoint seismic analysis in accordance with guidelines. The scientific committee has the option of requiring additional documents and studies in order to approve the safety checks elaborated. The Committee is supported by a technical and administrative secretariat composed of a group of expert in seismic engineering. At the moment several seismic safety checks have been completed. The results will be presented in this paper. Moreover, the policy to mitigate the seismic risk, set by Campania region, was to spend the most of the financial resources available on structural strengthening of public strategic buildings rather than in safety checks. A first set of buildings of which the response under seismic action was already known by data and studies of vulnerability previously realised, were selected for immediate retrofitting designs. Secondly, an other set of buildings were identified for structural strengthening. These were selected by using the criteria specified in the Guide Line prepared by the Scientific Committee and based on

  17. A procedure for seismic risk reduction in Campania Region

    International Nuclear Information System (INIS)

    Zuccaro, G.; Palmieri, M.; Cicalese, S.; Grassi, V.; Rauci, M.; Maggio, F.

    2008-01-01

    The Campania Region has set and performed a peculiar procedure in the field of seismic risk reduction. Great attention has been paid to public strategic buildings such as town halls, civil protection buildings and schools. The Ordinance 3274 promulgate in the 2004 by the Italian central authority obliged the owners of strategic buildings to perform seismic analyses within 2008 in order to check the safety of the structures and the adequacy to the use. In the procedure the Campania region, instead of the local authorities, ensure the complete drafting of seismic checks through financial resources of the Italian Government. A regional scientific technical committee has been constituted, composed of scientific experts, academics in seismic engineering. The committee has drawn up guidelines for the processing of seismic analyses. At the same time, the Region has issued a public competition to select technical seismic engineering experts to appoint seismic analysis in accordance with guidelines. The scientific committee has the option of requiring additional documents and studies in order to approve the safety checks elaborated. The Committee is supported by a technical and administrative secretariat composed of a group of expert in seismic engineering. At the moment several seismic safety checks have been completed. The results will be presented in this paper. Moreover, the policy to mitigate the seismic risk, set by Campania region, was to spend the most of the financial resources available on structural strengthening of public strategic buildings rather than in safety checks. A first set of buildings of which the response under seismic action was already known by data and studies of vulnerability previously realised, were selected for immediate retrofitting designs. Secondly, an other set of buildings were identified for structural strengthening. These were selected by using the criteria specified in the Guide Line prepared by the Scientific Committee and based on

  18. 9 CFR 93.436 - Ruminants from regions of minimal risk for BSE.

    Science.gov (United States)

    2010-01-01

    ... each animal's right hip, high on the tail-head (over the junction of the sacral and first cocygeal... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Ruminants from regions of minimal risk for BSE. 93.436 Section 93.436 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE...

  19. Regional risk assessment of environmental contamination from oil pipelines

    International Nuclear Information System (INIS)

    Pelmulder, S.D.; Eguchi, R.T.

    1991-01-01

    This paper presents a methodology for assessing the risk of environmental contamination from oil pipeline leaks due to earthquakes. Risk is measured both as volume of oil released and remediation cost. The methodology was developed for use on a regional scale and thus relies on a limited amount of input data. Monte Carlo techniques are used to simulate earthquake events, while a deterministic model is used to estimate the volume of oil released at a particular site. A library of cost models is used to estimate the contamination and resulting remediation cost based on the volume of oil released and the general site conditions. This methodology has been implemented in a computer program, OILOSS, and the results are presented as annual frequency of exceedence curves for volume of oil released and cost of remediation

  20. Telomerase activation by genomic rearrangements in high-risk neuroblastoma

    Science.gov (United States)

    Peifer, Martin; Hertwig, Falk; Roels, Frederik; Dreidax, Daniel; Gartlgruber, Moritz; Menon, Roopika; Krämer, Andrea; Roncaioli, Justin L.; Sand, Frederik; Heuckmann, Johannes M.; Ikram, Fakhera; Schmidt, Rene; Ackermann, Sandra; Engesser, Anne; Kahlert, Yvonne; Vogel, Wenzel; Altmüller, Janine; Nürnberg, Peter; Thierry-Mieg, Jean; Thierry-Mieg, Danielle; Mariappan, Aruljothi; Heynck, Stefanie; Mariotti, Erika; Henrich, Kai-Oliver; Glöckner, Christian; Bosco, Graziella; Leuschner, Ivo; Schweiger, Michal R.; Savelyeva, Larissa; Watkins, Simon C.; Shao, Chunxuan; Bell, Emma; Höfer, Thomas; Achter, Viktor; Lang, Ulrich; Theissen, Jessica; Volland, Ruth; Saadati, Maral; Eggert, Angelika; de Wilde, Bram; Berthold, Frank; Peng, Zhiyu; Zhao, Chen; Shi, Leming; Ortmann, Monika; Büttner, Reinhard; Perner, Sven; Hero, Barbara; Schramm, Alexander; Schulte, Johannes H.; Herrmann, Carl; O’Sullivan, Roderick J.; Westermann, Frank; Thomas, Roman K.; Fischer, Matthias

    2016-01-01

    Neuroblastoma is a malignant paediatric tumour of the sympathetic nervous system1. Roughly half of these tumours regress spontaneously or are cured by limited therapy. By contrast, high-risk neuroblastomas have an unfavourable clinical course despite intensive multimodal treatment, and their molecular basis has remained largely elusive2–4. Here we have performed whole-genome sequencing of 56 neuroblastomas (high-risk, n = 39; low-risk, n = 17) and discovered recurrent genomic rearrangements affecting a chromosomal region at 5p15.33 proximal of the telomerase reverse transcriptase gene (TERT). These rearrangements occurred only in high-risk neuroblastomas (12/39, 31%) in a mutually exclusive fashion with MYCN amplifications and ATRX mutations, which are known genetic events in this tumour type1,2,5. In an extended case series (n = 217), TERT rearrangements defined a subgroup of high-risk tumours with particularly poor outcome. Despite a large structural diversity of these rearrangements, they all induced massive transcriptional upregulation of TERT. In the remaining high-risk tumours, TERT expression was also elevated in MYCN-amplified tumours, whereas alternative lengthening of telomeres was present in neuroblastomas without TERT or MYCN alterations, suggesting that telomere lengthening represents a central mechanism defining this subtype. The 5p15.33 rearrangements juxtapose the TERT coding sequence to strong enhancer elements, resulting in massive chromatin remodelling and DNA methylation of the affected region. Supporting a functional role of TERT, neuroblastoma cell lines bearing rearrangements or amplified MYCN exhibited both upregulated TERT expression and enzymatic telomerase activity. In summary, our findings show that remodelling of the genomic context abrogates transcriptional silencing of TERT in high-risk neuroblastoma and places telomerase activation in the centre of transformation in a large fraction of these tumours. PMID:26466568

  1. Renal transplantation in high cardiovascular risk patients.

    Science.gov (United States)

    Bittar, Julio; Arenas, Paula; Chiurchiu, Carlos; de la Fuente, Jorge; de Arteaga, Javier; Douthat, Walter; Massari, Pablo U

    2009-10-01

    Current transplant success allows recipients with previous contraindications to transplant to have access to this procedure with more frequency and safety. The concept of high-risk patient has changed since the first stages of transplantation. In the first studies, the high-risk concept was based on probability of early graft failure or on a patient's clinical condition to cope with high perioperatory morbimortality. Later on, this concept implied immunological factors that were crucial to ensure transplant success because hypersensitized or polytransfused patients experienced a higher risk of acute rejection and subsequent graft loss. Afterward, the presence of various comorbidities would redefine the high-risk concept for renal transplant mainly considering recipient's clinical aspects. Currently, the change in epidemiological characteristics of patients starting dialysis causes that we now deal with a greater increase of elderly patients, diabetic patients, and patients with history of cardiovascular disease. Today, high-risk patients are those with clinical features that predict an increase in the risk of perioperative morbimortality or death with functioning graft. In this review, we will attempted to analyze currents results of renal transplant outcomes in terms of patients and graft survival in elderly patients, diabetic patients, and patients with previous cardiovascular disease from the most recent experiences in the literature and from experiences in our center. In any of the groups previously analyzed, survival offered by renal transplant is significantly higher compared to dialysis. Besides, these patients are the recipient group that benefit the most with the transplant because their mortality while remaining on dialysis is extremely high. Hence, renal transplantation should be offered more frequently to older patients, diabetic patients, and patients with pretransplant cardiac and peripheral vascular disease. A positive attitude toward renal

  2. Risk assessment of soil compaction in Walloon Region (Belgium)

    Science.gov (United States)

    Charlotte, Rosiere; Marie-France, Destain; Jean-Claude, Verbrugge

    2010-05-01

    The proposed Soil Framework Directive COM(2006)232 requires Member States to identify areas at risk of erosion, decline in organic matter, salinisation, compaction, sealing and landslides, as well as to set up an inventory of contaminated sites. The present project aims to identify the susceptibility to compaction of soils of the Walloon Region (Belgium) and to recommend good farming practices avoiding soil compaction as far as possible. Within this scope, the concept of precompression stress (Pc) (Horn and Fleige, 2003) was used. Pc is defined as the maximum major principal stress that a soil horizon can withstand against any applied external vertical stress. If applied stress is higher than Pc, the soil enters in a plastic state, not easily reversible. For a given soil, the intensity of soil compaction is mainly due to the applied load which depends on vehicle characteristics (axle load, tyre dimensions, tyre inflation pressure, and vehicle velocity). To determine soil precompression stress, pedotransfert functions of Lebert and Horn (1991) defined at two water suctions (pF 1.8 and 2.5) were used. Parameters required by these functions were found within several databases (Aardewerk and Digital Map of Walloon Soils) and literature. The validation of Pc was performed by measuring stress-strain relationships using automatic oedometers. Stresses of 15.6, 31, 3, 62.5, 125, 250, 500 and 1000 kPa were applied for 10 min each. In this study, the compaction due to beet harvesters was considered because the axle load can exceed 10 tons and these machines are often used during wet conditions. The compaction at two depth levels was considered: 30 and 50 cm. Compaction of topsoil was not taken into account because, under conventional tillage, the plough depth is lower than 25 cm. Before and after the passage of the machines, following measurements were performed: granulometry, density, soil moisture, pF curve, Atterberg limits, ... The software Soilflex (Keller et al., 2007

  3. Identification of Major Risk Sources for Surface Water Pollution by Risk Indexes (RI) in the Multi-Provincial Boundary Region of the Taihu Basin, China

    Science.gov (United States)

    Yao, Hong; Li, Weixin; Qian, Xin

    2015-01-01

    Environmental safety in multi-district boundary regions has been one of the focuses in China and is mentioned many times in the Environmental Protection Act of 2014. Five types were categorized concerning the risk sources for surface water pollution in the multi-provincial boundary region of the Taihu basin: production enterprises, waste disposal sites, chemical storage sites, agricultural non-point sources and waterway transportations. Considering the hazard of risk sources, the purification property of environmental medium and the vulnerability of risk receptors, 52 specific attributes on the risk levels of each type of risk source were screened out. Continuous piecewise linear function model, expert consultation method and fuzzy integral model were used to calculate the integrated risk indexes (RI) to characterize the risk levels of pollution sources. In the studied area, 2716 pollution sources were characterized by RI values. There were 56 high-risk sources screened out as major risk sources, accounting for about 2% of the total. The numbers of sources with high-moderate, moderate, moderate-low and low pollution risk were 376, 1059, 101 and 1124, respectively, accounting for 14%, 38%, 5% and 41% of the total. The procedure proposed could be included in the integrated risk management systems of the multi-district boundary region of the Taihu basin. It could help decision makers to identify major risk sources in the risk prevention and reduction of surface water pollution. PMID:26308032

  4. Identification of Major Risk Sources for Surface Water Pollution by Risk Indexes (RI) in the Multi-Provincial Boundary Region of the Taihu Basin, China.

    Science.gov (United States)

    Yao, Hong; Li, Weixin; Qian, Xin

    2015-08-21

    Environmental safety in multi-district boundary regions has been one of the focuses in China and is mentioned many times in the Environmental Protection Act of 2014. Five types were categorized concerning the risk sources for surface water pollution in the multi-provincial boundary region of the Taihu basin: production enterprises, waste disposal sites, chemical storage sites, agricultural non-point sources and waterway transportations. Considering the hazard of risk sources, the purification property of environmental medium and the vulnerability of risk receptors, 52 specific attributes on the risk levels of each type of risk source were screened out. Continuous piecewise linear function model, expert consultation method and fuzzy integral model were used to calculate the integrated risk indexes (RI) to characterize the risk levels of pollution sources. In the studied area, 2716 pollution sources were characterized by RI values. There were 56 high-risk sources screened out as major risk sources, accounting for about 2% of the total. The numbers of sources with high-moderate, moderate, moderate-low and low pollution risk were 376, 1059, 101 and 1124, respectively, accounting for 14%, 38%, 5% and 41% of the total. The procedure proposed could be included in the integrated risk management systems of the multi-district boundary region of the Taihu basin. It could help decision makers to identify major risk sources in the risk prevention and reduction of surface water pollution.

  5. Identification of Major Risk Sources for Surface Water Pollution by Risk Indexes (RI in the Multi-Provincial Boundary Region of the Taihu Basin, China

    Directory of Open Access Journals (Sweden)

    Hong Yao

    2015-08-01

    Full Text Available Environmental safety in multi-district boundary regions has been one of the focuses in China and is mentioned many times in the Environmental Protection Act of 2014. Five types were categorized concerning the risk sources for surface water pollution in the multi-provincial boundary region of the Taihu basin: production enterprises, waste disposal sites, chemical storage sites, agricultural non-point sources and waterway transportations. Considering the hazard of risk sources, the purification property of environmental medium and the vulnerability of risk receptors, 52 specific attributes on the risk levels of each type of risk source were screened out. Continuous piecewise linear function model, expert consultation method and fuzzy integral model were used to calculate the integrated risk indexes (RI to characterize the risk levels of pollution sources. In the studied area, 2716 pollution sources were characterized by RI values. There were 56 high-risk sources screened out as major risk sources, accounting for about 2% of the total. The numbers of sources with high-moderate, moderate, moderate-low and low pollution risk were 376, 1059, 101 and 1124, respectively, accounting for 14%, 38%, 5% and 41% of the total. The procedure proposed could be included in the integrated risk management systems of the multi-district boundary region of the Taihu basin. It could help decision makers to identify major risk sources in the risk prevention and reduction of surface water pollution.

  6. High risk process control system assessment methodology

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Venetia [Pontificia Universidade Catolica do Rio de Janeiro (PUC-Rio), RJ (Brazil); Zamberlan, Maria Cristina [National Institute of Tehnology (INT), Rio de Janeiro, RJ (Brazil). Human Reliability and Ergonomics Research Group for the Oil, Gas and Energy Sector

    2009-07-01

    The evolution of ergonomics methodology has become necessary due to the dynamics imposed by the work environment, by the increase of the need of human cooperation and by the high interaction between various sections within a company. In the last 25 years, as of studies made in the high risk process control, we have developed a methodology to evaluate these situations that focus on the assessment of activities and human cooperation, the assessment of context, the assessment of the impact of work of other sectors in the final activity of the operator, as well as the modeling of existing risks. (author)

  7. Context and Cardiovascular Risk Modification in Two Regions of Ontario, Canada: A Photo Elicitation Study

    Directory of Open Access Journals (Sweden)

    Renée Chevrier-Lamoureux

    2009-09-01

    Full Text Available Cardiovascular diseases, which include coronary heart diseases (CHD, remain the leading cause of death in Canada and other industrialized countries. This qualitative study used photo-elicitation, focus groups and in-depth interviews to understand health behaviour change from the perspectives of 38 people who were aware of their high risk for CHD and had received information about cardiovascular risk modification while participating in a larger intervention study. Participants were drawn from two selected regions: Sudbury and District (northern Ontario and the Greater Toronto Area (southern Ontario. Analysis drew on concepts of place and space to capture the complex interplay between geographic location, sociodemographic position, and people‟s efforts to understand and modify their risk for CHD. Three major sites of difference and ambiguity emerged: 1 place and access to health resources; 2 time and food culture; and 3 itineraries or travels through multiple locations. All participants reported difficulties in learning and adhering to new lifestyle patterns, but access to supportive health resources was different in the two regions. Even within regions, subgroups experienced different patterns of constraint and advantage. In each region, “fast” food and traditional foods were entrenched within different temporal and social meanings. Finally, different and shifting strategies for risk modification were required at various points during daily and seasonal travels through neighbourhoods, to workplaces, or on vacation. Thus health education for CHD risk modification should be place-specific and tailored to the needs and resources of specific communities.

  8. Asymptotically Honest Confidence Regions for High Dimensional

    DEFF Research Database (Denmark)

    Caner, Mehmet; Kock, Anders Bredahl

    While variable selection and oracle inequalities for the estimation and prediction error have received considerable attention in the literature on high-dimensional models, very little work has been done in the area of testing and construction of confidence bands in high-dimensional models. However...... develop an oracle inequality for the conservative Lasso only assuming the existence of a certain number of moments. This is done by means of the Marcinkiewicz-Zygmund inequality which in our context provides sharper bounds than Nemirovski's inequality. As opposed to van de Geer et al. (2014) we allow...

  9. Developing a high-resolution regional atmospheric reanalysis for Australia

    Science.gov (United States)

    White, Christopher; Fox-Hughes, Paul; Su, Chun-Hsu; Jakob, Dörte; Kociuba, Greg; Eisenberg, Nathan; Steinle, Peter; Harris, Rebecca; Corney, Stuart; Love, Peter; Remenyi, Tomas; Chladil, Mark; Bally, John; Bindoff, Nathan

    2017-04-01

    A dynamically consistent, long-term atmospheric reanalysis can be used to support high-quality assessments of environmental risk and likelihood of extreme events. Most reanalyses are presently based on coarse-scale global systems that are not suitable for regional assessments in fire risk, water and natural resources, amongst others. The Australian Bureau of Meteorology is currently working to close this gap by producing a high-resolution reanalysis over the Australian and New Zealand region to construct a sequence of atmospheric conditions at sub-hourly intervals over the past 25 years from 1990. The Australia reanalysis consists of a convective-scale analysis nested within a 12 km regional-scale reanalysis, which is bounded by a coarse-scale ERA-Interim reanalysis that provides the required boundary and initial conditions. We use an unchanging atmospheric modelling suite based on the UERRA system used at the UK Met Office and the more recent version of the Bureau of Meteorology's operational numerical prediction model used in ACCESS-R (Australian Community Climate and Earth-System Simulator-Regional system). An advanced (4-dimensional variational) data assimilation scheme is used to optimally combine model physics with multiple observations from aircrafts, sondes, surface observations and satellites to create a best estimate of state of the atmosphere over a 6-hour moving window. This analysis is in turn used to drive a higher-resolution (1.5 km) downscaling model over selected subdomains within Australia, currently eastern New South Wales and Tasmania, with the capability to support this anywhere in the Australia-New Zealand domain. The temporal resolution of the gridded analysis fields for both the regional and higher-resolution subdomains are generally one hour, with many fields such as 10 m winds and 2 m temperatures available every 10 minutes. The reanalysis also produces many other variables that include wind, temperature, moisture, pressure, cloud cover

  10. Not all risks are equal: the risk taking inventory for high-risk sports.

    Science.gov (United States)

    Woodman, Tim; Barlow, Matt; Bandura, Comille; Hill, Miles; Kupciw, Dominika; Macgregor, Alexandra

    2013-10-01

    Although high-risk sport participants are typically considered a homogenous risk-taking population, attitudes to risk within the high-risk domain can vary considerably. As no validated measure allows researchers to assess risk taking within this domain, we validated the Risk Taking Inventory (RTI) for high-risk sport across four studies. The RTI comprises seven items across two factors: deliberate risk taking and precautionary behaviors. In Study 1 (n = 341), the inventory was refined and tested via a confirmatory factor analysis used in an exploratory fashion. The subsequent three studies confirmed the RTI's good model-data fit via three further separate confirmatory factor analyses. In Study 2 (n = 518) and in Study 3 (n = 290), concurrent validity was also confirmed via associations with other related traits (sensation seeking, behavioral activation, behavioral inhibition, impulsivity, self-esteem, extraversion, and conscientiousness). In Study 4 (n = 365), predictive validity was confirmed via associations with mean accidents and mean close calls in the high-risk domain. Finally, in Study 4, the self-report version of the inventory was significantly associated with an informant version of the inventory. The measure will allow researchers and practitioners to investigate risk taking as a variable that is conceptually distinct from participation in a high-risk sport.

  11. Framework for probabilistic flood risk assessment in an Alpine region

    Science.gov (United States)

    Schneeberger, Klaus; Huttenlau, Matthias; Steinberger, Thomas; Achleitner, Stefan; Stötter, Johann

    2014-05-01

    historic and synthetic flood events have to be spatially interpolated from point scale (i.e. river gauges) to the river network. Therefore, topological kriging (Top-kriging) proposed by Skøien et al. (2006) is applied. Top-kriging considers the nested structure of river networks and is therefore suitable to regionalise flood characteristics. Thus, the characteristics of a large number of possible flood events can be transferred to arbitrary locations (e.g. community level) at the river network within a study region. This framework has been used to generate a set of spatial correlated river flood events in the Austrian Federal Province of Vorarlberg. In addition, loss-probability-curves for each community has been calculated based on official inundation maps of public authorities, elements at risks and their vulnerability. One location along the river network within each community refers as interface between the set of flood events and the individual loss-probability relationships for the individual communities. Consequently, every flood event from the historic and synthetic generated dataset can be monetary evaluated. Thus, a time series comprising a large number of flood events and their corresponding monetary losses serves as basis for a probabilistic flood risk assessment. This includes expected annual losses and estimates of extreme event losses, which occur over the course of a certain time period. The gained results are essential decision-support for primary insurers, reinsurance companies and public authorities in order to setup a scale adequate risk management.

  12. Management of Skin Cancer in the High-Risk Patient.

    Science.gov (United States)

    Behan, James W; Sutton, Adam; Wysong, Ashley

    2016-12-01

    Skin cancer is the most common of human cancers and outnumbers all other types of cancer combined in the USA by over threefold. The majority of non-melanoma skin cancers are easily treated with surgery or locally destructive techniques performed under local anesthesia in the cost-effective outpatient setting. However, there is a subset of "high-risk" cases that prove challenging in terms of morbidity, mortality, adjuvant treatment required, as well as overall cost to the health care system. In our opinion, the term "high risk" when applied to skin cancer can mean one of three things: a high-risk tumor with aggressive histologic and/or clinical features with an elevated risk for local recurrence or regional/distant metastasis, a high-risk patient with the ongoing development of multiple skin cancers, and a high-risk patient based on immunosuppression. We have recently proposed classifying NMSC as a chronic disease in a certain subset of patients. Although no consensus definition exists for a chronic disease in medicine, there are three components that are present in most definitions: duration of at least 1 year, need for ongoing medical care, and functional impairment and/or alteration of activities of daily living (ADLs) and quality of life (QOL). Immunosuppression can refer to exogenous (organ or stem cell transplant patients,) or endogenous (HIV, leukemia, lymphoma, genodermatoses with DNA mismatch repair problems or other immunosuppression) causes. These patients are at risk for high-risk tumors and/or the development of multiple tumors.

  13. Risk of suicide in high risk pregnancy: an exploratory study.

    Science.gov (United States)

    Benute, Gláucia Rosana Guerra; Nomura, Roseli Mieko Yamamoto; Jorge, Vanessa Marques Ferreira; Nonnenmacher, Daniele; Fráguas Junior, Renério; Lucia, Mara Cristina Souza de; Zugaib, Marcelo

    2011-01-01

    To identify the risk of suicidal behavior in high-risk pregnant women at a public hospital in São Paulo. We conducted a semi-structured interview with each of the participants (n = 268) through a previously prepared questionnaire. Risk of suicidal behavior was assessed by the Portuguese version of PRIME-MD. The mean age of patients was 29 years (SD = 0.507) and gestation period was 30 weeks (SD = 0.556). Of the total sample, specific risk of suicide was found in 5% (n = 14). Of these, 85% have a stable relationship (married or cohabitating), the pregnancy was planned in 50% of cases, and 71% have no religion or professional activities. The correlation of risk of suicide with data from marital status, planned birth, age, education, professional practice, risk of prematurity, and religion showed that having a religion is statistically significant (p = 0.012). There were no positive associations for any of the other selected variables when compared with the risk of suicide. By correlating the risk of suicide with other characteristic symptoms of major depression, there was statistical significance in the sample with regard to insomnia or hypersomnia (p = 0.003), fatigue or loss of energy (p = 0.001), decreased or increased appetite (p = 0.005), less interest in daily activities (p = 0.000), depressed mood (p = 0.000), feelings of worthlessness or guilt (p = 0.000), decreased concentration (p = 0.002), and agitation or psychomotor retardation (p = 0.002). We found that religion can be a protective factor against suicidal behavior. Besides providing a social support network needed by women during pregnancy, religion supports belief in life after death and in a loving God, giving purpose to life and self esteem and providing models for coping with crises. The results show the importance of prevention and early diagnosis of suicidal behavior, since suicide is an attempt to move from one sphere to another by force, seeking to solve what seems impossible.

  14. Improving cluster-based methods for investigating potential for insect pest species establishment: region-specific risk factors

    Directory of Open Access Journals (Sweden)

    Michael J. Watts

    2011-09-01

    Full Text Available Existing cluster-based methods for investigating insect species assemblages or profiles of a region to indicate the risk of new insect pest invasion have a major limitation in that they assign the same species risk factors to each region in a cluster. Clearly regions assigned to the same cluster have different degrees of similarity with respect to their species profile or assemblage. This study addresses this concern by applying weighting factors to the cluster elements used to calculate regional risk factors, thereby producing region-specific risk factors. Using a database of the global distribution of crop insect pest species, we found that we were able to produce highly differentiated region-specific risk factors for insect pests. We did this by weighting cluster elements by their Euclidean distance from the target region. Using this approach meant that risk weightings were derived that were more realistic, as they were specific to the pest profile or species assemblage of each region. This weighting method provides an improved tool for estimating the potential invasion risk posed by exotic species given that they have an opportunity to establish in a target region.

  15. High tech in the Öresund region

    DEFF Research Database (Denmark)

    Hansen, Povl Adler; Serin, Göran Folke

    This book discusses the development conditions in the high tech sector for both high tech manufacturing and services. A central issue in the book is the differences in externalities which exist between various industries in the high tech sector. In this connection the confusion of externalities...... related to different parts of the high tech sector will be addressed. The location of the high tech sector in the Öresund region will be analysed and the region will also be related to other high tech regions in Europe....

  16. Laser prostatectomy in high-risk patients

    International Nuclear Information System (INIS)

    Tayib, Abdulmalik M.

    2008-01-01

    Objective was to evaluate the short-term tolerability and outcome of high power green light potassium titanyl phosphate laser prostatectomy in high-risk patients with symptomatic benign prostatic hyperplasia. Eleven high risk operative patients were included in this study at the International Medical Center, Jeddah, Kingdom of Saudi Arabia, between January and September 2007. Patients enrolled in this study underwent preoperative and postoperative, cardiac and anesthesia evaluation. Clinical presentations, ultrasound of urinary tract and preoperative laboratory investigation were recorded. All patients underwent high power green light laser prostatectomy using the green light photo vaporization system with setting of 120 watts. The intraoperative and postoperative complications and follow-up were recorded. The patient's age varied between 65-82 years with a mean age of 75.3+-8.6 years old. Seven patients presented with refractory acute urinary retention and 4 patients presented with severe lower urinary tract symptoms. The average prostate volume was 61.22 cc. All patients had uneventful intra- and postoperative course, without the intensive care. The average blood loss was insignificant and only one of the patients required blood transfusion. Foley catheters were removed one day after the procedure. All patients voided satisfactorily after removal of catheter and 8 patients complained of urgency. High power green light laser prostatectomy is a safe and effective method of treating symptomatic benign prostatic hyperplasia in patients with high operative risk. (author)

  17. Hazard risk and vulnerability assessment : Regional District of Nanaimo : final report

    International Nuclear Information System (INIS)

    2006-06-01

    A Hazard Risk and Vulnerability Assessment (HRVA) is a mandated regulatory requirement in British Columbia that requires local authorities to prepare emergency plans that reflect the local authority's assessment of the relative risk of occurrence and the potential impact on people and property of the hazards, emergencies or disasters that could affect the jurisdictional area for which the local authority has responsibility. This report constituted an HRVA for the Regional District of Nanaimo, British Columbia. It presented the study scope and methodology and provided an overview of the Regional District of Nanaimo. This included information on the setting, demographics, and economy. Next, it discussed social vulnerability; critical response and recovery facilities; and critical infrastructure such as water, energy, telecommunications and transportation. A summary of the Regional District of Nanaimo's response capabilities that were considered when assessing the Regional District's overall risk to the hazards was also presented. Response capabilities were discussed with reference to fire and rescue; police; ambulance; and search and rescue. Emergency support and preparedness organizations were also identified. These included the Emergency Coordination Centre, environmental services, emergency social services, amateur radio and health authorities. Last, 33 hazards that could affect the Regional District of Nanaimo were identified and discussed. The study identified the following hazards as high risk: flooding; forest fires and wildland urban interface fires; and human diseases and pandemic. It was recommended that the advancement of business continuity planning in the Regional District of Nanaimo would help to reduce the impact of a possible human disease and pandemic risk outbreak affecting the population. 75 refs., 25 figs., 14 tabs., 2 appendices

  18. High body mass index and cancer risk

    DEFF Research Database (Denmark)

    Benn, Marianne; Tybjærg-Hansen, Anne; Smith, George Davey

    2016-01-01

    of follow-up (range 0-37), 8002 developed non-skin cancer, 3347 non-melanoma skin cancer, 1396 lung cancer, 637 other smoking related cancers, 1203 colon cancer, 159 kidney cancer, 1402 breast cancer, 1062 prostate cancer, and 2804 other cancers. Participants were genotyped for five genetic variants...... with a BMI ≥ 30 versus 18.5-24.9 kg/m(2). Corresponding risk of breast cancer was 20 % (0-44 %) higher in postmenopausal women. BMI was not associated with risk of colon, kidney, other smoking related cancers, prostate cancer, or other cancers. In genetic analyses, carrying 7-10 versus 0-4 BMI increasing......High body mass index (BMI) has been associated with increased risk of some cancer. Whether these reflect causal associations is unknown. We examined this issue. Using a Mendelian randomisation approach, we studied 108,812 individuals from the general population. During a median of 4.7 years...

  19. High-Risk Stress Fractures: Diagnosis and Management.

    Science.gov (United States)

    McInnis, Kelly C; Ramey, Lindsay N

    2016-03-01

    Stress fractures are common overuse injuries in athletes. They occur during periods of increased training without adequate rest, disrupting normal bone reparative mechanisms. There are a host of intrinsic and extrinsic factors, including biochemical and biomechanical, that put athletes at risk. In most stress fractures, the diagnosis is primarily clinical, with imaging indicated at times, and management focused on symptom-free relative rest with advancement of activity as tolerated. Overall, stress fractures in athletes have an excellent prognosis for return to sport, with little risk of complication. There is a subset of injuries that have a greater risk of fracture progression, delayed healing, and nonunion and are generally more challenging to treat with nonoperative care. Specific locations of high-risk stress fracture include the femoral neck (tension side), patella, anterior tibia, medial malleolus, talus, tarsal navicular, proximal fifth metatarsal, and great toe sesamoids. These sites share a characteristic region of high tensile load and low blood flow. High-risk stress fractures require a more aggressive approach to evaluation, with imaging often necessary, to confirm early and accurate diagnosis and initiate immediate treatment. Treatment consists of nonweight-bearing immobilization, often with a prolonged period away from sport, and a more methodic and careful reintroduction to athletic activity. These stress fractures may require surgical intervention. A high index of suspicion is essential to avoid delayed diagnosis and optimize outcomes in this subset of stress fractures. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  20. Regional variations in risk factors for asthma in school children.

    Science.gov (United States)

    Lawson, Joshua A; Rennie, Donna C; Senthilselvan, Ambikaipakan; Cockcroft, Donald W; McDuffie, Helen H

    2005-09-01

    The authors have previously reported an increased prevalence of asthma in Estevan, Saskatchewan (21.4%) compared with Swift Current, Saskatchewan (16.2%). To determine the association between asthma and personal and indoor environmental risk factors in these communities. A population-based cross-sectional study was conducted in January 2000. A questionnaire was distributed to school children in grades 1 to 6 for completion by a parent. Multivariate logistic regression was used to examine associations between various risk factors and physician-diagnosed asthma. Asthma was associated with respiratory allergy (adjusted OR [adjOR]=8.85, 95% CI 6.79 to 11.54), early respiratory illness (adjOR=2.81, 95% CI 1.96 to 4.03) and family history of asthma (adjOR=2.37, 95% CI 1.67 to 3.36). Several environmental factors varied with asthma by town. In Estevan, asthma was associated with home mould or dampness (adjOR=1.82, 95% CI 1.23 to 2.69) and was inversely associated with air conditioning (adjOR=0.56, 95% CI 0.37 to 0.85). The risk of asthma was increased if the child had previous exposure to environmental tobacco smoke from the mother in both communities (Swift Current: OR=1.87, 95% CI 1.06 to 3.30; Estevan: OR=2.00, 95% CI 1.17 to 3.43), and there was an inverse association with current exposure to environmental tobacco smoke from the mother in Estevan (OR=0.64, 95% CI 0.40 to 1.00). When multivariate analyses were stratified by sex, the relationship between home mould or dampness and asthma was most prominent in girls in Estevan. Despite a similar regional location, different risk factors for asthma were identified in each community. Local environmental factors are important to consider when interpreting findings and planning asthma care.

  1. High-Risk Series: An Update

    Science.gov (United States)

    2015-02-01

    the Medicare Trustees, the Office of the Actuary , and the Congressional Budget Office have raised concerns about whether some of the Medicare... actuarially sound. For more information, see the National Flood Insurance Program section of this High-Risk report. Among other things, the report...and mathematics (STEM) functional community. In addition to the efforts of the Working Group, the President’s Fiscal Year 2013 budget—released in

  2. Assessing and Responding to the Risks of Global and Societal Changes in the MENA Region

    Science.gov (United States)

    Lange, Manfred

    2017-04-01

    Interactions and feedbacks between rapidly increasing multiple pressures on water, energy and food security drive social-ecological systems at multiple scales towards critical thresholds in countries of the Eastern Mediterranean, the Middle East and North Africa (MENA Region). The MENA Region is expected to experience significantly above-global-mean changes in climatic conditions and has been designated as one of the global "climate change hot spots" (Giorgi, F., 2006). The MENA region is also characterized by one of the highest rates of population growth on Earth, having seen a 3.7-fold increase in population between 1950 to 2000. The region is expected to continue to see a roughly doubling of its population until 2050 (Population Reference Bureau, 2001). Significant gender inequalities and an extremely high rate of youth unemployment are repercussions of such developments that exacerbate the societal pressures and tensions in the region. In addition, the events of the "Arab Spring", have resulted in major political, economic and societal transitions and have frequently been accompanied by significant armed struggles within and between countries of the MENA Region. These developments and the still ongoing conflicts in parts of the region render this region to one of the global "political, societal and humanitarian hot-spots". Responding to these challenges requires integrated science and a close relationship between policy makers and stakeholders, a need that Future Earth (www.futureearth.org) has been designed to respond to. In order to address the requirements of nation states and local communities, Future Earth has adopted a regional governance structure. This has resulted in the establishment of the Future Earth MENA Regional Center at the Cyprus Institute (FEMRC) in Nicosia, Cyprus, as one of five Regional Centers worldwide. One of the major challenges in establishing a regional Future-Earth-related research agenda lies in a comprehensive assessments of the

  3. Hypertension Control and Cardiometabolic Risk: A Regional Perspective

    Directory of Open Access Journals (Sweden)

    Martin Thoenes

    2012-01-01

    Full Text Available Background. We investigated the association between blood pressure control and common cardiometabolic risk factors from a global and regional perspective. Methods. In the present analysis of a large cross-sectional i-SEARCH study, 17.092 outpatients receiving antihypertensive treatment were included in 26 countries. According to clinical guidelines for the management of arterial hypertension, patients were classified based on the level of seated systolic/diastolic blood pressure (SBP/DBP. Uncontrolled hypertension was defined as SBP/DBP ≥140/90 mmHg for non-diabetics, and ≥130/80 mmHg for diabetics. Results. Overall, mean age was 63.1 years, 52.8% were male, and mean BMI was 28.9 kg/m2. Mean SBP/DBP was 148.9/87.0 mmHg, and 76.3% of patients had uncontrolled hypertension. Diabetes was present in 29.1% with mean HbA1c of 6.8%. Mean LDL-cholesterol was 3.2 mmol/L, HDL-cholesterol 1.3 mmol/L, and triglycerides 1.8 mmol/L; 49.0% had hyperlipidemia. Patients with uncontrolled hypertension had a higher BMI (29.4 versus 28.6 kg/m2, LDL-cholesterol (3.4 versus 3.0 mmol/L, triglycerides (1.9 versus 1.7 mmol/L, and HbA1c (6.8 versus 6.7% than those with controlled blood pressure (P<0.0001 for all parameters. Conclusions. Among outpatients treated for arterial hypertension, three quarters had uncontrolled blood pressure. Elevated SBP/DBP and uncontrolled hypertension were associated with increasing BMI, LDL-cholesterol, triglycerides, and HbA1c, both globally and regionally.

  4. Hygienic assessment of drinking water quality and risks to public health in Krasnoyarsk region

    Directory of Open Access Journals (Sweden)

    D.V. Goryaev

    2016-09-01

    Full Text Available The article presents the hygienic assessment of water quality in water sources of the Krasnoyarsk region used for centralized drinking water supply. It is shown that the exceeding of hygienic standards was registered at such indicators as iron (iron content is noted at the level to 1.8 mg/dm 3 or 6 MPC; fluorine (up to 6 MPC; ammonia and ammonium nitrogen (up to 2 MPC, nitrates (up to 5 MPC, organochlorine compounds (chloroform, carbon tetrachloride up to 5 MPC, manganese (up to 5.5 MPC, aluminium (up to 2 MPC. In water carcinogenic contaminants are recorded in significant concentrations: benzo(apyrene, cadmium, arsenic, nickel, lead. It is determined that the total lifetime carcinogenic risk to public health in the cities and districts of the Krasnoyarsk region due to oral intake from drinking water of chemicals of carcinogenic nature is negligible in 22 areas, and requires no additional measures to reduce. 23 territories of the region have carcinogenic risk ranged 1.0E-6 to 1.0E-5, which meets the criteria of acceptable risk. 9 territories (the town of Borodino, Lesosibirsk, Yeniseisk, Kazachinskiy, Partizansky, Pirovskiy, Rybinskiy, Sayanskiy, Uyarskiy areas show the level of lifetime individual cancer risk from 1.0E-5 to 2.0E-4, which is unacceptable for the population in general. The main contribution to the risk level (80.8–98.4 % makes the contents of arsenic in the drinking water. There is an increased risk of district (NI=1.2 and NI=1.17, respectively; bone and teeth from residents of the Sukhobuzimsky district (NI=1.04. High hazard indexes due to the nitrate and fluoride. Providing the population of urban districts and municipal districts of the Krasnoyarsk region with safe drinking water requires a set of various measures with the development and implementation of programs on improvement of water supply of populated areas

  5. Regional probabilistic nuclear risk and vulnerability assessment by integration of mathematical modelling land GIS-analysis

    International Nuclear Information System (INIS)

    Rigina, O.; Baklanov, A.

    2002-01-01

    The Kola Peninsula, Russian Arctic exceeds all other regions in the world in the number of nuclear reactors. The study was aimed at estimating possible radiation risks to the population in the Nordic countries in case of a severe accident in the Kola Peninsula. A new approach based on probabilistic analysis of modelled possible pathways of radionuclide transport and precipitation was developed. For the general population, Finland is at most risk with respect to the Kola NPP, because of: high population density or proximity to the radiation-risk sites and relatively high probability of an airflow trajectory there, and precipitation. After considering the critical group, northern counties in Norway, Finland and Sweden appear to be most vulnerable. (au)

  6. Development of innovative methods for risk assessment in high-rise construction based on clustering of risk factors

    Science.gov (United States)

    Okolelova, Ella; Shibaeva, Marina; Shalnev, Oleg

    2018-03-01

    The article analyses risks in high-rise construction in terms of investment value with account of the maximum probable loss in case of risk event. The authors scrutinized the risks of high-rise construction in regions with various geographic, climatic and socio-economic conditions that may influence the project environment. Risk classification is presented in general terms, that includes aggregated characteristics of risks being common for many regions. Cluster analysis tools, that allow considering generalized groups of risk depending on their qualitative and quantitative features, were used in order to model the influence of the risk factors on the implementation of investment project. For convenience of further calculations, each type of risk is assigned a separate code with the number of the cluster and the subtype of risk. This approach and the coding of risk factors makes it possible to build a risk matrix, which greatly facilitates the task of determining the degree of impact of risks. The authors clarified and expanded the concept of the price risk, which is defined as the expected value of the event, 105 which extends the capabilities of the model, allows estimating an interval of the probability of occurrence and also using other probabilistic methods of calculation.

  7. Regional differences in self-reported screening, prevalence and management of cardiovascular risk factors in Switzerland

    Science.gov (United States)

    2012-01-01

    Background In Switzerland, health policies are decided at the local level, but little is known regarding their impact on the screening and management of cardiovascular risk factors (CVRFs). We thus aimed at assessing geographical levels of CVRFs in Switzerland. Methods Swiss Health Survey for 2007 (N = 17,879). Seven administrative regions were defined: West (Leman), West-Central (Mittelland), Zurich, South (Ticino), North-West, East and Central Switzerland. Obesity, smoking, hypertension, dyslipidemia and diabetes prevalence, treatment and screening within the last 12 months were assessed by interview. Results After multivariate adjustment for age, gender, educational level, marital status and Swiss citizenship, no significant differences were found between regions regarding prevalence of obesity or current smoking. Similarly, no differences were found regarding hypertension screening and prevalence. Two thirds of subjects who had been told they had high blood pressure were treated, the lowest treatment rates being found in East Switzerland: odds-ratio and [95% confidence interval] 0.65 [0.50-0.85]. Screening for hypercholesterolemia was more frequently reported in French (Leman) and Italian (Ticino) speaking regions. Four out of ten participants who had been told they had high cholesterol levels were treated and the lowest treatment rates were found in German-speaking regions. Screening for diabetes was higher in Ticino (1.24 [1.09 - 1.42]). Six out of ten participants who had been told they had diabetes were treated, the lowest treatment rates were found for German-speaking regions. Conclusions In Switzerland, cardiovascular risk factor screening and management differ between regions and these differences cannot be accounted for by differences in populations' characteristics. Management of most cardiovascular risk factors could be improved. PMID:22452881

  8. Improving Magnet Designs With High and Low Field Regions

    DEFF Research Database (Denmark)

    Bjørk, Rasmus; Bahl, Christian Robert Haffenden; Smith, Anders

    2011-01-01

    A general scheme for increasing the difference in magnetic flux density between a high and a low magnetic field region by removing unnecessary magnet material is presented. This is important in, e.g., magnetic refrigeration where magnet arrays have to deliver high field regions in close proximity...... to low field regions. Also, a general way to replace magnet material with a high permeability soft magnetic material where appropriate is discussed. As an example, these schemes are applied to a two dimensional concentric Halbach cylinder design resulting in a reduction of the amount of magnet material...

  9. DEVELOPMENT OF THE SOCIAL TENSION RISK PREDICTING ALGORITHM IN THE POPULATION OF CERTAIN REGIONS OF RUSSIA

    Directory of Open Access Journals (Sweden)

    A. B. Mulik

    2017-01-01

    Full Text Available Aim. The aim of the study was development of approaches to predict the risk of social tension for population of the Russian Federation regions.Methods. Theoretical studies based on the analysis of cartographic material from the National Atlas of Russia. The use of geo-information technologies has provided modeling of environmental load in the territory of certain regions of Russia. Experimental studies were performed using standard methods of psycho-physiological testing involving 336 persons 18-23 years old of both sexes.Results. As a fundamental biologically significant factor of the environment, differentiating the Russian Federation territory to areas with discrete actual physical effects, total solar radiation was determined. The subsequent allocation of model regions (Republic of Crimea, Rostov and Saratov regions based on the principle of minimizing regional differences associated factors of environmental pressure per person. Experimental studies have revealed persistent systemic relationships of phenotypic characteristics and tendency of person to neuropsychic tension. The risk of social tension for the study area population is predicted on the condition of finding more than two thirds of the representatives of sample within the borders of a high level of general non-specific reactivity of an organism.Main conclusions. The expediency of using the northern latitude as an integral index of differentiation of areas on the specifics of the severity of the physical factors of environmental impact on human activity is justified. The possibility of the application for the level of general nonspecific reactivity of an organism as a phenotypic trait marker of social tension risk is identified. An algorithm for predicting the risk of social tension among the population, compactly living in certain territories of the Russian Federation is designed. 

  10. Northeast Regional Cancer Institute's Cancer Surveillance and Risk Factor Program

    Energy Technology Data Exchange (ETDEWEB)

    Lesko, Samuel M.

    2007-07-31

    OBJECTIVES The Northeast Regional Cancer Institute is conducting a program of ongoing epidemiologic research to address cancer disparities in northeast Pennsylvania. Of particular concern are disparities in the incidence of, stage at diagnosis, and mortality from colorectal cancer. In northeast Pennsylvania, age-adjusted incidence and mortality rates for colorectal cancer are higher, and a significantly smaller proportion of new colorectal cancer cases are diagnosed with local stage disease than is observed in comparable national data. Further, estimates of the prevalence of colorectal cancer screening in northeast Pennsylvania are lower than the US average. The Northeast Regional Cancer Institute’s research program supports surveillance of common cancers, investigations of cancer risk factors and screening behaviors, and the development of resources to further cancer research in this community. This project has the following specific objectives: I. To conduct cancer surveillance in northeast Pennsylvania. a. To monitor incidence and mortality for all common cancers, and colorectal cancer, in particular, and b. To document changes in the stage at diagnosis of colorectal cancer in this high-risk, underserved community. II. To conduct a population-based study of cancer risk factors and screening behavior in a six county region of northeast Pennsylvania. a. To monitor and document changes in colorectal cancer screening rates, and b. To document the prevalence of cancer risk factors (especially factors that increase the risk of colorectal cancer) and to identify those risk factors that are unusually common in this community. APPROACH Cancer surveillance was conducted using data from the Northeast Regional Cancer Institute’s population-based Regional Cancer Registry, the Pennsylvania Cancer Registry, and NCI’s SEER program. For common cancers, incidence and mortality were examined by county within the region and compared to data for similar populations in the US

  11. Prevalence and risk factors associated with Theileria parva infection in cattle in three regions of Tanzania

    DEFF Research Database (Denmark)

    Kerario, Isack I.; Simuunza, Martin C; Chenyambuga, Sebastian W

    2017-01-01

    of ECF in Tanzania has continued to be a challenge due to inadequate epidemiological information. The main objective of this study was to determine the epidemiological situation of Theileria parva infections in cattle kept under pastoral and agro-pastoral farming systems in Mara, Singida, and Mbeya...... not found to be significant predictors of being PCR positive for T. parva. The present study showed high variation in tick burden and T. parva prevalence across the regions. Therefore, different strategic planning and cost-effective control measures for ticks and T. parva infection should be implemented...... regions of Tanzania. Blood samples were collected from 648 cattle in the three regions. Genomic DNA was extracted and amplified in a polymerase chain reaction (PCR) using T. parva-specific primers targeting the 104-kD antigen (P104) gene. In addition, information was collected on the possible risk factors...

  12. Expanding pedestrian injury risk to the body region level: how to model passive safety systems in pedestrian injury risk functions.

    Science.gov (United States)

    Niebuhr, Tobias; Junge, Mirko; Achmus, Stefanie

    2015-01-01

    Assessment of the effectiveness of advanced driver assistance systems (ADAS) plays a crucial role in accident research. A common way to evaluate the effectiveness of new systems is to determine the potentials for injury severity reduction. Because injury risk functions describe the probability of an injury of a given severity conditional on a technical accident severity (closing speed, delta V, barrier equivalent speed, etc.), they are predestined for such evaluations. Recent work has stated an approach on how to model the pedestrian injury risk in pedestrian-to-passenger car accidents as a family of functions. This approach gave explicit and easily interpretable formulae for the injury risk conditional on the closing speed of the car. These results are extended to injury risk functions for pedestrian body regions. Starting with a double-checked German In-depth Accident Study (GIDAS) pedestrian-to-car accident data set (N = 444) and a functional-anatomical definition of the body regions, investigations on the influence of specific body regions on the overall injury severity will be presented. As the measure of injury severity, the ISSx, a rescaled version of the well-known Injury Severity Score (ISS), was used. Though traditional ISS is computed by summation of the squares of the 3 most severe injured body regions, ISSx is computed by the summation of the exponentials of the Abbreviated Injury Scale (AIS) severities of the 3 most severely injured body regions. The exponentials used are scaled to fit the ISS range of values between 0 and 75. Three body regions (head/face/neck, thorax, hip/legs) clearly dominated abdominal and upper extremity injuries; that is, the latter 2 body regions had no influence at all on the overall injury risk over the range of technical accident severities. Thus, the ISSx is well described by use of the injury codes from the same body regions for any pedestrian injury severity. As a mathematical consequence, the ISSx becomes explicitly

  13. X-ray absorption intensity at high-energy region

    International Nuclear Information System (INIS)

    Fujikawa, Takashi; Kaneko, Katsumi

    2012-01-01

    We theoretically discuss X-ray absorption intensity in high-energy region far from the deepest core threshold to explain the morphology-dependent mass attenuation coefficient of some carbon systems, carbon nanotubes (CNTs), highly oriented pyrolytic graphite (HOPG) and fullerenes (C 60 ). The present theoretical approach is based on the many-body X-ray absorption theory including the intrinsic losses (shake-up losses). In the high-energy region the absorption coefficient has correction term dependent on the solid state effects given in terms of the polarization part of the screened Coulomb interaction W p . We also discuss the tail of the valence band X-ray absorption intensity. In the carbon systems C 2s contribution has some influence on the attenuation coefficient even in the high energy region at 20 keV.

  14. A Regional Decision Support Scheme for Pest Risk Analysis in Southeast Asia.

    Science.gov (United States)

    Soliman, T; MacLeod, A; Mumford, J D; Nghiem, T P L; Tan, H T W; Papworth, S K; Corlett, R T; Carrasco, L R

    2016-05-01

    A key justification to support plant health regulations is the ability of quarantine services to conduct pest risk analyses (PRA). Despite the supranational nature of biological invasions and the close proximity and connectivity of Southeast Asian countries, PRAs are conducted at the national level. Furthermore, some countries have limited experience in the development of PRAs, which may result in inadequate phytosanitary responses that put their plant resources at risk to pests vectored via international trade. We review existing decision support schemes for PRAs and, following international standards for phytosanitary measures, propose new methods that adapt existing practices to suit the unique characteristics of Southeast Asia. Using a formal written expert elicitation survey, a panel of regional scientific experts was asked to identify and rate unique traits of Southeast Asia with respect to PRA. Subsequently, an expert elicitation workshop with plant protection officials was conducted to verify the potential applicability of the developed methods. Rich biodiversity, shortage of trained personnel, social vulnerability, tropical climate, agriculture-dependent economies, high rates of land-use change, and difficulties in implementing risk management options were identified as challenging Southeast Asian traits. The developed methods emphasize local Southeast Asian conditions and could help support authorities responsible for carrying out PRAs within the region. These methods could also facilitate the creation of other PRA schemes in low- and middle-income tropical countries. © 2016 Society for Risk Analysis.

  15. Caesarean Risk Factors in Northern Region of Bangladesh: A ...

    African Journals Online (AJOL)

    Purpose: To explore the measurement of a scale of caesarean (C-section) risk factors and degree of risk contribution in different health facilities and to determine a suitable graphical representation (image) of caesarean cases. Methods: Based on seventeen indicators, a composite index was computed for each respondent ...

  16. Turbine component casting core with high resolution region

    Science.gov (United States)

    Kamel, Ahmed; Merrill, Gary B.

    2014-08-26

    A hollow turbine engine component with complex internal features can include a first region and a second, high resolution region. The first region can be defined by a first ceramic core piece formed by any conventional process, such as by injection molding or transfer molding. The second region can be defined by a second ceramic core piece formed separately by a method effective to produce high resolution features, such as tomo lithographic molding. The first core piece and the second core piece can be joined by interlocking engagement that once subjected to an intermediate thermal heat treatment process thermally deform to form a three dimensional interlocking joint between the first and second core pieces by allowing thermal creep to irreversibly interlock the first and second core pieces together such that the joint becomes physically locked together providing joint stability through thermal processing.

  17. Risk Management Plan (RMP) Facility Points, Region 9, 2011, US EPA Region 9

    Data.gov (United States)

    U.S. Environmental Protection Agency — Risk Management Plan (RMP): Under the Clean Air Act, Section 112(r), the EPA established a program requiring risk management plans to be provided to the EPA by...

  18. Risk Management Plan (RMP) Facility Points, Region 9, 2014, US EPA Region 9

    Data.gov (United States)

    U.S. Environmental Protection Agency — Risk Management Plan (RMP): Under the Clean Air Act, Section 112(r), the EPA established a program requiring risk management plans to be provided to the EPA by...

  19. Outcome after regional anesthesia: weighing risks and benefits

    NARCIS (Netherlands)

    Lirk, P.; Hollmann, M. W.

    2014-01-01

    Regional anesthesia has become a widely used method to provide intraoperative anesthesia, and postoperative analgesia. This review seeks to address the question whether patient outcomes are improved to an extent that justifies using regional anesthesia as a routine method. During the past decade, a

  20. A comparative review of multi-risk modelling methodologies for climate change adaptation in mountain regions

    Science.gov (United States)

    Terzi, Stefano; Torresan, Silvia; Schneiderbauer, Stefan

    2017-04-01

    Keywords: Climate change, mountain regions, multi-risk assessment, climate change adaptation. Climate change has already led to a wide range of impacts on the environment, the economy and society. Adaptation actions are needed to cope with the impacts that have already occurred (e.g. storms, glaciers melting, floods, droughts) and to prepare for future scenarios of climate change. Mountain environment is particularly vulnerable to the climate changes due to its exposure to recent climate warming (e.g. water regime changes, thawing of permafrost) and due to the high degree of specialization of both natural and human systems (e.g. alpine species, valley population density, tourism-based economy). As a consequence, the mountain local governments are encouraged to undertake territorial governance policies to climate change, considering multi-risks and opportunities for the mountain economy and identifying the best portfolio of adaptation strategies. This study aims to provide a literature review of available qualitative and quantitative tools, methodological guidelines and best practices to conduct multi-risk assessments in the mountain environment within the context of climate change. We analyzed multi-risk modelling and assessment methods applied in alpine regions (e.g. event trees, Bayesian Networks, Agent Based Models) in order to identify key concepts (exposure, resilience, vulnerability, risk, adaptive capacity), climatic drivers, cause-effect relationships and socio-ecological systems to be integrated in a comprehensive framework. The main outcomes of the review, including a comparison of existing techniques based on different criteria (e.g. scale of analysis, targeted questions, level of complexity) and a snapshot of the developed multi-risk framework for climate change adaptation will be here presented and discussed.

  1. Postoperative chemoradiotherapy in high risk locally advanced gastric cancer

    Energy Technology Data Exchange (ETDEWEB)

    Song, Sang Hyuk; Chie, Eui Kyu; Kim, Kyu Bo; Lee, Hyuk Joon; Yang, Han Kwang; Han, Sae Won; Oh, Do Youn; Im, Seok Ah; Bang, Yung Jue; Ha, Sung W. [Seoul National University College of Medicine, Seoul(Korea, Republic of)

    2012-12-15

    To evaluate treatment outcome of patients with high risk locally advanced gastric cancer after postoperative chemoradiotherapy. Between May 2003 and May 2012, thirteen patients who underwent postoperative chemoradiotherapy for gastric cancer with resection margin involvement or adjacent structure invasion were retrospectively analyzed. Concurrent chemotherapy was administered in 10 patients. Median dose of radiation was 50.4 Gy (range, 45 to 55.8 Gy). The median follow-up duration for surviving patients was 48 months (range, 5 to 108 months). The 5-year overall survival rate was 42% and the 5-year disease-free survival rate was 28%. Major pattern of failure was peritoneal seeding with 46%. Loco-regional recurrence was reported in only one patient. Grade 2 or higher gastrointestinal toxicity occurred in 54% of the patients. However, there was only one patient with higher than grade 3 toxicity. Despite reported suggested role of adjuvant radiotherapy with combination chemotherapy in gastric cancer, only very small portion of the patients underwent the treatment. Results from this study show that postoperative chemoradiotherapy provided excellent locoregional control with acceptable and manageable treatment related toxicity in patients with high risk locally advanced gastric cancer. Thus, postoperative chemoradiotherapy may improve treatment result in terms of locoregional control in these high risk patients. However, as these findings are based on small series, validation with larger cohort is suggested.

  2. Prescription of the High Risk Narcotics and Trading or Illicit Purchasing of High Risk Narcotics

    Directory of Open Access Journals (Sweden)

    Nicoleta-Elena Buzatu

    2012-05-01

    Full Text Available The present essay will analyze the offence of prescribing high risk narcotics and trading or illicit purchasing of high risk narcotics, as it was regulated - together with other offences - by Law no 143 of July 26, 2000 on preventing and fighting against the traffic and illicit consumption of narcotics. The same law defines the meaning of such a phrase “substances which are under national control” by mentioning the fact that they are the narcotics and their precursors listed in Annexes I-IV of the law. The analysis of the offence of prescribing the high risk narcotics and trading or illicit purchasing of high risk narcotics is following the already known structure mentioned in the doctrine and which consists of: object and subjects of the offence, its constituent content: the objective side with its material element, the immediate consequence and causality connections; the subjective side of the offence, as well as forms and modalities of these offences, and the applicable sanctions, of course.

  3. Social and Psychological Factors Related to Risk of Eating Disorders Among High School Girls.

    Science.gov (United States)

    Alfoukha, Marwa M; Hamdan-Mansour, Ayman M; Banihani, Manar Ali

    2017-01-01

    Prevalence of eating disorders (EDs) has increased among adolescents in Arabic and Western countries. The purposes are to identify the risk of ED and psychosocial correlates of risk of ED among high school girls in Jordan. The researchers employed a cross-sectional, correlational design using 799 high school girls from governmental and private schools in the central region of Jordan. The results indicate that prevalence of the risk of ED was 12%. The risk of ED had significant and positive correlation with body shape dissatisfaction, self-esteem, psychological distress, and pressure from family, peers, and media ( p self-esteem, negative peer pressure, and being young were significant predictors of the risk of EDs. Risk of ED is highly prevalent among high school girls, and school nurses need to adopt a model of care addressing the risk factors while caring for high school girls.

  4. People at High Risk of Developing Flu-Related Complications

    Science.gov (United States)

    ... Influenza Types Seasonal Avian Swine Variant Pandemic Other People at High Risk of Developing Flu–Related Complications ... related complications if they get sick with influenza. People at High Risk for Developing Flu-Related Complications ...

  5. Risk management in crop production based on the regional index

    Directory of Open Access Journals (Sweden)

    Kokot Željko

    2017-01-01

    Full Text Available Regional index insurance is one of the newer instruments for reducing losses in crop production. The regional index indicates the average yield or average production value in a region, representing the basis for the premium calculation and insurance benefits. The main advantage of this insurance model is that it does not require the damage assessment, which is one of major problems in the relationship between the insured and insurer. In the case of corn, wheat and sunflower production as the most important crops in the region of Ada municipality, the authors describe the methodology of application of the analysed insurance system. Implementation of this contemporary form of insurance in Serbia would reduce the negative financial consequences in agricultural production. The abovementioned model of insurance can be seen as a significant alternative to conventional insurance, which can increase insured area and number of insured, and trust and confidence in insurance companies would also be restored.

  6. A High-resolution Reanalysis for the European CORDEX Region

    Science.gov (United States)

    Bentzien, Sabrina; Bollmeyer, Christoph; Crewell, Susanne; Friederichs, Petra; Hense, Andreas; Keller, Jan; Keune, Jessica; Kneifel, Stefan; Ohlwein, Christian; Pscheidt, Ieda; Redl, Stephanie; Steinke, Sandra

    2014-05-01

    A High-resolution Reanalysis for the European CORDEX Region Within the Hans-Ertel-Centre for Weather Research (HErZ), the climate monitoring branch concentrates efforts on the assessment and analysis of regional climate in Germany and Europe. In joint cooperation with DWD (German Meteorological Service), a high-resolution reanalysis system based on the COSMO model has been developed. Reanalyses gain more and more importance as a source of meteorological information for many purposes and applications. Several global reanalyses projects (e.g., ERA, MERRA, CSFR, JMA9) produce and verify these data sets to provide time series as long as possible combined with a high data quality. Due to a spatial resolution down to 50-70km and 3-hourly temporal output, they are not suitable for small scale problems (e.g., regional climate assessment, meso-scale NWP verification, input for subsequent models such as river runoff simulations). The implementation of regional reanalyses based on a limited area model along with a data assimilation scheme is able to generate reanalysis data sets with high spatio-temporal resolution. The work presented here focuses on the regional reanalysis for Europe with a domain matching the CORDEX-EURO-11 specifications, albeit at a higher spatial resolution, i.e., 0.055° (6km) instead of 0.11° (12km). The COSMO reanalysis system comprises the assimilation of observational data using the existing nudging scheme of COSMO and is complemented by a special soil moisture analysis and boundary conditions given by ERA-interim data. The reanalysis data set currently covers 6 years (2007-2012). The evaluation of the reanalyses is done using independent observations with special emphasis on precipitation and high-impact weather situations. The development and evaluation of the COSMO-based reanalysis for the CORDEX-Euro domain can be seen as a preparation for joint European activities on the development of an ensemble system of regional reanalyses for Europe.

  7. High intensity region segmentation in MR imaging of multiple sclerosis

    International Nuclear Information System (INIS)

    Rodrigo, F; Filipuzzi, M; Graffigna, J P; Isoardi, R; Noceti, M

    2013-01-01

    Numerous pathologies are often manifest in Magnetic Resonance Imaging (MRI) as hyperintense or bright regions as compared to normal tissue. It is of particular interest to develop an algorithm to detect, identify and define those Regions of Interest (ROI) when analyzing MRI studies, particularly for lesions of Multiple Sclerosis (MS). The objective of this study is to analyze those parameters which optimize segmentation of the areas of interest. To establish which areas should be considered as hyperintense regions, we developed a database (DB), with studies of patients diagnosed with MS. This disease causes axonal demyelination and it is expressed as bright regions in PD, T2 and FLAIR MRI sequences. Thus, with more than 4300 hyperintense regions validated by an expert physician, an algorithm was developed to detect such spots, approximating the results the expert obtained. Alongside these hyperintense lesion regions, it also detected bone regions with high intensity levels, similar to the intensity of the lesions, but with other features that allow a good differentiation.The algorithm will then detect ROIs with similar intensity levels and performs classification through data mining techniques

  8. Risk factors for bovine tuberculosis in low incidence regions related to the movements of cattle

    Science.gov (United States)

    2013-01-01

    and the volume of cattle imported from endemic regions. Conclusions Although the most likely source of bTB infections in Scotland was cattle previously imported from endemic regions, we found indirect evidence of transmission within Scottish cattle farms and cannot rule out the possibility of low level transmission between farms. Further investigation is needed to determine whether targeting herds with unconfirmed reactors and a history of importing cattle from high risk regions would benefit control efforts. PMID:24206865

  9. Integration of industrial risk in regional policy management. Possibilities of evaluation

    International Nuclear Information System (INIS)

    Hubert, Philippe; Pages, Pierre

    1990-02-01

    Since the responsibility for risk management depends more and more on regional factors, evaluation methods and management regulations are not developed enough. This study start from the fact that an important methods exist for evaluation transport of dangerous materials in cities, risk analysis and emergency plans related to classified installations, management of quality of water, 'chronic' industrial risks at local and regional level, probabilistic estimation for industrial plants. The objective is in fact to show what risk analysis could bring to the municipality, the city or the region [fr

  10. Lifestyle and risk factor management in people at high risk of cardiovascular disease. A report from the European Society of Cardiology European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) IV cross-sectional survey in 14 European regions

    OpenAIRE

    Kotseva, Kornelia; De Bacquer, Dirk; De Backer, Guy; Ryden, Lars; Jennings, Catriona; Gyberg, Viveca; Abreu, Ana; Aguiar, Carlos; Conde, Almudena C.; Davletov, Kairat; Dilic, Mirza; Dolzhenko, Maryna; Gaita, Dan; Georgiev, Borislav; Gotcheva, Nina

    2016-01-01

    BACKGROUND: European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) IV in primary care was a cross-sectional survey carried out by the European Society of Cardiology, EURObservational Research Programme in 2014-2015 in 71 centres from 14 European countries. The main objective was to determine whether the 2012 Joint European Societies' guidelines on cardiovascular disease (CVD) prevention in people at high CVD risk have been followed in clinical practi...

  11. Potential risk of regional disease spread in West Africa through cross-border cattle trade.

    Directory of Open Access Journals (Sweden)

    Anna S Dean

    Full Text Available Transboundary animal movements facilitate the spread of pathogens across large distances. Cross-border cattle trade is of economic and cultural importance in West Africa. This study explores the potential disease risk resulting from large-scale, cross-border cattle trade between Togo, Burkina Faso, Ghana, Benin, and Nigeria for the first time.A questionnaire-based survey of livestock movements of 226 cattle traders was conducted in the 9 biggest cattle markets of northern Togo in February-March 2012. More than half of the traders (53.5% operated in at least one other country. Animal flows were stochastically simulated based on reported movements and the risk of regional disease spread assessed. More than three quarters (79.2%, range: 78.1-80.0% of cattle flowing into the market system originated from other countries. Through the cattle market system of northern Togo, non-neighbouring countries were connected via potential routes for disease spread. Even for diseases with low transmissibility and low prevalence in a given country, there was a high risk of disease introduction into other countries.By stochastically simulating data collected by interviewing cattle traders in northern Togo, this study identifies potential risks for regional disease spread in West Africa through cross-border cattle trade. The findings highlight that surveillance for emerging infectious diseases as well as control activities targeting endemic diseases in West Africa are likely to be ineffective if only conducted at a national level. A regional approach to disease surveillance, prevention and control is essential.

  12. Potential Risk of Regional Disease Spread in West Africa through Cross-Border Cattle Trade

    Science.gov (United States)

    Dean, Anna S.; Fournié, Guillaume; Kulo, Abalo E.; Boukaya, G. Aboudou; Schelling, Esther; Bonfoh, Bassirou

    2013-01-01

    Background Transboundary animal movements facilitate the spread of pathogens across large distances. Cross-border cattle trade is of economic and cultural importance in West Africa. This study explores the potential disease risk resulting from large-scale, cross-border cattle trade between Togo, Burkina Faso, Ghana, Benin, and Nigeria for the first time. Methods and Principal Findings A questionnaire-based survey of livestock movements of 226 cattle traders was conducted in the 9 biggest cattle markets of northern Togo in February-March 2012. More than half of the traders (53.5%) operated in at least one other country. Animal flows were stochastically simulated based on reported movements and the risk of regional disease spread assessed. More than three quarters (79.2%, range: 78.1–80.0%) of cattle flowing into the market system originated from other countries. Through the cattle market system of northern Togo, non-neighbouring countries were connected via potential routes for disease spread. Even for diseases with low transmissibility and low prevalence in a given country, there was a high risk of disease introduction into other countries. Conclusions By stochastically simulating data collected by interviewing cattle traders in northern Togo, this study identifies potential risks for regional disease spread in West Africa through cross-border cattle trade. The findings highlight that surveillance for emerging infectious diseases as well as control activities targeting endemic diseases in West Africa are likely to be ineffective if only conducted at a national level. A regional approach to disease surveillance, prevention and control is essential. PMID:24130721

  13. Patients at high risk of tuberculosis recurrence

    Directory of Open Access Journals (Sweden)

    Mehdi Mirsaeidi

    2018-01-01

    Full Text Available Recurrent tuberculosis (TB continues to be a significant problem and is an important indicator of the effectiveness of TB control. Recurrence can occur by relapse or exogenous reinfection. Recurrence of TB is still a major problem in high-burden countries, where there is lack of resources and no special attention is being given to this issue. The rate of recurrence is highly variable and has been estimated to range from 4.9% to 47%. This variability is related to differences in regional epidemiology of recurrence and differences in the definitions used by the TB control programs. In addition to treatment failure from noncompliance, there are several key host factors that are associated with high rates of recurrence. The widely recognized host factors independent of treatment program that predispose to TB recurrence include gender differences, malnutrition; comorbidities such as diabetes, renal failure, and systemic diseases, especially immunosuppressive states such as human immunodeficiency virus; substance abuse; and environmental exposures such as silicosis. With improved understanding of the human genome, proteome, and metabolome, additional host-specific factors that predispose to recurrence are being identified. Information on temporal and geographical trends of TB cases as well as studies with whole-genome sequencing might provide further information to enable us to fully understand TB recurrence and discriminate between reactivation and new infection. The recently launched World Health Organization End TB Strategy emphasizes the importance of integrated, patient-centered TB care. Continued improvement in diagnosis, treatment approaches, and an understanding of host-specific factors are needed to fully understand the clinical epidemiological and social determinants of TB recurrence.

  14. Patients at high risk of tuberculosis recurrence.

    Science.gov (United States)

    Mirsaeidi, Mehdi; Sadikot, Ruxana T

    2018-01-01

    Recurrent tuberculosis (TB) continues to be a significant problem and is an important indicator of the effectiveness of TB control. Recurrence can occur by relapse or exogenous reinfection. Recurrence of TB is still a major problem in high-burden countries, where there is lack of resources and no special attention is being given to this issue. The rate of recurrence is highly variable and has been estimated to range from 4.9% to 47%. This variability is related to differences in regional epidemiology of recurrence and differences in the definitions used by the TB control programs. In addition to treatment failure from noncompliance, there are several key host factors that are associated with high rates of recurrence. The widely recognized host factors independent of treatment program that predispose to TB recurrence include gender differences, malnutrition; comorbidities such as diabetes, renal failure, and systemic diseases, especially immunosuppressive states such as human immunodeficiency virus; substance abuse; and environmental exposures such as silicosis. With improved understanding of the human genome, proteome, and metabolome, additional host-specific factors that predispose to recurrence are being identified. Information on temporal and geographical trends of TB cases as well as studies with whole-genome sequencing might provide further information to enable us to fully understand TB recurrence and discriminate between reactivation and new infection. The recently launched World Health Organization End TB Strategy emphasizes the importance of integrated, patient-centered TB care. Continued improvement in diagnosis, treatment approaches, and an understanding of host-specific factors are needed to fully understand the clinical epidemiological and social determinants of TB recurrence.

  15. Relationship between the prognostic and predictive value of the intrinsic subtypes and a validated gene profile predictive of loco-regional control and benefit from post-mastectomy radiotherapy in patients with high-risk breast cancer

    DEFF Research Database (Denmark)

    Tramm, Trine; Kyndi, Marianne; Myhre, Simen

    2014-01-01

    , and has shown prognostic impact in terms of loco-regional failure and predictive impact for PMRT. Reports have also shown predictive value in terms of benefit of PMRT from intrinsic subtypes and derived approximations. The aim of this study was to examine: 1) the agreement between various methods...... for determining the intrinsic subtypes; and 2) the relationship between the prognostic and predictive impact of the DBCG-RT profile and the intrinsic subtypes. MATERIAL AND METHODS: Intrinsic subtypes and the DBCG-RT profile was determined from microarray analysis based on fresh frozen tissue from 191 patients...... and predictive information obtained from the DBCG-RT profile cannot be substituted by any approximation of the tumors intrinsic subtype. The predictive value of the intrinsic subtypes in terms of PMRT was influenced by the method used for assignment to the intrinsic subtypes....

  16. High beta and second stability region transport and stability analysis

    International Nuclear Information System (INIS)

    1990-01-01

    This document summarizes progress made on the research of high beta and second region transport and stability. In the area second stability region studies we report on an investigation of the possibility of second region access in the center of TFTR ''supershots.'' The instabilities found may coincide with experimental observation. Significant progress has been made on the resistive stability properties of high beta poloidal ''supershot'' discharges. For these studies profiles were taken from the TRANSP transport analysis code which analyzes experimental data. Invoking flattening of the pressure profile on mode rational surfaces causes tearing modes to persist into the experimental range of interest. Further, the experimental observation of the modes seems to be consistent with the predictions of the MHD model. In addition, code development in several areas has proceeded

  17. Client experiences with perinatal healthcare for high-risk and low-risk women

    NARCIS (Netherlands)

    van Stenus, Cherelle M.V.; Boere-Boonekamp, Magda M.; Kerkhof, Erna F.G.M.; Need, Ariana

    2018-01-01

    Problem: It is unknown if client experiences with perinatal healthcare differ between low-risk and high-risk women. Background: In the Netherlands, risk selection divides pregnant women into low- and high-risk groups. Receiving news that a pregnancy or childbirth has an increased likelihood of

  18. Climate risk management information, sources and responses in a pastoral region in East Africa

    Directory of Open Access Journals (Sweden)

    Anthony Egeru

    2016-01-01

    Full Text Available Pastoralists in East Africa face a range of stressors, climate variability and change being one of them. Effective climate risk management involves managing the full range of variability and balancing hazard management with efforts to capitalise on opportunity; climate risk management information is central in this process. In this study, pastoralists’ perceptions of climate change, climate risk management information types, sources and attendant responses in a pastoral region in East Africa are examined. Through a multi-stage sampling process, a total of 198 heads of households in three districts were selected and interviewed using a semi-structured questionnaire. In addition, 29 focus group discussions and 10 key informant interviews were conducted to generate qualitative information to supplement survey data. Descriptive and thematic analysis were utilised in summarizing the data. Ninety-nine percent of the pastoralists noted that the climate had changed evidenced by high but erratic rainfall, occurrence of floods and variation in rainfall onset and cessation among other indicators. This change in climate had led to emergence of ‘new’ livestock and crop diseases, crop failure and low yields leading to frequent food shortages, water shortages, poor market access, and variation in pasture availability among other effects. Climate risk management information was received from multiple sources including; radio, diviners, community meetings, shrine elders, humanitarian agencies, and Uganda People’s defence forces (UPDF. Community meetings were however perceived as most accessible, reliable and dependable sources of information. Shifting livestock to dry season grazing and watering areas, selling firewood and charcoal, seeking for military escorts to grazing areas, purchasing veterinary drugs, shifting livestock to disease ‘free’ areas, and performing rituals (depending on the perceived risk constituted a set of responses undertaken in

  19. A multicriteria framework for producing local, regional, and national insect and disease risk maps

    Science.gov (United States)

    Frank J. Jr. Krist; Frank J. Sapio

    2010-01-01

    The construction of the 2006 National Insect and Disease Risk Map, compiled by the USDA Forest Service, State and Private Forestry Area, Forest Health Protection Unit, resulted in the development of a GIS-based, multicriteria approach for insect and disease risk mapping that can account for regional variations in forest health concerns and threats. This risk mapping...

  20. Regional development via high-speed rail : A study of the Stockholm-Mälaren region and possibilities for Melbourne-regional Victoria

    OpenAIRE

    Bayley, Michael

    2012-01-01

    The purpose of this thesis is to examine, based on a study of the regional high-speed corridors in the Stockholm-Mälaren Region, the possibilities for regional high-speed rail in Melbourne-regional Victoria (Australia) to improve accessibility, and achieve regional development and balanced growth between the capital and its surrounding regions. It deals with the concept of 'regional' high-speed rail, a variant of classic high-speed rail that serves centres along regional corridors stemming fr...

  1. STATE-PRIVATE PARTNERSHIP IN REGIONAL DEVELOPMENT: ADVANTAGES AND RISKS

    OpenAIRE

    S.A. Neganov; L.I. Polizhyk

    2008-01-01

    In paper the problem of state and business interaction in main national projects realization is described. Advantages and risks are shown. To raise efficiency of partnership it is offered to optimize a perfection of a legal regime, society’s participation in discussion of the projects and the controlling over their performance.

  2. Prevalence and Risk Factors of High Risk Human Papillomavirus ...

    African Journals Online (AJOL)

    Cervical cancer is the most common female cancer in northern Nigeria, yet the pattern of infection with human papillomavirus, the principal aetiologic agent is unknown. This was a preliminary study conducted in two referral hospitals in order to establish base-line data on the prevalence and risk factors for the infection in ...

  3. Evaluation of a High-Resolution Regional Reanalysis for Europe

    Science.gov (United States)

    Ohlwein, C.; Wahl, S.; Keller, J. D.; Bollmeyer, C.

    2014-12-01

    Reanalyses gain more and more importance as a source of meteorological information for many purposes and applications. Several global reanalyses projects (e.g., ERA, MERRA, CSFR, JMA9) produce and verify these data sets to provide time series as long as possible combined with a high data quality. Due to a spatial resolution down to 50-70km and 3-hourly temporal output, they are not suitable for small scale problems (e.g., regional climate assessment, meso-scale NWP verification, input for subsequent models such as river runoff simulations). The implementation of regional reanalyses based on a limited area model along with a data assimilation scheme is able to generate reanalysis data sets with high spatio-temporal resolution. Within the Hans-Ertel-Centre for Weather Research (HErZ), the climate monitoring branch concentrates efforts on the assessment and analysis of regional climate in Germany and Europe. In joint cooperation with DWD (German Meteorological Service), a high-resolution reanalysis system based on the COSMO model has been developed. The regional reanalysis for Europe matches the domain of the CORDEX EURO-11 specifications, albeit at a higher spatial resolution, i.e., 0.055° (6km) instead of 0.11° (12km) and comprises the assimilation of observational data using the existing nudging scheme of COSMO complemented by a special soil moisture analysis with boundary conditions provided by ERA-Interim data. The reanalysis data set covers 6 years (2007-2012) and is currently extended to 16 years. Extensive evaluation of the reanalysis is performed using independent observations with special emphasis on precipitation and high-impact weather situations indicating a better representation of small scale variability. Further, the evaluation shows an added value of the regional reanalysis with respect to the forcing ERA Interim reanalysis and compared to a pure high-resolution dynamical downscaling approach without data assimilation.

  4. The high-resolution regional reanalysis COSMO-REA6

    Science.gov (United States)

    Ohlwein, C.

    2016-12-01

    Reanalyses gain more and more importance as a source of meteorological information for many purposes and applications. Several global reanalyses projects (e.g., ERA, MERRA, CSFR, JMA9) produce and verify these data sets to provide time series as long as possible combined with a high data quality. Due to a spatial resolution down to 50-70km and 3-hourly temporal output, they are not suitable for small scale problems (e.g., regional climate assessment, meso-scale NWP verification, input for subsequent models such as river runoff simulations). The implementation of regional reanalyses based on a limited area model along with a data assimilation scheme is able to generate reanalysis data sets with high spatio-temporal resolution. Within the Hans-Ertel-Centre for Weather Research (HErZ), the climate monitoring branch concentrates efforts on the assessment and analysis of regional climate in Germany and Europe. In joint cooperation with DWD (German Meteorological Service), a high-resolution reanalysis system based on the COSMO model has been developed. The regional reanalysis for Europe matches the domain of the CORDEX EURO-11 specifications, albeit at a higher spatial resolution, i.e., 0.055° (6km) instead of 0.11° (12km) and comprises the assimilation of observational data using the existing nudging scheme of COSMO complemented by a special soil moisture analysis with boundary conditions provided by ERA-Interim data. The reanalysis data set covers the past 20 years. Extensive evaluation of the reanalysis is performed using independent observations with special emphasis on precipitation and high-impact weather situations indicating a better representation of small scale variability. Further, the evaluation shows an added value of the regional reanalysis with respect to the forcing ERA Interim reanalysis and compared to a pure high-resolution dynamical downscaling approach without data assimilation.

  5. A high-resolution regional reanalysis for Europe

    Science.gov (United States)

    Ohlwein, C.

    2015-12-01

    Reanalyses gain more and more importance as a source of meteorological information for many purposes and applications. Several global reanalyses projects (e.g., ERA, MERRA, CSFR, JMA9) produce and verify these data sets to provide time series as long as possible combined with a high data quality. Due to a spatial resolution down to 50-70km and 3-hourly temporal output, they are not suitable for small scale problems (e.g., regional climate assessment, meso-scale NWP verification, input for subsequent models such as river runoff simulations). The implementation of regional reanalyses based on a limited area model along with a data assimilation scheme is able to generate reanalysis data sets with high spatio-temporal resolution. Within the Hans-Ertel-Centre for Weather Research (HErZ), the climate monitoring branch concentrates efforts on the assessment and analysis of regional climate in Germany and Europe. In joint cooperation with DWD (German Meteorological Service), a high-resolution reanalysis system based on the COSMO model has been developed. The regional reanalysis for Europe matches the domain of the CORDEX EURO-11 specifications, albeit at a higher spatial resolution, i.e., 0.055° (6km) instead of 0.11° (12km) and comprises the assimilation of observational data using the existing nudging scheme of COSMO complemented by a special soil moisture analysis with boundary conditions provided by ERA-Interim data. The reanalysis data set covers the past 20 years. Extensive evaluation of the reanalysis is performed using independent observations with special emphasis on precipitation and high-impact weather situations indicating a better representation of small scale variability. Further, the evaluation shows an added value of the regional reanalysis with respect to the forcing ERA Interim reanalysis and compared to a pure high-resolution dynamical downscaling approach without data assimilation.

  6. High beta and second stability region transport and stability analysis

    International Nuclear Information System (INIS)

    1991-01-01

    This document describes ideal and resistive MHD studies of high-beta plasmas and of the second stability region. Significant progress is reported on the resistive stability properties of high beta poloidal ''supershot'' discharges. For these studies initial profiles were taken from the TRANSP code which is used extensively to analyze experimental data. When an ad hoc method of removing the finite pressure stabilization of tearing modes is implemented it is shown that there is substantial agreement between MHD stability computation and experiment. In particular, the mode structures observed experimentally are consistent with the predictions of the resistive MHD model. We also report on resistive stability near the transition to the second region in TFTR. Tearing modes associated with a nearby infernal mode may explain the increase in MHD activity seen in high beta supershots and which impede the realization of Q∼1. We also report on a collaborative study with PPPL involving sawtooth stabilization with ICRF

  7. Correlation between the pionization region and the fragmentation region in high energy proton-proton collisions

    CERN Document Server

    Albrow, M G; Barber, D P; Bogaerts, A; Bosnjakovic, B; Brooks, J R; Clegg, A B; Erné, F C; Gee, C N P; Locke, D H; Loebinger, F K; Murphy, P G; Rudge, A; Sens, Johannes C

    1973-01-01

    Measurements are reported of two-particle correlations in high energy proton-proton collisions with one particle in the pionization region and the other a proton in the fragmentation region. The correlation function is independent of x of the fragmentation proton for 0.55

  8. Does Discrimination Explain High Risk of Depression among High-Income African American Men?

    Science.gov (United States)

    Assari, Shervin; Lankarani, Maryam Moghani; Caldwell, Cleopatra Howard

    2018-04-19

    Background: Higher socioeconomic status is known to decrease the risk for poor mental health overall. However, African American males of higher socioeconomic status (SES) are at an increased risk for having a major depressive episode (MDE). It is not known whether perceived discrimination (PD) explains this risk. The current study used nationally representative data to explore the role of PD in explaining the association between high-SES and having MDE among African American men. Methods: The National Survey of American Life (NSAL), 2003, included 4461 American adults including 1271 African American men. SES indicators (i.e., household income, educational attainment, employment status, and marital status) were the independent variables. 12-month MDE measured using the Composite International Diagnostic Interview (CIDI) was the outcome. Age, gender, and region were the covariates. PD was the potential mediator. For data analysis, we used logistic regression. Results: Among African American men, household income was positively associated with odds of 12-month MDE. The positive association between household income and odds of MDE remained unchanged after adding PD to the model, suggesting that PD may not explain why high-income African American men are at a higher risk of MDE. Conclusions: Perceived discrimination does not explain the increased risk for depression among African American males of higher SES. Future research should explore the role of other potential mechanisms such as stress, coping, social isolation, and/or negative social interaction that may increase psychological costs of upward social mobility for African American males.

  9. Does Discrimination Explain High Risk of Depression among High-Income African American Men?

    Directory of Open Access Journals (Sweden)

    Shervin Assari

    2018-04-01

    Full Text Available Background: Higher socioeconomic status is known to decrease the risk for poor mental health overall. However, African American males of higher socioeconomic status (SES are at an increased risk for having a major depressive episode (MDE. It is not known whether perceived discrimination (PD explains this risk. The current study used nationally representative data to explore the role of PD in explaining the association between high-SES and having MDE among African American men. Methods: The National Survey of American Life (NSAL, 2003, included 4461 American adults including 1271 African American men. SES indicators (i.e., household income, educational attainment, employment status, and marital status were the independent variables. 12-month MDE measured using the Composite International Diagnostic Interview (CIDI was the outcome. Age, gender, and region were the covariates. PD was the potential mediator. For data analysis, we used logistic regression. Results: Among African American men, household income was positively associated with odds of 12-month MDE. The positive association between household income and odds of MDE remained unchanged after adding PD to the model, suggesting that PD may not explain why high-income African American men are at a higher risk of MDE. Conclusions: Perceived discrimination does not explain the increased risk for depression among African American males of higher SES. Future research should explore the role of other potential mechanisms such as stress, coping, social isolation, and/or negative social interaction that may increase psychological costs of upward social mobility for African American males.

  10. Radon risk in Alpine regions in Austria: Risk assessment as a settlement planning strategy

    International Nuclear Information System (INIS)

    Gruber, V.; Baumgartner, A.; Seidel, C.; Maringer, F. J.

    2008-01-01

    Soil gas radon measurements complement indispensable and well-established radon indoor measurements in Austria. Radon in soil gas is a result of geochemical conditions as well as of geology, mineralogy, geophysics and meteorology. Therefore, geological factors can help to predict potential indoor radon concentrations via soil gas. Soil gas radon measurements in well-defined geological units give an estimate of local and regional radon hazards and build the basis for radon risk maps, which could be used for land-use planning and urban development. The creation of maps makes an important contribution to health care. For this purpose, several research projects were carried out in Austria. On the one hand, a study was already conducted in Lower Austria to determine the influence of meteorological and soil physical parameters on radon concentrations in soil gas and to evaluate soil gas radon concentrations with a radon emanation and migration model. On the other hand, radon measurements on different geomorphologic formations in the Austrian Alps, which are potential settlement areas, are of special interest. (authors)

  11. Trends and risk factors for syphilis infection in Piedmont Region, Italy, 2002-2008.

    Directory of Open Access Journals (Sweden)

    Federica Vigna-Taglianti

    2011-03-01

    Full Text Available

    Abstract:
    Background: This work aims to analyze trends of syphilis infections in the Piedmont Region (Italy between 2002 and 2008, and to evaluate risk factors for infection. Methods: Syphilis trends were described according to socio-demographic characteristics, sexual behavior, condom use, number of partners and HIV infection. Independent risk factors for syphilis among men having sex with men (MSM, men having sex with women (MSW, and women were identified through logistic regression comparing cases with 12,773 negative patients. Results: Between 2002 and 2008, 1,046 cases of syphilis were diagnosed, with peaks in 2004 and 2007. The risk of a syphilis diagnosis was independently associated with being older than 24, having a low education level, homosexual behavior, HIV self-reported infection (for MSM and MSW, number of partners (for MSW and women and non- consistent condom use (for women. Conclusions: Recent outbreaks suggest that the attention to syphilis can’t be lowered. Screening, treatment of cases and notification of partners should be reinforced and integrated with sexual health education and counselling in high-risk environments. Surveillance data must be continuously collected.

  12. The Psychosis High-Risk State

    Science.gov (United States)

    Fusar-Poli, Paolo; Borgwardt, Stefan; Bechdolf, Andreas; Addington, Jean; Riecher-Rössler, Anita; Schultze-Lutter, Frauke; Keshavan, Matcheri; Wood, Stephen; Ruhrmann, Stephan; Seidman, Larry J.; Valmaggia, Lucia; Cannon, Tyrone; Velthorst, Eva; De Haan, Lieuwe; Cornblatt, Barbara; Bonoldi, Ilaria; Birchwood, Max; McGlashan, Thomas; Carpenter, William; McGorry, Patrick; Klosterkötter, Joachim; McGuire, Philip; Yung, Alison

    2014-01-01

    Context During the past 2 decades, a major transition in the clinical characterization of psychotic disorders has occurred. The construct of a clinical high-risk (HR) state for psychosis has evolved to capture the prepsychotic phase, describing people presenting with potentially prodromal symptoms. The importance of this HR state has been increasingly recognized to such an extent that a new syndrome is being considered as a diagnostic category in the DSM-5. Objective To reframe the HR state in a comprehensive state-of-the-art review on the progress that has been made while also recognizing the challenges that remain. Data Sources Available HR research of the past 20 years from PubMed, books, meetings, abstracts, and international conferences. Study Selection and Data Extraction Critical review of HR studies addressing historical development, inclusion criteria, epidemiologic research, transition criteria, outcomes, clinical and functional characteristics, neurocognition, neuroimaging, predictors of psychosis development, treatment trials, socioeconomic aspects, nosography, and future challenges in the field. Data Synthesis Relevant articles retrieved in the literature search were discussed by a large group of leading worldwide experts in the field. The core results are presented after consensus and are summarized in illustrative tables and figures. Conclusions The relatively new field of HR research in psychosis is exciting. It has the potential to shed light on the development of major psychotic disorders and to alter their course. It also provides a rationale for service provision to those in need of help who could not previously access it and the possibility of changing trajectories for those with vulnerability to psychotic illnesses. PMID:23165428

  13. [Targeting high-risk drugs to optimize clinical pharmacists' intervention].

    Science.gov (United States)

    Mouterde, Anne-Laure; Bourdelin, Magali; Maison, Ophélie; Coursier, Sandra; Bontemps, Hervé

    2016-12-01

    By the Order of 6 April 2011, the pharmacist must validate all the prescriptions containing "high-risk drugs" or those of "patients at risk". To optimize this clinical pharmacy activity, we identified high-risk drugs. A list of high-risk drugs has been established using literature, pharmacists' interventions (PI) performed in our hospital and a survey sent to hospital pharmacists. In a prospective study (analysis of 100 prescriptions for each high-risk drug selected), we have identified the most relevant to target. We obtained a statistically significant PI rate (P<0.05) for digoxin, oral anticoagulants direct, oral methotrexate and colchicine. This method of targeted pharmaceutical validation based on high-risk drugs is relevant to detect patients with high risk of medicine-related illness. Copyright © 2016 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  14. Groundwater chemistry and human health risk assessment in the mining region of East Singhbhum, Jharkhand, India.

    Science.gov (United States)

    Singh, Umesh Kumar; Ramanathan, A L; Subramanian, V

    2018-08-01

    Groundwater chemistry of mining region of East Singhbhum district having complex contaminant sources were investigated based on heavy metals loads and other hydrochemical constituents. This study aimed to identify the degree of heavy metals exposure and their potential health risk to local population. The results of hydrochemical analysis showed that Na + , K + , and Ca 2+ ions are the dominant cations in the groundwater, while HCO 3 - , F - and Cl - ions dominate the anionic part of the groundwater. The weathering process was considered the dominant factor to determine the major ionic composition in the study area. Compositional analysis for heavy metal has identified that groundwater of the study area is contaminated by Cd, Pb and Cr elements. Source of these metals have been identified as an anthropogenic inputs from mining activities and mineral processing units. Health risk analysis of individual heavy metal for chronic daily intake (CDI) and hazard quotient (HQ) was found in the order of Cr > As > Cd > Pb which is indicating high health risk for the population. In addition, Hazard Index (HI) analysis for heavy metals was found significantly high (>1) which is considered as a threat for human population because they have the tendency to accumulate in the body and cause variety of diseases like kidney problem, dysfunction of liver and renal cortex as well as cancer. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Mapping regional soil water erosion risk in the Brittany-Loire basin for water management agency

    Science.gov (United States)

    Degan, Francesca; Cerdan, Olivier; Salvador-Blanes, Sébastien; Gautier, Jean-Noël

    2014-05-01

    Soil water erosion is one of the main degradation processes that affect soils through the removal of soil particles from the surface. The impacts for environment and agricultural areas are diverse, such as water pollution, crop yield depression, organic matter loss and reduction in water storage capacity. There is therefore a strong need to produce maps at the regional scale to help environmental policy makers and soil and water management bodies to mitigate the effect of water and soil pollution. Our approach aims to model and map soil erosion risk at regional scale (155 000 km²) and high spatial resolution (50 m) in the Brittany - Loire basin. The factors responsible for soil erosion are different according to the spatial and time scales considered. The regional scale entails challenges about homogeneous data sets availability, spatial resolution of results, various erosion processes and agricultural practices. We chose to improve the MESALES model (Le Bissonnais et al., 2002) to map soil erosion risk, because it was developed specifically for water erosion in agricultural fields in temperate areas. The MESALES model consists in a decision tree which gives for each combination of factors the corresponding class of soil erosion risk. Four factors that determine soil erosion risk are considered: soils, land cover, climate and topography. The first main improvement of the model consists in using newly available datasets that are more accurate than the initial ones. The datasets used cover all the study area homogeneously. Soil dataset has a 1/1 000 000 scale and attributes such as texture, soil type, rock fragment and parent material are used. The climate dataset has a spatial resolution of 8 km and a temporal resolution of mm/day for 12 years. Elevation dataset has a spatial resolution of 50 m. Three different land cover datasets are used where the finest spatial resolution is 50 m over three years. Using these datasets, four erosion factors are characterized and

  16. Ecological risk analysis as a key factor in environmental safety system development in the Arctic region of the Russian Federation

    International Nuclear Information System (INIS)

    Bolsunovskaya, Y A; Bolsunovskaya, L M

    2015-01-01

    Due to specific natural and climatic conditions combined with human intervention, the Arctic is regarded as a highly sensitive region to any environmental pressures. Arctic projects require continuous environmental monitoring. This poses for the government of the Russian Federation (RF) a tremendous task concerning the formation and implementation of sustainable nature management policy within the international framework. The current article examines the basic constraints to the effective ecological safety system implementation in the Arctic region of the RF. The ecological risks and their effects which influence the sustainable development of the region were analyzed. The model of complex environmental safety system was proposed

  17. Flash Flood Risk Perception in an Italian Alpine Region. From Research into Adaptive Strategies.

    Science.gov (United States)

    Scolobig, A.; de Marchi, B.; Borga, M.

    2009-04-01

    Flash floods are characterised by short lead times and high levels of uncertainty. Adaptive strategies to face them need to take into account not only the physical characteristics of the hydro-geological phenomena, but also peoples' risk perceptions, attitudes and behaviours in case of an emergency. It is quite obvious that a precondition for an effective adaptation, e.g. in the case of a warning, is the awareness of being endangered. At the same time the perceptions of those at risk and their likely actions inform hazard warning strategies and recovery programmes following such events. Usually low risk awareness or "wrong perceptions" of the residents are considered among the causes of an inadequate preparedness or response to flash floods as well as a symptom of a scarce self-protection culture. In this paper we will focus on flood risk perception and on how research on this topic may contribute to design adaptive strategies and give inputs to flood policy decisions. We will report on a flood risk perception study of the population residing in four villages in an Italian Alpine Region (Trentino Alto-Adige), carried out between October 2005 and January 2006. A total of 400 standardised questionnaires were submitted to local residents by face to face interviews. The surveys were preceded by focus groups with officers from agencies in charge of flood risk management and semi-structured and in-depth interviews with policy, scientific and technical experts. Survey results indicated that people are not so worried about hydro-geological phenomena, and think that their community is more endangered than themselves. The knowledge of the territory and danger sources, the unpredictability of flash floods and the feeling of safety induced by structural devices are the main elements which make the difference in shaping residents' perceptions. The study also demonstrated a widespread lack of adoption of preparatory measures among residents, together with a general low

  18. Disaster risk reduction in the Omusati and Oshana regions of Namibia

    Directory of Open Access Journals (Sweden)

    Elina Amadhila

    2013-08-01

    Full Text Available Namibia often experiences heavy rains in the north and north-eastern parts of the country, which results in severe flooding. For this reason, the country has endorsed the Hyogo Framework for Action (HFA which seeks to develop the resilience of nations and communities to disasters and to assist countries to move away from the approach of emergency response to one of integrated disaster risk reduction. The aim of this article is to assess the resilience of the communities within the identified regions. A quantitative questionnaire was designed to assess people at risk of disaster related impacts. The questionnaire used 20 indicators to measure the level of progress at local level and how local governance plays a role in the mitigation and management of disasters. Analysis of data was done on a limited number of descriptors such as age, gender and local governance involvement, amongst others. There was generally a very high perception of threat (38% in the study regions. Women perceived threat more accurately (mean = 4.09 than men. The community perceived threat more accurately than local government and civil society (mean = 4.08.

  19. Risk assessment of electric generation systems with high wind penetration

    International Nuclear Information System (INIS)

    Salgado Duarte, Yorlandys; Castillo Serpa, Alfredo M. del

    2017-01-01

    The research evaluates the risk function of an Electric Generation System (SGE) with high wind power penetration using the Sequential Monte Carlo Simulation (SMCS) method, which allows calculating indicators that characterize the performance of the SGE with expected average values. The research uses a Markov model of two states or four states according to the characteristics of the generator to simulate the instantaneous capacity. The primary sources of each conventional generator are assumed to be always available; however, wind power depends on the wind behavior in each analyzed region. In this research, the Chronological Series and Weibull models are used to model the wind behavior, and the analyzes are performed in the IEEE-RTS system. The work shows that the behavior of the probabilistic indicators used to analyze the static capacity of the SGE is determined by the model used to simulate the stochastic of the generators and by the primary energy source. (author)

  20. Seasonal variations of the high-latitude F region for

    International Nuclear Information System (INIS)

    Sojka, J.J.; Schunk, R.W.; Raitt, W.J.

    1982-01-01

    We combined a plasma convection model with an inosphere-atmospheric composition model in order to study the seasonal variations of the high-latitude F region for strong convection. Our numerical study produced time-dependent, three-dimensional, ion density distributions for the ions NO + , O 2 + , N 2 + , O + , N + , and He + . We covered the high-latitude ionosphere above 42 0 N magnetic latitude and at altitudes between 160 and 800 km for a time period of one complete day. From our study we found the following: (1) For strong convection, the high-altitude ionosphere exhibits a significant UT variation both during winter and summer. (2) In general, the electron density is lower in winter than in summer. However, at certain universal times the electron density in the dayside polar cap is larger in winter than in summer owing to the effect of the mid-latitude 'winter anomaly' in combination with strong antisunward convection. (3) In both summer and winter, the major region of low electron density is associated with the main or mid-latitudde trough. The trough is deeper and its local time extend is much greater in winter than in summer. (4) Typically, the electron density exhibits a much larger variation with altitude in winter than in summer. (5) The ion composition and molecular/atomic ion transition altitude are highly UT dependent in both summer and winter. (6) The ion composition also displays a significant seasonal variation. However, at a given location the seasonal variation can be opposite at different universal times. (7) High-speed convection cells should display a marked seasonal variation, with a much larger concentration of molecular ions near the F region peak in summer than in winter

  1. An assessment of high risk sexual behaviour and HIV transmission ...

    African Journals Online (AJOL)

    An assessment of high risk sexual behaviour and HIV transmission among migrant oil workers in the Niger Delta area of Nigeria. ... questionnaires to evaluate key highrisk sexual behavioral parameters such as multiplicity of sexual partners, bisexuality (closet homosexuality), high grade sexual behaviour and lesbianism.

  2. Evaluation model for safety capacity of chemical industrial park based on acceptable regional risk

    Institute of Scientific and Technical Information of China (English)

    Guohua Chen; Shukun Wang; Xiaoqun Tan

    2015-01-01

    The paper defines the Safety Capacity of Chemical Industrial Park (SCCIP) from the perspective of acceptable regional risk. For the purpose of exploring the evaluation model for the SCCIP, a method based on quantitative risk assessment was adopted for evaluating transport risk and to confirm reasonable safety transport capacity of chemical industrial park, and then by combining with the safety storage capacity, a SCCIP evaluation model was put forward. The SCCIP was decided by the smaller one between the largest safety storage capacity and the maximum safety transport capacity, or else, the regional risk of the park will exceed the acceptable level. The developed method was applied to a chemical industrial park in Guangdong province to obtain the maximum safety transport capacity and the SCCIP. The results can be realized in the regional risk control of the park effectively.

  3. Risk assessment and restoration possibilities of some abandoned mining ponds in Murcia Region, SE Spain

    Science.gov (United States)

    Faz, Angel; Acosta, Jose A.; Martinez-Martinez, Silvia; Carmona, Dora M.; Zornoza, Raul; Kabas, Sebla; Bech, Jaume

    2010-05-01

    In Murcia Region, SE Spain, there are 85 tailing ponds due to intensive mining activities that occurred during last century, especially in Sierra Minera de Cartagena-La Union. Although mining activity was abandoned several decades ago, those tailing ponds with high amounts of heavy metals still remain in the area. The ponds, due to their composition and location, may create environmental risks of geochemical pollution, negatively affecting soil, water, and plant, animal, and human populations, as well as infrastructures. The main objective of this research is to evaluate the restoration possibilities of two representative mining ponds in order to minimize the risk for human and ecosystems. To achieve this objective, two tailing ponds generated by mining activities were selected, El Lirio and El Gorguel. These ponds are representative of the rest of existent ponds in Sierra Minera de Cartagena-La Unión, with similar problems and characteristics. Several techniques and studies were applied to the tailing ponds for their characterization, including: geophysics, geotechnics, geochemical, geological, hydrological, and vegetation studies. In addition, effects of particulate size in the distribution of heavy metals will be used to assess the risk of dispersion of these metals in finest particles. Once the ponds were characterized, they were divided in several sectors in order to apply different amendments (pig slurry and marble waste) to reduce the risk of metal mobility and improve soil quality for a future phytostabilization. It is known that organic amendments promote soil development processes, microbial diversity, and finally, soil ecosystem restoration to a state of self-sustainability. By comparing the results before and after applications we will be able to evaluate the effect of the different amendments on soil quality and their effectively on risk reduction. Finally, plant metal-tolerant species are used to restore vegetation in the ponds, thereby decreasing

  4. Risk assessment of water pollution sources based on an integrated k-means clustering and set pair analysis method in the region of Shiyan, China.

    Science.gov (United States)

    Li, Chunhui; Sun, Lian; Jia, Junxiang; Cai, Yanpeng; Wang, Xuan

    2016-07-01

    Source water areas are facing many potential water pollution risks. Risk assessment is an effective method to evaluate such risks. In this paper an integrated model based on k-means clustering analysis and set pair analysis was established aiming at evaluating the risks associated with water pollution in source water areas, in which the weights of indicators were determined through the entropy weight method. Then the proposed model was applied to assess water pollution risks in the region of Shiyan in which China's key source water area Danjiangkou Reservoir for the water source of the middle route of South-to-North Water Diversion Project is located. The results showed that eleven sources with relative high risk value were identified. At the regional scale, Shiyan City and Danjiangkou City would have a high risk value in term of the industrial discharge. Comparatively, Danjiangkou City and Yunxian County would have a high risk value in terms of agricultural pollution. Overall, the risk values of north regions close to the main stream and reservoir of the region of Shiyan were higher than that in the south. The results of risk level indicated that five sources were in lower risk level (i.e., level II), two in moderate risk level (i.e., level III), one in higher risk level (i.e., level IV) and three in highest risk level (i.e., level V). Also risks of industrial discharge are higher than that of the agricultural sector. It is thus essential to manage the pillar industry of the region of Shiyan and certain agricultural companies in the vicinity of the reservoir to reduce water pollution risks of source water areas. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Fall prevention in high-risk patients.

    Science.gov (United States)

    Shuey, Kathleen M; Balch, Christine

    2014-12-01

    In the oncology population, disease process and treatment factors place patients at risk for falls. Fall bundles provide a framework for developing comprehensive fall programs in oncology. Small sample size of interventional studies and focus on ambulatory and geriatric populations limit the applicability of results. Additional research is needed. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Systems reliability in high risk situations

    International Nuclear Information System (INIS)

    Hunns, D.M.

    1974-12-01

    A summary is given of five papers and the discussion of a seminar promoted by the newly-formed National Centre of Systems Reliability. The topics covered include hazard analysis, reliability assessment, and risk assessment in both nuclear and non-nuclear industries. (U.K.)

  7. Play-fairway analysis for geothermal resources and exploration risk in the Modoc Plateau region

    Science.gov (United States)

    Siler, Drew; Zhang, Yingqi; Spycher, Nicolas F.; Dobson, Patrick; McClain, James S.; Gasperikova, Erika; Zierenberg, Robert A.; Schiffman, Peter; Ferguson, Colin; Fowler, Andrew; Cantwell, Carolyn

    2017-01-01

    The region surrounding the Modoc Plateau, encompassing parts of northeastern California, southern Oregon, and northwestern Nevada, lies at an intersection between two tectonic provinces; the Basin and Range province and the Cascade volcanic arc. Both of these provinces have substantial geothermal resource base and resource potential. Geothermal systems with evidence of magmatic heat, associated with Cascade arc magmatism, typify the western side of the region. Systems on the eastern side of the region appear to be fault controlled with heat derived from high crustal heat flow, both of which are typical of the Basin and Range. As it has the potential to host Cascade arc-type geothermal resources, Basin and Range-type geothermal resources, and/or resources with characteristics of both provinces, and because there is relatively little current development, the Modoc Plateau region represents an intriguing potential for undiscovered geothermal resources. It remains unclear however, what specific set(s) of characteristics are diagnostic of Modoc-type geothermal systems and how or if those characteristics are distinct from Basin and Range-type or Cascade arc-type geothermal systems. In order to evaluate the potential for undiscovered geothermal resources in the Modoc area, we integrate a wide variety of existing data in order to evaluate geothermal resource potential and exploration risk utilizing ‘play-fairway’ analysis. We consider that the requisite parameters for hydrothermal circulation are: 1) heat that is sufficient to drive circulation, and 2) permeability that is sufficient to allow for fluid circulation in the subsurface. We synthesize data that indicate the extent and distribution of these parameters throughout the Modoc region. ‘Fuzzy logic’ is used to incorporate expert opinion into the utility of each dataset as an indicator of either heat or permeability, and thus geothermal favorability. The results identify several geothermal prospects, areas that

  8. Evaluation of Risk Management Strategies for a Low-Cost, High-Risk Project

    Science.gov (United States)

    Shishko, Robert; Jorgensen, Edward J.

    1996-01-01

    This paper summarizes work in progress to define and implement a risk management process tailored to a low-cost, high-risk, NASA mission -the Microrover Flight Experiment (MFEX, commonly called the Mars microrover).

  9. Estrogens and the risk of complex regional pain syndrome (CRPS).

    Science.gov (United States)

    de Mos, M; Huygen, F J P M; Stricker, B H Ch; Dieleman, J P; Sturkenboom, M C J M

    2009-01-01

    Since complex regional pain syndrome (CRPS) shows a clear female predominance, we investigated the association between the cumulative as well as current exposure to estrogens, and CRPS. A population-based case-control study was conducted in the Integrated Primary Care Information (IPCI) project in the Netherlands. Cases were identified from electronic records (1996-2005) and included if they were confirmed during a visit (using International Association for the Study of Pain Criteria), or had been diagnosed by a specialist. Controls were matched to cases on gender, age, calendar time, and injury. Measures of cumulative endogenous estrogen exposure were obtained by questionnaire and included age of menarche and menopause, menstrual life, and cumulative months of pregnancy and breast-feeding. Current estrogen exposure at CRPS onset was retrieved from the electronic medical records and determined by current pregnancy or by the use of oral contraceptive (OC) drugs or hormonal replacement therapy (HRT). Hundred and forty-three female cases (1493 controls) were included in analyses on drug use and pregnancies, while cumulative endogenous estrogen exposure was studied in 53 cases (58 controls) for whom questionnaire data were available. There was no association between CRPS and either cumulative endogenous estrogen exposure, OC, or HRT use. CRPS onset was increased during the first 6 months after pregnancy (OR: 5.6, 95%CI: 1.0-32.4), although based on small numbers. We did not find an association between CRPS onset and cumulative endogenous estrogen exposure or current OC or HRT use, but more powered studies are needed to exclude potential minor associations.

  10. A metasynthesis of risk perception in women with high risk pregnancies

    OpenAIRE

    Lee, S.; Ayers, S.; Holden, D.

    2014-01-01

    Introduction: Risk perception in women with high risk pregnancies affects their decisions about perinatal care and is of interest to anyone involved in the care of pregnant women. This paper provides a metasynthesis of qualitative studies of risk perception in women with high risk pregnancies.\\ud \\ud Methods: A systematic search of eight electronic databases was conducted. Additional papers were obtained through searching references of identified articles. Six studies were identified that rep...

  11. Assessing Watershed-Wildfire Risks on National Forest System Lands in the Rocky Mountain Region of the United States

    Directory of Open Access Journals (Sweden)

    Jessica R. Haas

    2013-07-01

    Full Text Available Wildfires can cause significant negative impacts to water quality with resultant consequences for the environment and human health and safety, as well as incurring substantial rehabilitation and water treatment costs. In this paper we will illustrate how state-of-the-art wildfire simulation modeling and geospatial risk assessment methods can be brought to bear to identify and prioritize at-risk watersheds for risk mitigation treatments, in both pre-fire and post-fire planning contexts. Risk assessment results can be particularly useful for prioritizing management of hazardous fuels to lessen the severity and likely impacts of future wildfires, where budgetary and other constraints limit the amount of area that can be treated. Specifically we generate spatially resolved estimates of wildfire likelihood and intensity, and couple that information with spatial data on watershed location and watershed erosion potential to quantify watershed exposure and risk. For a case study location we focus on National Forest System lands in the Rocky Mountain Region of the United States. The Region houses numerous watersheds that are critically important to drinking water supplies and that have been impacted or threatened by large wildfires in recent years. Assessment results are the culmination of a broader multi-year science-management partnership intended to have direct bearing on wildfire management decision processes in the Region. Our results suggest substantial variation in the exposure of and likely effects to highly valued watersheds throughout the Region, which carry significant implications for prioritization. In particular we identified the San Juan National Forest as having the highest concentration of at-risk highly valued watersheds, as well as the greatest amount of risk that can be mitigated via hazardous fuel reduction treatments. To conclude we describe future opportunities and challenges for management of wildfire-watershed interactions.

  12. A high-resolution regional reanalysis for the European CORDEX region

    Science.gov (United States)

    Bollmeyer, Christoph; Keller, Jan; Ohlwein, Christian; Wahl, Sabrina

    2015-04-01

    Within the Hans-Ertel-Centre for Weather Research (HErZ), the climate monitoring branch concentrates efforts on the assessment and analysis of regional climate in Germany and Europe. In joint cooperation with DWD (German Weather Service), a high-resolution reanalysis system based on the COSMO model has been developed. Reanalyses gain more and more importance as a source of meteorological information for many purposes and applications. Several global reanalyses projects (e.g., ERA, MERRA, CSFR, JMA9) produce and verify these data sets to provide time series as long as possible combined with a high data quality. Due to a spatial resolution down to 50-70km and 3-hourly temporal output, they are not suitable for small scale problems (e.g., regional climate assessment, meso-scale NWP verification, input for subsequent models such as river runoff simulations, renewable energy applications). The implementation of regional reanalyses based on a limited area model along with a data assimilation scheme is able to generate reanalysis data sets with high spatio-temporal resolution. The work presented here focuses on two regional reanalyses for Europe and Germany. The European reanalysis COSMO-REA6 matches the CORDEX EURO-11 specifications, albeit at a higher spatial resolution, i.e., 0.055° (6km) instead of 0.11° (12km). Nested into COSMO-REA6 is COSMO-REA2, a convective-scale reanalysis with 2km resolution for Germany. COSMO-REA6 comprises the assimilation of observational data using the existing nudging scheme of COSMO and is complemented by a special soil moisture analysis and boundary conditions given by ERA-Interim data. COSMO-REA2 also uses the nudging scheme complemented by a latent heat nudging of radar information. The reanalysis data set currently covers 17 years (1997-2013) for COSMO-REA6 and 4 years (2010-2013) for COSMO-REA2 with a very large set of output variables and a high temporal output step of hourly 3D-fields and quarter-hourly 2D-fields. The evaluation

  13. Fine mapping in the MHC region accounts for 18% additional genetic risk for celiac disease

    NARCIS (Netherlands)

    Gutierrez-Achury, Javier; Zhernakova, Alexandra; Pulit, Sara L.; Trynka, Gosia; Hunt, Karen A.; Romanos, Jihane; Raychaudhuri, Soumya; van Heel, David A.; Wijmenga, Cisca; de Balcker, Paul I. W.

    Although dietary gluten is the trigger for celiac disease, risk is strongly influenced by genetic variation in the major histocompatibility complex (MHC) region. We fine mapped the MHC association signal to identify additional risk factors independent of the HLA-DQA1 and HLA-DQB1 alleles and

  14. A near real time scenario at regional scale for the hydrogeological risk

    Science.gov (United States)

    Ponziani, F.; Stelluti, M.; Zauri, R.; Berni, N.; Brocca, L.; Moramarco, T.; Salciarini, D.; Tamagnini, C.

    2012-04-01

    The early warning systems dedicated to landslides and floods represent the Umbria Region Civil Protection Service new generation tools for hydraulic and hydrogeological risk reduction. Following past analyses performed by the Functional Centre (part of the civil protection service dedicated to the monitoring and the evaluation of natural hazards) on the relationship between saturated soil conditions and rainfall thresholds, we have developed an automated early warning system for the landslide risk, called LANDWARN, which generates daily and 72h forecast risk matrix with a dense mesh of 100 x 100m, throughout the region. The system is based on: (a) the 20 days -observed and 72h -predicted rainfall, provided by the local meteorological network and the Local scale Meteorological Model COSMO ME, (b) the assessment of the saturation of soils by: daily extraction of ASCAT satellite data, data from a network of 16 TDR sensors, and a water balance model (developed by the Research Institute for Geo-Hydrological Protection, CNR, Perugia, Italy) that allows for the prediction of a saturation index for each point of the analysis grid up to a window of 72 h, (c) a Web-GIS platform that combines the data grids of calculated hazard indicators with layers of landslide susceptibility and vulnerability of the territory, in order to produce dynamic risk scenarios. The system is still under development and it's implemented at different scales: the entire region, and a set of known high-risk landslides in Umbria. The system is monitored and regularly reviewed through the back analysis of landslide reports for which the activation date is available. Up to now, the development of the system involves: a) the improvement of the reliability assessment of the condition of soil saturation, a key parameter which is used to dynamically adjust the values of rainfall thresholds used for the declaration of levels of landslide hazard. For this purpose, a procedure was created for the ASCAT

  15. VOLUNTEERS FOR A HIGH RISK SPORT.

    Science.gov (United States)

    Sport parachutists tend to be over-represented in the Western region of the United States. They are, by and large, relatively young males who look...upon the sport as a masculine expression. The sport is objectively dangerous, as measured by the accident rate, and is subjectively perceived as such... Sport parachutists tend to be single-minded in their attitude to the sport , sometimes giving it priority over their commitment to family roles

  16. The ATLAS high level trigger region of interest builder

    International Nuclear Information System (INIS)

    Blair, R.; Dawson, J.; Drake, G.; Haberichter, W.; Schlereth, J.; Zhang, J.; Ermoline, Y.; Pope, B.; Aboline, M.; High Energy Physics; Michigan State Univ.

    2008-01-01

    This article describes the design, testing and production of the ATLAS Region of Interest Builder (RoIB). This device acts as an interface between the Level 1 trigger and the high level trigger (HLT) farm for the ATLAS LHC detector. It distributes all of the Level 1 data for a subset of events to a small number of (16 or less) individual commodity processors. These processors in turn provide this information to the HLT. This allows the HLT to use the Level 1 information to narrow data requests to areas of the detector where Level 1 has identified interesting objects

  17. Radical prostatectomy for high-risk prostate cancer.

    Science.gov (United States)

    Yossepowitch, Ofer; Eastham, James A

    2008-06-01

    Consensus recommendations for the identification and treatment of men whose apparent organ confined prostate cancer has high risk features are lacking. Despite ongoing refinements in surgical technique and improvements in morbidity and functional outcomes, the tradition of steering high-risk patients away from radical prostatectomy (RP) remains steadfast. We performed a medical literature search in English using MEDLINE/PubMed that addressed high risk prostate cancer. We analyzed the literature with respect to the historical evolution of this concept, current risk stratification schemes and treatment guidelines and related short and long term outcomes following RP. Contemporary evidence suggest that patients classified with high-risk prostate cancer by commonly used definitions do not have a uniformly poor prognosis after RP. Many cancers categorized clinically as high risk are actually pathologically confined to the prostate, and most men with such cancers who undergo RP are alive and free of additional therapy long after surgery. RP in the high-risk setting appears to be associated with a similar morbidity as in lower-risk patients. Men with clinically localized high-risk prostate cancer should not be categorically disqualified from local definitive therapy with RP. With careful attention to surgical technique, cancer control rates should improve further, and adverse effects on quality of life after RP should continue to decrease.

  18. Towards a comprehensive assessment and framework for low and high flow water risks

    Science.gov (United States)

    Motschmann, Alina; Huggel, Christian; Drenkhan, Fabian; León, Christian

    2017-04-01

    Driven by international organizations such as the Intergovernmental Panel on Climate Change (IPCC) the past years have seen a move from a vulnerability concept of climate change impacts towards a risk framework. Risk is now conceived at the intersection of climate-driven hazard and socioeconomic-driven vulnerability and exposure. The concept of risk so far has been mainly adopted for sudden-onset events. However, for slow-onset and cumulative climate change impacts such as changing water resources there is missing clarity and experience how to apply a risk framework. Research has hardly dealt with the challenge of how to integrate both low and high flow risks in a common framework. Comprehensive analyses of risks related to water resources considering climate change within multi-dimensional drivers across different scales are complex and often missing in climate-sensitive mountain regions where data scarcity and inconsistencies represent important limitations. Here we review existing vulnerability and risk assessments of low and high flow water conditions and identify critical conceptual and practical gaps. Based on this, we develop an integrated framework for low and high flow water risks which is applicable to both past and future conditions. The framework explicitly considers a water balance model simulating both water supply and demand on a daily basis. We test and apply this new framework in the highly glacierized Santa River catchment (SRC, Cordillera Blanca, Peru), representative for many developing mountain regions with both low and high flow water risks and poor data availability. In fact, in the SRC, both low and high flow hazards, such as droughts and floods, play a central role especially for agricultural, hydropower, domestic and mining use. During the dry season (austral winter) people are increasingly affected by water scarcity due to shrinking glaciers supplying melt water. On the other hand during the wet season (austral summer) high flow water

  19. Regional risk assessment of reuse of ash in civil engineering applications; Regional riskanalys av askanvaendning i anlaeggningsbyggande

    Energy Technology Data Exchange (ETDEWEB)

    Wik, Ola

    2009-07-15

    A previously proposal (Vaermeforsk report 979, 2006) for common environmental guidelines for reuse of ash in civil engineering applications has only to a limited extent considered eventual additive effects of pollutants from other sources than recycled aggregates. Furthermore the assessment had a strict focus on local effects not considering the possible outcome of a large-scale use of alternative recycled aggregates. The objective of this project has been to characterize the risk of a large-scale use of ashes produced within a regional area. The project targeted at analysing: 1. The possible large-scale negative environmental effects of recycling all ashes fitting for civil engineering applications within a regional watershed area. 2. If environmental effects on a regional scale motivates adjustment of the proposed common environmental guidelines for reuse of ash. In order to perform a regional risk assessment information on the material flow of ashes and traditional aggregates as well as other anthropogenic and natural sources and flows of substances to be analysed is needed. The prime research task of this project was to: Generate material and substance flow information for two different watershed areas, Motala Stroem and Emaan, with respect to lead, cadmium and mercury; and to Compare the generated data with environmental quality standards for surface waters and draft river basin management plans presented by Swedish river basin district authorities. Data on material and substance flow was complied using the following practise; Ashes - data on material flow, substance content and emissions collected from all productions sites. Emissions was estimated using L/S 10 data from standardised leaching test. Missing data was assigned using expert judgement. Aggregates - data on material flow compiled from regional databases. Substance content and emissions calculated based on national generic data. Emissions was estimated using L/S 10 data from standardised leaching

  20. A metasynthesis of risk perception in women with high risk pregnancies.

    Science.gov (United States)

    Lee, Suzanne; Ayers, Susan; Holden, Des

    2014-04-01

    risk perception in women with high risk pregnancies affects their decisions about perinatal care and is of interest to anyone involved in the care of pregnant women. This paper provides a metasynthesis of qualitative studies of risk perception in women with high risk pregnancies. a systematic search of eight electronic databases was conducted. Additional papers were obtained through searching references of identified articles. Six studies were identified that reported qualitative research into risk perception in relation to high risk pregnancy. A metasynthesis was developed to describe and interpret the studies. the synthesis resulted in the identification of five themes: determinants of risk perception; not seeing it the way others do; normality versus risk; if the infant is ok, I׳m ok; managing risk. this metasynthesis suggests women at high risk during pregnancy use multiple sources of information to determine their risk status. It shows women are aware of the risks posed by their pregnancies but do not perceive risk in the same way as healthcare professionals. They will take steps to ensure the health of themselves and their infants but these may not include following all medical recommendations. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. High-risk bladder cancer: improving outcomes with perioperative chemotherapy

    Directory of Open Access Journals (Sweden)

    Daniel Y.C. Heng

    2011-12-01

    Full Text Available Despite treatment with radical cystectomy and pelvic lymph node dissection, muscle invasive bladder cancer has a relapse rate of 50%. Patients can develop regionally advanced or metastatic disease that ultimately leads to death. The addition of neoadjuvant or adjuvant chemotherapy to reduce the risk of relapse and death has been extensively studied over the past two decades. Two contemporary trials coupled with a recent meta-analysis evaluating neoadjuvant chemotherapy demonstrated a modest but real improvement in overall survival. This has made neoadjuvant chemotherapy a standard of care. Clinical trials evaluating adjuvant chemotherapy in patients with high-risk disease have been plagued with statistical flaws and have, therefore, been unable to define the survival impact of this approach. It is hoped that ongoing adjuvant trials that are powered to detect small but meaningful clinical differences will clarify the benefit of chemotherapy after cystectomy. Since there are theoretical advantages and disadvantages to each of these approaches, both are widely used in North America. The evidence behind each approach and potential future developments in this field will be described.

  2. Health effects in residents of regions with high background radiation

    International Nuclear Information System (INIS)

    Hanson, G.P.

    1984-01-01

    Possible health problems created by high natural levels of background radiation are hard to detect, partly because the health problems involved would exist to some degree irrespective of radiation exposure, partly because other factors affect the incidence of such problems, and partly because the differences between normal background radiation levels and radiation levels found in most high-radiation areas are not extreme. Nevertheless, the need to know about such health effects is evident, and so various studies conducted over the past 30 years have sought to determine whether those effects exist and what they are. Overall, however, the fragmentary and uncertain nature of many of these findings makes it hard to draw firm conclusions about the health risks involved or the desirability of countermeasures. So despite considerable efforts and some progress over the past three decades, the need for a clear quantitative assessment of the consequences is as great as ever

  3. Characterizing and Reaching High-Risk Drinkers Using Audience Segmentation

    Science.gov (United States)

    Moss, Howard B.; Kirby, Susan D.; Donodeo, Fred

    2010-01-01

    and couples living in fashionable neighborhoods on the urban fringe. Almost 65% of Cyber Millenials households are found in the Pacific and Middle Atlantic regions of the U.S. Additional consumer behaviors of the Cyber Millenials and other segments are also described. Conclusions Audience segmentation can assist in identifying and describing target audience segments, as well as identifying places where segments congregate on- or offline. This information can be helpful for recruiting subjects for alcohol prevention research, as well as planning health promotion campaigns. Through commercial data about high-risk drinkers as “consumers,” planners can develop interventions that have heightened salience in terms of opportunities, perceptions, and motivations, and have better media channel identification. PMID:19413650

  4. Characterizing and reaching high-risk drinkers using audience segmentation.

    Science.gov (United States)

    Moss, Howard B; Kirby, Susan D; Donodeo, Fred

    2009-08-01

    -savvy singles and couples living in fashionable neighborhoods on the urban fringe." Almost 65% of Cyber Millenials households are found in the Pacific and Middle Atlantic regions of the United States. Additional consumer behaviors of the Cyber Millenials and other segments are also described. Audience segmentation can assist in identifying and describing target audience segments, as well as identifying places where segments congregate on- or offline. This information can be helpful for recruiting subjects for alcohol prevention research as well as planning health promotion campaigns. Through commercial data about high-risk drinkers as "consumers," planners can develop interventions that have heightened salience in terms of opportunities, perceptions, and motivations, and have better media channel identification.

  5. High Blood Pressure, Afib and Your Risk of Stroke

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More High Blood Pressure, AFib and Your Risk of Stroke Updated:Aug ... have a stroke for the first time have high blood pressure . And an irregular atrial heart rhythm — a condition ...

  6. Prevalence and risk factors associated with nutrition-related noncommunicable diseases in the Eastern Mediterranean region

    Science.gov (United States)

    Musaiger, Abdulrahman O; Al-Hazzaa, Hazzaa M

    2012-01-01

    This paper reviews the current situation concerning nutrition-related noncommunicable diseases (N-NCDs) and the risk factors associated with these diseases in the Eastern Mediterranean region (EMR). A systematic literature review of studies and reports published between January 1, 1990 and September 15, 2011 was conducted using the PubMed and Google Scholar databases. Cardiovascular disease, type 2 diabetes, metabolic syndrome, obesity, cancer, and osteoporosis have become the main causes of morbidity and mortality, especially with progressive aging of the population. The estimated mortality rate due to cardiovascular disease and diabetes ranged from 179.8 to 765.2 per 100,000 population, with the highest rates in poor countries. The prevalence of metabolic syndrome was very high, ranging from 19% to 45%. The prevalence of overweight and obesity (body mass index ≥25 kg/m2) has reached an alarming level in most countries of the region, ranging from 25% to 82%, with a higher prevalence among women. The estimated mortality rate for cancer ranged from 61.9 to 151 per 100,000 population. Osteoporosis has become a critical problem, particularly among women. Several risk factors may be contributing to the high prevalence of N-NCDs in EMR, including nutrition transition, low intake of fruit and vegetables, demographic transition, urbanization, physical inactivity, hypertension, tobacco smoking, stunting of growth of preschool children, and lack of nutrition and health awareness. Intervention programs to prevent and control N-NCDs are urgently needed, with special focus on promotion of healthy eating and physical activity. PMID:22399864

  7. Prevalence and risk factors associated with nutrition-related noncommunicable diseases in the Eastern Mediterranean region

    Directory of Open Access Journals (Sweden)

    Musaiger AO

    2012-02-01

    Full Text Available Abdulrahman O Musaiger1, Hazzaa M Al-Hazzaa21Nutrition and Health Studies Unit, Deanship of Scientific Research, University of Bahrain, Bahrain, and Arab Center for Nutrition, Bahrain; 2Exercise Physiology Laboratory, Department of Physical Education and Movement Science, College of Education, and Scientific Board, Obesity Research Chair, King Saud University, Riyadh, Saudi ArabiaAbstract: This paper reviews the current situation concerning nutrition-related noncommunicable diseases (N-NCDs and the risk factors associated with these diseases in the Eastern Mediterranean region (EMR. A systematic literature review of studies and reports published between January 1, 1990 and September 15, 2011 was conducted using the PubMed and Google Scholar databases. Cardiovascular disease, type 2 diabetes, metabolic syndrome, obesity, cancer, and osteoporosis have become the main causes of morbidity and mortality, especially with progressive aging of the population. The estimated mortality rate due to cardiovascular disease and diabetes ranged from 179.8 to 765.2 per 100,000 population, with the highest rates in poor countries. The prevalence of metabolic syndrome was very high, ranging from 19% to 45%. The prevalence of overweight and obesity (body mass index ≥25 kg/m2 has reached an alarming level in most countries of the region, ranging from 25% to 82%, with a higher prevalence among women. The estimated mortality rate for cancer ranged from 61.9 to 151 per 100,000 population. Osteoporosis has become a critical problem, particularly among women. Several risk factors may be contributing to the high prevalence of N-NCDs in EMR, including nutrition transition, low intake of fruit and vegetables, demographic transition, urbanization, physical inactivity, hypertension, tobacco smoking, stunting of growth of preschool children, and lack of nutrition and health awareness. Intervention programs to prevent and control N-NCDs are urgently needed, with special focus

  8. Microinstabilities in the high latitude F region: a brief review

    International Nuclear Information System (INIS)

    Gary, S.P.

    1983-01-01

    This is a review of the theory of plasma microinstabilities that may arise in the high latitude F region ionosphere below 1000 km. Three free energy sources are considered: a density gradient perpendicular to the ambient magnetic field B, a current parallel to B and a steady electric field perpendicular to B. The BGK model for charged-neutral collisions is used, and the short wavelength properties of the universal density drift, current convective and E x B gradient drift instabilities are compared. At sufficiently high altitudes and sufficiently steep gradients, the universal instability is the short wavelength mode most likely to grow and, through wave-particle diffusion, to cause relatively steep wavenumber dependences in power spectra

  9. Alcohol consumption and high risk sexual behaviour among female ...

    African Journals Online (AJOL)

    Alcohol consumption has been associated with high risk sexual behaviour among key populations such as female sex workers. We explored the drivers of alcohol consumption and its relationship to high risk sexual behaviour. Participants were drawn from a cohort of 1 027 women selected from 'hot spots' in the suburbs of ...

  10. Correlation between high-risk pregnancy and developmental delay ...

    African Journals Online (AJOL)

    Background: The future development of children is considered more than ever now due to the advances in medical knowledge and thus the increase in survival rates of high-risk infants. This study investigated the correlation between high-risk pregnancy and developmental delay in children aged 4- 60 months. Methods: ...

  11. Drug response prediction in high-risk multiple myeloma

    DEFF Research Database (Denmark)

    Vangsted, A J; Helm-Petersen, S; Cowland, J B

    2018-01-01

    from high-risk patients by GEP70 at diagnosis from Total Therapy 2 and 3A to predict the response by the DRP score of drugs used in the treatment of myeloma patients. The DRP score stratified patients further. High-risk myeloma with a predicted sensitivity to melphalan by the DRP score had a prolonged...

  12. Elevated level of serum triglyceride among high risk stress bank ...

    African Journals Online (AJOL)

    The objective of this study was to estimate lipid profile among high risk stress bank employees' correlated with heart disorders in Riyadh, Saudi Arabia. A total of 129 patients with high risk stress employees were involved in this study, which were divided into 69 males and 60 females between the age of 25 to 55 years.

  13. Regional flood reconstruction in Kullu District (Himachal Pradesh, India): implication for Disaster Risk Management

    Science.gov (United States)

    Ballesteros-Cánovas, Juan Antonio; Stoffel, Markus; Trappmann, Daniel; Shekhar, Mayank; Bhattacharyya, Amalava

    2016-04-01

    Floods are a common natural hazard in the Western Indian Himalayas. They usually occur when humid monsoon airs are lifted along the Himalayan relief, thereby creating intense orographic rainfall and runoff, a process which is often enhanced by simultaneous snowmelt. Monsoon floods are considered a major threat in the region and frequently affect inhabited valleys, disturbing the status quo of communities, stressing the future welfare and condition of their economic development. Given the assumption that ongoing and future climatic changes may impact on monsoon patterns and extreme precipitation, the implementation of adaptation policies in this region is critically needed in order to improve local resilience of Himalayan communities. However, its success implementation is highly dependent on system knowledge and hence reliable baseline data of past disasters. In this communication, we demonstrate how newly gained knowledge on past flood incidents may improve flood hazard and risk assessments. Based on growth-ring analysis of trees growing in the floodplains and other, more classical paleo-hydrology techniques, we reconstruct the regional flood activity for the last decades. This information is then included as non-systematic data into the regional flood frequency by using Bayesian Markov Monte Carlo Chain algorithms, so as to analyse the impact of the additional data on flood hazard assessments. Moreover, through a detailed analysis of three flood risk hotspots, we demonstrate how the newly gained knowledge on past flood disasters derived from indirect proxies can explain failures in the implementation of disaster risk management (DRM). Our methodology allowed identification of thirty-four unrecorded flood events at the study sites located in the upper reaches since the early 20th century, and thus completion of the existing flood history in the region based on flow measurements in the lower part of the catchment. We observe that 56% of the floods occurred

  14. Improving performance of breast cancer risk prediction using a new CAD-based region segmentation scheme

    Science.gov (United States)

    Heidari, Morteza; Zargari Khuzani, Abolfazl; Danala, Gopichandh; Qiu, Yuchen; Zheng, Bin

    2018-02-01

    Objective of this study is to develop and test a new computer-aided detection (CAD) scheme with improved region of interest (ROI) segmentation combined with an image feature extraction framework to improve performance in predicting short-term breast cancer risk. A dataset involving 570 sets of "prior" negative mammography screening cases was retrospectively assembled. In the next sequential "current" screening, 285 cases were positive and 285 cases remained negative. A CAD scheme was applied to all 570 "prior" negative images to stratify cases into the high and low risk case group of having cancer detected in the "current" screening. First, a new ROI segmentation algorithm was used to automatically remove useless area of mammograms. Second, from the matched bilateral craniocaudal view images, a set of 43 image features related to frequency characteristics of ROIs were initially computed from the discrete cosine transform and spatial domain of the images. Third, a support vector machine model based machine learning classifier was used to optimally classify the selected optimal image features to build a CAD-based risk prediction model. The classifier was trained using a leave-one-case-out based cross-validation method. Applying this improved CAD scheme to the testing dataset, an area under ROC curve, AUC = 0.70+/-0.04, which was significantly higher than using the extracting features directly from the dataset without the improved ROI segmentation step (AUC = 0.63+/-0.04). This study demonstrated that the proposed approach could improve accuracy on predicting short-term breast cancer risk, which may play an important role in helping eventually establish an optimal personalized breast cancer paradigm.

  15. Modelization of highly nonlinear waves in coastal regions

    Science.gov (United States)

    Gouin, Maïté; Ducrozet, Guillaume; Ferrant, Pierre

    2015-04-01

    The proposed work deals with the development of a highly non-linear model for water wave propagation in coastal regions. The accurate modelization of surface gravity waves is of major interest in ocean engineering, especially in the field of marine renewable energy. These marine structures are intended to be settled in coastal regions where the effect of variable bathymetry may be significant on local wave conditions. This study presents a numerical model for the wave propagation with complex bathymetry. It is based on High-Order Spectral (HOS) method, initially limited to the propagation of non-linear wave fields over flat bottom. Such a model has been developed and validated at the LHEEA Lab. (Ecole Centrale Nantes) over the past few years and the current developments will enlarge its application range. This new numerical model will keep the interesting numerical properties of the original pseudo-spectral approach (convergence, efficiency with the use of FFTs, …) and enable the possibility to propagate highly non-linear wave fields over long time and large distance. Different validations will be provided in addition to the presentation of the method. At first, Bragg reflection will be studied with the proposed approach. If the Bragg condition is satisfied, the reflected wave generated by a sinusoidal bottom patch should be amplified as a result of resonant quadratic interactions between incident wave and bottom. Comparisons will be provided with experiments and reference solutions. Then, the method will be used to consider the transformation of a non-linear monochromatic wave as it propagates up and over a submerged bar. As the waves travel up the front slope of the bar, it steepens and high harmonics are generated due to non-linear interactions. Comparisons with experimental data will be provided. The different test cases will assess the accuracy and efficiency of the method proposed.

  16. High beta and second stability region transport and stability analysis

    International Nuclear Information System (INIS)

    Hughes, M.H.; Phillps, M.W.; Todd, A.M.M.; Krishnaswami, J.; Hartley, R.

    1992-09-01

    This report describes ideal and resistive studies of high-beta plasmas and of the second stability region. Emphasis is focused on ''supershot'' plasmas in TFIR where MHD instabilities are frequently observed and which spoil their confinement properties. Substantial results are described from the analysis of these high beta poloidal plasmas. During these studies, initial pressure and safety factor profiles were obtained from the TRANSP code, which is used extensively to analyze experimental data. Resistive MBD stability studies of supershot equilibria show that finite pressure stabilization of tearing modes is very strong in these high βp plasmas. This has prompted a detailed re-examination of linear tearing mode theory in which we participated in collaboration with Columbia University and General Atomics. This finite pressure effect is shown to be highly sensitive to small scale details of the pressure profile. Even when an ad hoc method of removing this stabilizing mechanism is implemented, however, it is shown that there is only superficial agreement between resistive MBD stability computation and the experimental data. While the mode structures observed experimentally can be found computationally, there is no convincing correlation with the experimental observations when the computed results are compared with a large set of supershot data. We also describe both the ideal and resistive stability properties of TFIR equilibria near the transition to the second region. It is shown that the highest β plasmas, although stable to infinite-n ideal ballooning modes, can be unstable to the so called ''infernal'' modes associated with small shear. The sensitivity of these results to the assumed pressure and current density profiles is discussed. Finally, we describe results from two collaborative studies with PPPL. The first involves exploratory studies of the role of the 1/1 mode in tokamaks and, secondly, a study of sawtooth stabilization using ICRF

  17. Risk factors associated with hantavirosis fatality: a regional analysis from a case-control study in Brazil

    Directory of Open Access Journals (Sweden)

    Maria Cristina Antunes Willemann

    2014-01-01

    Full Text Available Introduction: In Brazil, hantavirus cardiopulmonary syndrome (HCPS has a high lethality rate that varies by region. This study aimed to identify the risk factors associated with fatal hantavirosis. Methods: This study was a case-control study that included all laboratory confirmed cases of hantavirosis. The cases were stratified by the different Brazilian regions using data from the Notifiable Diseases Information System. “Cases” were patients who progressed to death, whereas “controls” were patients who were cured. The odds ratio (OR and the adjusted OR were calculated. Results: Overall, 158 cases and 281 controls were included in this study. In the Midwest region, the cases were 60% less likely to present with flank pain, and the time between the beginning of symptoms and death was shorter than the time between the beginning of symptoms and a cure. In the Southeast region, the cases were 60% less likely to present with thrombocytopenia or reside in rural areas compared to those who progressed to a cure. Additionally, the cases sought medical assistance, notification and investigation more quickly than the controls. In the Southern region, the cases that died were 70% less likely to be male compared to the controls. Conclusions: HCPS manifests with nonspecific symptoms, and there are few published studies related to the condition, so determining a patient's therapeutic strategy is difficult. This study presents findings from different Brazilian regions and highlights the need for further investigations to improve comprehension about regional risk factors associated with hantavirosis and to reduce morbimortality.

  18. Seismic Hazard and risk assessment for Romania -Bulgaria cross-border region

    Science.gov (United States)

    Simeonova, Stela; Solakov, Dimcho; Alexandrova, Irena; Vaseva, Elena; Trifonova, Petya; Raykova, Plamena

    2016-04-01

    Among the many kinds of natural and man-made disasters, earthquakes dominate with regard to their social and economical impact on the urban environment. Global seismic hazard and vulnerability to earthquakes are steadily increasing as urbanization and development occupy more areas that are prone to effects of strong earthquakes. The assessment of the seismic hazard and risk is particularly important, because it provides valuable information for seismic safety and disaster mitigation, and it supports decision making for the benefit of society. Romania and Bulgaria, situated in the Balkan Region as a part of the Alpine-Himalayan seismic belt, are characterized by high seismicity, and are exposed to a high seismic risk. Over the centuries, both countries have experienced strong earthquakes. The cross-border region encompassing the northern Bulgaria and southern Romania is a territory prone to effects of strong earthquakes. The area is significantly affected by earthquakes occurred in both countries, on the one hand the events generated by the Vrancea intermediate-depth seismic source in Romania, and on the other hand by the crustal seismicity originated in the seismic sources: Shabla (SHB), Dulovo, Gorna Orjahovitza (GO) in Bulgaria. The Vrancea seismogenic zone of Romania is a very peculiar seismic source, often described as unique in the world, and it represents a major concern for most of the northern part of Bulgaria as well. In the present study the seismic hazard for Romania-Bulgaria cross-border region on the basis of integrated basic geo-datasets is assessed. The hazard results are obtained by applying two alternative approaches - probabilistic and deterministic. The MSK64 intensity (MSK64 scale is practically equal to the new EMS98) is used as output parameter for the hazard maps. We prefer to use here the macroseismic intensity instead of PGA, because it is directly related to the degree of damages and, moreover, the epicentral intensity is the original

  19. Patients at High-Risk for Surgical Site Infection.

    Science.gov (United States)

    Mueck, Krislynn M; Kao, Lillian S

    Surgical site infections (SSIs) are a significant healthcare quality issue, resulting in increased morbidity, disability, length of stay, resource utilization, and costs. Identification of high-risk patients may improve pre-operative counseling, inform resource utilization, and allow modifications in peri-operative management to optimize outcomes. Review of the pertinent English-language literature. High-risk surgical patients may be identified on the basis of individual risk factors or combinations of factors. In particular, statistical models and risk calculators may be useful in predicting infectious risks, both in general and for SSIs. These models differ in the number of variables; inclusion of pre-operative, intra-operative, or post-operative variables; ease of calculation; and specificity for particular procedures. Furthermore, the models differ in their accuracy in stratifying risk. Biomarkers may be a promising way to identify patients at high risk of infectious complications. Although multiple strategies exist for identifying surgical patients at high risk for SSIs, no one strategy is superior for all patients. Further efforts are necessary to determine if risk stratification in combination with risk modification can reduce SSIs in these patient populations.

  20. The Effect of High Ambient Temperature on the Elderly Population in Three Regions of Sweden

    Directory of Open Access Journals (Sweden)

    Joacim Rocklöv

    2010-06-01

    Full Text Available The short-term effects of high temperatures are a serious concern in the context of climate change. In areas that today have mild climates the research activity has been rather limited, despite the fact that differences in temperature susceptibility will play a fundamental role in understanding the exposure, acclimatization, adaptation and health risks of a changing climate. In addition, many studies employ biometeorological indexes without careful investigation of the regional heterogeneity in the impact of relative humidity. We aimed to investigate the effects of summer temperature and relative humidity and regional differences in three regions of Sweden allowing for heterogeneity of the effect over the scale of summer temperature. To do so, we collected mortality data for ages 65+ from Stockholm, Göteborg and Skåne from the Swedish National Board of Health and Welfare and the Swedish Meteorological and Hydrological Institute for the years 1998 through 2005. In Stockholm and Skåne on average 22 deaths per day occurred, while in Göteborg the mean frequency of daily deaths was 10. We fitted time-series regression models to estimate relative risks of high ambient temperatures on daily mortality using smooth functions to control for confounders, and estimated non-linear effects of exposure while allowing for auto-regressive correlation of observations within summers. The effect of temperature on mortality was found distributed over the same or following day, with statistically significant cumulative combined relative risk of about 5.1% (CI = 0.3, 10.1 per °C above the 90th percentile of summer temperature. The effect of high relative humidity was statistically significant in only one of the regions, as was the effect of relative humidity (above 80th percentile and temperature (above 90th percentile. In the southernmost region studied there appeared to be a significant increase in mortality with decreasing low summer temperatures that was not

  1. High Center Volume Does Not Mitigate Risk Associated with Using High Donor Risk Organs in Liver Transplantation.

    Science.gov (United States)

    Beal, Eliza W; Black, Sylvester M; Mumtaz, Khalid; Hayes, Don; El-Hinnawi, Ashraf; Washburn, Kenneth; Tumin, Dmitry

    2017-09-01

    High-risk donor allografts increase access to liver transplant, but potentially reduce patient and graft survival. It is unclear whether the risk associated with using marginal donor livers is mitigated by increasing center experience. The United Network for Organ Sharing registry was queried for adult first-time liver transplant recipients between 2/2002 and 12/2015. High donor risk was defined as donor risk index >1.9, and 1-year patient and graft survival were compared according to donor risk index in small and large centers. Multivariable Cox regression estimated the hazard ratio (HR) associated with using high-risk donor organs, according to a continuous measure of annual center volume. The analysis included 51,770 patients. In 67 small and 67 large centers, high donor risk index predicted increased mortality (p = 0.001). In multivariable analysis, high-donor risk index allografts predicted greater mortality hazard at centers performing 20 liver transplants per year (HR 1.35; 95% CI 1.22, 1.49; p donor risk index and center volume was not statistically significant (p = 0.747), confirming that the risk associated with using marginal donor livers was comparable between smaller and larger centers. Results were consistent when examining graft loss. At both small and large centers, high-risk donor allografts were associated with reduced patient and graft survival after liver transplant. Specific strategies to mitigate the risk of liver transplant involving high-risk donors are needed, in addition to accumulation of center expertise.

  2. Danger ahead: the burden of diseases, injuries, and risk factors in the Eastern Mediterranean Region, 1990-2015.

    Science.gov (United States)

    2018-05-01

    The Eastern Mediterranean Region faces several health challenges at a difficult time with wars, unrest, and economic change. We used the Global Burden of Disease 2015 study to present the burden of diseases, injuries, and risk factors in the Eastern Mediterranean Region from 1990 to 2015. Ischemic heart disease was the leading cause of death in the region in 2015, followed by cerebrovascular disease. Changes in total deaths ranged from a reduction of 25% for diarrheal diseases to an increase of about 42% for diabetes and tracheal, bronchus, and lung cancer. Collective violence and legal intervention increased by 850% during the time period. Diet was the leading risk factor for disability-adjusted life years (DALYs) for men compared to maternal malnutrition for females. Childhood undernutrition was the leading risk factor for DALYs in 1990 and 2005, but the second in 2015 after high blood pressure. Our study shows that the region is facing several health challenges and calls for global efforts to stabilise the region and to address the current and future burden of disease.

  3. Regional Risk Evaluation of Flood Disasters for the Trunk-Highway in Shaanxi, China

    Directory of Open Access Journals (Sweden)

    Hong-Liang Qi

    2015-10-01

    Full Text Available Due to the complicated environment there are various types of highway disasters in Shaanxi Province (China. The damages caused are severe, losses are heavy, and have rapidly increased over the years, especially those caused by flood disasters along the rivers in mountainous areas. Therefore, research on risk evaluations, which play important roles in the prevention and mitigation of highway disasters are very important. An evaluation model was established based on the superposition theory of regional influencing factors to highway flood disasters. Based on the formation mechanism and influencing factors of highway flood disasters, the main influencing factors were selected. These factors include rainstorms, terrain slopes, soil types, vegetation coverage and regional river density, which are based on evaluation indexes from climate conditions and underlying surface of the basin. A regional risk evaluation of highway flood disasters in Shaanxi was established using GIS. The risk index was divided into five levels using statistical methods, in accordance with the regional characteristics of highway flood disasters. Considering the difference in upfront investments, road grade, etc, between expressways and trunk-highways in China, a regional risk evaluation of trunk-highway flood disasters was completed. The evaluation results indicate that the risk evaluation is consistent with the actual situation.

  4. Regional Risk Evaluation of Flood Disasters for the Trunk-Highway in Shaanxi, China.

    Science.gov (United States)

    Qi, Hong-Liang; Tian, Wei-Ping; Li, Jia-Chun

    2015-10-29

    Due to the complicated environment there are various types of highway disasters in Shaanxi Province (China). The damages caused are severe, losses are heavy, and have rapidly increased over the years, especially those caused by flood disasters along the rivers in mountainous areas. Therefore, research on risk evaluations, which play important roles in the prevention and mitigation of highway disasters are very important. An evaluation model was established based on the superposition theory of regional influencing factors to highway flood disasters. Based on the formation mechanism and influencing factors of highway flood disasters, the main influencing factors were selected. These factors include rainstorms, terrain slopes, soil types, vegetation coverage and regional river density, which are based on evaluation indexes from climate conditions and underlying surface of the basin. A regional risk evaluation of highway flood disasters in Shaanxi was established using GIS. The risk index was divided into five levels using statistical methods, in accordance with the regional characteristics of highway flood disasters. Considering the difference in upfront investments, road grade, etc, between expressways and trunk-highways in China, a regional risk evaluation of trunk-highway flood disasters was completed. The evaluation results indicate that the risk evaluation is consistent with the actual situation.

  5. Antibiotics in the coastal environment of the Hailing Bay region, South China Sea: Spatial distribution, source analysis and ecological risks.

    Science.gov (United States)

    Chen, Hui; Liu, Shan; Xu, Xiang-Rong; Zhou, Guang-Jie; Liu, Shuang-Shuang; Yue, Wei-Zhong; Sun, Kai-Feng; Ying, Guang-Guo

    2015-06-15

    In this study, the occurrence and spatial distribution of 38 antibiotics in surface water and sediment samples of the Hailing Bay region, South China Sea, were investigated. Twenty-one, 16 and 15 of 38 antibiotics were detected with the concentrations ranging from antibiotics in the water phase were correlated positively with chemical oxygen demand and nitrate. The source analysis indicated that untreated domestic sewage was the primary source of antibiotics in the study region. Fluoroquinolones showed strong sorption capacity onto sediments due to their high pseudo-partitioning coefficients. Risk assessment indicated that oxytetracycline, norfloxacin and erythromycin-H2O posed high risks to aquatic organisms. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. High Framingham risk score decreases quality of life in adults

    Directory of Open Access Journals (Sweden)

    Christian Yosaputra

    2010-04-01

    Full Text Available Cardiovascular disease (CVD risk factors, such as diabetes, hypertension, hypercholesterolemia, smoking, and obesity tend to occur together in the general population. Increasing prevalence of multiple CVD risk factors has been related to increased risk of death from coronary heart disease and stroke. Studies have suggested that people with several risk factors of CVD may have impaired health-related quality of life. The objective of this study was to assess the association of CVD risk factors with quality of life (QOL among adults aged 40 to 65 years. A cross-sectional study was conducted involving 220 subjects 40 - 65 years of age at a health center. The CVD risk factors were assessed using the Framingham risk score that is the standard instrument for assessment of the risk of a first cardiac event. The risk factors assessed were age, smoking, blood pressure, total cholesterol and high density lipoprotein cholesterol concentrations. QOL was assessed by means of the WHOQOL-BREF instrument that had been prevalidated. The results of the study showed that 28.2% of subjects were smokers, 56.4% had stage 1 hypertension, 42.8% high total cholesterol and 13.6% low HDL cholesterol. The high risk group amounted to 45.5% and 42.3% constitued an intermediate risk group. High CVD risk scores were significantly associated with a low QOL for all domains (physical, psychological, social and environment (p=0.000. Preventing or reducing the multiple CVD risk factors to improve QOL is necessary among adults.

  7. Disturbed functional connectivity of cortical activation during semantic discrimination in patients with schizophrenia and subjects at genetic high-risk.

    Science.gov (United States)

    Li, Xiaobo; Branch, Craig A; Nierenberg, Jay; Delisi, Lynn E

    2010-03-01

    Schizophrenia has a strong genetic component that is relevant to the understanding of the pathophysiology of the syndrome. Thus, recent investigations have shifted from studies of diagnosed patients with schizophrenia to examining their unaffected relatives. Previous studies found that during language processing, relatives thought to be at genetic high-risk for the disorder exhibit aberrant functional activation in regions of language processing, specifically in the left inferior frontal gyrus (Broca's area). However, functional connectivity among the regions involved in language pathways is not well understood. In this study, we examined the functional connectivity between a seed located in Broca's area and the remainder of the brain during a visual lexical decision task, in 20 schizophrenia patients, 21 subjects at genetic high risk for the disorder and 21 healthy controls. Both the high-risk subjects and patients showed significantly reduced activation correlations between seed and regions related to visual language processing. Compared to the high-risk subjects, the schizophrenia patients showed even fewer regions that were correlated with the seed regions. These results suggest that there is aberrant functional connectivity within cortical language circuitry in high-risk subjects and patients with schizophrenia. Broca's area, which is one of the important regions for language processing in healthy controls, had a significantly reduced role in the high-risk subjects and patients with schizophrenia. Our findings are consistent with the existence of an underlying biological disturbance that begins in genetically at risk individuals and progresses to a greater extent in those who eventually develop schizophrenia.

  8. The Very High Risk Prostate Cancer – a Contemporary Update

    Science.gov (United States)

    Mano, Roy; Eastham, James; Yossepowitch, Ofer

    2017-01-01

    Background Treatment of high-risk prostate cancer has evolved considerably over the past two decades, yet patients with very high-risk features may still experience poor outcome despite aggressive therapy. We review the contemporary literature focusing on current definitions, role of modern imaging and treatment alternatives in very high-risk prostate cancer. Methods We searched the MEDLINE database for all clinical trials or practice guidelines published in English between 2000 – 2016 with the following search terms: ‘prostatic neoplasms’ (MeSH Terms) AND (‘high risk’ (keyword) OR ‘locally advanced’ (keyword) OR ‘node positive’ (keyword)). Abstracts pertaining to very high-risk prostate cancer were evaluated and 40 pertinent studies served as the basis for this review. Results The term ‘very’ high-risk prostate cancer remains ill defined. The EAU and NCCN guidelines provide the only available definitions, categorizing those with clinical stage T3-4 or minimal nodal involvement as very-high risk irrespective of PSA level or biopsy Gleason score. Modern imaging with mpMRI and PET-PSMA scans plays a role in pretreatment assessment. Local definitive therapy by external beam radiation combined with androgen deprivation is supported by several randomized clinical trials whereas the role of surgery in the very high-risk setting combined with adjuvant radiation/ androgen deprivation therapy is emerging. Growing evidence suggest neoadjuvant taxane based chemotherapy in the context of a multimodal approach may be beneficial. Conclusions Men with very high-risk tumors may benefit from local definitive treatment in the setting of a multimodal regimen, offering local control and possibly cure in well selected patients. Further studies are necessary to better characterize the ‘very’ high-risk category and determine the optimal therapy for the individual patient. PMID:27618950

  9. Navigation safety and risk assessment challenges in the High North

    DEFF Research Database (Denmark)

    Marchenko, N.A.; Borch, O.J.; Andreassen, N.

    2017-01-01

    marine accidents. Therefore, in this study a mostly qualitative analysis and expert judgement is the basis for the risk assessments. Implications for the emergency preparedness system of the region are discussed. The consequences of incidents depend on the incident type, scale and location,....... In this paper we look into the risks of accidents in the Atlantic Arctic based on previous ship accidents and the changes in maritime activity. The risk has to be assessed to ensure a proper level of response in emergency situations. As accidents are rare, there are limited statistics available for Arctic...

  10. High risk behaviour near OPG dams and power stations : results from two surveys

    Energy Technology Data Exchange (ETDEWEB)

    Giesbrecht, N.; Schmidt, R.; Ialomiteanu, A. [Centre for Addiction and Mental Health, Toronto, ON (Canada)

    2009-07-01

    High risk behaviour near dams is not uncommon. This presentation discussed the results from 2 surveys on high risk behaviour near dams and power stations operated by Ontario Power Generation (OPG). The main components of the project were presented, with particular reference to analyses of recent literature on high-risk behaviour; interviews with OPG managers and staff in 4 regions; main survey of respondents from 4 regions; follow-up interviews with high-risk respondents; interviews with community members and contacts from recreational associations; and recommendations. Specific questions and results were provided from each survey. From the first survey, the characteristics of respondents that used OPG sites for recreation were identified. One hundred high risk respondents completed a follow-up interview. The survey showed that although high-risk behaviour is not uncommon, the main reason people use the facilities are for recreation and relaxation, and not for thrill seeking purposes. Recommendations stemming from the surveys included the need for definition of boundaries and delivery of messages via children, recreational associations, and law enforcement personnel. tabs., figs.

  11. Risk of contamination of wild berries from upper Orava region by cadmium

    Directory of Open Access Journals (Sweden)

    Stanislav Zupka

    2016-01-01

    Full Text Available The upper Orava region is located at the North Slovakia, near of potential sources of environmental contamination due by mining of coal, zinc and lead ores. The aim of the study was to evaluate the risk of consumption of wild forest fruit from Upper Orava region from the aspect of cadmium content. Ten sampling points were found by random search. From these points samples of soil, leaves and fruits of wild berries (9 samples of blueberries Vaccinium Myrtillus and 1 sample of strawberries Fragaria Vesca were collected. In soil samples the active soil reaction (pH/H2O ranged from 3.53 (strong acidity to 4.56 (extremly strong acidity, and the determined percentage of humus ranged from 1.66 (low humic soil to 4.90 (high humic soil.  In two soil samples the total content of cadmium determinated in soil extracts by aqua regia exceeded limit 0.70 mg.kg-1 given by the legislation in tne Slovak Republic. In three soil samples the determined content of cadmium mobile forms determined in soil extracts by NH4NO3 exceeded the limit 0.10 mg.kg-1. The content of Cd determined in leaves as well as in fruits was evaluated according to Food Codex of the Slovak Republic. Only in one sample of leaf samples the limit 1.00 mg.kg-1 was exceeded. The other leaf samples are safely when used as an ingredient in tea mixtures. On the other hand even in 7 fruit samples the limit 0.05 mg.kg-1 was exceeded. This fruit can pose a risk for the human organism when is directly consumed as well as may negatively affect the human health when is used as raw materials in the food industry. 

  12. Increased risk environment for emergency general surgery in the context of regionalization and specialization.

    Science.gov (United States)

    Beecher, S; O'Leary, D P; McLaughlin, R

    2015-09-01

    The pressures on tertiary hospitals with increased volume and complexity related to regionalization and specialization has impacted upon availability of operating theatres with consequent displacement of emergencies to high risk out of hours settings. A retrospective review of an electronic emergency theatre list prospectively maintained database was performed over a two year period. Data gathered included type of operation performed, Time to Theatre (TTT), operation start time and length of stay (LOS). Of 7041 emergency operations 25% were performed out of hours. 2949 patient had general surgical emergency procedures with 910 (30%) performed out of hours. 53% of all emergency laparotomies and 54% of appendicectomies were out of hours. 57% of cases operated on out of hours had been awaiting surgery during the day. Mean TTT was shorter for those admitted at the weekend compared to those admitted during the week (15.6 vs 24.9 h) (p emergency surgery is performed out of hours in a way unfavorable to good clinical outcomes. It is of concern that more than half of the most life threating procedures involving laparotomy, take place out of hours. Regionalization needs to be accompanied by infrastructure planning to accommodate emergency surgery. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  13. Prevalence and risk factors for poor nutritional status among children in the Kilimanjaro region of Tanzania.

    Science.gov (United States)

    Abubakar, Amina; Uriyo, Jacqueline; Msuya, Sia E; Swai, Mark; Stray-Pedersen, Babill

    2012-10-05

    The current study investigated the prevalence and risk factors for poor nutritional status among children less than 36 months of age in the Kilimanjaro region of Tanzania. Using a cross sectional study design, children and their caregivers were recruited into the study. Anthropometric measures were taken based on established protocol while a standard questionnaire was utilized to collect socio-demographic data. A finger-prick blood sample was collected from all the children and haemoglobin (Hb) concentration analyzed using a HemoCue photometer (HemoCue AB, Angelholm, Sweden). Four hundred and twenty three (423) children (214 females) took part in this study. Participating children were aged between 1–35 months (mean = 13.04, SD = 7.70). We observed high rates of stunting (44.2%) and underweight (19.1%). Nearly 70% (n = 295) of the sample was anaemic (Hb education, and child's age were found to independently predict stunting; whereas concerns over child's growth and development, and distance to water source were found to uniquely predict being underweight. Maternal education was the only factor related to the child's anaemia. The current study further emphasizes the need to implement context relevant interventions to combat malnutrition in this region of Tanzania and other similar settings.

  14. White rice consumption and risk of esophageal cancer in Xinjiang Uyghur Autonomous Region, northwest China: a case-control study

    OpenAIRE

    Tang, Li; Xu, Fenglian; Zhang, Taotao; Lei, Jun; Binns, Colin W.; Lee, Andy H.

    2015-01-01

    This study investigated the association between white rice consumption and the risk of esophageal cancer in remote northwest China, where the cancer incidence is known to be high. A case-control study was conducted during 2008?2009 in Urumqi and Shihezi, Xinjiang Uyghur Autonomous Region of China. Participants were 359 incident esophageal cancer patients and 380 hospital-based controls. Information on habitual white rice consumption was obtained by personal interview using a validated semi-qu...

  15. Risk Factors and Spatial Clusters of Cryptosporidium Infection among School-Age Children in a Rural Region of Eastern China.

    Science.gov (United States)

    Zheng, Hao; He, Jianfeng; Wang, Li; Zhang, Rong; Ding, Zhen; Hu, Wenbiao

    2018-05-06

    The epidemiological features of Cryptosporidium infection among school-age children in China still remain unclear. Hereby, a cross-sectional study of 1637 children aged 3⁻9 years was designed to investigate the risk factors and spatial clusters of Cryptosporidium infection in a rural region of Eastern China. Stool specimens collected from participants were examined using the auramine-phenol and modified acid-fast staining. Univariable and multivariable analyses were performed to identify the risk factors of Cryptospordium infection. The spatial clusters were analyzed by a discrete Poisson model using SaTScan software. Our results showed that the overall prevalence of Cryptosporidium infection was 11‰ in the research region. At the age of 3⁻6 years (odds ratios (OR) = 3.072, 95% confidence intervals (CI) : 1.001⁻9.427), not washing hands before eating and after defecation (OR = 3.003, 95% CI: 1.060⁻8.511) were recognized as risk factors. Furthermore, a high-risk spatial cluster (relative risk = 4.220, p = 0.025) was identified. These findings call for effective sustainable interventions including family and school-based hygienic education to reduce the prevalence of Cryptosporidium infection. Therefore, an early warning system based spatiotemporal models with risk factors is required to further improve the effectiveness and efficiency of cryptosporidiosis control in the future.

  16. Automated breast tissue density assessment using high order regional texture descriptors in mammography

    Science.gov (United States)

    Law, Yan Nei; Lieng, Monica Keiko; Li, Jingmei; Khoo, David Aik-Aun

    2014-03-01

    Breast cancer is the most common cancer and second leading cause of cancer death among women in the US. The relative survival rate is lower among women with a more advanced stage at diagnosis. Early detection through screening is vital. Mammography is the most widely used and only proven screening method for reliably and effectively detecting abnormal breast tissues. In particular, mammographic density is one of the strongest breast cancer risk factors, after age and gender, and can be used to assess the future risk of disease before individuals become symptomatic. A reliable method for automatic density assessment would be beneficial and could assist radiologists in the evaluation of mammograms. To address this problem, we propose a density classification method which uses statistical features from different parts of the breast. Our method is composed of three parts: breast region identification, feature extraction and building ensemble classifiers for density assessment. It explores the potential of the features extracted from second and higher order statistical information for mammographic density classification. We further investigate the registration of bilateral pairs and time-series of mammograms. The experimental results on 322 mammograms demonstrate that (1) a classifier using features from dense regions has higher discriminative power than a classifier using only features from the whole breast region; (2) these high-order features can be effectively combined to boost the classification accuracy; (3) a classifier using these statistical features from dense regions achieves 75% accuracy, which is a significant improvement from 70% accuracy obtained by the existing approaches.

  17. Identification of high risk patients with hypertrophic cardiomyopathy in a northern Greek population

    Directory of Open Access Journals (Sweden)

    Karvounis Charalambos

    2009-07-01

    Full Text Available Abstract Background The percentage of hypertrophic cardiomyopathy (HCM patients who are in high risk for Sudden Death (SD constitutes only a minority of all HCM population but the incidence of SD in this subset is high (at least 5% annually. The identification of this small but important proportion of high risk HCM patients has been the clue in the clinical evaluation of these patients. Methods Our study cohort consisted from 123 patients with HCM who are currently followed up in our Institution. Five clinical risk factors were assessed: a family history of premature SD, unexplained syncope, Non Sustained Ventricular Tachycardia (NSVT on 24-h ECG monitoring, Abnormal Blood Pressure Response (ABPR during upright exercise testing and Maximum left ventricular Wall Thickness (MWT ≥30 mm. The purpose of our study was the identification of high risk HCM patients coming from Northern Greece. Results Fifteen patients (12.2% of the whole cohort had MWT ≥ 30 mm, 30 patients (24.4% had an ABPR to exercise, 17 patients (13.8% had episodes of NSVT in 24-h Holter monitoring, 17 patients (13.8% suffered from syncope, and 8 patients (6.5% had a positive family history of premature SD. Data analysis revealed that 74 patients (60.1% had none risk factor. Twenty four patients (19.5% had 1 risk factor, 17 patients (13.8% had 2 risk factors, 4 patients (3.25% had 3 risk factors, and 4 patients (3.25% had 4 risk factors, while none patient had 5 risk factors. Twenty five patients (20.3% had 2 or more risk factors. Conclusion This study for the first time confirms that, although a 60% of patients with HCM coming from a regional Greek population are in low risk for SD, a substantial proportion (almost 20% carries a high risk for SD justifying prophylactic therapy with amiodaron or ICD implantation.

  18. High-Risk and Low-Risk Human Papillomavirus and the Absolute Risk of Cervical Intraepithelial Neoplasia or Cancer

    DEFF Research Database (Denmark)

    Thomsen, Louise T; Frederiksen, Kirsten; Munk, Christian

    2014-01-01

    OBJECTIVE: To determine the absolute risk of cervical intraepithelial neoplasia (CIN) grade 3 or cervical cancer (CIN 3 or worse) after detection of low-risk human papillomavirus (HPV) and after a negative high-risk HPV test. METHODS: In this prospective cohort study, consecutive liquid......-based cervical cytology samples were collected from women screened for cervical cancer in Copenhagen, Denmark, during 2002-2005. Samples were tested with a clinical test for 13 high-risk and five low-risk HPV types. The cohort (N=35,539; aged 14-90 years) was monitored in a nationwide pathology register for up...... cytology. Detection of low-risk HPV does not predict CIN 3 or worse. Cervical cancer screening should not include testing for low-risk HPV types. LEVEL OF EVIDENCE: II....

  19. Health effects in residents of high background radiation regions

    International Nuclear Information System (INIS)

    Hanson, G.P.; Komarov, E.

    1983-01-01

    Studies carried out in various countries and by the World Health Organization on health effects of exposure of populations to high levels of natural background radiation result in observations of different significance. There are indications of changes in chromosome aberration rate; Down's syndrome has been observed to be possibly related to radiation exposure; malignant neoplasms in bone apparently correspond to high concentrations of 226 Ra in drinking water. Although various researchers have looked for them, effects have not been demonstrated regarding cancer mortality (other than malignant neoplasms involving bone), gross congenital abnormalities, fertility index, growth and development, hereditary disease (other than the possibility of Down's syndrome), infant mortality, longevity, multiple births, sex ratio, or spontaneous abortion rate. On the basis of reported data clear quantitative conception of the risk of low-level radiation from natural sources could not be developed and feasibility studies of further epidemiological programmes should be organized. The possibility of reducing the collective population dose from natural sources could be further explored and a basis for necessary legal action on establishment of standards for possible sources of natural radiation, such as building materials, fertilizers, natural gas and water, might be developed. (author)

  20. A social work study high-risk behavior among teenagers

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Iravani

    2012-01-01

    Full Text Available Teenagers are believed the people who are supposed to build the world's future. High-risk behaviors such as addiction to drugs, smoking cigarettes, sex, etc. could significantly hurts teenagers and there must be some supporting programs to reduce these issues as much as possible. This paper performs an empirical investigation to study the different factors influencing high- risk behavior among teenagers who live in a city of Esfahan, Iran. The proposed study designs a questionnaire and distribute between two groups of female and male teenagers. The results indicate that while there is a meaningful relationship between high-risk behaviors and average high school marks among male students there is no meaningful relationship between high-risk behaviors and high school grades among female students. The results also indicate that there is a meaningful difference between gender and high-risk behavior. The season of birth for female and male students is another important factor for having high-risk behaviors. While the order of birth plays an important role among male students, the order of birth is not an important factor among female teenagers. Finally, the results indicate that teenagers' parental financial affordability plays a vital role on both female and male teenagers.

  1. Rapid Point-of-Care Diagnostic Test for Syphilis in High-Risk Populations, Manaus, Brazil

    OpenAIRE

    Sabid?, Meritxell; Benzaken, Adele S.; de Andrade Rodrigues, ?nio Jos?; Mayaud, Philippe

    2009-01-01

    : We assessed the acceptability and operational suitability of a rapid point-of-care syphilis test and identified barriers to testing among high-risk groups and healthcare professionals in a sexually transmitted infections clinic in Manaus, Brazil. Use of this test could considerably alleviate the impact of syphilis in hard-to-reach populations in the Amazon region of Brazil.

  2. Properties of Highly Rotationally Excited H2 in Photodissociation Regions

    Science.gov (United States)

    Cummings, Sally Jane; Wan, Yier; Stancil, Phillip C.; Yang, Benhui H.; Zhang, Ziwei

    2018-06-01

    H2 is the dominant molecular species in the vast majority of interstellar environments and it plays a crucial role as a radiative coolant. In photodissociation regions, it is one of the primary emitters in the near to mid-infrared which are due to lines originating from highly excited rotational levels. However, collisional data for rotational levels j>10 are sparse, particularly for H2-H2 collisions. Utilizing new calculations for para-H2 and ortho-H2 collisional rate coefficients with H2 for j as high as 30, we investigate the effects of the new results in standard PDR models with the spectral simulation package Cloudy. We also perform Cloudy models of the Orion Bar and use Radex to explore rotational line ratio diagnostics. The resulting dataset of H2 collisional data should find wide application to other molecular environments. This work was support by Hubble Space Telescope grant HST-AR-13899.001-A and NASA grants NNX15AI61G and NNX16AF09G.

  3. Original Research Identifying patients at high risk for obstructive ...

    African Journals Online (AJOL)

    determine the factors associated with high risk for obstructive sleep apnoea and use it to identify patients at risk for the condition in ... mainstay of management is CPAP in addition to behavioral ..... the present study has some potential limitations which ... consequences of obstructive sleep apnea and short sleep duration.

  4. Awareness and prevalence of metabolic syndrome among high-risk ...

    African Journals Online (AJOL)

    MetS) in high-risk individuals attending 30 internal medicine clinics in Amman, Jordan, and also to evaluate the various factors associated with increased risk of MetS among them. Methods: This retrospective cross-sectional study was carried out ...

  5. Incidence of infective endocarditis among patients considered at high risk

    DEFF Research Database (Denmark)

    Østergaard, Lauge; Valeur, Nana; Ihlemann, Nikolaj

    2018-01-01

    Aims: Patients with prior infective endocarditis (IE), a prosthetic heart valve, or a cyanotic congenital heart disease (CHD) are considered to be at high risk of IE by guidelines. However, knowledge is sparse on the relative risk of IE between these three groups and compared controls. Methods...

  6. Risk assessment of PM2.5 to child residents in Brazilian Amazon region with biofuel production

    Directory of Open Access Journals (Sweden)

    de Oliveira Beatriz Fátima

    2012-09-01

    Full Text Available Abstract Background Exposure to fine fractions of particulate matter (PM2.5 is associated with increased hospital admissions and mortality for respiratory and cardiovascular disease in children and the elderly. This study aims to estimate the toxicological risk of PM2.5 from biomass burning in children and adolescents between the age of 6 and 14 in Tangará da Serra, a municipality of Subequatorial Brazilian Amazon. Methods Risk assessment methodology was applied to estimate the risk quotient in two scenarios of exposure according to local seasonality. The potential dose of PM2.5 was estimated using the Monte Carlo simulation, stratifying the population by age, gender, asthma and Body Mass Index (BMI. Results Male asthmatic children under the age of 8 at normal body rate had the highest risk quotient among the subgroups. The general potential average dose of PM2.5 was 1.95 μg/kg.day (95% CI: 1.62 – 2.27 during the dry scenario and 0.32 μg/kg.day (95% CI: 0.29 – 0.34 in the rainy scenario. During the dry season, children and adolescents showed a toxicological risk to PM2.5 of 2.07 μg/kg.day (95% CI: 1.85 – 2 .30. Conclusions Children and adolescents living in the Subequatorial Brazilian Amazon region were exposed to high levels of PM2.5 resulting in toxicological risk for this multi-pollutant. The toxicological risk quotients of children in this region were comparable or higher to children living in metropolitan regions with PM2.5 air pollution above the recommended limits to human health.

  7. Brachytherapy boost and cancer-specific mortality in favorable high-risk versus other high-risk prostate cancer

    Directory of Open Access Journals (Sweden)

    Vinayak Muralidhar

    2016-02-01

    Full Text Available Purpose : Recent retrospective data suggest that brachytherapy (BT boost may confer a cancer-specific survival benefit in radiation-managed high-risk prostate cancer. We sought to determine whether this survival benefit would extend to the recently defined favorable high-risk subgroup of prostate cancer patients (T1c, Gleason 4 + 4 = 8, PSA 20 ng/ml. Material and methods: We identified 45,078 patients in the Surveillance, Epidemiology, and End Results database with cT1c-T3aN0M0 intermediate- to high-risk prostate cancer diagnosed 2004-2011 treated with external beam radiation therapy (EBRT only or EBRT plus BT. We used multivariable competing risks regression to determine differences in the rate of prostate cancer-specific mortality (PCSM after EBRT + BT or EBRT alone in patients with intermediate-risk, favorable high-risk, or other high-risk disease after adjusting for demographic and clinical factors. Results : EBRT + BT was not associated with an improvement in 5-year PCSM compared to EBRT alone among patients with favorable high-risk disease (1.6% vs. 1.8%; adjusted hazard ratio [AHR]: 0.56; 95% confidence interval [CI]: 0.21-1.52, p = 0.258, and intermediate-risk disease (0.8% vs. 1.0%, AHR: 0.83, 95% CI: 0.59-1.16, p = 0.270. Others with high-risk disease had significantly lower 5-year PCSM when treated with EBRT + BT compared with EBRT alone (3.9% vs. 5.3%; AHR: 0.73; 95% CI: 0.55-0.95; p = 0.022. Conclusions : Brachytherapy boost is associated with a decreased rate of PCSM in some men with high-risk prostate cancer but not among patients with favorable high-risk disease. Our results suggest that the recently-defined “favorable high-risk” category may be used to personalize therapy for men with high-risk disease.

  8. Physical activity barriers and motivators among high-risk employees.

    Science.gov (United States)

    Paguntalan, John C; Gregoski, Mathew

    2016-11-22

    Worksite wellness programs offer an ideal setting to target high-risk sedentary workers to improve health status. Lack of physical activity is associated with increased risk for coronary heart disease and mortality. Despite the risks, the number of sedentary workers is increasing. This study examined the perceived barriers and motivators for physical activity among employees at high-risk for coronary heart disease. A purposive sample of 24 high-risk workers participating in a wellness program in rural South Carolina were enrolled in the study. Qualitative data was obtained through semi-structured face-to-face interviews. Grounded theory was used to analyze qualitative data, and identify overarching themes. Physical limitations due to pain and weakness, lack of motivation, and lack of time emerged as the main barriers to physical activity. Family relationships were reported as the strongest motivator along with social support and potential health benefits. Findings highlight the unique experience of high-risk workers with physical activity. The findingsunderscore the need to design and implement effective interventions specifically designed to meet the needs of high-risk employees.

  9. DASH - Youth Risk Behavior Surveillance System (YRBSS): High School

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1991-2015. High School Dataset. The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health behaviors among youth and young...

  10. Chemicals in Meat Cooked at High Temperatures and Cancer Risk

    Science.gov (United States)

    ... Services Directory Cancer Prevention Overview Research Chemicals in Meat Cooked at High Temperatures and Cancer Risk On ... hydrocarbons, and how are they formed in cooked meats? What factors influence the formation of HCA and ...

  11. Risk factors for prevalence of pig parasitoses in Mbeya Region, Tanzania.

    Science.gov (United States)

    Kabululu, Mwemezi Lutakyawa; Ngowi, Helena Aminiel; Kimera, Sharadhuli Iddi; Lekule, Faustin Paul; Kimbi, Eliakunda Casmir; Johansen, Maria Vang

    2015-09-15

    A cross-sectional study was carried out to determine risk factors for prevalence of common endo- and ectoparasites of pigs kept by smallholder farmers in Mbozi and Mbeya (Rural) districts of Mbeya Region, in Tanzania. A total of 482 pigs from 220 households of 16 villages, eight in each district were randomly selected and examined. Prevalence of Taenia solium cysticercosis was 11.5%, gastrointestinal nematodes 63.7% and ectoparasites 21.2% based on Ag-ELISA, McMaster technique and full body searches/ear scrapings, respectively. Nematode eggs identified were strongyles (Oesophagostomum spp. and Trichostrongylus spp.), Ascaris suum, Trichuris suis and Strongyloides ransomi with prevalence of 57.4%, 17.5%, 5.3% and 1.1%, respectively. Four groups of ectoparasites were identified, i.e. lice (Haematopinus suis), ticks (Rhipicephalus spp., Amblyomma spp., Haemaphysalis spp. and Boophilus spp.), fleas (Ctenocephalides canis) and mites (Sarcoptes scabiei var. suis and Demodex phylloides), with prevalence of 19.1%, 2.1%, 0.4%, and 1.2%, respectively. Pigs in Mbeya (Rural) District had higher odds for porcine cysticercosis (OR=2.63, 95% CI: [1.22-5.55]). Poor pen hygiene and infrequent antiparasitic treatment were identified to be risk factors for prevalence of nematode infections (OR=1.95 [1.09-3.52] and OR=1.78 [1.06-2.94], respectively). The odds for high nematode burdens increased in cases of poor pen hygiene (OR=4.20 [2.54-6.62]) and poor feed quality (OR=3.7 [1.66-8.33]). Pigs not treated with antiparasitic drugs within the last three months had higher odds for ectoparasite (OR=4.0 [1.78-9.09]) and lice infestations (OR=8.33 [1.96-14.28]) than treated pigs. This study has shown that parasitoses constitute a major burden for smallholder pigs in Mbeya Region and major risk factors included infrequent antiparasitic treatment, poor pen hygiene and poor feed quality. Cost-effective intervention strategies are needed to improve pork production, secure pig welfare and ensure

  12. Polycyclic aromatic hydrocarbons and risk elements in honey from the South Moravian region (Czech Republic

    Directory of Open Access Journals (Sweden)

    Petra Batelková

    2012-01-01

    Full Text Available The aim of this study was to determine the actual content of some exogenous contaminants in the honey from the South Moravian region of the Czech Republic. The content of polycyclic aromatic hydrocarbons (PAHs and risk elements (Mercury - Hg, Cadmium - Cd, Lead - Pb, and Arsenic - As in multifloral blossom and honey dew samples of honey were determined by high-performance liquid chromatography and atomic absorption spectroscopy methods. The samples were collected form beekeepers and from retail stores located in South Moravia in the Czech Republic. Concentrations of individual PAHs in honey samples ranged between 0.02 μg·kg-1–1.93 μg·kg-1. The limit of benzo[a]pyrene for infant formula (1.0 μg·kg-1 was not exceeded and fluoranthene was not quantified in any of the samples. Concentrations of Hg, Cd, and Pb were in the range of 3.24 μg·kg-1–11.31 μg·kg-1, 0.95 μg·kg-1–32.35 μg·kg-1, and 22.80 μg·kg-1–177.85 μg·kg-1, respectively. Concentration of As exceeded the detection limit only in three samples, ranging from 3.51 μg·kg-1 to 4.35 μg·kg-1. Acceptable limits for trace elements in infant formula were met. Results of this study complete present knowledge of the contaminant content in Czech honey and confirmed high quality and safety of honey from the South Moravian region.

  13. Sensation seeking in males involved in recreational high risk sports

    OpenAIRE

    M Guszkowska; A Bołdak

    2010-01-01

    The study examined sensation seeking intensity level in males involved in recreational high risk sports and investigated whether its level depends on type of sport practised. Additionally, in case of parachutists, sport experience of study participants were scrutinised with regard to its possible impact on the level of sensation seeking.The research involved 217 males aged 17 to 45, practising recreational high risk sports, namely: parachuting (n=98); wakeboarding (n=30); snowboarding (n=30);...

  14. Increased Cardiometabolic Risk and Worsening Hypoxemia at High Altitude

    OpenAIRE

    Miele, Catherine H.; Schwartz, Alan R.; Gilman, Robert H.; Pham, Luu; Wise, Robert A.; Davila-Roman, Victor G.; Jun, Jonathan C.; Polotsky, Vsevolod Y.; Miranda, J. Jaime; Leon-Velarde, Fabiola; Checkley, William

    2016-01-01

    Miele, Catherine H., Alan R. Schwartz, Robert H. Gilman, Luu Pham, Robert A. Wise, Victor G. Davila-Roman, Jonathan C. Jun, Vsevolod Y. Polotsky, J. Jaime Miranda, Fabiola Leon-Velarde, and William Checkley. Increased cardiometabolic risk and worsening hypoxemia at high altitude. High Alt Med Biol. 17:93���100, 2016.���Metabolic syndrome, insulin resistance, diabetes, and dyslipidemia are associated with an increased risk of cardiovascular disease. While excessive erythrocytosis is associated...

  15. Identification of the high risk emergency surgical patient: Which risk prediction model should be used?

    Science.gov (United States)

    Stonelake, Stephen; Thomson, Peter; Suggett, Nigel

    2015-09-01

    National guidance states that all patients having emergency surgery should have a mortality risk assessment calculated on admission so that the 'high risk' patient can receive the appropriate seniority and level of care. We aimed to assess if peri-operative risk scoring tools could accurately calculate mortality and morbidity risk. Mortality risk scores for 86 consecutive emergency laparotomies, were calculated using pre-operative (ASA, Lee index) and post-operative (POSSUM, P-POSSUM and CR-POSSUM) risk calculation tools. Morbidity risk scores were calculated using the POSSUM predicted morbidity and compared against actual morbidity according to the Clavien-Dindo classification. The actual mortality was 10.5%. The average predicted risk scores for all laparotomies were: ASA 26.5%, Lee Index 2.5%, POSSUM 29.5%, P-POSSUM 18.5%, CR-POSSUM 10.5%. Complications occurred following 67 laparotomies (78%). The majority (51%) of complications were classified as Clavien-Dindo grade 2-3 (non-life-threatening). Patients having a POSSUM morbidity risk of greater than 50% developed significantly more life-threatening complications (CD 4-5) compared with those who predicted less than or equal to 50% morbidity risk (P = 0.01). Pre-operative risk stratification remains a challenge because the Lee Index under-predicts and ASA over-predicts mortality risk. Post-operative risk scoring using the CR-POSSUM is more accurate and we suggest can be used to identify patients who require intensive care post-operatively. In the absence of accurate risk scoring tools that can be used on admission to hospital it is not possible to reliably audit the achievement of national standards of care for the 'high-risk' patient.

  16. Evaluation of the Prostate Cancer Prevention Trial Risk Calculator in a High-Risk Screening Population

    Science.gov (United States)

    Kaplan, David J.; Boorjian, Stephen A.; Ruth, Karen; Egleston, Brian L.; Chen, David Y.T.; Viterbo, Rosalia; Uzzo, Robert G.; Buyyounouski, Mark K.; Raysor, Susan; Giri, Veda N.

    2009-01-01

    Introduction Clinical factors in addition to PSA have been evaluated to improve risk assessment for prostate cancer. The Prostate Cancer Prevention Trial (PCPT) risk calculator provides an assessment of prostate cancer risk based on age, PSA, race, prior biopsy, and family history. This study evaluated the risk calculator in a screening cohort of young, racially diverse, high-risk men with a low baseline PSA enrolled in the Prostate Cancer Risk Assessment Program. Patients and Methods Eligibility for PRAP include men ages 35-69 who are African-American, have a family history of prostate cancer, or have a known BRCA1/2 mutation. PCPT risk scores were determined for PRAP participants, and were compared to observed prostate cancer rates. Results 624 participants were evaluated, including 382 (61.2%) African-American men and 375 (60%) men with a family history of prostate cancer. Median age was 49.0 years (range 34.0-69.0), and median PSA was 0.9 (range 0.1-27.2). PCPT risk score correlated with prostate cancer diagnosis, as the median baseline risk score in patients diagnosed with prostate cancer was 31.3%, versus 14.2% in patients not diagnosed with prostate cancer (p<0.0001). The PCPT calculator similarly stratified the risk of diagnosis of Gleason score ≥7 disease, as the median risk score was 36.2% in patients diagnosed with Gleason ≥7 prostate cancer versus 15.2% in all other participants (p<0.0001). Conclusion PCPT risk calculator score was found to stratify prostate cancer risk in a cohort of young, primarily African-American men with a low baseline PSA. These results support further evaluation of this predictive tool for prostate cancer risk assessment in high-risk men. PMID:19709072

  17. High-risk PCI: how to define it today?

    Science.gov (United States)

    DE Marzo, Vincenzo; D'Amario, Domenico; Galli, Mattia; Vergallo, Rocco; Porto, Italo

    2018-04-11

    Before the percutaneous spread, the mortality rate of patients with coronary heart disease not suitable for cardiac surgery was markedly high. This limit has been progressively exceeded with the advent of minimally invasive approaches, which, although was initially intended exclusively for low risk patients, was then employed in complex patients often too compromised to undergo cardiac surgery. Given to the rising of high-risk population, due to an increase of patients with multiple chronic conditions linked to the best care offered, we are witnessing an expansion of the high-risk percutaneous coronary interventions (PCI) population. Despite defining what high-risk is remains still unclear, all proposed definitions of high-risk PCI combine features related to three clinical areas: 1) patient risk factors and comorbidities (incorporating those which preclude surgical or percutaneous revascularization such as diabetes, COPD, CKD, lung disease, frailty, advanced age); 2) location of the disease and complexity of coronary anatomy (including multi-vessel disease, left main disease, CTO, bifurcations); 3) hemodynamic clinical status (ventricular dysfunction, concomitant valvular disease or unstable characteristics). Since cardiologists have ascertained the encouraging results in terms of efficacy and rewards compared to the low-risks patients, the important role of treating high-risk patients is becoming more and more relevant to the point that current guidelines have now changed the appropriateness of percutaneous interventions indications. Considering the complexity in managing higher-risk patients with coronary artery disease, the next step to ensure the best care for this type of patients is to create a team-based model of cooperation in order to properly establish the right treatment for the right patient.

  18. Common and rare variants in the exons and regulatory regions of osteoporosis-related genes improve osteoporotic fracture risk prediction.

    Science.gov (United States)

    Lee, Seung Hun; Kang, Moo Il; Ahn, Seong Hee; Lim, Kyeong-Hye; Lee, Gun Eui; Shin, Eun-Soon; Lee, Jong-Eun; Kim, Beom-Jun; Cho, Eun-Hee; Kim, Sang-Wook; Kim, Tae-Ho; Kim, Hyun-Ju; Yoon, Kun-Ho; Lee, Won Chul; Kim, Ghi Su; Koh, Jung-Min; Kim, Shin-Yoon

    2014-11-01

    Osteoporotic fracture risk is highly heritable, but genome-wide association studies have explained only a small proportion of the heritability to date. Genetic data may improve prediction of fracture risk in osteopenic subjects and assist early intervention and management. To detect common and rare variants in coding and regulatory regions related to osteoporosis-related traits, and to investigate whether genetic profiling improves the prediction of fracture risk. This cross-sectional study was conducted in three clinical units in Korea. Postmenopausal women with extreme phenotypes (n = 982) were used for the discovery set, and 3895 participants were used for the replication set. We performed targeted resequencing of 198 genes. Genetic risk scores from common variants (GRS-C) and from common and rare variants (GRS-T) were calculated. Nineteen common variants in 17 genes (of the discovered 34 functional variants in 26 genes) and 31 rare variants in five genes (of the discovered 87 functional variants in 15 genes) were associated with one or more osteoporosis-related traits. Accuracy of fracture risk classification was improved in the osteopenic patients by adding GRS-C to fracture risk assessment models (6.8%; P risk in an osteopenic individual.

  19. Screening for breast cancer in a high-risk series

    International Nuclear Information System (INIS)

    Woodard, E.D.; Hempelmann, L.H.; Janus, J.; Logan, W.; Dean, P.

    1982-01-01

    A unique cohort of women at increased risk of breast cancer because of prior X-ray treatment of acute mastitis and their selected high-risk siblings were offered periodic breast cancer screening including physical examination of the breasts, mammography, and thermography. Twelve breast cancers were detected when fewer than four would have been expected based on age-specific breast cancer detection rates from the National Cancer institute/American Cancer Society Breast Cancer Demonstration Detection Projects. Mammograpy was positive in all cases but physical examination was positive in only three cases. Thermography was an unreliable indicator of disease. Given the concern over radiation-induced risk, use of low-dose technique and of criteria for participation that select women at high risk of breast cancer will maximize the benefit/risk ratio for mammography screening

  20. Prevalence and Risk Factors of Diabetic Nephropathy in Omani Type 2 Diabetics in Al-Dakhiliyah Region

    Directory of Open Access Journals (Sweden)

    Abdulhakeem Hamood Alrawahi

    2012-05-01

    Full Text Available Objective: To assess the prevalence and risk factors of diabetic nephropathy among Omani type 2 diabetics in Al-Dakhiliyah region of the Sultanate of Oman.Methods: A cross-sectional and a case control study designs were used to assess the prevalence and risk factors respectively. For the prevalence study a sample of 699 diabetic subjects were selected randomly from two polyclinics in Al-Dakhiliyah region; Sumail and Nizwa polyclinics. For the case control study, a sample consisting of 215 cases and 358 controls were randomly selected from those who were included in the cross-sectional study. A well designed questionnaire has been used to collect data regarding the disease and risk factors. Data was analyzed using SPSS19 statistical program.Results: Total prevalence of diabetic nephropathy was calculated as 42.5% (95% C.I: 38.83% - 46.15%. The difference in the prevalence in the two polyclinic catchment area was not significant. The prevalence was significantly higher among males (51.6% compared to females (36.5%. Crude analysis of the risk factors showed significant association between diabetic nephropathy and the following factors; male gender, decreased literacy, long duration of diabetes mellitus, hypertension, retinopathy, neuropathy, family history of diabetic nephropathy, poor glycemic control (high HbA1c, and hypertriglyceridemia. Multivariate analysis showed the following factors to be independent risk factors; male gender, decreased literacy, long duration of diabetes, family history of diabetic nephropathy and poor glycaemic control (high HbA1c.Conclusion: The prevalence of diabetic nephropathy in this study was 42.5% and the significant risk factors associated with it included male gender, decreased literacy, long duration of diabetes, family history of diabetic nephropathy and poor glycemic control (high HbA1c.

  1. Communicating about risk: strategies for situations where public concern is high but the risk is low

    Directory of Open Access Journals (Sweden)

    Claire Hooker

    2017-02-01

    Full Text Available In this article, we summarise research that identifies best practice for communicating about hazards where the risk is low but public concern is high. We apply Peter Sandman’s ‘risk = hazard + outrage’ formulation to these risks, and review factors associated with the amplification of risk signals. We discuss the structures that determine the success of risk communication strategies, such as the capacity for early communication to ‘capture’ the dominant representation of risk issues, the importance of communicating uncertainty, and the usefulness of engaging with communities. We argue that, when facing trade-offs in probable outcomes from communication, it is always best to choose strategies that maintain or build trust, even at the cost of initial overreactions. We discuss these features of successful risk communication in relation to a range of specific examples, particularly opposition to community water fluoridation, Ebola, and routine childhood immunisation.

  2. Application of a regional hurricane wind risk forecasting model for wood-frame houses.

    Science.gov (United States)

    Jain, Vineet Kumar; Davidson, Rachel Ann

    2007-02-01

    Hurricane wind risk in a region changes over time due to changes in the number, type, locations, vulnerability, and value of buildings. A model was developed to quantitatively estimate changes over time in hurricane wind risk to wood-frame houses (defined in terms of potential for direct economic loss), and to estimate how different factors, such as building code changes and population growth, contribute to that change. The model, which is implemented in a simulation, produces a probability distribution of direct economic losses for each census tract in the study region at each time step in the specified time horizon. By changing parameter values and rerunning the analysis, the effects of different changes in the built environment on the hurricane risk trends can be estimated and the relative effectiveness of hypothetical mitigation strategies can be evaluated. Using a case study application for wood-frame houses in selected counties in North Carolina from 2000 to 2020, this article demonstrates how the hurricane wind risk forecasting model can be used: (1) to provide insight into the dynamics of regional hurricane wind risk-the total change in risk over time and the relative contribution of different factors to that change, and (2) to support mitigation planning. Insights from the case study include, for example, that the many factors contributing to hurricane wind risk for wood-frame houses interact in a way that is difficult to predict a priori, and that in the case study, the reduction in hurricane losses due to vulnerability changes (e.g., building code changes) is approximately equal to the increase in losses due to building inventory growth. The potential for the model to support risk communication is also discussed.

  3. Regional Appeal Court Duesseldorf, judgement of December 28, 1984 (Information on the risk of radiation treatment)

    International Nuclear Information System (INIS)

    Anon.

    1987-01-01

    In its decision of December 28, 1984, the Regional Appeal Court of Duesseldorf deals with the obligation to give information about the risks involved in radiation treatment. The intensity and exactness of the medical explanation is to be judged with regard to the current knowledge of the physicians which reasonably can be expected. (WG) [de

  4. Predicting reattendance at a high-risk breast cancer clinic.

    Science.gov (United States)

    Ormseth, Sarah R; Wellisch, David K; Aréchiga, Adam E; Draper, Taylor L

    2015-10-01

    The research about follow-up patterns of women attending high-risk breast-cancer clinics is sparse. This study sought to profile daughters of breast-cancer patients who are likely to return versus those unlikely to return for follow-up care in a high-risk clinic. Our investigation included 131 patients attending the UCLA Revlon Breast Center High Risk Clinic. Predictor variables included age, computed breast-cancer risk, participants' perceived personal risk, clinically significant depressive symptomatology (CES-D score ≥ 16), current level of anxiety (State-Trait Anxiety Inventory), and survival status of participants' mothers (survived or passed away from breast cancer). A greater likelihood of reattendance was associated with older age (adjusted odds ratio [AOR] = 1.07, p = 0.004), computed breast-cancer risk (AOR = 1.10, p = 0.017), absence of depressive symptomatology (AOR = 0.25, p = 0.009), past psychiatric diagnosis (AOR = 3.14, p = 0.029), and maternal loss to breast cancer (AOR = 2.59, p = 0.034). Also, an interaction was found between mother's survival and perceived risk (p = 0.019), such that reattendance was associated with higher perceived risk among participants whose mothers survived (AOR = 1.04, p = 0.002), but not those whose mothers died (AOR = 0.99, p = 0.685). Furthermore, a nonlinear inverted "U" relationship was observed between state anxiety and reattendance (p = 0.037); participants with moderate anxiety were more likely to reattend than those with low or high anxiety levels. Demographic, medical, and psychosocial factors were found to be independently associated with reattendance to a high-risk breast-cancer clinic. Explication of the profiles of women who may or may not reattend may serve to inform the development and implementation of interventions to increase the likelihood of follow-up care.

  5. Modern Risk Assessment for Nuclear Power Plants High-Voltage Substations

    International Nuclear Information System (INIS)

    Ioan, S.; Hurdubetiu, S.; Marza, F.; Mocanu, M.; Stefan, M.

    2002-01-01

    The paper describes a first Romanian attempt to set up the methodology for risk assessment and control within high-voltage substations, developed for the Nuclear power plant in Cernavoda (Romania). Considering the present risk assessment methods the MENER Project will develop a new methodology, in line with the European Community legislation and with the specific regional needs. In order to correctly shape the necessary resources required by a risk analysis a large size enterprise (a nuclear power plant) is selected and the following five indicators will be estimated: the economic profit, environmental risk, indirect (future) risk, technology improvement and physic and psychological risk. The results are expected to considerably facilitate risk assessment, by: evaluating project acceptability; evaluating equipment compliance to regulatory criteria; estimating excluding clearances; easing the design of emergency programmes; identifying the equipment use restrictions; identifying the risk sources; selecting the maintenance and risk reduction methods; testing the procedures leading to future regulatory norms; suitability of the risk management system modification. The immediate result of employing modern risk assessment methods could be the decrease by one third of the expenses required by environment protection, staff health and labor safety and quality management. (author)

  6. Prevalence and risk factors associated with human Taenia solium infections in Mbozi District, Mbeya Region, Tanzania.

    Directory of Open Access Journals (Sweden)

    Gloria Mwanjali

    Full Text Available BACKGROUND: Taenia solium cysticercosis/taeniosis is emerging as a serious public health and economic problem in many developing countries. This study was conducted to determine prevalence and risk factors of human T. solium infections in Mbeya Region, Tanzania. METHODS AND FINDINGS: A cross-sectional survey was conducted in 13 villages of Mbozi district in 2009. Sera of 830 people (mean 37.9±11.3 years (SD; 43% females were tested for circulating cysticerci antigen (Ag-ELISA and antibody (Ab-ELISA. A subset of persons found seropositive by Ag-ELISA underwent computed tomography (CT scan of the brain for evidence of neurocysticercosis. Stool samples from 820 of the same participants were tested for taeniosis by copro-antigens (copro-Ag-ELISA and formol-ether concentration technique. Cases of T. solium taeniosis were confirmed serologically by EITB assay (rES38. A questionnaire was used for identification of risk factors. Active cysticercosis by positive Ag-ELISA was found in 139 (16.7% persons while anti-cysticercal antibodies were detected in 376 (45.3% persons by Ab-ELISA. Among 55 persons positive for Ag-ELISA undergoing CT scan, 30 (54.6% were found to have structures in the brain suggestive of neurocysticercosis. Using faecal analysis, 43 (5.2% stool samples tested positive for taeniosis by copro-Ag-ELISA while Taenia eggs were detected in 9 (1.1% stool samples by routine coprology. Antibodies specifically against adult T. solium were detected in 34 copro-Ag-ELISA positive participants by EITB (rES38 indicating T. solium taeniosis prevalence of 4.1%. Increasing age and hand washing by dipping in contrast to using running water, were found associated with Ag-ELISA seropositivity by logistic regression. Gender (higher risk in females and water source were risk factors associated with Ab-ELISA seropositivity. Reported symptoms of chronic severe headaches and history of epileptic seizures were found associated with positive Ag-ELISA (p≤0

  7. Prevalence and Risk Factors Associated with Human Taenia Solium Infections in Mbozi District, Mbeya Region, Tanzania

    Science.gov (United States)

    Mwanjali, Gloria; Kihamia, Charles; Kakoko, Deodatus Vitalis Conatus; Lekule, Faustin; Ngowi, Helena; Johansen, Maria Vang; Thamsborg, Stig Milan; Willingham, Arve Lee

    2013-01-01

    Background Taenia solium cysticercosis/taeniosis is emerging as a serious public health and economic problem in many developing countries. This study was conducted to determine prevalence and risk factors of human T. solium infections in Mbeya Region, Tanzania. Methods and Findings A cross-sectional survey was conducted in 13 villages of Mbozi district in 2009. Sera of 830 people (mean 37.9±11.3 years (SD); 43% females) were tested for circulating cysticerci antigen (Ag-ELISA) and antibody (Ab-ELISA). A subset of persons found seropositive by Ag-ELISA underwent computed tomography (CT) scan of the brain for evidence of neurocysticercosis. Stool samples from 820 of the same participants were tested for taeniosis by copro-antigens (copro-Ag-ELISA) and formol-ether concentration technique. Cases of T. solium taeniosis were confirmed serologically by EITB assay (rES38). A questionnaire was used for identification of risk factors. Active cysticercosis by positive Ag-ELISA was found in 139 (16.7%) persons while anti-cysticercal antibodies were detected in 376 (45.3%) persons by Ab-ELISA. Among 55 persons positive for Ag-ELISA undergoing CT scan, 30 (54.6%) were found to have structures in the brain suggestive of neurocysticercosis. Using faecal analysis, 43 (5.2%) stool samples tested positive for taeniosis by copro-Ag-ELISA while Taenia eggs were detected in 9 (1.1%) stool samples by routine coprology. Antibodies specifically against adult T. solium were detected in 34 copro-Ag-ELISA positive participants by EITB (rES38) indicating T. solium taeniosis prevalence of 4.1%. Increasing age and hand washing by dipping in contrast to using running water, were found associated with Ag-ELISA seropositivity by logistic regression. Gender (higher risk in females) and water source were risk factors associated with Ab-ELISA seropositivity. Reported symptoms of chronic severe headaches and history of epileptic seizures were found associated with positive Ag-ELISA (p≤0

  8. The high-risk HPV infection and urinary system tumor

    Directory of Open Access Journals (Sweden)

    Yang Wenyan

    2018-04-01

    Full Text Available HPV is classified into high-risk and low-risk types depending on its probability of leading to tumorigenesis. Many studies have shown that HPV infection, especially the infection caused by the high-risk type, is always related to prostate cancer, bladder cancer, penile cancer, testicular cancer, and other urinary system tumors. However, previous studies differed in sexual openness and racial genetic susceptibility of the study object, sample size, and experimental methods. Hence, the correlation between high-risk HPV infection and urinary system tumors remains controversial. The early open reading frame of the HPV genome is composed of E1–E7, among which E6 and E7 are the key transfer proteins. The combination of these proteins with oncogene and anti-oncogene may be one of the mechanisms leading to tumorigenesis.

  9. fMRI investigation of response inhibition, emotion, impulsivity, and clinical high-risk behavior in adolescents.

    Science.gov (United States)

    Brown, Matthew R G; Benoit, James R A; Juhás, Michal; Dametto, Ericson; Tse, Tiffanie T; MacKay, Marnie; Sen, Bhaskar; Carroll, Alan M; Hodlevskyy, Oleksandr; Silverstone, Peter H; Dolcos, Florin; Dursun, Serdar M; Greenshaw, Andrew J

    2015-01-01

    High-risk behavior in adolescents is associated with injury, mental health problems, and poor outcomes in later life. Improved understanding of the neurobiology of high-risk behavior and impulsivity shows promise for informing clinical treatment and prevention as well as policy to better address high-risk behavior. We recruited 21 adolescents (age 14-17) with a wide range of high-risk behavior tendencies, including medically high-risk participants recruited from psychiatric clinics. Risk tendencies were assessed using the Adolescent Risk Behavior Screen (ARBS). ARBS risk scores correlated highly (0.78) with impulsivity scores from the Barratt Impulsivity scale (BIS). Participants underwent 4.7 Tesla functional magnetic resonance imaging (fMRI) while performing an emotional Go/NoGo task. This task presented an aversive or neutral distractor image simultaneously with each Go or NoGo stimulus. Risk behavior and impulsivity tendencies exhibited similar but not identical associations with fMRI activation patterns in prefrontal brain regions. We interpret these results as reflecting differences in response inhibition, emotional stimulus processing, and emotion regulation in relation to participant risk behavior tendencies and impulsivity levels. The results are consistent with high impulsivity playing an important role in determining high risk tendencies in this sample containing clinically high-risk adolescents.

  10. fMRI investigation of response inhibition, emotion, impulsivity, and clinical high-risk behaviour in adolescents

    Directory of Open Access Journals (Sweden)

    Matthew R G Brown

    2015-09-01

    Full Text Available High-risk behaviour in adolescents is associated with injury, mental health problems, and poor outcomes in later life. Improved understanding of the neurobiology of high-risk behaviour and impulsivity shows promise for informing clinical treatment and prevention as well as policy to better address high-risk behaviour. We recruited 21 adolescents (age 14-17 with a wide range of high-risk behaviour tendencies, including medically high-risk participants recruited from psychiatric clinics. Risk tendencies were assessed using the Adolescent Risk Behaviour Screen (ARBS. ARBS risk scores correlated highly (0.78 with impulsivity scores from the Barratt Impulsivity scale (BIS. Participants underwent 4.7 Tesla functional magnetic resonance imaging (fMRI while performing an emotional Go/NoGo task. This task presented an aversive or neutral distractor image simultaneously with each Go or NoGo stimulus. Risk behaviour and impulsivity tendencies exhibited similar but not identical associations with fMRI activation patterns in prefrontal brain regions. We interpret these results as reflecting differences in response inhibition, emotional stimulus processing, and emotion regulation in relation to participant risk behaviour tendencies and impulsivity levels. The results are consistent with high impulsivity playing an important role in determining high risk tendencies in this sample containing clinically high-risk adolescents.

  11. Diagnosis and Management of High Risk Group for Gastric Cancer

    Science.gov (United States)

    Yoon, Hyuk; Kim, Nayoung

    2015-01-01

    Gastric cancer is associated with high morbidity and mortality worldwide. To reduce the socioeconomic burden related to gastric cancer, it is very important to identify and manage high risk group for gastric cancer. In this review, we describe the general risk factors for gastric cancer and define high risk group for gastric cancer. We discuss strategies for the effective management of patients for the prevention and early detection of gastric cancer. Atrophic gastritis (AG) and intestinal metaplasia (IM) are the most significant risk factors for gastric cancer. Therefore, the accurate selection of individuals with AG and IM may be a key strategy for the prevention and/or early detection of gastric cancer. Although endoscopic evaluation using enhanced technologies such as narrow band imaging-magnification, the serum pepsinogen test, Helicobacter pylori serology, and trefoil factor 3 have been evaluated, a gold standard method to accurately select individuals with AG and IM has not emerged. In terms of managing patients at high risk of gastric cancer, it remains uncertain whether H. pylori eradication reverses and/or prevents the progression of AG and IM. Although endoscopic surveillance in high risk patients is expected to be beneficial, further prospective studies in large populations are needed to determine the optimal surveillance interval. PMID:25547086

  12. Chromosomal imbalance in the progression of high-risk non-muscle invasive bladder cancer

    International Nuclear Information System (INIS)

    Zieger, Karsten; Wiuf, Carsten; Jensen, Klaus Møller-Ernst; Ørntoft, Torben Falck; Dyrskjøt, Lars

    2009-01-01

    Non-muscle invasive bladder neoplasms with invasion of the lamina propria (stage T1) or high grade of dysplasia are at 'high risk' of progression to life-threatening cancer. However, the individual course is difficult to predict. Chromosomal instability (CI) is associated with high tumor stage and grade, and possibly with the risk of progression. To investigate the relationship between CI and subsequent disease progression, we performed a case-control-study of 125 patients with 'high-risk' non-muscle invasive bladder neoplasms, 67 with later disease progression, and 58 with no progression. Selection criteria were conservative (non-radical) resections and full prospective clinical follow-up (> 5 years). We investigated primary lesions in 59, and recurrent lesions in 66 cases. We used Affymetrix GeneChip ® Mapping 10 K and 50 K SNP microarrays to evaluate genome wide chromosomal imbalance (loss-of-heterozygosity and DNA copy number changes) in 48 representative tumors. DNA copy number changes of 15 key instability regions were further investigated using QPCR in 101 tumors (including 25 tumors also analysed on 50 K SNP microarrays). Chromosomal instability did not predict any higher risk of subsequent progression. Stage T1 and high-grade tumors had generally more unstable genomes than tumors of lower stage and grade (mostly non-primary tumors following a 'high-risk' tumor). However, about 25% of the 'high-risk' tumors had very few alterations. This was independent of subsequent progression. Recurrent lesions represent underlying field disease. A separate analysis of these lesions did neither reflect any difference in the risk of progression. Of specific chromosomal alterations, a possible association between loss of chromosome 8p11 and the risk of progression was found. However, the predictive value was limited by the heterogeneity of the changes. Chromosomal instability (CI) was associated with 'high risk' tumors

  13. Climate change impact assessment in Veneto and Friuli Plain groundwater. Part II: a spatially resolved regional risk assessment.

    Science.gov (United States)

    Pasini, S; Torresan, S; Rizzi, J; Zabeo, A; Critto, A; Marcomini, A

    2012-12-01

    Climate change impact assessment on water resources has received high international attention over the last two decades, due to the observed global warming and its consequences at the global to local scale. In particular, climate-related risks for groundwater and related ecosystems pose a great concern to scientists and water authorities involved in the protection of these valuable resources. The close link of global warming with water cycle alterations encourages research to deepen current knowledge on relationships between climate trends and status of water systems, and to develop predictive tools for their sustainable management, copying with key principles of EU water policy. Within the European project Life+ TRUST (Tool for Regional-scale assessment of groundwater Storage improvement in adaptation to climaTe change), a Regional Risk Assessment (RRA) methodology was developed in order to identify impacts from climate change on groundwater and associated ecosystems (e.g. surface waters, agricultural areas, natural environments) and to rank areas and receptors at risk in the high and middle Veneto and Friuli Plain (Italy). Based on an integrated analysis of impacts, vulnerability and risks linked to climate change at the regional scale, a RRA framework complying with the Sources-Pathway-Receptor-Consequence (SPRC) approach was defined. Relevant impacts on groundwater and surface waters (i.e. groundwater level variations, changes in nitrate infiltration processes, changes in water availability for irrigation) were selected and analyzed through hazard scenario, exposure, susceptibility and risk assessment. The RRA methodology used hazard scenarios constructed through global and high resolution model simulations for the 2071-2100 period, according to IPCC A1B emission scenario in order to produce useful indications for future risk prioritization and to support the addressing of adaptation measures, primarily Managed Artificial Recharge (MAR) techniques. Relevant

  14. Risk Assessment of Geologic Formation Sequestration in The Rocky Mountain Region, USA

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Si-Yong; McPherson, Brian

    2013-08-01

    The purpose of this report is to describe the outcome of a targeted risk assessment of a candidate geologic sequestration site in the Rocky Mountain region of the USA. Specifically, a major goal of the probabilistic risk assessment was to quantify the possible spatiotemporal responses for Area of Review (AoR) and injection-induced pressure buildup associated with carbon dioxide (CO₂) injection into the subsurface. Because of the computational expense of a conventional Monte Carlo approach, especially given the likely uncertainties in model parameters, we applied a response surface method for probabilistic risk assessment of geologic CO₂ storage in the Permo-Penn Weber formation at a potential CCS site in Craig, Colorado. A site-specific aquifer model was built for the numerical simulation based on a regional geologic model.

  15. Screening for Behavioral Risk: Identification of High Risk Cut Scores within the Social, Academic, and Emotional Behavior Risk Screener (SAEBRS)

    Science.gov (United States)

    Kilgus, Stephen P.; Taylor, Crystal N.; von der Embse, Nathaniel P.

    2018-01-01

    The purpose of this study was to support the identification of Social, Academic, and Emotional Behavior Risk Screener (SAEBRS) cut scores that could be used to detect high-risk students. Teachers rated students across two time points (Time 1 n = 1,242 students; Time 2 n = 704) using the SAEBRS and the Behavioral and Emotional Screening System…

  16. The risk ogf high-risk jobs : psychological health consequences in forensic physicians and ambulance workers

    NARCIS (Netherlands)

    Ploeg, E. van der

    2003-01-01

    The risk of high-risk jobs: Psychological health consequences in forensic doctors and ambulance workers This thesis has shown that forensic physicians and ambulance personnel frequently suffer from psychological complaints as a result of dramatic events and sources of chronic work stress. A

  17. On risk, leverage and banks: do highly leveraged banks take on excessive risk?

    NARCIS (Netherlands)

    Koudstaal, M.; van Wijnbergen, S.

    2012-01-01

    This paper deals with the relation between excessive risk taking and capital structure in banks. Examining a quarterly dataset of U.S. banks between 1993 and 2010, we find that equity is valued higher when more risky portfolios are chosen when leverage is high, and that more risk taking has a

  18. Who Takes Risks in High-Risk Sports? A Typological Personality Approach

    Science.gov (United States)

    Castanier, Carole; Le Scanff, Christine; Woodman, Tim

    2010-01-01

    We investigated the risk-taking behaviors of 302 men involved in high-risk sports (downhill skiing, mountaineering, rock climbing, paragliding, or skydiving). The sportsmen were classified using a typological approach to personality based on eight personality types, which were constructed from combinations of neuroticism, extraversion, and…

  19. Risk-based prioritization of ground water threatening point sources at catchment and regional scales

    DEFF Research Database (Denmark)

    Overheu, Niels Døssing; Tuxen, Nina; Flyvbjerg, John

    2014-01-01

    framework has been developed to enable a systematic and transparent risk assessment and prioritization of contaminant point sources, considering the local, catchment, or regional scales (Danish EPA, 2011, 2012). The framework has been tested in several catchments in Denmark with different challenges...... and needs, and two of these are presented. Based on the lessons learned, the Danish EPA has prepared a handbook to guide the user through the steps in a risk-based prioritization (Danish EPA, 2012). It provides guidance on prioritization both in an administratively defined area such as a Danish Region...... of the results are presented using the case studies as examples. The methodology was developed by a broad industry group including the Danish EPA, the Danish Regions, the Danish Nature Agency, the Technical University of Denmark, and consultants — and the framework has been widely accepted by the professional...

  20. Influences of Regional Development on Land Use of Nagara Basin and Flood Risk Control

    Directory of Open Access Journals (Sweden)

    Banba Michiko

    2016-01-01

    Full Text Available Land developments, and construction of factories or logistic centers should be implemented with the wellconsidered land use plans by taking account of disaster risks to improve the resilience of region to mitigate damages. In this paper, the relationship between regional development and land use from the perspective of flood risk control. Nagara basin in Gifu prefecture (Gifu, Mino, and Seki City, where transportation network has been developed to raise the potential for more development, is selected as a case study site. First, changes of industrial structures of the region and its influences on land use were analyzed. Then, possible flood control measures were summarized, and issues from the land use perspective are analysed

  1. Quantitative assessment of changes in landslide risk using a regional scale run-out model

    Science.gov (United States)

    Hussin, Haydar; Chen, Lixia; Ciurean, Roxana; van Westen, Cees; Reichenbach, Paola; Sterlacchini, Simone

    2015-04-01

    The risk of landslide hazard continuously changes in time and space and is rarely a static or constant phenomena in an affected area. However one of the main challenges of quantitatively assessing changes in landslide risk is the availability of multi-temporal data for the different components of risk. Furthermore, a truly "quantitative" landslide risk analysis requires the modeling of the landslide intensity (e.g. flow depth, velocities or impact pressures) affecting the elements at risk. Such a quantitative approach is often lacking in medium to regional scale studies in the scientific literature or is left out altogether. In this research we modelled the temporal and spatial changes of debris flow risk in a narrow alpine valley in the North Eastern Italian Alps. The debris flow inventory from 1996 to 2011 and multi-temporal digital elevation models (DEMs) were used to assess the susceptibility of debris flow triggering areas and to simulate debris flow run-out using the Flow-R regional scale model. In order to determine debris flow intensities, we used a linear relationship that was found between back calibrated physically based Flo-2D simulations (local scale models of five debris flows from 2003) and the probability values of the Flow-R software. This gave us the possibility to assign flow depth to a total of 10 separate classes on a regional scale. Debris flow vulnerability curves from the literature and one curve specifically for our case study area were used to determine the damage for different material and building types associated with the elements at risk. The building values were obtained from the Italian Revenue Agency (Agenzia delle Entrate) and were classified per cadastral zone according to the Real Estate Observatory data (Osservatorio del Mercato Immobiliare, Agenzia Entrate - OMI). The minimum and maximum market value for each building was obtained by multiplying the corresponding land-use value (€/msq) with building area and number of floors

  2. A regional-scale ecological risk framework for environmental flow evaluations

    Science.gov (United States)

    O'Brien, Gordon C.; Dickens, Chris; Hines, Eleanor; Wepener, Victor; Stassen, Retha; Quayle, Leo; Fouchy, Kelly; MacKenzie, James; Graham, P. Mark; Landis, Wayne G.

    2018-02-01

    Environmental flow (E-flow) frameworks advocate holistic, regional-scale, probabilistic E-flow assessments that consider flow and non-flow drivers of change in a socio-ecological context as best practice. Regional-scale ecological risk assessments of multiple stressors to social and ecological endpoints, which address ecosystem dynamism, have been undertaken internationally at different spatial scales using the relative-risk model since the mid-1990s. With the recent incorporation of Bayesian belief networks into the relative-risk model, a robust regional-scale ecological risk assessment approach is available that can contribute to achieving the best practice recommendations of E-flow frameworks. PROBFLO is a holistic E-flow assessment method that incorporates the relative-risk model and Bayesian belief networks (BN-RRM) into a transparent probabilistic modelling tool that addresses uncertainty explicitly. PROBFLO has been developed to evaluate the socio-ecological consequences of historical, current and future water resource use scenarios and generate E-flow requirements on regional spatial scales. The approach has been implemented in two regional-scale case studies in Africa where its flexibility and functionality has been demonstrated. In both case studies the evidence-based outcomes facilitated informed environmental management decision making, with trade-off considerations in the context of social and ecological aspirations. This paper presents the PROBFLO approach as applied to the Senqu River catchment in Lesotho and further developments and application in the Mara River catchment in Kenya and Tanzania. The 10 BN-RRM procedural steps incorporated in PROBFLO are demonstrated with examples from both case studies. PROBFLO can contribute to the adaptive management of water resources and contribute to the allocation of resources for sustainable use of resources and address protection requirements.

  3. DNA Methylation Analysis of BRD1 Promoter Regions and the Schizophrenia rs138880 Risk Allele.

    Directory of Open Access Journals (Sweden)

    Mads Dyrvig

    Full Text Available The bromodomain containing 1 gene, BRD1 is essential for embryogenesis and CNS development. It encodes a protein that participates in histone modifying complexes and thereby regulates the expression of a large number of genes. Genetic variants in the BRD1 locus show association with schizophrenia and bipolar disorder and risk alleles in the promoter region correlate with reduced BRD1 expression. Insights into the transcriptional regulation of BRD1 and the pathogenic mechanisms associated with BRD1 risk variants, however, remain sparse. By studying transcripts in human HeLa and SH-SY5Y cells we provide evidence for differences in relative expression of BRD1 transcripts with three alternative 5' UTRs (exon 1C, 1B, and 1A. We further show that expression of these transcript variants covaries negatively with DNA methylation proportions in their upstream promoter regions suggesting that promoter usage might be regulated by DNA methylation. In line with findings that the risk allele of the rs138880 SNP in the BRD1 promoter region correlates with reduced BRD1 expression, we find that it is also associated with moderate regional BRD1 promoter hypermethylation in both adipose tissue and blood. Importantly, we demonstrate by inspecting available DNA methylation and expression data that these regions undergo changes in methylation during fetal brain development and that differences in their methylation proportions in fetal compared to postnatal frontal cortex correlate significantly with BRD1 expression. These findings suggest that BRD1 may be dysregulated in both the developing and mature brain of risk allele carriers. Finally, we demonstrate that commonly used mood stabilizers Lithium, Valproate, and Carbamazepine affect the expression of BRD1 in SH-SY5Y cells. Altogether this study indicates a link between genetic risk and epigenetic dysregulation of BRD1 which raises interesting perspectives for targeting the mechanisms pharmacologically.

  4. Enrichment of risk SNPs in regulatory regions implicate diverse tissues in Parkinson's disease etiology.

    Science.gov (United States)

    Coetzee, Simon G; Pierce, Steven; Brundin, Patrik; Brundin, Lena; Hazelett, Dennis J; Coetzee, Gerhard A

    2016-07-27

    Recent genome-wide association studies (GWAS) of Parkinson's disease (PD) revealed at least 26 risk loci, with associated single nucleotide polymorphisms (SNPs) located in non-coding DNA having unknown functions in risk. In order to explore in which cell types these SNPs (and their correlated surrogates at r(2) ≥ 0.8) could alter cellular function, we assessed their location overlap with histone modification regions that indicate transcription regulation in 77 diverse cell types. We found statistically significant enrichment of risk SNPs at 12 loci in active enhancers or promoters. We investigated 4 risk loci in depth that were most significantly enriched (-logeP > 14) and contained 8 putative enhancers in the different cell types. These enriched loci, along with eQTL associations, were unexpectedly present in non-neuronal cell types. These included lymphocytes, mesendoderm, liver- and fat-cells, indicating that cell types outside the brain are involved in the genetic predisposition to PD. Annotating regulatory risk regions within specific cell types may unravel new putative risk mechanisms and molecular pathways that contribute to PD development.

  5. Enrichment of risk SNPs in regulatory regions implicate diverse tissues in Parkinson’s disease etiology

    Science.gov (United States)

    Coetzee, Simon G.; Pierce, Steven; Brundin, Patrik; Brundin, Lena; Hazelett, Dennis J.; Coetzee, Gerhard A.

    2016-01-01

    Recent genome-wide association studies (GWAS) of Parkinson’s disease (PD) revealed at least 26 risk loci, with associated single nucleotide polymorphisms (SNPs) located in non-coding DNA having unknown functions in risk. In order to explore in which cell types these SNPs (and their correlated surrogates at r2 ≥ 0.8) could alter cellular function, we assessed their location overlap with histone modification regions that indicate transcription regulation in 77 diverse cell types. We found statistically significant enrichment of risk SNPs at 12 loci in active enhancers or promoters. We investigated 4 risk loci in depth that were most significantly enriched (−logeP > 14) and contained 8 putative enhancers in the different cell types. These enriched loci, along with eQTL associations, were unexpectedly present in non-neuronal cell types. These included lymphocytes, mesendoderm, liver- and fat-cells, indicating that cell types outside the brain are involved in the genetic predisposition to PD. Annotating regulatory risk regions within specific cell types may unravel new putative risk mechanisms and molecular pathways that contribute to PD development. PMID:27461410

  6. Chromosome 5p Region SNPs Are Associated with Risk of NSCLC among Women

    International Nuclear Information System (INIS)

    Dyke, A. L. V.

    2009-01-01

    In a population-based case-control study, we explored the associations between 42 polymorphisms in seven genes in this region and non-small cell lung cancer (NSCLC) risk among Caucasian (364 cases; 380 controls) and African American (95 cases; 103 controls) women. Two TERT region SNPs, rs2075786 and rs2853677, conferred an increased risk of developing NSCLC, especially among African American women, and TERT-rs2735940 was associated with a decreased risk of lung cancer among African Americans. Five of the 20 GHR polymorphisms and SEPP1-rs6413428 were associated with a marginally increased risk of NSCLC among Caucasians. Random forest analysis reinforced the importance of GHR among Caucasians and identified AMACR, TERT, and GHR among African Americans, which were also significant using gene-based risk scores. Smoking-SNP interactions were explored, and haplotype in TERT and GHR associated with NSCLC risk were identified. The roles of TERT, GHR, AMACR and SEPP1 genes in lung carcinogenesis warrant further exploration

  7. Antibiotics in the coastal environment of the Hailing Bay region, South China Sea: Spatial distribution, source analysis and ecological risks

    International Nuclear Information System (INIS)

    Chen, Hui; Liu, Shan; Xu, Xiang-Rong; Zhou, Guang-Jie; Liu, Shuang-Shuang; Yue, Wei-Zhong; Sun, Kai-Feng; Ying, Guang-Guo

    2015-01-01

    Highlights: • Thirty-eight antibiotics were systematically investigated in marine environment. • The distribution of antibiotics was significantly correlated with COD and NO 3 –N. • Untreated domestic sewage was the primary source of antibiotics. • Fluoroquinolones showed a strong sorption capacity onto sediments. • Oxytetracycline, norfloxacin and erythromycin–H 2 O indicated high risks. - Abstract: In this study, the occurrence and spatial distribution of 38 antibiotics in surface water and sediment samples of the Hailing Bay region, South China Sea, were investigated. Twenty-one, 16 and 15 of 38 antibiotics were detected with the concentrations ranging from <0.08 (clarithromycin) to 15,163 ng/L (oxytetracycline), 2.12 (methacycline) to 1318 ng/L (erythromycin–H 2 O), <1.95 (ciprofloxacin) to 184 ng/g (chlortetracycline) in the seawater, discharged effluent and sediment samples, respectively. The concentrations of antibiotics in the water phase were correlated positively with chemical oxygen demand and nitrate. The source analysis indicated that untreated domestic sewage was the primary source of antibiotics in the study region. Fluoroquinolones showed strong sorption capacity onto sediments due to their high pseudo-partitioning coefficients. Risk assessment indicated that oxytetracycline, norfloxacin and erythromycin–H 2 O posed high risks to aquatic organisms

  8. Identification of the high risk emergency surgical patient: Which risk prediction model should be used?

    Directory of Open Access Journals (Sweden)

    Stephen Stonelake

    2015-09-01

    Conclusions: In the absence of accurate risk scoring tools that can be used on admission to hospital it is not possible to reliably audit the achievement of national standards of care for the ‘high-risk’ patient.

  9. The clinical profile of high-risk mentally disordered offenders.

    Science.gov (United States)

    Yiend, Jenny; Freestone, Mark; Vazquez-Montes, Maria; Holland, Josephine; Burns, Tom

    2013-07-01

    High-risk mentally disordered offenders present a diverse array of clinical characteristics. To contain and effectively treat this heterogeneous population requires a full understanding of the group's clinical profile. This study aimed to identify and validate clusters of clinically coherent profiles within one high-risk mentally disordered population in the UK. Latent class analysis (a statistical technique to identify clustering of variance from a set of categorical variables) was applied to 174 cases using clinical diagnostic information to identify the most parsimonious model of best fit. Validity analyses were performed. Three identified classes were a 'delinquent' group (n = 119) characterised by poor educational history, strong criminal careers and high recidivism risk; a 'primary psychopathy' group (n = 38) characterised by good educational profiles and homicide offences and an 'expressive psychopathy' group (n = 17) presenting the lowest risk and characterised by more special educational needs and sexual offences. Individuals classed as high-risk mentally disordered offenders can be loosely segregated into three discrete subtypes: 'delinquent', 'psychopathic' or 'expressive psychopathic', respectively. These groups represent different levels of risk to society and reflect differing treatment needs.

  10. The "polyenviromic risk score": Aggregating environmental risk factors predicts conversion to psychosis in familial high-risk subjects.

    Science.gov (United States)

    Padmanabhan, Jaya L; Shah, Jai L; Tandon, Neeraj; Keshavan, Matcheri S

    2017-03-01

    Young relatives of individuals with schizophrenia (i.e. youth at familial high-risk, FHR) are at increased risk of developing psychotic disorders, and show higher rates of psychiatric symptoms, cognitive and neurobiological abnormalities than non-relatives. It is not known whether overall exposure to environmental risk factors increases risk of conversion to psychosis in FHR subjects. Subjects consisted of a pilot longitudinal sample of 83 young FHR subjects. As a proof of principle, we examined whether an aggregate score of exposure to environmental risk factors, which we term a 'polyenviromic risk score' (PERS), could predict conversion to psychosis. The PERS combines known environmental risk factors including cannabis use, urbanicity, season of birth, paternal age, obstetric and perinatal complications, and various types of childhood adversity, each weighted by its odds ratio for association with psychosis in the literature. A higher PERS was significantly associated with conversion to psychosis in young, familial high-risk subjects (OR=1.97, p=0.009). A model combining the PERS and clinical predictors had a sensitivity of 27% and specificity of 96%. An aggregate index of environmental risk may help predict conversion to psychosis in FHR subjects. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Factors Influencing Cancer Risk Perception in High Risk Populations: A Systematic Review

    Science.gov (United States)

    2011-01-01

    Background Patients at higher than average risk of heritable cancer may process risk information differently than the general population. However, little is known about clinical, demographic, or psychosocial predictors that may impact risk perception in these groups. The objective of this study was to characterize factors associated with perceived risk of developing cancer in groups at high risk for cancer based on genetics or family history. Methods We searched Ovid MEDLINE, Ovid Embase, Ovid PsycInfo, and Scopus from inception through April 2009 for English-language, original investigations in humans using core concepts of "risk" and "cancer." We abstracted key information and then further restricted articles dealing with perceived risk of developing cancer due to inherited risk. Results Of 1028 titles identified, 53 articles met our criteria. Most (92%) used an observational design and focused on women (70%) with a family history of or contemplating genetic testing for breast cancer. Of the 53 studies, 36 focused on patients who had not had genetic testing for cancer risk, 17 included studies of patients who had undergone genetic testing for cancer risk. Family history of cancer, previous prophylactic tests and treatments, and younger age were associated with cancer risk perception. In addition, beliefs about the preventability and severity of cancer, personality factors such as "monitoring" personality, the ability to process numerical information, as well as distress/worry also were associated with cancer risk perception. Few studies addressed non-breast cancer or risk perception in specific demographic groups (e.g. elderly or minority groups) and few employed theory-driven analytic strategies to decipher interrelationships of factors. Conclusions Several factors influence cancer risk perception in patients at elevated risk for cancer. The science of characterizing and improving risk perception in cancer for high risk groups, although evolving, is still

  12. Factors Influencing Cancer Risk Perception in High Risk Populations: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Tilburt Jon C

    2011-05-01

    Full Text Available Abstract Background Patients at higher than average risk of heritable cancer may process risk information differently than the general population. However, little is known about clinical, demographic, or psychosocial predictors that may impact risk perception in these groups. The objective of this study was to characterize factors associated with perceived risk of developing cancer in groups at high risk for cancer based on genetics or family history. Methods We searched Ovid MEDLINE, Ovid Embase, Ovid PsycInfo, and Scopus from inception through April 2009 for English-language, original investigations in humans using core concepts of "risk" and "cancer." We abstracted key information and then further restricted articles dealing with perceived risk of developing cancer due to inherited risk. Results Of 1028 titles identified, 53 articles met our criteria. Most (92% used an observational design and focused on women (70% with a family history of or contemplating genetic testing for breast cancer. Of the 53 studies, 36 focused on patients who had not had genetic testing for cancer risk, 17 included studies of patients who had undergone genetic testing for cancer risk. Family history of cancer, previous prophylactic tests and treatments, and younger age were associated with cancer risk perception. In addition, beliefs about the preventability and severity of cancer, personality factors such as "monitoring" personality, the ability to process numerical information, as well as distress/worry also were associated with cancer risk perception. Few studies addressed non-breast cancer or risk perception in specific demographic groups (e.g. elderly or minority groups and few employed theory-driven analytic strategies to decipher interrelationships of factors. Conclusions Several factors influence cancer risk perception in patients at elevated risk for cancer. The science of characterizing and improving risk perception in cancer for high risk groups, although

  13. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

    Science.gov (United States)

    Forouzanfar, Mohammad H; Alexander, Lily; Anderson, H Ross; Bachman, Victoria F; Biryukov, Stan; Brauer, Michael; Burnett, Richard; Casey, Daniel; Coates, Matthew M; Cohen, Aaron; Delwiche, Kristen; Estep, Kara; Frostad, Joseph J; Astha, K C; Kyu, Hmwe H; Moradi-Lakeh, Maziar; Ng, Marie; Slepak, Erica Leigh; Thomas, Bernadette A; Wagner, Joseph; Aasvang, Gunn Marit; Abbafati, Cristiana; Abbasoglu Ozgoren, Ayse; Abd-Allah, Foad; Abera, Semaw F; Aboyans, Victor; Abraham, Biju; Abraham, Jerry Puthenpurakal; Abubakar, Ibrahim; Abu-Rmeileh, Niveen M E; Aburto, Tania C; Achoki, Tom; Adelekan, Ademola; Adofo, Koranteng; Adou, Arsène K; Adsuar, José C; Afshin, Ashkan; Agardh, Emilie E; Al Khabouri, Mazin J; Al Lami, Faris H; Alam, Sayed Saidul; Alasfoor, Deena; Albittar, Mohammed I; Alegretti, Miguel A; Aleman, Alicia V; Alemu, Zewdie A; Alfonso-Cristancho, Rafael; Alhabib, Samia; Ali, Raghib; Ali, Mohammed K; Alla, François; Allebeck, Peter; Allen, Peter J; Alsharif, Ubai; Alvarez, Elena; Alvis-Guzman, Nelson; Amankwaa, Adansi A; Amare, Azmeraw T; Ameh, Emmanuel A; Ameli, Omid; Amini, Heresh; Ammar, Walid; Anderson, Benjamin O; Antonio, Carl Abelardo T; Anwari, Palwasha; Argeseanu Cunningham, Solveig; Arnlöv, Johan; Arsenijevic, Valentina S Arsic; Artaman, Al; Asghar, Rana J; Assadi, Reza; Atkins, Lydia S; Atkinson, Charles; Avila, Marco A; Awuah, Baffour; Badawi, Alaa; Bahit, Maria C; Bakfalouni, Talal; Balakrishnan, Kalpana; Balalla, Shivanthi; Balu, Ravi Kumar; Banerjee, Amitava; Barber, Ryan M; Barker-Collo, Suzanne L; Barquera, Simon; Barregard, Lars; Barrero, Lope H; Barrientos-Gutierrez, Tonatiuh; Basto-Abreu, Ana C; Basu, Arindam; Basu, Sanjay; Basulaiman, Mohammed O; Batis Ruvalcaba, Carolina; Beardsley, Justin; Bedi, Neeraj; Bekele, Tolesa; Bell, Michelle L; Benjet, Corina; Bennett, Derrick A; Benzian, Habib; Bernabé, Eduardo; Beyene, Tariku J; Bhala, Neeraj; Bhalla, Ashish; Bhutta, Zulfiqar A; Bikbov, Boris; Bin Abdulhak, Aref A; Blore, Jed D; Blyth, Fiona M; Bohensky, Megan A; Bora Başara, Berrak; Borges, Guilherme; Bornstein, Natan M; Bose, Dipan; Boufous, Soufiane; Bourne, Rupert R; Brainin, Michael; Brazinova, Alexandra; Breitborde, Nicholas J; Brenner, Hermann; Briggs, Adam D M; Broday, David M; Brooks, Peter M; Bruce, Nigel G; Brugha, Traolach S; Brunekreef, Bert; Buchbinder, Rachelle; Bui, Linh N; Bukhman, Gene; Bulloch, Andrew G; Burch, Michael; Burney, Peter G J; Campos-Nonato, Ismael R; Campuzano, Julio C; Cantoral, Alejandra J; Caravanos, Jack; Cárdenas, Rosario; Cardis, Elisabeth; Carpenter, David O; Caso, Valeria; Castañeda-Orjuela, Carlos A; Castro, Ruben E; Catalá-López, Ferrán; Cavalleri, Fiorella; Çavlin, Alanur; Chadha, Vineet K; Chang, Jung-Chen; Charlson, Fiona J; Chen, Honglei; Chen, Wanqing; Chen, Zhengming; Chiang, Peggy P; Chimed-Ochir, Odgerel; Chowdhury, Rajiv; Christophi, Costas A; Chuang, Ting-Wu; Chugh, Sumeet S; Cirillo, Massimo; Claßen, Thomas K D; Colistro, Valentina; Colomar, Mercedes; Colquhoun, Samantha M; Contreras, Alejandra G; Cooper, Cyrus; Cooperrider, Kimberly; Cooper, Leslie T; Coresh, Josef; Courville, Karen J; Criqui, Michael H; Cuevas-Nasu, Lucia; Damsere-Derry, James; Danawi, Hadi; Dandona, Lalit; Dandona, Rakhi; Dargan, Paul I; Davis, Adrian; Davitoiu, Dragos V; Dayama, Anand; de Castro, E Filipa; De la Cruz-Góngora, Vanessa; De Leo, Diego; de Lima, Graça; Degenhardt, Louisa; del Pozo-Cruz, Borja; Dellavalle, Robert P; Deribe, Kebede; Derrett, Sarah; Des Jarlais, Don C; Dessalegn, Muluken; deVeber, Gabrielle A; Devries, Karen M; Dharmaratne, Samath D; Dherani, Mukesh K; Dicker, Daniel; Ding, Eric L; Dokova, Klara; Dorsey, E Ray; Driscoll, Tim R; Duan, Leilei; Durrani, Adnan M; Ebel, Beth E; Ellenbogen, Richard G; Elshrek, Yousef M; Endres, Matthias; Ermakov, Sergey P; Erskine, Holly E; Eshrati, Babak; Esteghamati, Alireza; Fahimi, Saman; Faraon, Emerito Jose A; Farzadfar, Farshad; Fay, Derek F J; Feigin, Valery L; Feigl, Andrea B; Fereshtehnejad, Seyed-Mohammad; Ferrari, Alize J; Ferri, Cleusa P; Flaxman, Abraham D; Fleming, Thomas D; Foigt, Nataliya; Foreman, Kyle J; Paleo, Urbano Fra; Franklin, Richard C; Gabbe, Belinda; Gaffikin, Lynne; Gakidou, Emmanuela; Gamkrelidze, Amiran; Gankpé, Fortuné G; Gansevoort, Ron T; García-Guerra, Francisco A; Gasana, Evariste; Geleijnse, Johanna M; Gessner, Bradford D; Gething, Pete; Gibney, Katherine B; Gillum, Richard F; Ginawi, Ibrahim A M; Giroud, Maurice; Giussani, Giorgia; Goenka, Shifalika; Goginashvili, Ketevan; Gomez Dantes, Hector; Gona, Philimon; Gonzalez de Cosio, Teresita; González-Castell, Dinorah; Gotay, Carolyn C; Goto, Atsushi; Gouda, Hebe N; Guerrant, Richard L; Gugnani, Harish C; Guillemin, Francis; Gunnell, David; Gupta, Rahul; Gupta, Rajeev; Gutiérrez, Reyna A; Hafezi-Nejad, Nima; Hagan, Holly; Hagstromer, Maria; Halasa, Yara A; Hamadeh, Randah R; Hammami, Mouhanad; Hankey, Graeme J; Hao, Yuantao; Harb, Hilda L; Haregu, Tilahun Nigatu; Haro, Josep Maria; Havmoeller, Rasmus; Hay, Simon I; Hedayati, Mohammad T; Heredia-Pi, Ileana B; Hernandez, Lucia; Heuton, Kyle R; Heydarpour, Pouria; Hijar, Martha; Hoek, Hans W; Hoffman, Howard J; Hornberger, John C; Hosgood, H Dean; Hoy, Damian G; Hsairi, Mohamed; Hu, Guoqing; Hu, Howard; Huang, Cheng; Huang, John J; Hubbell, Bryan J; Huiart, Laetitia; Husseini, Abdullatif; Iannarone, Marissa L; Iburg, Kim M; Idrisov, Bulat T; Ikeda, Nayu; Innos, Kaire; Inoue, Manami; Islami, Farhad; Ismayilova, Samaya; Jacobsen, Kathryn H; Jansen, Henrica A; Jarvis, Deborah L; Jassal, Simerjot K; Jauregui, Alejandra; Jayaraman, Sudha; Jeemon, Panniyammakal; Jensen, Paul N; Jha, Vivekanand; Jiang, Fan; Jiang, Guohong; Jiang, Ying; Jonas, Jost B; Juel, Knud; Kan, Haidong; Kany Roseline, Sidibe S; Karam, Nadim E; Karch, André; Karema, Corine K; Karthikeyan, Ganesan; Kaul, Anil; Kawakami, Norito; Kazi, Dhruv S; Kemp, Andrew H; Kengne, Andre P; Keren, Andre; Khader, Yousef S; Khalifa, Shams Eldin Ali Hassan; Khan, Ejaz A; Khang, Young-Ho; Khatibzadeh, Shahab; Khonelidze, Irma; Kieling, Christian; Kim, Daniel; Kim, Sungroul; Kim, Yunjin; Kimokoti, Ruth W; Kinfu, Yohannes; Kinge, Jonas M; Kissela, Brett M; Kivipelto, Miia; Knibbs, Luke D; Knudsen, Ann Kristin; Kokubo, Yoshihiro; Kose, M Rifat; Kosen, Soewarta; Kraemer, Alexander; Kravchenko, Michael; Krishnaswami, Sanjay; Kromhout, Hans; Ku, Tiffany; Kuate Defo, Barthelemy; Kucuk Bicer, Burcu; Kuipers, Ernst J; Kulkarni, Chanda; Kulkarni, Veena S; Kumar, G Anil; Kwan, Gene F; Lai, Taavi; Lakshmana Balaji, Arjun; Lalloo, Ratilal; Lallukka, Tea; Lam, Hilton; Lan, Qing; Lansingh, Van C; Larson, Heidi J; Larsson, Anders; Laryea, Dennis O; Lavados, Pablo M; Lawrynowicz, Alicia E; Leasher, Janet L; Lee, Jong-Tae; Leigh, James; Leung, Ricky; Levi, Miriam; Li, Yichong; Li, Yongmei; Liang, Juan; Liang, Xiaofeng; Lim, Stephen S; Lindsay, M Patrice; Lipshultz, Steven E; Liu, Shiwei; Liu, Yang; Lloyd, Belinda K; Logroscino, Giancarlo; London, Stephanie J; Lopez, Nancy; Lortet-Tieulent, Joannie; Lotufo, Paulo A; Lozano, Rafael; Lunevicius, Raimundas; Ma, Jixiang; Ma, Stefan; Machado, Vasco M P; MacIntyre, Michael F; Magis-Rodriguez, Carlos; Mahdi, Abbas A; Majdan, Marek; Malekzadeh, Reza; Mangalam, Srikanth; Mapoma, Christopher C; Marape, Marape; Marcenes, Wagner; Margolis, David J; Margono, Christopher; Marks, Guy B; Martin, Randall V; Marzan, Melvin B; Mashal, Mohammad T; Masiye, Felix; Mason-Jones, Amanda J; Matsushita, Kunihiro; Matzopoulos, Richard; Mayosi, Bongani M; Mazorodze, Tasara T; McKay, Abigail C; McKee, Martin; McLain, Abigail; Meaney, Peter A; Medina, Catalina; Mehndiratta, Man Mohan; Mejia-Rodriguez, Fabiola; Mekonnen, Wubegzier; Melaku, Yohannes A; Meltzer, Michele; Memish, Ziad A; Mendoza, Walter; Mensah, George A; Meretoja, Atte; Mhimbira, Francis Apolinary; Micha, Renata; Miller, Ted R; Mills, Edward J; Misganaw, Awoke; Mishra, Santosh; Mohamed Ibrahim, Norlinah; Mohammad, Karzan A; Mokdad, Ali H; Mola, Glen L; Monasta, Lorenzo; Montañez Hernandez, Julio C; Montico, Marcella; Moore, Ami R; Morawska, Lidia; Mori, Rintaro; Moschandreas, Joanna; Moturi, Wilkister N; Mozaffarian, Dariush; Mueller, Ulrich O; Mukaigawara, Mitsuru; Mullany, Erin C; Murthy, Kinnari S; Naghavi, Mohsen; Nahas, Ziad; Naheed, Aliya; Naidoo, Kovin S; Naldi, Luigi; Nand, Devina; Nangia, Vinay; Narayan, K M Venkat; Nash, Denis; Neal, Bruce; Nejjari, Chakib; Neupane, Sudan P; Newton, Charles R; Ngalesoni, Frida N; Ngirabega, Jean de Dieu; Nguyen, Grant; Nguyen, Nhung T; Nieuwenhuijsen, Mark J; Nisar, Muhammad I; Nogueira, José R; Nolla, Joan M; Nolte, Sandra; Norheim, Ole F; Norman, Rosana E; Norrving, Bo; Nyakarahuka, Luke; Oh, In-Hwan; Ohkubo, Takayoshi; Olusanya, Bolajoko O; Omer, Saad B; Opio, John Nelson; Orozco, Ricardo; Pagcatipunan, Rodolfo S; Pain, Amanda W; Pandian, Jeyaraj D; Panelo, Carlo Irwin A; Papachristou, Christina; Park, Eun-Kee; Parry, Charles D; Paternina Caicedo, Angel J; Patten, Scott B; Paul, Vinod K; Pavlin, Boris I; Pearce, Neil; Pedraza, Lilia S; Pedroza, Andrea; Pejin Stokic, Ljiljana; Pekericli, Ayfer; Pereira, David M; Perez-Padilla, Rogelio; Perez-Ruiz, Fernando; Perico, Norberto; Perry, Samuel A L; Pervaiz, Aslam; Pesudovs, Konrad; Peterson, Carrie B; Petzold, Max; Phillips, Michael R; Phua, Hwee Pin; Plass, Dietrich; Poenaru, Dan; Polanczyk, Guilherme V; Polinder, Suzanne; Pond, Constance D; Pope, C Arden; Pope, Daniel; Popova, Svetlana; Pourmalek, Farshad; Powles, John; Prabhakaran, Dorairaj; Prasad, Noela M; Qato, Dima M; Quezada, Amado D; Quistberg, D Alex A; Racapé, Lionel; Rafay, Anwar; Rahimi, Kazem; Rahimi-Movaghar, Vafa; Rahman, Sajjad Ur; Raju, Murugesan; Rakovac, Ivo; Rana, Saleem M; Rao, Mayuree; Razavi, Homie; Reddy, K Srinath; Refaat, Amany H; Rehm, Jürgen; Remuzzi, Giuseppe; Ribeiro, Antonio L; Riccio, Patricia M; Richardson, Lee; Riederer, Anne; Robinson, Margaret; Roca, Anna; Rodriguez, Alina; Rojas-Rueda, David; Romieu, Isabelle; Ronfani, Luca; Room, Robin; Roy, Nobhojit; Ruhago, George M; Rushton, Lesley; Sabin, Nsanzimana; Sacco, Ralph L; Saha, Sukanta; Sahathevan, Ramesh; Sahraian, Mohammad Ali; Salomon, Joshua A; Salvo, Deborah; Sampson, Uchechukwu K; Sanabria, Juan R; Sanchez, Luz Maria; Sánchez-Pimienta, Tania G; Sanchez-Riera, Lidia; Sandar, Logan; Santos, Itamar S; Sapkota, Amir; Satpathy, Maheswar; Saunders, James E; Sawhney, Monika; Saylan, Mete I; Scarborough, Peter; Schmidt, Jürgen C; Schneider, Ione J C; Schöttker, Ben; Schwebel, David C; Scott, James G; Seedat, Soraya; Sepanlou, Sadaf G; Serdar, Berrin; Servan-Mori, Edson E; Shaddick, Gavin; Shahraz, Saeid; Levy, Teresa Shamah; Shangguan, Siyi; She, Jun; Sheikhbahaei, Sara; Shibuya, Kenji; Shin, Hwashin H; Shinohara, Yukito; Shiri, Rahman; Shishani, Kawkab; Shiue, Ivy; Sigfusdottir, Inga D; Silberberg, Donald H; Simard, Edgar P; Sindi, Shireen; Singh, Abhishek; Singh, Gitanjali M; Singh, Jasvinder A; Skirbekk, Vegard; Sliwa, Karen; Soljak, Michael; Soneji, Samir; Søreide, Kjetil; Soshnikov, Sergey; Sposato, Luciano A; Sreeramareddy, Chandrashekhar T; Stapelberg, Nicolas J C; Stathopoulou, Vasiliki; Steckling, Nadine; Stein, Dan J; Stein, Murray B; Stephens, Natalie; Stöckl, Heidi; Straif, Kurt; Stroumpoulis, Konstantinos; Sturua, Lela; Sunguya, Bruno F; Swaminathan, Soumya; Swaroop, Mamta; Sykes, Bryan L; Tabb, Karen M; Takahashi, Ken; Talongwa, Roberto T; Tandon, Nikhil; Tanne, David; Tanner, Marcel; Tavakkoli, Mohammad; Te Ao, Braden J; Teixeira, Carolina M; Téllez Rojo, Martha M; Terkawi, Abdullah S; Texcalac-Sangrador, José Luis; Thackway, Sarah V; Thomson, Blake; Thorne-Lyman, Andrew L; Thrift, Amanda G; Thurston, George D; Tillmann, Taavi; Tobollik, Myriam; Tonelli, Marcello; Topouzis, Fotis; Towbin, Jeffrey A; Toyoshima, Hideaki; Traebert, Jefferson; Tran, Bach X; Trasande, Leonardo; Trillini, Matias; Trujillo, Ulises; Dimbuene, Zacharie Tsala; Tsilimbaris, Miltiadis; Tuzcu, Emin Murat; Uchendu, Uche S; Ukwaja, Kingsley N; Uzun, Selen B; van de Vijver, Steven; Van Dingenen, Rita; van Gool, Coen H; van Os, Jim; Varakin, Yuri Y; Vasankari, Tommi J; Vasconcelos, Ana Maria N; Vavilala, Monica S; Veerman, Lennert J; Velasquez-Melendez, Gustavo; Venketasubramanian, N; Vijayakumar, Lakshmi; Villalpando, Salvador; Violante, Francesco S; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Wagner, Gregory R; Waller, Stephen G; Wallin, Mitchell T; Wan, Xia; Wang, Haidong; Wang, JianLi; Wang, Linhong; Wang, Wenzhi; Wang, Yanping; Warouw, Tati S; Watts, Charlotte H; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G; Werdecker, Andrea; Wessells, K Ryan; Westerman, Ronny; Whiteford, Harvey A; Wilkinson, James D; Williams, Hywel C; Williams, Thomas N; Woldeyohannes, Solomon M; Wolfe, Charles D A; Wong, John Q; Woolf, Anthony D; Wright, Jonathan L; Wurtz, Brittany; Xu, Gelin; Yan, Lijing L; Yang, Gonghuan; Yano, Yuichiro; Ye, Pengpeng; Yenesew, Muluken; Yentür, Gökalp K; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Younoussi, Zourkaleini; Yu, Chuanhua; Zaki, Maysaa E; Zhao, Yong; Zheng, Yingfeng; Zhou, Maigeng; Zhu, Jun; Zhu, Shankuan; Zou, Xiaonong; Zunt, Joseph R; Lopez, Alan D; Vos, Theo; Murray, Christopher J

    2015-12-05

    [UI] 55·8-58·5) of deaths and 41·6% (40·1-43·0) of DALYs. Risks quantified account for 87·9% (86·5-89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa. Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options

  14. Psychological characteristics in high-risk MSM in China

    Directory of Open Access Journals (Sweden)

    Chen Guanzhi

    2012-01-01

    Full Text Available Abstract Background Men who have sex with men (MSM have become a high-risk group of HIV infection in China. To date, little is known regarding the behavioral, social and psychological characteristics in Chinese MSM, which makes the implementation of preventive and therapeutic strategies for this high-risk subpopulation of people extremely difficult. Methods A total of 714 questionnaires were retrieved from the database of a Chinese government-sponsored National Key Research Project titled "Risk Analysis and Strategic Prevention of HIV Transmission from MSM to the General Population in China". The respondents were categorized into a high-risk group and a control group. Their behavioral, social and psychological characteristics were comparatively analyzed. Results Of the 714 MSM analyzed, 59 (8.26% had high-risk homosexual behaviors. This sub-group of MSM had a higher in-marriage rate, a higher monthly income, heavier alcohol consumption and more serious problems with sexual abuse in childhood, intentional suicide attempts and mistaken assumption on condom's role in protecting HIV infection, as compared with the control group (P P > 0.05. A vast majority of the individuals in both behavior categories expressed support of legally protected gay clubs as well as gay marriage legislation in China. There was a strong correlation between high-risk behaviors and sexual abuse in childhood, alcohol drinking, income level and a mistaken belief in perfect HIV protection through the use of condoms. Conclusions MSM with and without high-risk homosexual behaviors have different social and psychological characteristics, which should be taken into account when implementing behavioral and therapeutic interventions aimed at preventing HIV/AIDS transmission among MSM as well as from MSM to the general population in China.

  15. Increased risk of flooding on the coast of Alicante (Region of Valencia, Spain

    Directory of Open Access Journals (Sweden)

    J. Olcina Cantos

    2010-11-01

    Full Text Available In the past two decades, episodes of flooding on the coast of Alicante (Spain have led to substantial losses in human life in economic terms. With increased exposure to these phenomena comes also increased vulnerability. Given the various effects of flooding in areas of similar exposure, differences in vulnerability across regions at risk need to be analysed also in terms of the socioeconomic factors of the groups of society that may be affected, and of their perception of risk. This paper studies the increased risk of flooding in three locations on the Alicante coast as a result of urban occupation of areas subject to this hazard. The consequences of the most recent episodes in this area are analysed and a risk assessment, using survey-based research in the affected areas, is performed.

  16. Forecasting high-priority infectious disease surveillance regions: a socioeconomic model.

    Science.gov (United States)

    Chan, Emily H; Scales, David A; Brewer, Timothy F; Madoff, Lawrence C; Pollack, Marjorie P; Hoen, Anne G; Choden, Tenzin; Brownstein, John S

    2013-02-01

    Few researchers have assessed the relationships between socioeconomic inequality and infectious disease outbreaks at the population level globally. We use a socioeconomic model to forecast national annual rates of infectious disease outbreaks. We constructed a multivariate mixed-effects Poisson model of the number of times a given country was the origin of an outbreak in a given year. The dataset included 389 outbreaks of international concern reported in the World Health Organization's Disease Outbreak News from 1996 to 2008. The initial full model included 9 socioeconomic variables related to education, poverty, population health, urbanization, health infrastructure, gender equality, communication, transportation, and democracy, and 1 composite index. Population, latitude, and elevation were included as potential confounders. The initial model was pared down to a final model by a backwards elimination procedure. The dependent and independent variables were lagged by 2 years to allow for forecasting future rates. Among the socioeconomic variables tested, the final model included child measles immunization rate and telephone line density. The Democratic Republic of Congo, China, and Brazil were predicted to be at the highest risk for outbreaks in 2010, and Colombia and Indonesia were predicted to have the highest percentage of increase in their risk compared to their average over 1996-2008. Understanding socioeconomic factors could help improve the understanding of outbreak risk. The inclusion of the measles immunization variable suggests that there is a fundamental basis in ensuring adequate public health capacity. Increased vigilance and expanding public health capacity should be prioritized in the projected high-risk regions.

  17. Inconsistencies of Breast Cancer Risk Factors between the Northern and Southern Regions of Vietnam

    Science.gov (United States)

    Trieu, Phuong Dung (Yun); Mello-Thoms, Claudia; Peat, Jennifer K; Do, Thuan Doan; Brennan, Patrick C

    2017-10-26

    Background: In recent decades the amount of new breast cancer cases in the southern region has been reported to increase more rapidly than in the northernVietnam. The aim of this study is to compare breast cancer risk factors between the two regions and establish if westernized influences have an impact on any reported differences. Method: Data was collected from the two largest oncology hospitals in the north and the south of Vietnam in 2015. Breast density, demographic, reproductive and lifestyle data of 127 cases and 269 controls were collected in the north and 141 cases and 250 controls were gathered from the south. Baseline differences in factors between cases and age-matched controls in each region were assessed using chi-square tests and independent t-tests. Odds ratios (OR) for independent risk factors for breast cancer were obtained from conditional logistic regression. Results: In northern Vietnam significantly increased risks in developing breast cancer were observed for women with age at first menstrual period less than 14 years old (OR=2.1; Pcup of coffee per day (OR=1.9; P<0.05) were more likely to be diagnosed with breast cancer. Conclusion: We found that women living in the south had some breast cancer associations, such as increased mammographic density and coffee consumption, which are closer to the risks in westernized populations than women in the north. Creative Commons Attribution License

  18. Analysis of regional natural flow for evaluation of flood risk according to RCP climate change scenarios

    Science.gov (United States)

    Lee, J. Y.; Chae, B. S.; Wi, S.; KIm, T. W.

    2017-12-01

    Various climate change scenarios expect the rainfall in South Korea to increase by 3-10% in the future. The future increased rainfall has significant effect on the frequency of flood in future as well. This study analyzed the probability of future flood to investigate the stability of existing and new installed hydraulic structures and the possibility of increasing flood damage in mid-sized watersheds in South Korea. To achieve this goal, we first clarified the relationship between flood quantiles acquired from the flood-frequency analysis (FFA) and design rainfall-runoff analysis (DRRA) in gauged watersheds. Then, after synthetically generating the regional natural flow data according to RCP climate change scenarios, we developed mathematical formulas to estimate future flood quantiles based on the regression between DRRA and FFA incorporated with regional natural flows in unguaged watersheds. Finally, we developed a flood risk map to investigate the change of flood risk in terms of the return period for the past, present, and future. The results identified that the future flood quantiles and risks would increase in accordance with the RCP climate change scenarios. Because the regional flood risk was identified to increase in future comparing with the present status, comprehensive flood control will be needed to cope with extreme floods in future.

  19. Ecological risk of methylmercury to piscivorous fish of the Great Lakes region.

    Science.gov (United States)

    Sandheinrich, Mark B; Bhavsar, Satyendra P; Bodaly, R A; Drevnick, Paul E; Paul, Eric A

    2011-10-01

    Contamination of fish populations with methylmercury is common in the region of the Laurentian Great Lakes as a result of atmospheric deposition and methylation of inorganic mercury. Using fish mercury monitoring data from natural resource agencies and information on tissue concentrations injurious to fish, we conducted a screening-level risk assessment of mercury to sexually mature female walleye (Sander vitreus), northern pike (Esox lucius), smallmouth bass (Micropterus dolomieu), and largemouth bass (Micropterus salmoides) in the Great Lakes and in interior lakes, impoundments, and rivers of the Great Lakes region. The assessment included more than 43,000 measurements of mercury in fish from more than 2000 locations. Sexually mature female fish that exceeded threshold-effect tissue concentrations of 0.20 μg g(-1) wet weight in the whole body occurred at 8% (largemouth bass) to 43% (walleye) of sites. Fish at 3% to 18% of sites were at risk of injury and exceeded 0.30 μg g(-1) where an alteration in reproduction or survival is predicted to occur. Most fish at increased risk were from interior lakes and impoundments. In the Great Lakes, no sites had sexually mature fish that exceeded threshold-effect concentrations. Results of this screening-level assessment indicate that fish at a substantive number of locations within the Great Lakes region are potentially at risk from methylmercury contamination and would benefit from reduction in mercury concentrations.

  20. Potential Bias in Projecting Future Regional Megadrought Risk: Insights From A Global Data-Model Framework

    Science.gov (United States)

    Overpeck, J. T.; Ault, T.; Cole, J. E.; Fasullo, J.; Loope, G. R.; Parsons, L. A.; Stevenson, S.

    2015-12-01

    Megadrought is one of the most significant and costly climate extremes, and one that stakeholders (e.g., water and other resource managers) the world over wish to understand better; in particular, they need estimates of the risk of severe droughts as a function of drought frequency, severity, duration, and atmospheric greenhouse gas concentration. In many dry-climate regions of the globe, megadrought is synonymous with multi-decadal drought. However, in other regions, megadrought can be defined as extended drought, mostly not seen in the period of instrumental observations, and that would have large impacts if it were to occur in the future. New and published paleoclimatic observations allow us to understand the spectrum of drought in many regions of the globe; droughts exceeding 50 years have occurred in recent Earth history in southwestern North America, sub-Saharan Africa, the Mediterranean and Australia, whereas shorter megadroughts have occurred in Monsoon Asia, Amazonia and elsewhere. Data-model comparisons for regions with sufficiently long (e.g., 1000-2000 years) records of observed hydroclimatic variability suggest that state-of-the-art models can provide realistic estimates of interannual to decadal drought risk, but underestimate the risk of megadrought. Likely reasons for this shortcoming are the lack of sufficient multi-decadal variability in simulations of the past and future, plus an underappreciated understanding about how temperature variability and land-surface feedbacks interact with hydrological and ecological drought, as well as the roles played by unusually wet hydroclimatic extremes (e.g., ENSO related) in ending droughts of long duration. Paleoclimatic records also provide the opportunity to estimate how much models underestimate megadrought risk as a function of locale, frequency, severity, duration, and atmospheric greenhouse gas concentration; they also aid in providing stakeholders with bias-corrected estimates of megadrought risk.

  1. Regional Ecological Risk Assessment in the Huai River Watershed during 2010–2015

    Directory of Open Access Journals (Sweden)

    Yan Lu

    2017-12-01

    Full Text Available Ecosystem deterioration has been and is still a serious threat to human survival and regional economic development. Theoretical and methodological challenges exist in assessing ecological risk of watershed ecosystem that is imposed by natural changes or human activities. To fill this research gap, this research proposes an interdisciplinary and quantitative methodology based on some techniques such as the Procedure for Ecological Tiered Assessment of Risk (PETAR, the Entropy, and the Celluar Automata Markov (CA-Markov. We focused on six vulnerable environmental variables, namely land-use change, water quantity, water quality, gross domestic product (GDP, environmental pollutants, and soil erosion in the Huai River watershed in the Henan Province in order to build multi-dimensional quantitative method. Further, the Coupling Coordination Degree Model is constructed, and the “threshold index” is also addressed to reflect the limitation of ecological risk. Our results show that the spatio-temperal distribution of the eco-environmental quality has greatly varied across this study area during different time spans. Natural eco-environmental quality has moderately degraded in 70% of this study area (mainly agricultural region, at a prefectural level from 2000 to 2010, and has slightly improved over the agricultural region (<170 m above sea level during 2010–2015. However, when considering negative stressors from human social system on the natural ecosystem, the extent and distribution of the ecological risk varied across the whole area during 2000–2015. The results show that there was almost 90.40% of this region under the ecological risk, with varying extents over the study time, e.g., Kaifeng, Shangqiu, Xuchang, and Xinyang, with a moderate deterioration in the eco-environmental quality, and Zhengzhou with a slight deterioration in the eco-environmental quality. This paper provides a valuable perspective for governments at all levels to manage

  2. Screening for Hypoglycemia in Exclusively Breastfed High-risk Neonates.

    Science.gov (United States)

    Singh, Princy; Upadhyay, Amit; Sreenivas, Vishnubhatla; Jaiswal, Vijay; Saxena, Pranjali

    2017-06-15

    To determine incidence of hypoglycemia in exclusively breastfed, high-risk but healthy newborns, and risk factors for its development. This observational study enrolled 407 exclusively breastfed high-risk (low birth weight newborns (1800-2499 g), late preterms, small-for-gestation, large-for-gestation and infant of diabetic mother), who did not require admission to neonatal intensive care unit and were kept in postnatal wards with mother. Hypoglycemia was defined as blood glucose £46 mg/dL (2.6 mmol/L). Blood glucose was monitored till 48 hours of life. 27% of the screened newborns developed hypoglycemia in first 48 hours. 31 (7.6%) developed recurrent (>2) episodes, 28 (6.8%) had moderate (<37mg/dL) while 8 (1.9%) developed symptomatic hypoglycemia. With increase in birthweight, risk of hypoglycemia reduced significantly (P=0.003). Hypoglycemia was observed more frequently in first 2 hours as compared to next 48 hours (P=0.0001). Low birth- weight, preterm gestation and male gender was significantly associated with increased risk of hypoglycemia. Healthy, high-risk exclusively breastfed newborns in postnatal wards need close monitoring for hypoglycemia in first 24 hrs of life.

  3. Potential Risk Factors for the Onset of Complex Regional Pain Syndrome Type 1: A Systematic Literature Review

    Directory of Open Access Journals (Sweden)

    Tracey Pons

    2015-01-01

    Full Text Available Anaesthetists in the acute and chronic pain teams are often involved in treating Complex Regional Pain Syndromes. Current literature about the risk factors for the onset of Complex Regional Pain Syndrome Type 1 (CRPS 1 remains sparse. This syndrome has a low prevalence, a highly variable presentation, and no gold standard for diagnosis. In the research setting, the pathogenesis of the syndrome continues to be elusive. There is a growing body of literature that addresses efficacy of a wide range of interventions as well as the likely mechanisms that contribute to the onset of CRPS 1. The objective for this systematic search of the literature focuses on determining the potential risk factors for the onset of CRPS 1. Eligible articles were analysed, dated 1996 to April 2014, and potential risk factors for the onset of CRPS 1 were identified from 10 prospective and 6 retrospective studies. Potential risk factors for the onset of CRPS 1 were found to include being female, particularly postmenopausal female, ankle dislocation or intra-articular fracture, immobilisation, and a report of higher than usual levels of pain in the early phases of trauma. It is not possible to draw definite conclusions as this evidence is heterogeneous and of mixed quality, relevance, and weighting strength against bias and has not been confirmed across multiple trials or in homogenous studies.

  4. Nitrogen removal in shallow groundwater below three arable land systems in a high nitrogen loading region

    Science.gov (United States)

    Yan, X.; Zhou, W.

    2017-12-01

    The Taihu Lake region (TLR) is one of the most intensive agricultural regions with high nitrogen (N) loading in eastern China. Large inputs of synthetic N fertilizer have led to a series of environmental problems including eutrophication of surface waters, nitrate (NO3-) pollution of groundwater. To fully evaluate the risk of NO3- on groundwater environments, it is necessary to know the natural NO3- removal ability. In this study, denitrification capacity was assessed for two years through measuring the concentration of different N species (NO3-, NH4+, TN, excess N2 and dissolved N2O) in groundwater below three typical agricultural land-use types in the TLR. The results suggested that the conversion of paddy field (PF) to vineyard (VY) and vegetable (VF) significantly increased the groundwater NO3-N concentration, but denitrification consumed 76%, 83% and 65% of the groundwater NO3-N in VY, VF and PF, respectively. Because of the low O2 and high DOC concentrations in groundwater, denitrification activity was high in the study sites, resulting in high excess N2 accumulation in groundwater, and the concentration even exceeded the total active N in the deep layer. The large amounts of excess N2 observed in the VY and VF over all the sample times indicated that considerable N was stored as gaseous N2 in groundwater and should not be ignored in balancing N budgets in aquifers where denitrification is high. Our results also demonstrated that the indirect N2O emission factor (EF5-g) in VY (0.0052)and VF (0.0057)was significantly higher than PF (0.0011)as well as higher than the IPCC default values (0.0025. In view of the increasing trend of paddy fields being converted to uplands combined with the low GWT in the TLR, we thus concluded that the risk of NO3- contamination in groundwater and indirect N2O emission will intensify below arable land.

  5. Risk of flooding: Activities, parameters and regional peculiarities, Case study: Varbitsa watershed basin, Bulgaria

    Directory of Open Access Journals (Sweden)

    Lubenov Todor

    2009-01-01

    Full Text Available An overview of the activities overtaken during risk of flooding situations, in one of the more often flooding region - the watershed of Varbitsa river (Southeastern part of Bulgaria - has been performed. The main cognitive parameters for risk perception and risk definition, depending on regional, social and historical factors have been examined. The existing information and instructions for mass media communication in relation to the process of interaction in a disaster situation have been discussed. In connection to determination of the risky segments in the basin and plans for announcement, the prevention communication measures have been outlined. On the basis of the Bulgarian normative legislation, the activities concerning organization of communications in a risk-of-disaster situation and mutual aid between authorities, which are part of the Integrated Help System have been indicated. It has been accented on the necessity of a more effective realization of the action plans during natural disasters and especially flooding, in order to improve the partnership between authorities and participants in the communication process during risk-of-flooding situations.

  6. Applying the lessons of high risk industries to health care.

    Science.gov (United States)

    Hudson, P

    2003-12-01

    High risk industries such as commercial aviation and the oil and gas industry have achieved exemplary safety performance. This paper reviews how they have managed to do that. The primary reasons are the positive attitudes towards safety and the operation of effective formal safety management systems. The safety culture provides an important explanation of why such organisations perform well. An evolutionary model of safety culture is provided in which there is a range of cultures from the pathological through the reactive to the calculative. Later, the proactive culture can evolve towards the generative organisation, an alternative description of the high reliability organisation. The current status of health care is reviewed, arguing that it has a much higher level of accidents and has a reactive culture, lagging behind both high risk industries studied in both attitude and systematic management of patient risks.

  7. Radical prostatectomy in clinically localized high-risk prostate cancer

    DEFF Research Database (Denmark)

    Røder, Martin Andreas; Berg, Kasper Drimer; Christensen, Ib Jarle

    2013-01-01

    ) is regarded as primary therapy by others. This study examined the outcome for high-risk localized PCa patients treated with RP. Material and methods. Of 1300 patients who underwent RP, 231 were identified as high-risk. Patients were followed for biochemical recurrence (BCR) (defined as prostate-specific......Abstract Objective. The optimal therapeutic strategy for high-risk localized prostate cancer (PCa) is controversial. Supported by randomized trials, the combination of external beam radiation therapy (EBRT) and endocrine therapy (ET) is advocated by many, while radical prostatectomy (RP...... antigen ≥ 0.2 ng/ml), metastatic disease and survival. Excluding node-positive patients, none of the patients received adjuvant therapy before BCR was confirmed. Univariate and multivariate analysis was performed with Kaplan-Meier and Cox proportional hazard models. Results. Median follow-up was 4.4 years...

  8. Assessing carbon dioxide removal through global and regional ocean alkalinization under high and low emission pathways

    Science.gov (United States)

    Lenton, Andrew; Matear, Richard J.; Keller, David P.; Scott, Vivian; Vaughan, Naomi E.

    2018-04-01

    Atmospheric carbon dioxide (CO2) levels continue to rise, increasing the risk of severe impacts on the Earth system, and on the ecosystem services that it provides. Artificial ocean alkalinization (AOA) is capable of reducing atmospheric CO2 concentrations and surface warming and addressing ocean acidification. Here, we simulate global and regional responses to alkalinity (ALK) addition (0.25 PmolALK yr-1) over the period 2020-2100 using the CSIRO-Mk3L-COAL Earth System Model, under high (Representative Concentration Pathway 8.5; RCP8.5) and low (RCP2.6) emissions. While regionally there are large changes in alkalinity associated with locations of AOA, globally we see only a very weak dependence on where and when AOA is applied. On a global scale, while we see that under RCP2.6 the carbon uptake associated with AOA is only ˜ 60 % of the total, under RCP8.5 the relative changes in temperature are larger, as are the changes in pH (140 %) and aragonite saturation state (170 %). The simulations reveal AOA is more effective under lower emissions, therefore the higher the emissions the more AOA is required to achieve the same reduction in global warming and ocean acidification. Finally, our simulated AOA for 2020-2100 in the RCP2.6 scenario is capable of offsetting warming and ameliorating ocean acidification increases at the global scale, but with highly variable regional responses.

  9. Risks and injuries in laser and high-frequency applications

    Science.gov (United States)

    Giering, K.; Philipp, Carsten M.; Berlien, Hans-Peter

    1995-01-01

    An analysis of injuries and risks using high frequency (HF) and lasers in medicine based on a literature search with MEDLINE was performed. The cases reported in the literature were classified according to the following criteria: (1) Avoidable in an optimal operational procedure. These kind of injuries are caused by a chain of unfortunate incidents. They are in principle avoidable by the 'right action at the right time' which presupposes an appropriate training of the operating team, selection of the optimal parameters for procedure and consideration of all safety instructions. (2) Avoidable, caused by malfunction of the equipment and/or accessories. The injuries classified into this group are avoidable if all safety regulations were fulfilled. This includes a pre-operational check-up and the use of medical lasers and high frequency devices only which meet the international safety standards. (3) Avoidable, caused by misuse/mistake. Injuries of this group were caused by an inappropriate selection of the procedure, wrong medical indication or mistakes during application. (4) Unavoidable, fateful. These injuries can be caused by risks inherent to the type of energy used, malfunction of the equipment and/or accessories though a pre-operational check-up was done. Some risks and complications are common to high frequency and laser application. But whereas these risks can be excluded easily in laser surgery there is often a great expenditure necessary or they are not avoidable if high frequency if used. No unavoidable risks due to laser energy occur.

  10. AIDS Risk Perception and its related factors in Women with High-Risk Behaviors in Iran

    Directory of Open Access Journals (Sweden)

    Mahin Tafazoli

    2016-02-01

    Full Text Available Background & aim: AIDS is one of the major public health challenges all over the world. Perceived risk is a significant predictor of high-risk behaviors related to AIDS. Women constitute more than half of the HIV patients, and the rate of female sex workers with AIDS is more than the rest of female population. Therefore, the present study aimed to evaluate AIDS risk perception and its related factors in females with high-risk behaviors in Mashhad, Iran. Methods:This descriptive study was performed on 58 women who were arrested on prostitution charges and imprisoned in Mashhad Vakil Abad Prison in 2013. The data were collected using self-designed questionnaires assessing knowledge regarding AIDS as well as sexual activities and also perceived risk of HIV questionnaire. One-way ANOVA, independent samples t-test, linear regression, and Chi-square tests were run, using SPSS version 16. Results: The mean score of HIV risk perception was 18.43±5.92, which was average. There was a significant relationship between the mean score of perceived risk of HIV and knowledge regarding AIDS (P=0.005, alcohol consumption (P=0.04, history of addiction (P=0.008, using contraceptive methods (P=0.01, condom use during intercourse (P=0.02, voluntary HIV testing (P=0.001, and follow-up of HIV test (P=0.009. Conclusion:The findings of the present study revealed that knowledge, alcohol consumption, history of addiction, contraceptive methods, the rate of condom use during intercourse, as well as voluntary HIV testing and follow-up were associated with perceived risk of HIV infection. Therefore, taking the necessary steps towards health promotion through appropriate training and interventional approaches seems to be mandatory for reducing high-risk behaviors in populations with low risk perception.

  11. Healthcare waste management practices and risk perceptions: findings from hospitals in the Algarve region, Portugal.

    Science.gov (United States)

    Ferreira, Vera; Teixeira, Margarida Ribau

    2010-12-01

    The management of healthcare wastes is receiving greater attention because of the risks to both human health and the environment caused by inadequate waste management practices. In that context, the objective of this study was to analyse the healthcare waste management practices in hospitals of the Algarve region, Portugal, and in particular to assess the risk perceptions of, and actual risk to, healthcare staff. The study included three of the six hospitals in the region, covering 41% of the bed capacity. Data were collected via surveys, interviews, and on-site observations. The results indicate that waste separation is the main deficiency in healthcare waste practice, with correct separation being positively related to the degree of daily contact with the waste. Risk perceptions of healthcare staff show the highest levels for the environment (4.24) and waste workers (4.08), and the lowest for patients (3.29) and visitors (2.80), again being positively associated with the degree of daily contact. Risk perceptions of healthcare staff are related to the difficulties of the correct separation of wastes and the lack of knowledge concerning the importance of that separation. The risk of infection with needlesticks/sharps is higher during patient care than during waste handling, and the frequency of these injuries is related to the daily tasks of each healthcare group (doctors, nurses, and housekeepers). Furthermore, legislative definitions and classifications of healthcare wastes appear to have conditioned the management practices associated with, and the perceptions of risk concerning, healthcare wastes. Copyright © 2010 Elsevier Ltd. All rights reserved.

  12. Beam test results of CMS RPCs at high eta region under high-radiation environment

    CERN Document Server

    Park, S; Bahk, S Y; Hong, B; Hong, S J; Kang, D H; Kang, T I; Kim, T J; Kim, Y J; Kim, Y U; Koo, D G; Lee, H W; Lee, K S; Lee, S J; Lim, J K; Moon, D H; Nam, S K; Oh, J K; Park, W J; Rhee, J T; Ryu, M S; Shim, H H; Sim, K S

    2004-01-01

    The Compact Muon Solenoid (CMS) forward resistivity plate chambers (RPCs) at the high eta region must be operated in presence of a radiation-induced rate as high as 1 kHz/cm**2. It is still unknown if the RPCs coated with linseed oil can be operated under such a high- radiation environment over the lifetime of CMS. Non-oiled RPCs may be one of the options since phenolic or melamine-coated bakelite is chemically stabler than linseed oil. We have constructed oiled and non-oiled RPCs at the high eta region of CMS using phenolic bakelite and tested them in the Gamma Irradiation Facility at CERN. While both RPCs show the same characteristics in the efficiency and the strip multiplicity, the non-oiled RPC generates an intrinsic noise rate of 50 Hz/cm**2, compared to only 5 Hz/cm**2 for the oiled RPC, both at 10.0kV which is about 100 V above the 95% knee of the efficiency curve.

  13. Beam test results of CMS RPCs at high eta region under high-radiation environment

    International Nuclear Information System (INIS)

    Park, S.; Ahn, S.H.; Bahk, S.Y.; Hong, B.; Hong, S.J.; Kang, D.H.; Kang, T.I.; Kim, T.J.; Kim, Y.J.; Kim, Y.U.; Koo, D.G.; Lee, H.W.; Lee, K.S.; Lee, S.J.; Lim, J.K.; Moon, D.H.; Nam, S.K.; Oh, J.K.; Park, W.J.; Rhee, J.T.; Ryu, M.S.; Shim, H.H.; Sim, K.S.

    2004-01-01

    The Compact Muon Solenoid (CMS) forward resistivity plate chambers (RPCs) at the high eta region must be operated in presence of a radiation-induced rate as high as 1kHz/cm2. It is still unknown if the RPCs coated with linseed oil can be operated under such a high-radiation environment over the lifetime of CMS. Non-oiled RPCs may be one of the options since phenolic or melamine-coated bakelite is chemically stabler than linseed oil. We have constructed oiled and non-oiled RPCs at the high eta region of CMS using phenolic bakelite and tested them in the Gamma Irradiation Facility at CERN. While both RPCs show the same characteristics in the efficiency and the strip multiplicity, the non-oiled RPC generates an intrinsic noise rate of 50Hz/cm2, compared to only 5Hz/cm2 for the oiled RPC, both at 10.0kV which is about 100V above the 95% knee of the efficiency curve

  14. Imaging Frontostriatal Function in Ultra-High-Risk, Early, and Chronic Schizophrenia During Executive Processing

    Science.gov (United States)

    Morey, Rajendra A.; Inan, Seniha; Mitchell, Teresa V.; Perkins, Diana O.; Lieberman, Jeffrey A.; Belger, Aysenil

    2009-01-01

    Context Individuals experiencing prodromal symptoms of schizophrenia (ultra-high-risk group) demonstrate impaired performance on tasks of executive function, attention, and working memory. The neurobiological underpinnings of such executive deficits in ultra-high-risk individuals remains unclear. Objective We assessed frontal and striatal functions during a visual oddball continuous performance task, in ultra-high-risk, early, and chronic schizophrenic patients with the use of functional magnetic resonance imaging. Design Cross-sectional case-control design. Setting Community; outpatient clinic. Patients Fifty-two individuals (control, n = 16; ultra-high risk, n = 10; early, n = 15; chronic, n = 11) from a referred clinical sample and age- and sex-matched control volunteers underwent scanning. Main Outcome Measures Percentage of active voxels and percentage signal change calculated for the anterior cingulate gyrus (ACG), middle frontal gyrus (MFG), inferior frontal gyrus (IFG), basal ganglia, and thalamus. Performance on the visual oddball task was measured with percentage of hits and d′ (a measure based on the hit rate and the false-alarm rate). Results The ultra-high-risk group showed significantly smaller differential activation between task-relevant and task-irrelevant stimuli in the frontal regions (ACG, IFG, MFG) than the control group. Frontostriatal activation associated with target stimuli in the early and chronic groups was significantly lower than the control group, while the ultra-high-risk group showed a trend toward the early group. Conclusions Our findings suggest that prefrontal function begins to decline before the onset of syndromally defined illness and hence may represent a vulnerability marker in assessing the risk of developing psychotic disorders among ultra-high-risk individuals. PMID:15753238

  15. Implementation of equity in resource allocation for regional earthquake risk mitigation using two-stage stochastic programming.

    Science.gov (United States)

    Zolfaghari, Mohammad R; Peyghaleh, Elnaz

    2015-03-01

    This article presents a new methodology to implement the concept of equity in regional earthquake risk mitigation programs using an optimization framework. It presents a framework that could be used by decisionmakers (government and authorities) to structure budget allocation strategy toward different seismic risk mitigation measures, i.e., structural retrofitting for different building structural types in different locations and planning horizons. A two-stage stochastic model is developed here to seek optimal mitigation measures based on minimizing mitigation expenditures, reconstruction expenditures, and especially large losses in highly seismically active countries. To consider fairness in the distribution of financial resources among different groups of people, the equity concept is incorporated using constraints in model formulation. These constraints limit inequity to the user-defined level to achieve the equity-efficiency tradeoff in the decision-making process. To present practical application of the proposed model, it is applied to a pilot area in Tehran, the capital city of Iran. Building stocks, structural vulnerability functions, and regional seismic hazard characteristics are incorporated to compile a probabilistic seismic risk model for the pilot area. Results illustrate the variation of mitigation expenditures by location and structural type for buildings. These expenditures are sensitive to the amount of available budget and equity consideration for the constant risk aversion. Most significantly, equity is more easily achieved if the budget is unlimited. Conversely, increasing equity where the budget is limited decreases the efficiency. The risk-return tradeoff, equity-reconstruction expenditures tradeoff, and variation of per-capita expected earthquake loss in different income classes are also presented. © 2015 Society for Risk Analysis.

  16. InSAR deformation monitoring of high risk landslides

    Science.gov (United States)

    Singhroy, V.; Li, J.

    2013-05-01

    During the past year there were at least twenty five media reports of landslides and seismic activities some fatal, occurring in various areas in Canada. These high risk geohazards sites requires high resolution monitoring both spatially and temporally for mitigation purposes, since they are near populated areas and energy, transportation and communication corridors. High resolution air photos, lidar and satellite images are quite common in areas where the landslides can be fatal. Radar interferometry (InSAR) techniques using images from several radar satellites are increasingly being used in slope stability assessment. This presentation provides examples of using high-resolution (1-3m) frequent revisits InSAR techniques from RADARSAT 2 and TerraSAR X to monitor several types of high-risk landslides affecting transportation and energy corridors and populated areas. We have analyses over 200 high resolution InSAR images over a three year period on geologically different landslides. The high-resolution InSAR images are effective in characterizing differential motion within these low velocity landslides. The low velocity landslides become high risk during the active wet spring periods. The wet soils are poor coherent targets and corner reflectors provide an effective means of InSAR monitoring the slope activities.

  17. Improving Flood Risk Maps as a Capacity Building Activity: Fostering Public Participation and Raising Flood Risk Awareness in the German Mulde Region (project RISK MAP)

    Science.gov (United States)

    Luther, J.; Meyer, V.; Kuhlicke, C.; Scheuer, S.; Unnerstall, H.

    2012-04-01

    The EU Floods Directive requires the establishment of flood risk maps for high risk areas in all EU Member States by 2013. However, if existing at all, the current practice of risk mapping still shows some deficits: Risk maps are often seen as an information tool rather than a communication tool. This means that e.g. important local knowledge is not incorporated and forms a contrast to the understanding of capacity building which calls for engaging individuals in the process of learning and adapting to change and for the establishment of a more interactive public administration that learns equally from its actions and from the feedback it receives. Furthermore, the contents of risk maps often do not match the requirements of the end users, so that risk maps are often designed and visualised in a way which cannot be easily understood by laypersons and/or which is not suitable for the respective needs of public authorities in risk and flood event management. The project RISK MAP aimed at improving flood risk maps as a means to foster public participation and raising flood risk awareness. For achieving this aim, RISK MAP (1) developed rules for appropriate stakeholder participation enabling the incorporation of local knowledge and preferences; (2) improved the content of risk maps by considering different risk criteria through the use of a deliberative multicriteria risk mapping tool; and (3) improved the visualisation of risk maps in order to produce user-friendly risk maps by applying the experimental graphic semiology (EGS) method that uses the eye tracking approach. The research was carried out in five European case studies where the status quo of risk mapping and the legal framework was analysed, several stakeholder interviews and workshops were conducted, the visual perception of risk maps was tested and - based on this empirical work - exemplary improved risk maps were produced. The presentation and paper will outline the main findings of the project which

  18. Risk assessments for the disposal of high level radioactive wastes

    International Nuclear Information System (INIS)

    Smith, C.F.

    1975-01-01

    The risks associated with the disposal of high level wastes derive from the potential for release of radioactive materials into the environment. The assessment of these risks requires a methodology for risk analysis, an identification of the radioactive sources, and a method by which to express the relative hazard of the various radionuclides that comprise the high level waste. The development of a methodology for risk analysis is carried out after a review of previous work in the area of probabilistic risk assessment. The methodology suggested involves the probabilistic analysis of a general accident consequence distribution. In this analysis, the frequency aspect of the distribution is treated separately from the normalized probability function. At the final stage of the analysis, the frequency and probability characteristics of the distribution are recombined to provide an estimate of the risk. The characterization of the radioactive source term is accomplished using the ORIGEN computer code. Calculations are carried out for various reactor types and fuel cycles, and the overall waste hazard for a projected thirty-five year nuclear power program is determined

  19. High Prevalence of Nontraumatic Shoulder Pain in a Regional Sample of Female High School Volleyball Athletes

    Science.gov (United States)

    Frisch, Kayt E.; Clark, Jacob; Hanson, Chad; Fagerness, Chris; Conway, Adam; Hoogendoorn, Lindsay

    2017-01-01

    Background: Shoulder pain is becoming increasingly problematic in young players as volleyball gains popularity. Associations between repetitive motion and pain and overuse injury have been observed in other overhand sports (most notably baseball). Studies of adult athletes suggest that there is a shoulder pain and overuse problem present in volleyball players, but minimal research has been done to establish rates and causes in juvenile participants. Purpose: To establish rates of shoulder pain, regardless of whether it resulted in a loss of playing time, in female high school volleyball players. A secondary goal was to determine whether high repetition volumes correlated with an increased likelihood of experiencing pain. Study Design: Descriptive epidemiology study. Methods: A self-report survey focusing on the prevalence of pain not associated with a traumatic event in female high school youth volleyball players was developed. Survey questions were formulated by certified athletic trainers, experienced volleyball coaches, and biomechanics experts. Surveys were received from 175 healthy, active high school volleyball players in Iowa, South Dakota, and Minnesota. Results: Forty percent (70/175) of active high school volleyball players remembered experiencing shoulder pain not related to traumatic injury, but only 33% (23/70) reported taking time off to recover from the pain. Based on these self-reported data, activities associated with significantly increased risk of nontraumatic shoulder pain included number of years playing competitive volleyball (P = .01) and lifting weights out of season (P = .001). Players who reported multiple risk factors were more likely to experience nontraumatic shoulder pain. Conclusion: When using time off for recovery as the primary injury criterion, we found that the incidence of shoulder pain is more than twice as high as the incidence of injury reported by previous studies. Findings also indicated that the incidence of shoulder pain

  20. High Prevalence of Nontraumatic Shoulder Pain in a Regional Sample of Female High School Volleyball Athletes.

    Science.gov (United States)

    Frisch, Kayt E; Clark, Jacob; Hanson, Chad; Fagerness, Chris; Conway, Adam; Hoogendoorn, Lindsay

    2017-06-01

    Shoulder pain is becoming increasingly problematic in young players as volleyball gains popularity. Associations between repetitive motion and pain and overuse injury have been observed in other overhand sports (most notably baseball). Studies of adult athletes suggest that there is a shoulder pain and overuse problem present in volleyball players, but minimal research has been done to establish rates and causes in juvenile participants. To establish rates of shoulder pain, regardless of whether it resulted in a loss of playing time, in female high school volleyball players. A secondary goal was to determine whether high repetition volumes correlated with an increased likelihood of experiencing pain. Descriptive epidemiology study. A self-report survey focusing on the prevalence of pain not associated with a traumatic event in female high school youth volleyball players was developed. Survey questions were formulated by certified athletic trainers, experienced volleyball coaches, and biomechanics experts. Surveys were received from 175 healthy, active high school volleyball players in Iowa, South Dakota, and Minnesota. Forty percent (70/175) of active high school volleyball players remembered experiencing shoulder pain not related to traumatic injury, but only 33% (23/70) reported taking time off to recover from the pain. Based on these self-reported data, activities associated with significantly increased risk of nontraumatic shoulder pain included number of years playing competitive volleyball ( P = .01) and lifting weights out of season ( P = .001). Players who reported multiple risk factors were more likely to experience nontraumatic shoulder pain. When using time off for recovery as the primary injury criterion, we found that the incidence of shoulder pain is more than twice as high as the incidence of injury reported by previous studies. Findings also indicated that the incidence of shoulder pain may be correlated with volume of previous volleyball experience.

  1. Hygienic assessment of ambient air quality and health risks to population of Krasnoyarsk region

    Directory of Open Access Journals (Sweden)

    D.V. Goryaev

    2016-06-01

    Full Text Available This study fulfills the hygienic assessment of ambient air quality in the populated areas of the Krasnoyarsk Region. It is shown that the total number of emission sources in the region is more than 23 600 units, what is higher than in previous years. Around 90.7 % out of them correspond to the set standards of permissible emissions. Air monitoring was carried by the establishments of Roshydromet, Rospotrebnadzor and by other organizations at 94 observation posts in eight urban districts and 2 municipal districts of the region. The status of the ambient air in a sequence of the populated areas of Krasnoyarsk region, namely in the cities Achinsk, Kansk, Krasnoyarsk, Lesosibirsk, Minusinsk, Norilsk, is characterized by the presence of certain pollutants, the level of which exceeds the hygienic standards. Prioritized pollutants are benzo(apyrene, suspended solids, nitrogen, and sulfur dioxide, formaldehyde and others. In the settlements the economic entities violate the legal requirements in the field of sanitary and epidemiological welfare of the population. The probability of the population’s health deterioration grows along with the growth of risk factors. The risks of respiratory diseases, immune system, blood and blood-forming organs and the additional mortality are assessed as unacceptable. Ensuring air quality of the urban residential areas and municipal districts of the Krasnoyarsk Territory requires the introducing the complex measures to improve it. The established levels of human health risk associated with exposure to polluted air are an additional criterion for selection of the priority objects when planning the implementation of risk-based model for supervisory activities in the field of sanitary and epidemiological welfare of the population.

  2. Accumulation, transfer, and environmental risk of soil mercury in a rapidly industrializing region of the Yangtze River Delta, China

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Biao; Yan, Lianxiang; Sun, Weixia; Zhao, Yongcun; Shi, Xuezheng [Chinese Academy of Sciences, Nanjing (China). State Key Lab. of Soil and Sustainable Agriculture; Wang, Mei [Chinese Academy of Sciences, Nanjing (China). State Key Lab. of Soil and Sustainable Agriculture; Graduate Univ. of the Chinese Academy of Sciences, Beijing (China); Weindorf, David C. [Louisiana State Univ., Baton Rouge, LA (United States). AgCenter

    2011-06-15

    Purpose: Mercury (Hg) accumulation and transfer in soil ecosystems has been altered on local, regional, and even global scales, and their environmental risk has increasingly been a concern to the public and the scientific community. Materials and methods: A county level region in Zhangjiagang County, the Yangtze River Delta (YRD) region of China and a factory with Hg-contaminated wastewater discharging within the region were selected to study the accumulation, bioavailability, and transfer of Hg from different sources in soils and crops under rapid industrialization, urbanization, and intensive agricultural activities. Regional soil samples close to and away from factories and local soil and crop samples around a typical factory were collected in the YRD region of China. Soil and crop Hg and basic soil properties were examined. Results and discussion: Significant soil Hg accumulation was found in soils away from factories regardless of Cambosols (Entisols) and Anthrosols (Inceptisols), while the mobile HCl-extractable Hg (HCl-Hg) were greater in soils closer to factories due to a decrease and increase in soil pH and organic matter. A high level of soil total Hg (T-Hg) was found around the factory, and soil and crop Hg accumulation in the vicinity of the factory was localized with an exponential decrease as distance away from the wastewater discharge outlet increased. Although Hg accumulated in these soils, the T-Hg levels at only a few sampling sites in acidic Anthrosols area were found to exceed the second most stringent critical value of Chinese Environmental Quality Standards for Soils. Conclusions: Considering the cessation of Hg-containing agrochemicals and limitation of effects of industrial activities on Hg accumulation, more attention should be paid to the changes in soil properties and crop rotations than controlling the pathways of Hg entering soils because the current environmental risk is mobilization of accumulated soil Hg. (orig.)

  3. High-Resolution Regional Phase Attenuation Models of the Iranian Plateau and Surrounding Regions

    Science.gov (United States)

    2014-03-03

    crustal structure or sediment thickness across much of the Iranian plateau. The lone exception is the region between the central Zagros and the Lut block...L11303, 2007. Meunier, P., N. Hovius, and J. A. Haines, Topographic site effects and the location of earthquake induced landslides, Earth Planet . Sci

  4. [Drugs use in pregnancy in the Valencia Region and the risk of congenital anomalies].

    Science.gov (United States)

    Cavero-Carbonell, Clara; Gimeno-Martos, Silvia; Páramo-Rodríguez, Lucía; Rabanaque-Hernández, María José; Martos-Jiménez, Carmen; Zurriaga, Óscar

    2017-09-01

    Despite the potential risks of drug use during pregnancy, consumption has increased in recent decades. To identify the risk of congenital anomalies (CA) associated with the use of drugs in primary care in pregnant women residents in the Valencia Region. A case-control study, considering a case as a less than one year old live birth in 2009-2010, diagnosed with a CA and resident in the Valencia Region, obtained from the CA population-based registry. Controls were selected from the Metabolic Disease Registry, and the drugs prescribed and dispensed from the Integral Management of Pharmaceutical Services. Crude odds ratio (OR) was calculated with its 95% confidence intervals and adjusted OR was calculated using logistic regression. A total of 1,913 cases and 3,826 controls were identified. The most frequently used drug groups were those acting on the musculoskeletal, nervous and respiratory systems, on the blood and blood forming organs, and anti-infection drugs. The most common drugs used were ibuprofen, dexketoprofen, paracetamol, amoxicillin, ferrous sulphate, and a combination of folic acid. A significantly increased risk of CA was identified for drugs acting on the musculoskeletal system (adjusted OR 1.14 [95% confidence interval 1.02-1.28]). A significantly decreased risk was observed for drugs acting on the blood and blood forming organs (adjusted OR 0.87 [95% confidence interval 0.78-0.98]). Associations between drugs and CA in pregnant women resident in the Valencia Region have been identified for drugs that act as risk factors of CA, and for drugs that act as protective factors of CA. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Reduction of risk level as one of the main challenges of development in covered karst regions

    Directory of Open Access Journals (Sweden)

    Makhnatov Stanislav A.

    2013-01-01

    Full Text Available The paper describes the experience of application of the residual karst risk concept, and presents coefficients of karst risk level reduction for planning constructional karst-protection. Practical experience of design for karstified territories of Nizhny Novgorod region demonstrates that special research of the interaction between constructions and foundations is required. Numerous accidents can serve vivid examples proving the need. I2n this situation it is important to approach the issue of safety in a proper way, taking into account probable economic, environmental and social damage. The problem can be solved by introduction of the karst risk level parameter, which permits to take into consideration constructional characteristics of objects (design philosophy, service life, as well as conditions and mechanisms of interaction between the foundation and the construction (sinkholes, local subsidence, karst-suffosion deformations, etc.. The importance of risk reduction is highlighted by current Russian Federal laws. Depending on karst risk level adequate karst-protection should be performed. For building projects, reduction of karst risk to a permissible level (conventionally equal to 1 is one of the most important research challenges of the karstified territories development, and its solution permits to plan appropriate karst protection measures.

  6. Ecological Risk Assessment of the Southern Fujian Golden Triangle in China Based on Regional Transportation Development

    Directory of Open Access Journals (Sweden)

    Xinyi Yang

    2018-06-01

    Full Text Available Regional transportation development (RTD is an important stressor of urban agglomeration ecosystems. Groundwater recharge potential may be adversely affected when natural soil is replaced by impervious materials. To systematically identify the urban agglomeration ecological risk (UAER of RTD in the southern Fujian Golden Triangle, water regulation was used as an assessment endpoint, and RTD was considered the stressor. We used the Soil Conservation Service Curve Number method (SCS-CN to analyze the internal relationship between the assessment endpoint and the stressor factors. Then, a multi-level risk characterization method was used to show the evolutionary process of risk, and to provide a scientific basis for the management of UAER. Based on the current RTD plan, the UAER assessment shows that there is a 0.90 probability of that the risk distribution results will occur by 2030. The intensity of stress from arterial roads on the urban agglomeration ecosystem is greater than that of the railway system. By considering the development of the railway system as a factor in the stress of RTD, this study of UAER assessment differs from past studies of urban ecological risk assessment, since the latter considers only highways. We also propose a systematic method of risk assessment simulation-prediction.

  7. Relationship between Background Parenchymal Enhancement on High-risk Screening MRI and Future Breast Cancer Risk.

    Science.gov (United States)

    Grimm, Lars J; Saha, Ashirbani; Ghate, Sujata V; Kim, Connie; Soo, Mary Scott; Yoon, Sora C; Mazurowski, Maciej A

    2018-03-27

    To determine if background parenchymal enhancement (BPE) on screening breast magnetic resonance imaging (MRI) in high-risk women correlates with future cancer. All screening breast MRIs (n = 1039) in high-risk women at our institution from August 1, 2004, to July 30, 2013, were identified. Sixty-one patients who subsequently developed breast cancer were matched 1:2 by age and high-risk indication with patients who did not develop breast cancer (n = 122). Five fellowship-trained breast radiologists independently recorded the BPE. The median reader BPE for each case was calculated and compared between the cancer and control cohorts. Cancer cohort patients were high-risk because of a history of radiation therapy (10%, 6 of 61), high-risk lesion (18%, 11 of 61), or breast cancer (30%, 18 of 61); BRCA mutation (18%, 11 of 61); or family history (25%, 15 of 61). Subsequent malignancies were invasive ductal carcinoma (64%, 39 of 61), ductal carcinoma in situ (30%, 18 of 61) and invasive lobular carcinoma (7%, 4of 61). BPE was significantly higher in the cancer cohort than in the control cohort (P = 0.01). Women with mild, moderate, or marked BPE were 2.5 times more likely to develop breast cancer than women with minimal BPE (odds ratio = 2.5, 95% confidence interval: 1.3-4.8, P = .005). There was fair interreader agreement (κ = 0.39). High-risk women with greater than minimal BPE at screening MRI have increased risk of future breast cancer. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  8. Assessment of landslide risk using gis and statistical methods in kysuce region

    Directory of Open Access Journals (Sweden)

    Barančoková Mária

    2014-03-01

    Full Text Available The landslide susceptibility was assessed based on multivariation analysis. The input parameters were represented by lithology, land use, slope inclination and average annual precipitation. These parameters were evaluated as independent variables, and the existing landslides as dependent variables. The individual input parameters were reclassified and spatially adjusted. Spatial analysis resulted in 15 988 combinations of input parameters representing the homogeneous condition unit (HCU . Based on the landslide density within individual units, the HCU polygons have been classified according to landslide risk into stable, conditionally stable, conditionally stable and unstable (subdivided into low, medium and high landslide risk. A total of 2002 HCU s were affected by landslides, and the remaining 13 986 were not affected. The total HCU area affected by landslides is about 156.92 km2 (20.1%. Stable areas covered 623.01 km2 (79.8%, and conditionally stable areas covered 228.77 km2 (29.33% out of this area. Unstable areas were divided into three levels of landslide risk - low, medium and high risk. An area of 111.19 km2 (14.3% represents low landslide risk, medium risk 29.7 km2 (3.8% and 16.01 km2 (2% represents high risk. Since Zlín Formation lithological unit covers approximately one-third of the study area, it also influences the overall landslide risk assessment. This lithological formation covers the largest area within all landslide risk classes as well as in conditionally stable areas. The most frequent slope class was in the range of 14-19. The higher susceptibility of Zlín Formation to landslides is caused mainly by different geomorphological value of claystone and sandstone sequence. The higher share of claystone results in higher susceptibility of this formation to exogenous degradation processes.

  9. Iodine supply in diet in various european regions and risks of iodine prophylaxis

    International Nuclear Information System (INIS)

    Dumont, J.E.

    1991-01-01

    The main risk of low level irradiation of the thyroid is the induction of thyroid neoplasia. In the case of nuclear accidents this risk depends on the level of radioiodine uptake and half life in the thyroid, on the size of the gland and on the relative biological efficiency of the emitted radiation especially at low doses. The level of radioiodine uptake is inversely related to stable iodine supply in the diet. In this study it was proposed to: 1. systematically survey iodine supply in the diet, radioiodine uptake and thyroid kinetics in various European regions. Most of these data are readily available. Taken together with presently accepted estimates of relative biological efficiency, the radiation doses at various contamination levels and risks could be computed and tabulated as an easy-to-use basis for decision guidelines. 2. to obtain in vitro from human autopsy material, radioiodine kinetics data in fetal thyroid to complement data in vivo in a model animal close to man (the chimpanzee) at various dietary iodine levels. Urinary iodine excretions vary in Europe from one region to another from 16 to 250 ug/day. The full spectrum from severe iodine deficiency to normal dietary intake exists in Europe. It is therefore quite to be expected that 24h thyroid radioiodine uptakes vary from 19 to 83%. Therefore for a similar radioiodide contamination the thyroid exposure will vary from one region to another by a factor of 4

  10. High-Altitude Illnesses: Physiology, Risk Factors, Prevention, and Treatment

    Directory of Open Access Journals (Sweden)

    Andrew T. Taylor

    2011-01-01

    Full Text Available High-altitude illnesses encompass the pulmonary and cerebral syndromes that occur in non-acclimatized individuals after rapid ascent to high altitude. The most common syndrome is acute mountain sickness (AMS which usually begins within a few hours of ascent and typically consists of headache variably accompanied by loss of appetite, nausea, vomiting, disturbed sleep, fatigue, and dizziness. With millions of travelers journeying to high altitudes every year and sleeping above 2,500 m, acute mountain sickness is a wide-spread clinical condition. Risk factors include home elevation, maximum altitude, sleeping altitude, rate of ascent, latitude, age, gender, physical condition, intensity of exercise, pre-acclimatization, genetic make-up, and pre-existing diseases. At higher altitudes, sleep disturbances may become more profound, mental performance is impaired, and weight loss may occur. If ascent is rapid, acetazolamide can reduce the risk of developing AMS, although a number of high-altitude travelers taking acetazolamide will still develop symptoms. Ibuprofen can be effective for headache. Symptoms can be rapidly relieved by descent, and descent is mandatory, if at all possible, for the management of the potentially fatal syndromes of high-altitude pulmonary and cerebral edema. The purpose of this review is to combine a discussion of specific risk factors, prevention, and treatment options with a summary of the basic physiologic responses to the hypoxia of altitude to provide a context for managing high-altitude illnesses and advising the non-acclimatized high-altitude traveler.

  11. Value at Risk and Hedge Fund Return - Does High Risk Bring High Return?

    OpenAIRE

    Jing, Tao; Zhao, Hongxiang

    2010-01-01

    This paper mainly focuses on the correlation between live hedge fund return and their value at risk (VaR), and is based on the historical data from May 2000 to April 2010. The authors adopt portfolio level analyses and fund level cross-sectional regression, and find that there is significant positive correlation, both statistically and economically, between the hedge fund return and VaRs (parametric, non-parametric and GARCH). Further research is conducted by sub-dividing the overall period i...

  12. Risk forewarning of regional development sustainability based on a natural resources and environmental carrying index in China

    Science.gov (United States)

    Fan, Jie; Wang, Yafei; Ouyang, Zhiyun; Li, Lijuan; Xu, Yong; Zhang, Wenzhong; Wang, Chuansheng; Xu, Weihua; Li, Jiuyi; Yu, Jianhui; Zhou, Kan

    2017-02-01

    It is a matter of public consensus that China's high growth rate has been achieved at the expense of natural resources and the environment, leading to serious risks to sustainability. This research, which proposes a theoretical model to forewarn of risks to regional developmental sustainability in China, constitutes the first empirical evaluation of this to be undertaken there. The results show that: (a) the areas at risk cover almost 43% of the land and 44% of the population of mainland China. In those areas, 83.56% of people at risk are threatened by the low carrying capacity of the environment and limited water resources. (b) With 70% of the total population living in "at risk" areas, urbanization zones remain as the primary category suffering from overload across China. Extensive industrialization has resulted in environmental pollution, which contributes the most to the forewarning status, while the secondary cause is found to be the special coupling of the scarcity of natural water resources and their inefficient use. In addition, most urban conglomerations suffer from pollution by industrial production and household consumption, which tends to extend to their surrounding agricultural areas. Extensive mineral exploitation in ecologically fragile areas has made them increasingly more vulnerable to disturbances from their neighboring resource-driven urban areas. The paper uses these findings to suggest how to intensify the special regulatory administration of resources and the environment, and to transform approaches to industrialization, in order to address sustainable development issues in developing countries.

  13. Risk and size estimation of debris flow caused by storm rainfall in mountain regions

    Institute of Scientific and Technical Information of China (English)

    CHENG; Genwei

    2003-01-01

    Debris flow is a common disaster in mountain regions. The valley slope, storm rainfall and amassed sand-rock materials in a watershed may influence the types of debris flow. The bursting of debris flow is not a pure random event. Field investigations show the periodicity of its burst, but no directive evidence has been found yet. A risk definition of debris flow is proposed here based upon the accumulation and the starting conditions of loose material in channel. According to this definition, the risk of debris flow is of quasi-periodicity. A formula of risk estimation is derived. Analysis of relative factors reveals the relationship between frequency and size of debris flow. For a debris flow creek, the longer the time interval between two occurrences of debris flows is, the bigger the bursting event will be.

  14. Homogenity of geological units with respect to the radon risk in the Walloon region of Belgium.

    Science.gov (United States)

    Tondeur, François; Cinelli, Giorgia; Dehandschutter, Boris

    2014-10-01

    In the process of mapping indoor radon risk, an important step is to define geological units well-correlated with indoor radon. The present paper examines this question for the Walloon region of Belgium, using a database of more than 18,000 indoor radon measurements. With a few exceptions like the Carboniferous (to be divided into Tournaisian, Visean and Namurian-Westphalian) and the Tertiary (in which all Series may be treated together), the Series/Epoch stratigraphic level is found to be the most appropriate geological unit to classify the radon risk. A further division according to the geological massif or region is necessary to define units with a reasonable uniformity of the radon risk. In particular, Paleozoic series from Cambrian to Devonian show strong differences between different massifs. Local hot-spots are also observed in the Brabant massif. Finally, 35 geological units are defined according to their radon risk, 6 of which still present a clear weak homogeneity. In the case of 4 of these units (Jurassic, Middle Devonian of Condroz and of Fagne-Famenne, Ordovician of the Stavelot massif) homogeneity is moderate, but the data are strongly inhomogeneous for Visean in Condroz and in the Brabant massif. The 35 geological units are used in an ANOVA analysis, to evaluate the part of indoor radon variability which can be attributed to geology. The result (15.4-17.7%) agrees with the values observed in the UK. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. The Regional-Matrix Approach to the Training of Highly Qualified Personnel for the Sustainable Development of the Mining Region

    Science.gov (United States)

    Zhernov, Evgeny; Nehoda, Evgenia

    2017-11-01

    The state, regional and industry approaches to the problem of personnel training for building an innovative knowledge economy at all levels that ensures sustainable development of the region are analyzed in the article using the cases of the Kemerovo region and the coal industry. A new regional-matrix approach to the training of highly qualified personnel is proposed, which allows to link the training systems with the regional economic matrix "natural resources - cognitive resources" developed by the author. A special feature of the new approach is the consideration of objective conditions and contradictions of regional systems of personnel training, which have formed as part of economic systems of regions differ-entiated in the matrix. The methodology of the research is based on the statement about the interconnectivity of general and local knowledge, from which the understanding of the need for a combination of regional, indus-try and state approaches to personnel training is derived. A new form of representing such a combination is the proposed approach, which is based on matrix analysis. The results of the research can be implemented in the practice of modernization of professional education of workers in the coal industry of the natural resources extractive region.

  16. Seroprevalence and risk factor analysis of human leptospirosis in distinct climatic regions of Pakistan.

    Science.gov (United States)

    Sohail, Muhammad Luqman; Khan, Muhammad Sarwar; Ijaz, Muhammad; Naseer, Omer; Fatima, Zahida; Ahmad, Abdullah Saghir; Ahmad, Waqas

    2018-05-01

    Leptospirosis is a worldwide emerging infectious disease of zoonotic importance and large epidemics and epizootics have been reported all over the globe. A cross survey study was conducted to estimate seroprevalence of human leptospirosis in climatically distinct regions of Pakistan and to identify the risk factors associated with the disease. Blood samples from 360 humans were collected through convenient sampling, 120 from each of three study areas. Serological testing was performed using ELISA kit as per manufacturer's recommendations. The results showed an overall prevalence of 40.83% (95% CI; 35.71-46.11). Statistical analysis showed significant (P climatic region (50.83%; 95% CI; 41.55-60.07), followed by semi-arid region (44.16%; 95% CI; 35.11-53.52) and lowest in hot and dry region (27.50%; 95% CI; 19.75-36.40). After multivariate analysis age, gender, exposure to flooding water, source of water usage, disinfection schedule of surroundings and history of cut and wound were found significantly associated with the seropositivity of Leptospira. The present study, first to uncover seroprevalence of human Leptospira in different climatic regions of Pakistan, alarms about effect of climate on prevalence of Leptospira in the region. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. Risk-based consequences of extreme natural hazard processes in mountain regions - Multi-hazard analysis in Tyrol (Austria)

    Science.gov (United States)

    Huttenlau, Matthias; Stötter, Johann

    2010-05-01

    Reinsurance companies are stating a high increase in natural hazard related losses, both insured and economic losses, within the last decades on a global scale. This ongoing trend can be described as a product of the dynamic in the natural and in the anthroposphere. To analyze the potential impact of natural hazard process to a certain insurance portfolio or to the society in general, reinsurance companies or risk management consultants have developed loss models. However, those models are generally not fitting the scale dependent demand on regional scales like it is appropriate (i) for analyses on the scale of a specific province or (ii) for portfolio analyses of regional insurance companies. Moreover, the scientific basis of most of the models is not transparent documented and therefore scientific evaluations concerning the methodology concepts are not possible (black box). This is contrary to the scientific principles of transparency and traceability. Especially in mountain regions like the European Alps with their inherent (i) specific characteristic on small scales, (ii) the relative high process dynamics in general, (iii) the occurrence of gravitative mass movements which are related to high relief energy and thus only exists in mountain regions, (iv) the small proportion of the area of permanent settlement on the overall area, (v) the high value concentration in the valley floors, (vi) the exposition of important infrastructures and lifelines, and others, analyses must consider these circumstances adequately. Therefore, risk-based analyses are methodically estimating the potential consequences of hazard process on the built environment standardized with the risk components (i) hazard, (ii) elements at risk, and (iii) vulnerability. However, most research and progress have been made in the field of hazard analyses, whereas the other both components are not developed accordingly. Since these three general components are influencing factors without any

  18. Physical performance following acute high-risk abdominal surgery

    DEFF Research Database (Denmark)

    Jønsson, Line Rokkedal; Ingelsrud, Lina Holm; Tengberg, Line Toft

    2018-01-01

    BACKGROUND: Acute high-risk abdominal (AHA) surgery is associated with high mortality, multiple postoperative complications and prolonged hospital stay. Further development of strategies for enhanced recovery programs following AHA surgery is needed. The aim of this study was to describe physical...... are primarily fatigue and abdominal pain. Further studies investigating strategies for early mobilization and barriers to mobilization in the immediate postoperative period after AHA surgery are needed.......BACKGROUND: Acute high-risk abdominal (AHA) surgery is associated with high mortality, multiple postoperative complications and prolonged hospital stay. Further development of strategies for enhanced recovery programs following AHA surgery is needed. The aim of this study was to describe physical...... performance and barriers to independent mobilization among patients who received AHA surgery (postoperative days [POD] 1-7). METHODS: Patients undergoing AHA surgery were consecutively enrolled from a university hospital in Denmark. In the first postoperative week, all patients were evaluated daily...

  19. Risk factors for acute myocardial infarction in coastal region of india: A case-control study

    Directory of Open Access Journals (Sweden)

    Vinay Rao

    2014-01-01

    Full Text Available Background: Various studies have shown that people of Indian origin have an increased risk of ischemic heart disease (IHD compared with most other ethnic groups. This increased risk has been attributed to multiple risk factors related to lifestyle. Patients and Methods: A total of 100 cases and 100 age and sex-matched controls were taken into this prospective case-control study from Intensive Coronary Care Unit. Prevalence of the following risk factors for myocardial infarction: Age, sex, diet, smoking, alcohol consumption, history of hypertension, history of diabetes mellitus, and lipid profile were studied. Patient data were extracted from the medical records department and by interview. Results: The most important predictor of acute myocardial infarction (AMI was high low-density lipoprotein (adjusted odds ratio [OR]: 4.124, confidence interval [CI]: 1.44-11.73, P = 0.008 history of hypertension and of overt diabetes mellitus were also independent risk factors (OR: 2, CI: 1.4-3 and OR: 2.29, CI: 1.5-3.5, respectively. Low high-density lipoprotein was found to have no significant association with AMI. Heavy drinkers were found to have a high-risk (OR: 68, while moderate drinkers were found to have protection (OR: 1. Conclusion: Smoking and heavy drinking cessation, treatment of hypertension and reduction in blood glucose, correction of abnormal lipid profile either through use of statins or by dietary modification may be important in preventing IHD in Asian Indians.

  20. Extinction Risk of Pseudotsuga Menziesii Populations in the Central Region of Mexico: An AHP Analysis

    Directory of Open Access Journals (Sweden)

    Javier López-Upton

    2015-05-01

    Full Text Available Within the Analytic Hierarchy Process (AHP framework, a hierarchical model was created considering anthropogenic, genetic and ecological criteria and sub-criteria that directly affect Douglas-fir (Pseudotsuga menziesii (Mirb. risk of extinction in central Mexico. The sub-criteria values were standardized, weighted, and ordered by importance in a pairwise comparison matrix; the model was mathematically integrated to quantify the degree of extinction risk for each of the 29 populations present in the study area. The results indicate diverse levels of risk for the populations, ranging from very low to very high. Estanzuela, Presa Jaramillo, Peñas Cargadas and Plan del Baile populations have very low risk, with values less than 0.25. On the other hand, Vicente Guerrero, Morán, Minatitlán, La Garita and Tonalapa populations have very high risk (>0.35 because they are heavily influenced by anthropogenic (close to roads and towns, ecological (presence of exotic species and little or no natural regeneration and genetic (presence of mature to overmature trees and geographic isolation factors. In situ conservation activities, prioritizing their implementation in populations at most risk is highly recommended; in addition, germplasm collection for use of assisted gene flow and migration approaches, including artificial reforestation, should be considered in these locations.

  1. SOCIALLY ACTIVE BEHAVIOR OF YOUNG PEOPLE AS A RISK FACTOR OF FAMILY AND MARITAL RELATIONS IN A PROVINCIAL REGION (THROUGH THE EXAMPLE OF KURSK AND THE KURSK REGION

    Directory of Open Access Journals (Sweden)

    Tatyana Nikolaevna Kameneva

    2013-10-01

    Full Text Available Modern society currently undergoes socio-cultural transformation. Taking into account the high degree of dynamism of this kind of society it can be considered as a risk society, where the existence of traditional institutions itself (the family institution, in particular is menaced. This is especially prominent among young people, because most of them are actively involved (engaged? in the processes under consideration.Objective. The objective of this article is to analyze the interrelation between socially active behavior of modern youth and their attitude as to family and marital relationships.Method. Achievement of the aforecited objective was initiated by another sociological survey conducted within the area of Kursk and the Kursk region (using method of questionnaires.Results. As a result of the sociological survey within the area of Kursk and the Kursk region, it was revealed that young people feel the need to participate as in social life, in general, so in social life of their region, in particular. However, many young people actively participating in social life prone to leave over their family plans, or prefer to have only one child, or live with a partner not entering into marriage. Thus, socially active behavior of modern youth cause a risk from the perspective of their family and marital attitudes.Research results application area. The data obtained herein can be used, for example, to provide recommendations for officials developing various directions of youth and population policies, as well as within the frames of courses devoted to sociology of youth and family.DOI: http://dx.doi.org/10.12731/2218-7405-2013-7-35

  2. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.

    Science.gov (United States)

    Lim, Stephen S; Vos, Theo; Flaxman, Abraham D; Danaei, Goodarz; Shibuya, Kenji; Adair-Rohani, Heather; Amann, Markus; Anderson, H Ross; Andrews, Kathryn G; Aryee, Martin; Atkinson, Charles; Bacchus, Loraine J; Bahalim, Adil N; Balakrishnan, Kalpana; Balmes, John; Barker-Collo, Suzanne; Baxter, Amanda; Bell, Michelle L; Blore, Jed D; Blyth, Fiona; Bonner, Carissa; Borges, Guilherme; Bourne, Rupert; Boussinesq, Michel; Brauer, Michael; Brooks, Peter; Bruce, Nigel G; Brunekreef, Bert; Bryan-Hancock, Claire; Bucello, Chiara; Buchbinder, Rachelle; Bull, Fiona; Burnett, Richard T; Byers, Tim E; Calabria, Bianca; Carapetis, Jonathan; Carnahan, Emily; Chafe, Zoe; Charlson, Fiona; Chen, Honglei; Chen, Jian Shen; Cheng, Andrew Tai-Ann; Child, Jennifer Christine; Cohen, Aaron; Colson, K Ellicott; Cowie, Benjamin C; Darby, Sarah; Darling, Susan; Davis, Adrian; Degenhardt, Louisa; Dentener, Frank; Des Jarlais, Don C; Devries, Karen; Dherani, Mukesh; Ding, Eric L; Dorsey, E Ray; Driscoll, Tim; Edmond, Karen; Ali, Suad Eltahir; Engell, Rebecca E; Erwin, Patricia J; Fahimi, Saman; Falder, Gail; Farzadfar, Farshad; Ferrari, Alize; Finucane, Mariel M; Flaxman, Seth; Fowkes, Francis Gerry R; Freedman, Greg; Freeman, Michael K; Gakidou, Emmanuela; Ghosh, Santu; Giovannucci, Edward; Gmel, Gerhard; Graham, Kathryn; Grainger, Rebecca; Grant, Bridget; Gunnell, David; Gutierrez, Hialy R; Hall, Wayne; Hoek, Hans W; Hogan, Anthony; Hosgood, H Dean; Hoy, Damian; Hu, Howard; Hubbell, Bryan J; Hutchings, Sally J; Ibeanusi, Sydney E; Jacklyn, Gemma L; Jasrasaria, Rashmi; Jonas, Jost B; Kan, Haidong; Kanis, John A; Kassebaum, Nicholas; Kawakami, Norito; Khang, Young-Ho; Khatibzadeh, Shahab; Khoo, Jon-Paul; Kok, Cindy; Laden, Francine; Lalloo, Ratilal; Lan, Qing; Lathlean, Tim; Leasher, Janet L; Leigh, James; Li, Yang; Lin, John Kent; Lipshultz, Steven E; London, Stephanie; Lozano, Rafael; Lu, Yuan; Mak, Joelle; Malekzadeh, Reza; Mallinger, Leslie; Marcenes, Wagner; March, Lyn; Marks, Robin; Martin, Randall; McGale, Paul; McGrath, John; Mehta, Sumi; Mensah, George A; Merriman, Tony R; Micha, Renata; Michaud, Catherine; Mishra, Vinod; Mohd Hanafiah, Khayriyyah; Mokdad, Ali A; Morawska, Lidia; Mozaffarian, Dariush; Murphy, Tasha; Naghavi, Mohsen; Neal, Bruce; Nelson, Paul K; Nolla, Joan Miquel; Norman, Rosana; Olives, Casey; Omer, Saad B; Orchard, Jessica; Osborne, Richard; Ostro, Bart; Page, Andrew; Pandey, Kiran D; Parry, Charles D H; Passmore, Erin; Patra, Jayadeep; Pearce, Neil; Pelizzari, Pamela M; Petzold, Max; Phillips, Michael R; Pope, Dan; Pope, C Arden; Powles, John; Rao, Mayuree; Razavi, Homie; Rehfuess, Eva A; Rehm, Jürgen T; Ritz, Beate; Rivara, Frederick P; Roberts, Thomas; Robinson, Carolyn; Rodriguez-Portales, Jose A; Romieu, Isabelle; Room, Robin; Rosenfeld, Lisa C; Roy, Ananya; Rushton, Lesley; Salomon, Joshua A; Sampson, Uchechukwu; Sanchez-Riera, Lidia; Sanman, Ella; Sapkota, Amir; Seedat, Soraya; Shi, Peilin; Shield, Kevin; Shivakoti, Rupak; Singh, Gitanjali M; Sleet, David A; Smith, Emma; Smith, Kirk R; Stapelberg, Nicolas J C; Steenland, Kyle; Stöckl, Heidi; Stovner, Lars Jacob; Straif, Kurt; Straney, Lahn; Thurston, George D; Tran, Jimmy H; Van Dingenen, Rita; van Donkelaar, Aaron; Veerman, J Lennert; Vijayakumar, Lakshmi; Weintraub, Robert; Weissman, Myrna M; White, Richard A; Whiteford, Harvey; Wiersma, Steven T; Wilkinson, James D; Williams, Hywel C; Williams, Warwick; Wilson, Nicholas; Woolf, Anthony D; Yip, Paul; Zielinski, Jan M; Lopez, Alan D; Murray, Christopher J L; Ezzati, Majid; AlMazroa, Mohammad A; Memish, Ziad A

    2012-12-15

    Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time. We estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010. We estimated exposure distributions for each year, region, sex, and age group, and relative risks per unit of exposure by systematically reviewing and synthesising published and unpublished data. We used these estimates, together with estimates of cause-specific deaths and DALYs from the Global Burden of Disease Study 2010, to calculate the burden attributable to each risk factor exposure compared with the theoretical-minimum-risk exposure. We incorporated uncertainty in disease burden, relative risks, and exposures into our estimates of attributable burden. In 2010, the three leading risk factors for global disease burden were high blood pressure (7·0% [95% uncertainty interval 6·2-7·7] of global DALYs), tobacco smoking including second-hand smoke (6·3% [5·5-7·0]), and alcohol use (5·5% [5·0-5·9]). In 1990, the leading risks were childhood underweight (7·9% [6·8-9·4]), household air pollution from solid fuels (HAP; 7·0% [5·6-8·3]), and tobacco smoking including second-hand smoke (6·1% [5·4-6·8]). Dietary risk factors and physical inactivity collectively accounted for 10·0% (95% UI 9·2-10·8) of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium. Several risks that primarily affect childhood communicable diseases, including unimproved

  3. Private sector embedded water risk: Merging the corn supply chain network and regional watershed depletion

    Science.gov (United States)

    Kim, T.; Brauman, K. A.; Schmitt, J.; Goodkind, A. L.; Smith, T. M.

    2016-12-01

    Water scarcity in US corn farming regions is a significant risk consideration for the ethanol and meat production sectors, which comprise 80% of all US corn demand. Water supply risk can lead to effects across the supply chain, affecting annual corn yields. The purpose of our study is to assess the water risk to the US's most corn-intensive sectors and companies by linking watershed depletion estimates with corn production, linked to downstream companies through a corn transport model. We use a water depletion index as an improved metric for seasonal water scarcity and a corn sourcing supply chain model based on economic cost minimization. Water depletion was calculated as the fraction of renewable (ground and surface) water consumption, with estimates of more than 75% depletion on an annual average basis indicating a significant water risk. We estimated company water risk as the amount of embedded corn coming from three categories of water stressed counties. The ethanol sector had 3.1% of sourced corn grown from counties that were more than 75% depleted while the beef sector had 14.0%. From a firm perspective, Tyson, JBS, Cargill, the top three US corn demanding companies, had 4.5%, 9.6%, 12.8% of their sourced corn respectively, coming from watersheds that are more than 75% depleted. These numbers are significantly higher than the global average of 2.2% of watersheds being classified as more than 75% depleted. Our model enables corn using industries to evaluate their supply chain risk of water scarcity through modeling corn sourcing and watershed depletion, providing the private sector a new method for risk estimation. Our results suggest corn dependent industries are already linked to water scarcity risk in disproportionate amounts due to the spatial heterogeneity of corn sourcing and water scarcity.

  4. Dronedarone in high-risk permanent atrial fibrillation

    DEFF Research Database (Denmark)

    Connolly, Stuart J; Camm, A John; Halperin, Jonathan L

    2011-01-01

    Dronedarone restores sinus rhythm and reduces hospitalization or death in intermittent atrial fibrillation. It also lowers heart rate and blood pressure and has antiadrenergic and potential ventricular antiarrhythmic effects. We hypothesized that dronedarone would reduce major vascular events...... in high-risk permanent atrial fibrillation....

  5. Identifying patients at high risk for obstructive sleep apnoea ...

    African Journals Online (AJOL)

    Background: Obstructive sleep apnoea is associated with significant health consequences. A significant proportion of hospitalized patients at risk for obstructive sleep apnoea were never identified and referred for polysomnography for diagnosis. The objective of this study was to determine the factors associated with high ...

  6. Prevalence and risk factors of obesity and high blood pressure ...

    African Journals Online (AJOL)

    Background: The prevalence of diet-related chronic diseases like hypertension and obesity among others has become a public health concern. Risk factors for these diseases have been well studied in high income countries but less studied in developing countries. Objective: The study was to document the prevalence and ...

  7. Sensation seeking in males involved in recreational high risk sports

    Directory of Open Access Journals (Sweden)

    M Guszkowska

    2010-09-01

    Full Text Available The study examined sensation seeking intensity level in males involved in recreational high risk sports and investigated whether its level depends on type of sport practised. Additionally, in case of parachutists, sport experience of study participants were scrutinised with regard to its possible impact on the level of sensation seeking.The research involved 217 males aged 17 to 45, practising recreational high risk sports, namely: parachuting (n=98; wakeboarding (n=30; snowboarding (n=30; scuba diving (n=22; alpinism (n=20; paragliding (n=17. The control group included 54 men not involved in sports. Polish version of Sensation Seeking Scale (SSS-IV of Zuckerman was applied.Results show, that high risk sports males are featured by stronger need of sensations in comparison to control group and this concerned all but one aspect of sensation seeking variable. The only exception was the need of intellectual stimulation. Except from the thrill and adventure seeking dimension, type of sport may also be an important determinant of sensation seeking. Men practising snowboard and wakeboard presented stronger need for sensations, especially in the dimension of experience seeking, disinhibition and boredom susceptibility. Sport experience (number of jumps in parachuting did not differentiate the level of sensation seeking among investigated parachutists. Population of sport high risk male takers was not homogeneous, and therefore in future research one should analyse specific sports (or events in a certain sport separately.

  8. Detection of Patients at High Risk of Medication Errors

    DEFF Research Database (Denmark)

    Sædder, Eva Aggerholm; Lisby, Marianne; Nielsen, Lars Peter

    2016-01-01

    Medication errors (MEs) are preventable and can result in patient harm and increased expenses in the healthcare system in terms of hospitalization, prolonged hospitalizations and even death. We aimed to develop a screening tool to detect acutely admitted patients at low or high risk of MEs...

  9. Alcohol-Related Problems And High Risk Sexual Behaviour In ...

    African Journals Online (AJOL)

    There was a significant association between alcohol-related problems and risky sexual behavior. Alcohol-related problems are fairly common in people already infected with HIV/AIDS and are associated with high-risk sexual behavior. Thus, screening and treatment should be part of an effective HIV intervention program.

  10. Cyberbullying and Its Risk Factors among Chinese High School Students

    Science.gov (United States)

    Zhou, Zongkui; Tang, Hanying; Tian, Yuan; Wei, Hua; Zhang, Fengjuan; Morrison, Chelsey M.

    2013-01-01

    Cyberbullying has become a common occurrence among adolescents worldwide; however, it has yet to receive adequate scholarly attention in China, especially in the mainland. The present study investigated the epidemiological characteristics and risk factors of cyberbullying, utilizing a sample of 1,438 high school students from central China.…

  11. The High-mountain Cryosphere: Environmental Changes and Human Risks

    Directory of Open Access Journals (Sweden)

    Maria Shahgedanova

    2016-08-01

    Full Text Available Reviewed: The High-mountain Cryosphere: Environmental Changes and Human Risks Edited by Christian Huggel, Mark Carey, John J. Clague, and Andreas Kääb. Cambridge, UK: Cambridge University Press, 2015. xii + 363 pp. Hardcover: US$ 140.00, ISBN 978-1-107-06584-0. E-book: US$ 112.00, ISBN 978-1-316-35515-2.

  12. Staying Alive! Training High-Risk Teams for Self Correction

    Science.gov (United States)

    Slack, Kelley; Noe, Raymond; Weaver, Sallie

    2011-01-01

    Research examining teams working in high-risk operations has been lacking. The present symposium showcases research on team training that helps to optimize team performance in environments characterized by life or death situations arising spontaneously after long periods of mundane activity by pulling experts from diverse areas of industry: space flight, health care, and medical simulation.

  13. Update on the Management of High-Risk Penetrating Keratoplasty.

    Science.gov (United States)

    Jabbehdari, Sayena; Rafii, Alireza Baradaran; Yazdanpanah, Ghasem; Hamrah, Pedram; Holland, Edward J; Djalilian, Ali R

    2017-03-01

    In this article, we review the indications and latest management of high-risk penetrating keratoplasty. Despite the immune-privilege status of the cornea, immune-mediated graft rejection still remains the leading cause of corneal graft failure. This is particularly a problem in the high-risk graft recipients, namely patients with previous graft failure due to rejection and those with inflamed and vascularized corneal beds. A number of strategies including both local and systemic immunosuppression are currently used to increase the success rate of high-risk corneal grafts. Moreover, in cases of limbal stem cell deficiency, limbal stem cells transplantation is employed. Corticosteroids are still the top medication for prevention and treatment in cases of corneal graft rejection. Single and combined administration of immunosuppressive agents e.g. tacrolimus, cyclosporine and mycophenolate are promising adjunctive therapies for prolonging graft survival. In the future, cellular and molecular therapies should allow us to achieve immunologic tolerance even in high-risk grafts.

  14. Monitoring paneer for Listeria monocytogenes - A high risk food ...

    African Journals Online (AJOL)

    A multiplex polymerase chain reaction (PCR) assay was developed and applied to spiked and natural paneer samples to detect Listeria monocytogenes, a high risk food pathogen. The sensitivity of the assay on L. monocytogenes spiked paneer samples was 104 cells prior to enrichment, was improved to 103 cells after 4 h ...

  15. Optimizing the Management of High-Risk, Localized Prostate Cancer

    OpenAIRE

    Sundi, Debasish; Jeong, Byong Chang; Lee, Seung Bae; Han, Misop

    2012-01-01

    Prostate cancer has a high prevalence and a rising incidence in many parts of the world. Although many screen-detected prostate cancers may be indolent, prostate cancer remains a major contributor to mortality in men. Therefore, the appropriate diagnosis and treatment of localized prostate cancer with lethal potential are of great importance. High-risk, localized prostate cancer has multiple definitions. Treatment options that should be individualized to each patient include observation, radi...

  16. Risk assessments of regional climate change over Europe: generation of probabilistic ensemble and uncertainty assessment for EURO-CODEX

    Science.gov (United States)

    Yuan, J.; Kopp, R. E.

    2017-12-01

    Quantitative risk analysis of regional climate change is crucial for risk management and impact assessment of climate change. Two major challenges to assessing the risks of climate change are: CMIP5 model runs, which drive EURO-CODEX downscaling runs, do not cover the full range of uncertainty of future projections; Climate models may underestimate the probability of tail risks (i.e. extreme events). To overcome the difficulties, this study offers a viable avenue, where a set of probabilistic climate ensemble is generated using the Surrogate/Model Mixed Ensemble (SMME) method. The probabilistic ensembles for temperature and precipitation are used to assess the range of uncertainty covered by five bias-corrected simulations from the high-resolution (0.11º) EURO-CODEX database, which are selected by the PESETA (The Projection of Economic impacts of climate change in Sectors of the European Union based on bottom-up Analysis) III project. Results show that the distribution of SMME ensemble is notably wider than both distribution of raw ensemble of GCMs and the spread of the five EURO-CORDEX in RCP8.5. Tail risks are well presented by the SMME ensemble. Both SMME ensemble and EURO-CORDEX projections are aggregated to administrative level, and are integrated into impact functions of PESETA III to assess climate risks in Europe. To further evaluate the uncertainties introduced by the downscaling process, we compare the 5 runs from EURO-CORDEX with runs from the corresponding GCMs. Time series of regional mean, spatial patterns, and climate indices are examined for the future climate (2080-2099) deviating from the present climate (1981-2010). The downscaling processes do not appear to be trend-preserving, e.g. the increase in regional mean temperature from EURO-CORDEX is slower than that from the corresponding GCM. The spatial pattern comparison reveals that the differences between each pair of GCM and EURO-CORDEX are small in winter. In summer, the temperatures of EURO

  17. Analysis of High Plains Resource Risk and Economic Impacts

    Energy Technology Data Exchange (ETDEWEB)

    Tidwell, Vincent C. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Vargas, Vanessa N [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Jones, Shannon M [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Dealy, Bern Caudill [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Shaneyfelt, Calvin [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Smith, Braeton James [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Moreland, Barbara Denise [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2016-04-01

    The importance of the High Plains Aquifer is broadly recognized as is its vulnerability to continued overuse. T his study e xplore s how continued depletions of the High Plains Aquifer might impact both critical infrastructure and the economy at the local, r egional , and national scale. This analysis is conducted at the county level over a broad geographic region within the states of Kansas and Nebraska. In total , 140 counties that overlie the High Plains Aquifer in these two states are analyzed. The analysis utilizes future climate projections to estimate crop production. Current water use and management practices are projected into the future to explore their related impact on the High Plains Aquifer , barring any changes in water management practices, regulat ion, or policy. Finally, the impact of declining water levels and even exhaustion of groundwater resources are projected for specific sectors of the economy as well as particular elements of the region's critical infrastructure.

  18. On risk assessment of high level radioactive waste disposal

    International Nuclear Information System (INIS)

    Smith, C.F.; Kastenberg, W.E.

    1976-01-01

    One of the major concerns with the continued growth of the nuclear power industry is the production of the high level radioactive wastes. The risks associated with the disposal of these wastes derives from the potential for release of radioactive materials into the environment. The development of a methodology for risk analysis is carried out. The methodology suggested involves the probabilistic analysis of a general accident consequence distribution. In this analysis, the frequency aspect of the distribution is treated separately from the normalized probability function. In the final stage of the analysis, the frequency and probability characteristics of the distribution are recombined to provide an estimate of the risk. The characterization of the radioactive source term is accomplished using the ORIGEN computer code. Calculations are carried out for various reactor types and fuel cycles, and the overall waste hazard for a projected 35 year nuclear power program is determined. An index of relative nuclide hazard appropriate to problems involving the management of high level radioactive wastes is developed. As an illustration of the methodology, risk analyses are made for two proposed methods for waste management: extraterrestrial disposal and interim surface storage. The results of these analyses indicate that, within the assumptions used, the risks of these management schemes are small compared with natural background radiation doses. (Auth.)

  19. Myocardial infarction in the conscious dog: three dimensional mapping of infarct, collateral flow and region at risk

    International Nuclear Information System (INIS)

    Jugdutt, B.I.; Hutchins, G.M.; Bulkley, B.H.; Becker, L.C.

    1979-01-01

    Myocardial infarcts were examined in dogs to determine the spatial distribution of infarction in the region at risk and the relation between infarction and collateral blood flow. Permanent occlusion of the left circumflex (LC) coronary artery at a constant site was made in 27 conscious dogs that were sacrificed 2 days later. The anatomic region at risk was defined by postmortem coronary arteriography as the volume of the occluded LC coronary bed. The masses of the left ventricle (LV), infarct (I) and risk region (R) were calculated from planimetered areas of weighted bread-loaf sections of LV. Infarct size was directly related to the mass of the risk region (I = 0.53 R - 9.87; r = 0.97; p < 0.001). There was no infarction when R was less than about 20 g or 20% of the LV. The infarcts were mainly subendocardial and tapered from base to apex of the LV; 34% of the risk region became infarcted at the base compared with 22% at the apex. In all dogs, a significant rim of noninfarcted myocardium was identified at lateral aspects of the risk region, even at the endocardial surface. Using 9-μ radioactive microspheres, initial postocclusion flow at the margin of the infarct, but well within the risk region, was higher than at the center, and outer flows were higher than inner flows. Postocclusion flow was even higher in the noninfarcted rim within the risk region, but was still significantly less than flow to normal, nonrisk areas. Collateral flows throughout the risk region increased during the first hour after occlusion, and were even higher at 2 days.Epicardially and laterally within the anatomic risk region there is a substantial amount of tissue that does not infarct despite initally reduced blood flow

  20. Patterns of white matter microstructure in individuals at ultra-high-risk for psychosis

    DEFF Research Database (Denmark)

    Krakauer, K; Ebdrup, B H; Glenthøj, B Y

    2017-01-01

    BACKGROUND: Individuals at ultra-high-risk (UHR) for psychosis present with emerging symptoms and decline in functioning. Previous univariate analyses have indicated widespread white matter (WM) aberrations in multiple brain regions in UHR individuals and patients with schizophrenia. Using multiv......, MO, and higher RD. CONCLUSIONS: UHR individuals demonstrate complex brain patterns of WM abnormalities. Despite the subtle psychopathology of UHR individuals, aberrations in WM appear associated with positive and negative symptoms as well as level of functioning....

  1. Lung cancer risk and pollution in an industrial region of Northern Spain: a hospital-based case-control study.

    Science.gov (United States)

    López-Cima, María Felicitas; García-Pérez, Javier; Pérez-Gómez, Beatriz; Aragonés, Nuria; López-Abente, Gonzalo; Tardón, Adonina; Pollán, Marina

    2011-01-25

    Asturias, an Autonomous Region in Northern Spain with a large industrial area, registers high lung cancer incidence and mortality. While this excess risk of lung cancer might be partially attributable to smoking habit and occupational exposure, the role of industrial and urban pollution also needs to be assessed. The objective was to ascertain the possible effect of air pollution, both urban and industrial, on lung cancer risk in Asturias. This was a hospital-based case-control study covering 626 lung cancer patients and 626 controls recruited in Asturias and matched by ethnicity, hospital, age, and sex. Distances from the respective participants' residential locations to industrial facilities and city centers were computed. Using logistic regression, odds ratios (ORs) and 95% confidence intervals (95%CIs) for categories of distance to urban and industrial pollution sources were calculated, with adjustment for sex, age, hospital area, tobacco consumption, family history of cancer, and occupation. Whereas individuals living near industries displayed an excess risk of lung cancer (OR = 1.49; 95%CI = 0.93-2.39), which attained statistical significance for small cell carcinomas (OR = 2.23; 95%CI = 1.01-4.92), residents in urban areas showed a statistically significant increased risk for adenocarcinoma (OR = 1.92; 95%CI = 1.09-3.38). In the Gijon health area, residents in the urban area registered a statistically significant increased risk of lung cancer (OR = 2.17; 95%CI = 1.25-3.76), whereas in the Aviles health area, no differences in risk were found by area of exposure. This study provides further evidence that air pollution is a moderate risk factor for lung cancer.

  2. Increased Cardiometabolic Risk and Worsening Hypoxemia at High Altitude.

    Science.gov (United States)

    Miele, Catherine H; Schwartz, Alan R; Gilman, Robert H; Pham, Luu; Wise, Robert A; Davila-Roman, Victor G; Jun, Jonathan C; Polotsky, Vsevolod Y; Miranda, J Jaime; Leon-Velarde, Fabiola; Checkley, William

    2016-06-01

    Miele, Catherine H., Alan R. Schwartz, Robert H. Gilman, Luu Pham, Robert A. Wise, Victor G. Davila-Roman, Jonathan C. Jun, Vsevolod Y. Polotsky, J. Jaime Miranda, Fabiola Leon-Velarde, and William Checkley. Increased cardiometabolic risk and worsening hypoxemia at high altitude. High Alt Med Biol. 17:93-100, 2016.-Metabolic syndrome, insulin resistance, diabetes, and dyslipidemia are associated with an increased risk of cardiovascular disease. While excessive erythrocytosis is associated with cardiovascular complications, it is unclear how worsening hypoxemia of any degree affects cardiometabolic risk factors in high-altitude populations. We studied the relationship between daytime resting oxyhemoglobin saturation and cardiometabolic risk factors in adult participants living in Puno, Peru (3825 m above sea level). We used multivariable logistic regression models to study the relationship between having a lower oxyhemoglobin saturation and markers of cardiometabolic risk. Nine hundred and fifty-four participants (mean age 55 years, 52% male) had information available on pulse oximetry and markers of cardiometabolic risk. Average oxyhemoglobin saturation was 90% (interquartile range 88%-92%) and 43 (4.5%) had excessive erythrocytosis. Older age, decreased height-adjusted lung function, and higher body mass index (BMI) were associated with having an oxyhemoglobin saturation ≤85%. When adjusting for age, sex, socioeconomic status, having excessive erythrocytosis, and site, we found that each 5% decrease in oxyhemoglobin saturation was associated with a higher adjusted odds of metabolic syndrome (OR = 1.35, 95% CI: 1.07-1.72, p 2 mass units (OR = 1.29, 95% CI: 1.00-1.67, p < 0.05), hemoglobin A1c ≥6.5% (OR = 1.66, 95% CI: 1.09-2.51, p < 0.04), and high sensitivity C-reactive protein (hs-CRP) ≥3 mg/L (OR = 1.46, 95% CI: 1.09-1.96, p < 0.01). In high-altitude populations in Puno, Peru, a higher BMI and lower pulmonary function were

  3. HIGH RISK ZONES ON FLOODS AND LANDSLIDES DISASTERS IN RWANDA

    Directory of Open Access Journals (Sweden)

    Nsengiyumva J.ean Baptiste

    2014-01-01

    Full Text Available Disaster risk management as an issue at stake worldwide shifts its emphases from post disaster to pre-disaster phases. Management activities required in pre-disaster phases, such as risk assessment, hazard identification, preparedness or preventive and mitigation measures needs detailed information about hazard characteristics, social, economic, structural vulnerability and capacity. That information is not usually available in many different countries, as it is the case in Rwanda. Based on the international experiences and practices, knowledge of disaster prone areas can be assumed as an alternative for detailed information acquisition, thus contributing to effective disaster risk management. Identification of disaster higher risk zones on floods and landslides, can lead to better understanding of disaster risk and putting in place measures for risk reduction. Consequently, as Rwanda is prone to natural hazards with lack of adequate information that is essential for effective disaster risk management, due to limited scientific researches; this study aims to address that gap. The results revealed that some areas of the North-Western parts of Rwanda are highly prone to floods and landslides, namely Burera, Musanze, Rulindo, Nyabihu, Ngororero and Rubavu Districts. This is aggravated by some triggering factors such as steep slopes, soil types, heavy rains, landuse Practices and others. Intensity and frequency of disaster events vary from district to district and this geographical dispersal confirms the non-spatial clustering (as confirmed by Moran’s I analysis of risks due to uneven level of Disaster vulnerabilities, coping capacities and available hazards whereby lack of normal distribution of hazards all over all Districts.

  4. Trial of accelerator cells machining with high precision and high efficiency at Okayama region

    International Nuclear Information System (INIS)

    Yoshikawa, Mitsuo; Yoden, Hiroyuki; Yokomizo, Seiichi; Sumida, Tsuneto; Kunishida, Jun; Oshita, Isao

    2005-01-01

    In the framework of the project 'Promotion of Science and Technology in Regional Areas' by the Ministry of Education, Culture, Sports, Science and Technology, we have prepared a special apparatus for machining accelerator cells with a high precision and a high efficiency for the future linear collider. A machining with as small an error as 2 micrometers has been realized. Necessary time to finish one accelerator cell is reduced from 128 minutes to 34 minutes due to the suppression of the heating of the object at the machining. If newly developed one chuck method was employed, the precision and efficiency would be further improved. By cutting at both sides of the spindle, the necessary time for machining would be reduced by half. (author)

  5. Logic-probable approach to the determination of the risk-sustainable strategy of the region and enterprises

    Directory of Open Access Journals (Sweden)

    Yu. M. Sokolinskaya

    2017-01-01

    Full Text Available The article describes a logical-probabilistic approach to the definition of crisis situations that threaten economic security. The onset of risk events of any kind entails two types of damage - direct economic and social damage, and indirect damage, which can be much more significant. The main strategic goal of ensuring economic security is the stable and most efficient functioning of the enterprise at present and ensuring its high potential for future development. The lack of a unified management mechanism due to systemic threats imposed on the economy as a whole led to an exacerbation of the situation primarily in the basic sectors (infrastructure, health, education, law enforcement. This, in turn, is the destructor of the basis for development and ensuring national security of the regions and the country as a whole, contributing to a decrease in the standard of living and quality of life of the population. Methods and methods of risk and safety management require the use of analysis covering all types of possible threats, such as engineering, economic, social factors, etc. And they must also take into account not only existing, but also remote consequences of the decisions made. The choice of a strategy for responding to a risk situation relies on the results of a comprehensive risk assessment, additional analysis of the technological and economic potential of the Voronezh region and industrial enterprise, the projected external environment, the current legal and regulatory framework (taxes, inflation, increase in the number of competitors, marketing and other studies. The organization of a risk management system based on their integrated assessment allows tracking and timely signaling of undesirable events in business activities.

  6. A pilot application of regional scale risk assessment to the forestry management of the upper Grand Ronde watershed, Oregon

    Science.gov (United States)

    Suzanne M. Anderson; Wayne G. Landis

    2012-01-01

    An issue in forestry management has been the integration of a variety of different information into a threat analysis or risk assessment. In this instance, regional scale risk assessment was applied to the Upper Grande Ronde watershed in eastern Oregon to examine the potential of risk assessment for use in the management of broad landscapes. The site was a focus of...

  7. Occupational risk factors have to be considered in the definition of high-risk lung cancer populations.

    Science.gov (United States)

    Wild, P; Gonzalez, M; Bourgkard, E; Courouble, N; Clément-Duchêne, C; Martinet, Y; Févotte, J; Paris, C

    2012-03-27

    The aim of this study was to compute attributable fractions (AF) to occupational factors in an area in North-Eastern France with high lung cancer rates and a past of mining and steel industry. A population-based case-control study among males aged 40-79 was conducted, including confirmed primary lung cancer cases from all hospitals of the study region. Controls were stratified by broad age-classes, district and socioeconomic classes. Detailed occupational and personal risk factors were obtained in face-to-face interviews. Cumulative occupational exposure indices were obtained from the questionnaires. Attributable fractions were computed from multiple unconditional logistic regression models. A total of 246 cases and 531 controls were included. The odds ratios (ORs) adjusted on cumulative smoking and family history of lung cancer increased significantly with the cumulative exposure indices to asbestos, polycyclic aromatic hydrocarbons and crystalline silica, and with exposure to diesel motor exhaust. The AF for occupational factors exceeded 50%, the most important contributor being crystalline silica and asbestos. These AFs are higher than most published figures. This can be because of the highly industrialised area or methods for exposure assessments. Occupational factors are important risk factors and should not be forgotten when defining high-risk lung cancer populations.

  8. High Regional Variation in Urethroplasty in the United States

    Science.gov (United States)

    Figler, Bradley D.; Gore, John L.; Holt, Sarah K.; Voelzke, Bryan B.; Wessells, Hunter

    2015-01-01

    Purpose We identified clinical and regional factors associated with the use of urethroplasty vs repeat endoscopic management for urethral stricture disease. Materials and Methods We analyzed claims for patients 18 to 65 years old in the 2007 to 2011 MarketScan ® Commercial Claims and Encounters Database with a diagnosis of urethral stricture. The primary outcome was treatment with urethroplasty vs repeat endoscopic management, defined as more than 2 dilations or direct vision internal urethrotomies. The likelihood of urethroplasty vs repeat endoscopic management was determined for each major metropolitan area in the United States. Multivariate logistic regression was done to identify factors associated with urethroplasty. Results We identified 41,056 patients with urethral stricture, yielding a diagnosis rate of 296/100,000 men in MarketScan. Repeat endoscopic management and urethroplasty were performed in 2,700 and 1,444 patients, respectively. Compared to patients treated with repeat endoscopic management those with urethroplasty were younger (median age 44 vs 54 years) and more likely to have a Charlson comorbidity score of 0 (84% vs 77%), have traveled out of a metropolitan area for care (34% vs 17%) and have a reconstructive urologist in the treatment metropolitan area (76% and 62%, each p urethroplasty vs repeat endoscopic management. Conclusions Despite the well established benefits of urethroplasty compared to repeat endoscopic management a strong bias for repeat endoscopic management exists in many regions in the United States. PMID:25072180

  9. SECTOR-SPECIFIC STRUCTURE OF THE REGIONAL ECONOMY AS A FACTOR OF ELEVATION OF RISKS TO ITS ECONOMIC SECURITY

    Directory of Open Access Journals (Sweden)

    Rostislav BILYK

    2016-07-01

    Full Text Available The article analyzes a sector-specific specialization of the regional economy in Ukraine. It also reveals possibility and conditions of transformation of a sector-specific specialization of the region and risks to its economic security. The article suggests an assessment of influence of a sector-specific specialization on occurrence of threats to the economic security of the region.

  10. ECONOMIC MECHANISMS OF POPULATION PROTECTION AGAINST PENSION RISKS AS A TOOL FOR SOCIO-ECONOMIC DEVELOPMENT OF THE REGION

    Directory of Open Access Journals (Sweden)

    Lyubov V. Grigoryeva

    2017-06-01

    Full Text Available The problem of finding effective economic instruments for socio-economic development of the regions has recently become of increasing relevance. Strengthening the regional differentiation, highlighting the leading and lagging regions, the lack of own resources in the regions has forced regional authorities to use new instruments of territorial development, in particular, economic mechanisms of protection against pension risks. The use of these mechanisms has a dual effect (economic and social, due to the attraction of the regions with additional financial resources in the form of “long money” and increasing the protection of citizens against pension risks (the increase in the level of pension payments. The analysis of the current use of economic mechanisms of protection against pension risks in the regions of the Southern Federal District helped to articulate key issues of their use, in particular, low pension literacy of the population, distrust towards specialized financial institutions, the investment policy of the regions does not take into account the possibility of attracting private pension funds into regional projects, and there is no mechanism to support regional National Pension Fund. Territorial analysis revealed the potential application of economic mechanisms to protect against pension risks in the regions of the Southern Federal District as a tool for socio-economic development, which is based on the existence of regional pension funds and insurance companies (providing services for pension insurance, as well as participation in private pension provision. The Krasnodar, Rostov and Volgograd regions have the highest potential among the regions of the Southern Federal District, as there already exist regional National Pension Fund, and the participation in private pension insurance is confirmed by the statistics of the contributions paid. The study of existing economic mechanisms to protect against pension risks will provide the

  11. Regional Risk Assessment for the analysis of the risks related to storm surge extreme events in the coastal area of the North Adriatic Sea.

    Science.gov (United States)

    Rizzi, Jonathan; Torresan, Silvia; Gallina, Valentina; Critto, Andrea; Marcomini, Antonio

    2013-04-01

    Europe's coast faces a variety of climate change threats from extreme high tides, storm surges and rising sea levels. In particular, it is very likely that mean sea level rise will contribute to upward trends in extreme coastal high water levels, thus posing higher risks to coastal locations currently experiencing coastal erosion and inundation processes. In 2007 the European Commission approved the Flood Directive (2007/60/EC), which has the main purpose to establish a framework for the assessment and management of flood risks for inland and coastal areas, thus reducing the adverse consequences for human health, the environment, cultural heritage and economic activities. Improvements in scientific understanding are thus needed to inform decision-making about the best strategies for mitigating and managing storm surge risks in coastal areas. The CLIMDAT project is aimed at improving the understanding of the risks related to extreme storm surge events in the coastal area of the North Adriatic Sea (Italy), considering potential climate change scenarios. The project implements a Regional Risk Assessment (RRA) methodology developed in the FP7 KULTURisk project for the assessment of physical/environmental impacts posed by flood hazards and employs the DEcision support SYstem for Coastal climate change impact assessment (DESYCO) for the application of the methodology to the case study area. The proposed RRA methodology is aimed at the identification and prioritization of targets and areas at risk from water-related natural hazards in the considered region at the meso-scale. To this aim, it integrates information about extreme storm surges with bio-geophysical and socio-economic information (e.g. vegetation cover, slope, soil type, population density) of the analyzed receptors (i.e. people, economic activities, cultural heritages, natural and semi-natural systems). Extreme storm surge hazard scenarios are defined using tide gauge time series coming from 28 tide gauge

  12. Landslide hazard and land management in high-density urban areas of Campania region, Italy

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    D. Di Martire

    2012-04-01

    Full Text Available Results deriving from a research focused on the interplay between landslides and urban development are presented here, with reference to two densely populated settings located in the Campania region, Italy: the city of Naples and the island of Ischia. Both areas suffer adverse consequences from various types of landslides since at least 2000 yr. Our study evidences that, despite the long history of slope instabilities, the urban evolution, often illegal, disregarded the high landslide propensity of the hillsides; thus, unsafe lands have been occupied, even in recent years, when proper and strict rules have been enacted to downgrade the landslide risk. It is finally argued that future guidelines should not be entirely based upon physical countermeasures against mass movements. On the contrary, national and local authorities should enforce the territorial control, obliging citizens to respect the existing regulations and emphasizing the role of alternative, non-structural solutions.

  13. Chronic kidney disease and bleeding risk in patients at high cardiovascular risk: a cohort study.

    Science.gov (United States)

    Ocak, G; Rookmaaker, M B; Algra, A; de Borst, G J; Doevendans, P A; Kappelle, L J; Verhaar, M C; Visseren, F L

    2018-01-01

    Essentials The association between chronic kidney disease and bleeding is unknown. We followed 10 347 subjects at high cardiovascular risk for bleeding events. Chronic kidney disease was associated with a 1.5-fold increased bleeding risk. Especially albuminuria rather than decreased kidney function was associated with bleeding events. Background There are indications that patients with chronic kidney disease have an increased bleeding risk. Objectives To investigate the association between chronic kidney disease and bleeding in patients at high cardiovascular risk. Methods We included 10 347 subjects referred to the University Medical Center Utrecht (the Netherlands) from September 1996 to February 2015 for an outpatient visit with classic risk factors for arterial disease or with symptomatic arterial disease (Second Manifestation of Arterial disease [SMART] cohort). Patients were staged according to the KDIGO guidelines, on the basis of estimated glomerular filtration rate (eGFR) and albuminuria, and were followed for the occurrence of major hemorrhagic events until March 2015. Hazard ratios (HRs) with 95% confidence intervals (CIs) for bleeding were calculated with Cox proportional hazards analyses. Results The incidence rate for bleeding in subjects with chronic kidney disease was 8.0 per 1000 person-years and that for subjects without chronic kidney disease was 3.5 per 1000 person-years. Patients with chronic kidney disease (n = 2443) had a 1.5-fold (95% CI 1.2-1.9) increased risk of bleeding as compared with subjects without chronic kidney disease (n = 7904) after adjustment. Subjects with an eGFR of Chronic kidney disease is a risk factor for bleeding in patients with classic risk factors for arterial disease or with symptomatic arterial disease, especially in the presence of albuminuria. © 2017 University Medical Center Utrecht. Journal of Thrombosis and Haemostasis © 2017 International Society on Thrombosis and Haemostasis.

  14. The Prevalence of High-Risk HPV Types and Factors Determining Infection in Female Colombian Adolescents.

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    Luisa Del Río-Ospina

    Full Text Available This study reports six HR-HPV types' infection prevalence discriminated by species and multiple infection in unvaccinated Colombian female adolescents, as well as some factors modulating the risk of infection. HPV DNA for six high-risk viral types was identified in cervical samples taken from 2,134 12-19 year-old females using conventional generic and type-specific PCR. Binomial logistical regression analysis was used for modelling HR-HPV infection and multiple infection risk. The interaction between variables in a stepwise model was also included in such analysis. Viral DNA was detected in 48.97% of the females; 28.52% of them had multiple infections, HPV-16 being the most frequently occurring type (37.44%. Cytological abnormality prevalence was 15.61%. Being over 16 years-old (1.66: 1.01-2.71 95%CI, white ethnicity (4.40: 1.16-16.73 95%CI, having had 3 or more sexual partners (1.77: 1.11-2.81 95%CI and prior sexually-transmitted infections (STI (1.65: 1.17-2.32 95%CI were associated with a greater risk of HPV infection. Having given birth was related to a higher risk of infection by A7 species and antecedent of abortion to less risk of coinfection. Where the females in this study came from also influenced the risk of infection by A7 species as female adolescents from the Andean region had a lower risk of infection (0.42: 0.18-0.99 95%CI. The presence of factors related to risky sexual behaviour in the study population indicated that public health services should pay special attention to female adolescents to modify the risk of infection by high-risk HPV types and decrease their impact on this age group.

  15. Risk factors and the occurrence of cerebral palsy in high risk infants

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    Setyo Handryastuti

    2018-04-01

    Full Text Available Background The incidence of cerebral palsy (CP has increased due to better survival rates of high-risk babies. Early detection and time to the occurrence of CP in the first year of life is important in order to provide early intervention. Objectives To determine the proportion of CP in high-risk babies, the time to the occurrence of CP in the first year, and assess possible associations between risk factors of CP and time to the occurrence of CP. Methods A prospective cohort study was done on 150 high-risk babies up to the age of 12 months. We obtained history of motor ability and assessed primitive reflexes and postural reactions of subjects at the ages of 4 and 6 months. The diagnosis of CP was established at 6 and 12 months of age. Results The proportion of CP was 26% at 6 months and 24% at 12 months of age. Significant risk factors associated with CP at 6 and 12 months of age were cerebral ultrasound abnormalities, hypoxic-ischemic encephalopathy, and intracranial hemorrhage. In 88.7% of subjects with CP, CP was detected in the first 6 months. Mean age at the occurrence of CP was 9.99 months (95%CI 9.46 to 10.53. Risk factors that significantly affected the time to the occurrence of CP by survival analysis were ultrasound abnormalities and hypoxic-ischemic encephalopathy. Conclusions Cerebral palsy can be detected as early as the first 6 months of life. Cerebral ultrasound abnormalities and hypoxic ischemic encephalopathy are the risk factors associated with CP.

  16. Discovery and Evaluation of Polymorphisms in the and Promoter Regions for Risk of Korean Lung Cancer

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    Jae Sook Sung

    2012-09-01

    Full Text Available AKT is a signal transduction protein that plays a central role in the tumorigenesis. There are 3 mammalian isoforms of this serine/threonine protein kinase-AKT1, AKT2, and AKT3-showing a broad tissue distribution. We first discovered 2 novel polymorphisms (AKT2 -9826 C/G and AKT3 -811 A/G, and we confirmed 6 known polymorphisms (AKT2 -9473 C/T, AKT2 -9151 C/T, AKT2 -9025 C/T, AKT2 -8618G/A, AKT3 -675 A/-, and AKT3 -244 C/T of the AKT2 and AKT3 promoter region in 24 blood samples of Korean lung cancer patients using direct sequencing. To evaluate the role of AKT2 and AKT3 polymorphisms in the risk of Korean lung cancer, genotypes of the AKT2 and AKT3 polymorphisms (AKT2 -9826 C/G, AKT2 -9473 C/T, AKT2 -9151 C/T, AKT2 -9025 C/T, AKT2 -8618G/A, and AKT3 -675 A/- were determined in 360 lung cancer patients and 360 normal controls. Statistical analyses revealed that the genotypes and haplotypes in the AKT2 and AKT3 promoter regions were not significantly associated with the risk of lung cancer in the Korean population. These results suggest that polymorphisms of the AKT2 and AKT3 promoter regions do not contribute to the genetic susceptibility to lung cancer in the Korean population.

  17. High Birth Weight Increases the Risk for Bone Tumor: A Systematic Review and Meta-Analysis

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    Songfeng Chen

    2015-09-01

    Full Text Available There have been several epidemiologic studies on the relationship between high birth weight and the risk for bone tumor in the past decades. However, due to the rarity of bone tumors, the sample size of individual studies was generally too small for reliable conclusions. Therefore, we have performed a meta-analysis to pool all published data on electronic databases with the purpose to clarify the potential relationship. According to the inclusion and exclusion criteria, 18 independent studies with more than 2796 cases were included. As a result, high birth weight was found to increase the risk for bone tumor with an Odds Ratio (OR of 1.13, with the 95% confidence interval (95% CI ranging from 1.01 to 1.27. The OR of bone tumor for an increase of 500 gram of birth weight was 1.01 (95% CI 1.00–1.02; p = 0.048 for linear trend. Interestingly, individuals with high birth weight had a greater risk for osteosarcoma (OR = 1.22, 95% CI 1.06–1.40, p = 0.006 than those with normal birth weight. In addition, in the subgroup analysis by geographical region, elevated risk was detected among Europeans (OR = 1.14, 95% CI 1.00–1.29, p = 0.049. The present meta-analysis supported a positive association between high birth weight and bone tumor risk.

  18. High-Risk Cutaneous Squamous Cell Carcinoma of the Head and Neck

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    Michael J. Veness

    2007-01-01

    Full Text Available Nonmelanoma skin cancers (squamous cell and basal cell carcinomas occur at an epidemic rate in many countries with the worldwide incidence increasing. The sun-exposed head and neck are the most frequent sites for these cancers to arise and in most patients diagnosed with a cutaneous squamous cell carcinoma, local treatment is usually curative. However, a subset is diagnosed with a high-risk cutaneous squamous cell carcinoma. High-risk factors include size (> 2 cm, thickness/depth of invasion (> 4 mm, recurrent lesions, the presence of perineural invasion, location near the parotid gland, and immunosuppression. These patients have a higher risk (> 10–20% of developing metastases to regional lymph nodes (often parotid nodes, and in some cases also of experiencing local morbidity (perineural invasion, based on unfavourable primary lesion and patient factors. Despite treatment, many patients developing metastatic cutaneous squamous cell carcinoma experience mortality and morbidity usually as a consequence of uncontrolled metastatic nodal disease. It is therefore important that clinicians treating nonmelanoma skin cancers have an understanding and awareness of these high-risk patients. The aim of this article is to discuss the factors that define a high-risk patient and to present some of the issues pertinent to their management.

  19. Prediabetes: a high-risk state for diabetes development.

    Science.gov (United States)

    Tabák, Adam G; Herder, Christian; Rathmann, Wolfgang; Brunner, Eric J; Kivimäki, Mika

    2012-06-16

    Prediabetes (intermediate hyperglycaemia) is a high-risk state for diabetes that is defined by glycaemic variables that are higher than normal, but lower than diabetes thresholds. 5-10% of people per year with prediabetes will progress to diabetes, with the same proportion converting back to normoglycaemia. Prevalence of prediabetes is increasing worldwide and experts have projected that more than 470 million people will have prediabetes by 2030. Prediabetes is associated with the simultaneous presence of insulin resistance and β-cell dysfunction-abnormalities that start before glucose changes are detectable. Observational evidence shows associations between prediabetes and early forms of nephropathy, chronic kidney disease, small fibre neuropathy, diabetic retinopathy, and increased risk of macrovascular disease. Multifactorial risk scores using non-invasive measures and blood-based metabolic traits, in addition to glycaemic values, could optimise estimation of diabetes risk. For prediabetic individuals, lifestyle modification is the cornerstone of diabetes prevention, with evidence of a 40-70% relative-risk reduction. Accumulating data also show potential benefits from pharmacotherapy. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Prediabetes: A high-risk state for developing diabetes

    Science.gov (United States)

    Tabák, Adam G.; Herder, Christian; Rathmann, Wolfgang; Brunner, Eric J.; Kivimäki, Mika

    2013-01-01

    Summary Prediabetes (or “intermediate hyperglycaemia”), based on glycaemic parameters above normal but below diabetes thresholds is a high risk state for diabetes with an annualized conversion rate of 5%–10%; with similar proportion converting back to normoglycaemia. The prevalence of prediabetes is increasing worldwide and it is projected that >470 million people will have prediabetes in 2030. Prediabetes is associated with the simultaneous presence of insulin resistance and β-cell dysfunction, abnormalities that start before glucose changes are detectable. Observational evidence shows associations of prediabetes with early forms of nephropathy, chronic kidney disease, small fibre neuropathy, diabetic retinopathy, and increased risk of macrovascular disease. Multifactorial risk scores could optimize the estimation of diabetes risk using non-invasive parameters and blood-based metabolic traits in addition to glycaemic values. For prediabetic individuals, lifestyle modification is the cornerstone of diabetes prevention with evidence of a 40%–70% relative risk reduction. Accumulating data also suggests potential benefits from pharmacotherapy. PMID:22683128

  1. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.

    Science.gov (United States)

    2016-10-08

    6-58·8) of global deaths and 41·2% (39·8-42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI

  2. Single-compound and cumulative risk assessment of mycotoxins present in breakfast cereals consumed by children from Lisbon region, Portugal.

    Science.gov (United States)

    Assunção, Ricardo; Vasco, Elsa; Nunes, Baltazar; Loureiro, Susana; Martins, Carla; Alvito, Paula

    2015-12-01

    Humans can be exposed to multiple chemicals, but current risk assessment is usually carried out on one chemical at a time. Mycotoxins are commonly found in a variety of foods including those intended to consumption by children namely breakfast cereals. The present study aims to perform, the risk assessment of single and multiple mycotoxins present in breakfast cereals consumed by children (1-3 years old) from Lisbon region, Portugal. Daily exposure of children to ochratoxin A, fumonisins and trichothecenes showed no health risks to the children population considering individual mycotoxins, while exposure to aflatoxin B1 (AFB1) suggested a potential health concern for the high percentiles of intake (P90, P95 and P99). The combined exposure to fumonisins and trichothecenes are not expected to be of health concern. The combined margin of exposure (MoET) for the aflatoxins group could constitute a potential health concern and AFB1 was the main contributor for MoET. Legal limits and control strategies regarding the presence of multiple mycotoxins in foodstuffs is an urgent need. To the best of our knowledge, this is the first time a cumulative risk assessment was performed on multiple mycotoxins present in breakfast cereals consumed by children. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. [Regional difference of NPK fertilizers application and environmental risk assessment in Jiangsu Province, China].

    Science.gov (United States)

    Liu, Qin-pu

    2015-05-01

    It is of great importance to have a deep understanding of the spatial distribution of NPK fertilizers application and the potential threat to the ecological environment in Jiangsu Province, which is helpful for regulating the rational fertilization, strengthening the fertilizer use risk management and guidance, and preventing agricultural non-point pollution. Based on the environmental risk assessment model with consideration of different impacts of N, P, K fertilizers on environment, this paper researched the regional differentiation characteristic and environmental risk of intensity of NPK fertilizer usages in Jiangsu. Analystic hierarchy process ( AHP) was used to determine the weithts of N, P, K. The environmental safety thresholds of N, P, K were made according to the standard of 250 kg · hm(-2) for the construction of ecological counties sponsered by Chinese government and the proportion of 1:0.5:0.5 for N:P:K surposed by some developed countries. The results showed that the intensity of NPK fertilizer application currently presented a gradually increasing trend from south to north of Jiangsu, with the extremum ratio of 3.3, and the extremum ratios of nitrogen fertilizer, phosphorus fertilizer and potassium fertilizer were 3.3, 4.5 and 4.4, respectively. The average proportion of nitrogen fertilizer, phosphorus fertilizer and potassium fertilizer of 13 cities in Jiangsu was 1:0.39:0.26. Their proportion was relatively in equilibrium in southern Jiangsu, but the nutrient structure disorder was serious in northern Jiangsu. In Jiangsu, the environmental risk index of fertilization averaged at 0.69 and in the middle-range of environmental risk. The environmental risk index of fertilizer application in southern and central Jiangsu was respectively at the low and moderate levels, while that of cities in northern Jiangsu was at the moderate, serious or severe level. In Jiangsu, the regional difference of fertilizer application and environmental risk assessment were

  4. The contribution of the Global Change Observatory Central Asia to seismic hazard and risk assessment in the Central Asian region

    Science.gov (United States)

    Parolai, S.; Bindi, D.; Haberland, C. A.; Pittore, M.; Pilz, M.; Rosenau, M.; Schurr, B.; Wieland, M.; Yuan, X.

    2012-12-01

    Central Asia has one of the world's highest levels of earthquake hazard, owing to its exceptionally high deformation rates. Moreover, vulnerability to natural disasters in general is increasing, due to rising populations and a growing dependence on complex lifelines and technology. Therefore, there is an urgent need to undertake seismic hazard and risk assessment in this region, while at the same time improving upon existing methodologies, including the consideration of temporal variability in the seismic hazard, and in structural and social vulnerability. Over the last few years, the German Research Center for Geosciences (GFZ), in collaboration with local partners, has initiated a number of scientific activities within the framework of the Global Change Observatory Central Asia (GCO-CA). The work is divided into projects with specific concerns: - The installation and maintenance of the Central-Asian Real-time Earthquake MOnitoring Network (CAREMON) and the setup of a permanent wireless mesh network for structural health monitoring in Bishkek. - The TIPAGE and TIPTIMON projects focus on the geodynamics of the Tien-Shan, Pamir and Hindu Kush region, the deepest and most active intra-continental subduction zone in the world. The work covers time scales from millions of years to short-term snapshots based on geophysical measurements of seismotectonic activity and of the physical properties of the crust and upper mantle, as well as their coupling with other surface processes (e.g., landslides). - Existing risk analysis methods assume time-independent earthquake hazard and risk, although temporal changes are likely to occur due to, for example, co- and post-seismic changes in the regional stress field. We therefore aim to develop systematic time-dependent hazard and risk analysis methods in order to undertake the temporal quantification of earthquake activity (PROGRESS). - To improve seismic hazard assessment for better loss estimation, detailed site effects studies

  5. PRESSCA: A regional operative Early Warning System for landslides risk scenario assessment

    Science.gov (United States)

    Ponziani, Francesco; Stelluti, Marco; Berni, Nicola; Brocca, Luca; Moramarco, Tommaso

    2013-04-01

    The Italian national alert system for the hydraulic and hydrogeological risk is ensured by the National Civil Protection Department, through the "Functional Centres" Network, together with scientific/technical Support Centres, named "Competence Centres". The role of the Functional Centres is to alert regional/national civil protection network, to manage the prediction and the monitoring phases, thus ensuring the flow of data for the management of the emergency. The Umbria regional alerting procedure is based on three increasing warning levels of criticality for 6 sub-areas (~1200 km²). Specifically, for each duration (from 1 to 48 hours), three criticality levels are assigned to the rainfall values corresponding to a recurrence interval of 2, 5, and 10 years. In order to improve confidence on the daily work for hydrogeological risk assessment and management, a simple and operational early warning system for the prediction of shallow landslide triggering on regional scale was implemented. The system is primarily based on rainfall thresholds, which represent the main element of evaluation for the early-warning procedures of the Italian Civil Protection system. Following previous studies highlighting that soil moisture conditions play a key role on landslide triggering, a continuous physically-based soil water balance model was implemented for the estimation of soil moisture conditions over the whole regional territory. In fact, a decreasing trend between the cumulated rainfall values over 24, 36 and 48 hours and the soil moisture conditions prior to past landslide events was observed. This trend provides an easy-to-use tool to dynamically adjust the operational rainfall thresholds with the soil moisture conditions simulated by the soil water balance model prior to rainfall events. The application of this procedure allowed decreasing the uncertainties tied to the application of the rainfall thresholds only. The system is actually operational in real-time and it was

  6. Risk Reduction Methods for Managing the Development of Regional Electric Power Industry

    Directory of Open Access Journals (Sweden)

    Mikhail Kozhevnikov

    2017-11-01

    Full Text Available The development of the regional electric power industry has come to the forefront due to the changing scale, quality, and configuration of electric power infrastructure, and the spread of distributed generation. This gives rise to more stringent requirements regarding the reliability, safety, and environmental impact of electric power supply. This article aims to justify a package of methods that make it possible to identify and minimize investment, production, financial, and environmental risks in order to ensure sustainable development of the regional electric power industry that performs anti-crisis functions, and of individual energy companies. The key method to be employed is integrated resource planning (IRP. As a part of the method, energy conservation, renewable energy sources, and combined heat and power production are considered as equally valid ways of meeting future demand. The authors have designed a methodology for taking into account uncertainty and risk when implementing IRP. The methodology includes analysis of scenarios and decision making processes by calculating past and projected values of profit indicators. When conducting the environmental and economic assessment of an investment project in the electric power industry, the authors suggest using an aggregate indicator of environmental and economic effectiveness that is calculated on the basis of a combination of locally significant positive and negative environmental and economic impacts of the project. The authors formulate conceptual provisions that serve as the foundation for a promising model of the regional electric power industry and which contain recommendations for managing the development of the industry while minimizing organizational, market, and technological risks.

  7. EVALUATION OF STABILITY OF MASONRY MINARET IN HIGH SEISMICITY REGION

    Directory of Open Access Journals (Sweden)

    Amir Čaušević, Nerman Rustempašić

    2012-10-01

    Full Text Available This paper is a result of authors' involvement in the Project ofRehabilitation of the Ferhad-Pasha’s Mosque.The aim of the project was to construct an authentic buildingusing authentic materials, while respecting the principlesof aesthetics and the approaches of ancient builders. Thebuilding will be reconstructed to the same condition as it wasbefore destruction using similar construction methods. It isforeseen that it will be difficult to comply with this principle,due to significant developments in architecture since the initialconstruction. Monuments are precious things that must berespected, and altered as little as possible. These observationscould lead to contradictory decisions, at times accepting ahigher degree of risk in order to avoid or limit changes to theoriginal concept. The Ferhad-Pasha’s Mosque is the work of ahighly-qualified mimar (builder and muhendis (engineer, aproduct of Sinan's school.On 7 May 1993 the mosque was dynamited and razed to theground, and the material removed to the city landfill site inRamiće. The computer program SAP 2000 was used to analyzethe minarets with shell elements. Assuming no tension, it wasfound that the stress was exceeded to a greater extent underthe earthquake load. Deformations caused by shear forceshave an insignificant influence upon the rigidity of tall slenderstructures, thus they can be neglected in practical calculations.To reduce the tensile stress, which appears due to seismicmovements, we recommended two solutions.

  8. High risk pregnancy in the workplace. Influencing positive outcomes.

    Science.gov (United States)

    Cannon, R B; Schmidt, J V; Cambardella, B; Browne, S E

    2000-09-01

    Childbearing employees are well served by the occupational health nurse who promotes optimal preconceptual and pregnancy health practices, uses community resources, and maintains current knowledge about high risk pregnancy prevention and care. These broad goals of care can lead to decreased absenteeism, healthier and happier employees, and more positive outcomes of pregnancy. For employees with high risk pregnancies, the role of the occupational health nurse includes, but is not limited to, facilitating awareness with the employer, making suggestions for adjusting working conditions, making frequent assessments of the employee's needs, and communicating with prenatal health care providers. Occupational health nurses should never underestimate their role and potential influence on the mother, and on her significant other, for a positive outcome of her pregnancy.

  9. High risk factors in patient with carcinoma esophagus

    International Nuclear Information System (INIS)

    Afridi, S.P.; Khan, A.; Waheed, I.

    2000-01-01

    This study was conducted to identify the presence of high risk factors in carcinoma esophagus from February, 1992 to August, 1995 at Surgical unit 1, Jinnah Postgraduate Medical Centre (JPMC), Karachi. In all 37 patients, 22 males and 15 females, were included in the study through outpatient department, surgical emergency and those referred from other cities of the country. All patients were cachectic. Diagnosis was made by detailed history, examination and laboratory investigations. Diagnosis was confirmed on barium swallow and endoscopic biopsy. Highest number of patients were in their 6th decade of life. History of snuff inhalation and opium was present in 2.7% cases each. Lower 3rd of the esophagus was affected in 62.16% middle third in 21.62% and upper third in 16.21% cases. Smoking, pan chewing, naswar eating and snuff inhalation were identified as high risk factors among patients of carcinoma esophagus. (author)

  10. Individual and Parental Risk Factors for Sexual Exploitation Among High-Risk Youth in Uganda.

    Science.gov (United States)

    Self-Brown, Shannon; Culbreth, Rachel; Wilson, Rebecca; Armistead, Lisa; Kasirye, Rogers; Swahn, Monica H

    2018-04-01

    This study examined risk factors to determine associations with commercial sexual exploitation of children and youth (CSEC) in a convenience sample of adolescents living in the slums in Kampala, Uganda. Individual-level factors included demographic, adverse experiences (ever living on the streets; victim of dating violence, parental abuse, or rape), and behavioral risk (social media, alcohol use, age at first intercourse). Parental-risk factors included parent alcohol use and approval attitudes toward youth sex. Analyses included those who self-reported sexually active adolescents ( n = 593) of whom 39% reported CSEC history. CSEC was significantly associated with being female (odds ratio [ OR] = 6.85, 95% confidence interval (CI) = [4.22, 11.12]), living on the streets ( OR = 2.68; 95% CI = [1.65, 4.36]), using social media ( OR = 1.48; 95% CI = [0.94, 2.35]), being a victim of physical dating violence ( OR = 1.74; 95% CI = [1.08, 2.80]), and ever being raped ( OR = 4.03; 95% CI = [2.51, 6.47]). Further analyses suggested differential risk associates among females and males. This study contributes to our knowledge of risk factors for CSEC among adolescents living in high-risk circumstances in low-resource countries and suggests that preventive efforts should prioritize adolescents with a history of living on the streets who engage in social media, use alcohol, and have a history of trauma.

  11. Risk Factors for Post-treatment Complex Regional Pain Syndrome (CRPS)

    DEFF Research Database (Denmark)

    Petersen, Pelle B; Mikkelsen, Kim Lyngby; Lauritzen, Jes B

    2018-01-01

    OBJECTIVES: Complex regional pain syndrome is a challenging condition that includes a broad spectrum of sensory, autonomic, and motor features predominantly in extremities recovering from a trauma. Few large-scale studies have addressed occurrence of and factors associated with complex regional......, gender, initial diagnosis, treatment, and amount of compensation were extracted. Multivariate logistic regressions were performed to identify variables associated with approval of the claim. For carpal tunnel syndrome (CTS) patients, we registered whether symptoms were bilateral or unilateral...... normal neurophysiology. CONCLUSIONS: Female gender, surgical treatment, and treatment to the upper limb were risk factors. Elective surgery accounted for a large number of post-treatment CRPS patients. In CTS patients developing CRPS, normal neurophysiological examination findings were common...

  12. SUSTAINABLE DEVELOPMENT OF HIGHLY TOURISTIC REGION OF ISTRIA

    Directory of Open Access Journals (Sweden)

    Jasmina GRZINIC

    2010-01-01

    Full Text Available As the scale of tourism grows, the resource use threatens to become unsustainable. Withought environmental responsibility the levels of cheaper mass tourism will increase, forcing more “nature-based” tourism to move on to new destinations. This scenario is opposite to the “Croatian Tourism Development by 2010” strategy. With a favourable geographic position, almost at the heart of Europe, Istria has always represented a bridge connecting the Middle European continental area with the Mediterranean. This area is the most visited Croatian tourist region with 27% of all visitors and 35% of time spent in all of Croatia. The Croatian National Bank’s preliminary figures for 2007 show that international tourism generated 18.4% of Croatian GDP. For these reasons the Istrian tourism industry can not ignore environmental issues in its management and requires the informed participation of all relevant stakeholders (according to the Agenda 21 for tourism industry. Properly planned tourism development, combined with environmental protection, produces the concept of sustainable tourism. Environmentally sustainable form of tourism represents a step forward from "sea and sun" mass tourism developed at the coastal part of Istria. There are a myriad of definitions for Sustainable Tourism, including eco-tourism, green travel, environmentally and culturally responsible tourism, fair trade and ethical travel. Mentioned selective tourism forms are adopted as the concept of the present and future Istrian destination development.

  13. Reproductive health education and sexual risk among high-risk female adolescents and young adults.

    Science.gov (United States)

    Ancheta, Rosedelia; Hynes, Colin; Shrier, Lydia A

    2005-04-01

    The objective of this study was to explore the associations of sources, content, and timing of reproductive health education with cognitive and behavioral sexual risk in a sample of high-risk female adolescents and young adults. Female adolescents and young adults (n=113, median age 17 years) receiving treatment for a sexually transmitted disease (STD) reported sources of reproductive health education, topics covered, and when first formal education occurred. Dependent variables included sexual risk knowledge; condom attitudes, negotiation skills, and use (consistent and at last sex); and number of sexual partners. Most participants reported receiving reproductive health education from both parental (80%) and formal sources (92%). Parents discussed the menstrual cycle (94%) more frequently than other sex education topics, while formal sources focused most on teaching about STDs (91%). Although median age of first formal instruction was 12 years, 26% of girls received their first formal education during or after the year they initiated coitus. Girls with a parental source of education and those receiving formal instruction on pregnancy reported greater ability to negotiate condom use. Girls who received education later in relation to the onset of sexual activity and those with a parental source of education reported more sexual partners. Early reproductive health education and education from both parental and formal sources is associated with reduced sexual risk among high-risk adolescent girls. Interestingly, receiving parental education is also associated with more sexual partners, suggesting that parental educational efforts may be reactive to their daughters' increasing sexual risk behavior. Future research should examine multiple sources of reproductive health education and the timing of education from these sources to enhance understanding the dynamic interactions between reproductive health education and adolescent sexual risk.

  14. [Regional features of food standards and health risks associated with chemical contamination of food].

    Science.gov (United States)

    Klepikov, O V; Khatuaev, R O; Istomin, A V; Rumyantseva, L A

    In the article there are presented results of a study of the balance of food consumption by the population of the Voronezh region, the assessment of the level of contamination of food products and both carcinogenic and non-carcinogenic and public health risk caused by this contamination. There was evaluated the level of nutrition-dependent diseases. A special feature of this study is a comparative analysis of data obtained during the two five-year periods of 1995-1999 and 2010-2014, that permitted to reveal changes in food consumption, the dynamics of morbidity rate associated with the nutritional factor.

  15. Quality assurance system for sitting high risk facilities

    International Nuclear Information System (INIS)

    Rodriguez, Aymee; Peralta, Jose L.; Fernandez, Manuel

    1999-01-01

    The paper shows how we have conceived and designed the quality assurance system for the site selection process of an area for sitting the facility of high risk in correspondence with the approved methodology. The results obtained in the implementation of the system have permitted the satisfactory performance of each one the expected stage, defining the most favorable sectors in order to continue the studies of the repository site for the disposal of low and intermedium. (author)

  16. Monitoring of newborns at high risk for brain injury

    OpenAIRE

    Pisani, Francesco; Spagnoli, Carlotta

    2016-01-01

    Due to the increasing number of surviving preterm newborns and to the recognition of therapeutic hypothermia as the current gold standard in newborns with hypoxic-ischaemic encephalopathy, there has been a growing interest in the implementation of brain monitoring tools in newborns at high risk for neurological disorders. Among the most frequent neurological conditions and presentations in the neonatal period, neonatal seizures and neonatal status epilepticus, paroxysmal non-epileptic motor p...

  17. Improving Asthma Communication in High-Risk Children

    OpenAIRE

    Butz, Arlene M.; Walker, Jennifer; Land, Cassia Lewis; Vibbert, Carrie; Winkelstein, Marilyn

    2007-01-01

    Few child asthma studies address the specific content and techniques needed to enhance child communication during asthma preventive care visits. This study examined the content of child and parent communications regarding their asthma management during a medical encounter with their primary care provider (PCP). The majority of parents and children required prompting to communicate symptom information to the PCP during the clinic visit. Some high-risk families may require an asthma advocate to...

  18. High risk bladder cancer: current management and survival

    Directory of Open Access Journals (Sweden)

    Anna M. Leliveld

    2011-04-01

    Full Text Available PURPOSE: To evaluate the pattern of care in patients with high risk non muscle invasive bladder cancer (NMIBC in the Comprehensive Cancer Center North-Netherlands (CCCN and to assess factors associated with the choice of treatment, recurrence and progression free survival rates. MATERIALS AND METHODS: Retrospective analysis of 412 patients with newly diagnosed high risk NMIBC. Clinical, demographic and follow-up data were obtained from the CCCN Cancer Registry and a detailed medical record review. Uni and multivariate analysis was performed to identify factors related to choice of treatment and 5 year recurrence and progression free survival. RESULTS: 74/412 (18% patients with high risk NMIBC underwent a transurethral resection (TUR as single treatment. Adjuvant treatment after TUR was performed in 90.7% of the patients treated in teaching hospitals versus 71.8 % in non-teaching hospitals (p 80 years OR 0.1 p = 0.001 and treatment in non-teaching hospitals (OR 0.25; p < 0.001 were associated with less adjuvant treatment after TUR. Tumor recurrence occurred in 191/392 (49% and progression in 84 /392 (21.4% patients. The mean 5-years progression free survival was 71.6% (95% CI 65.5-76.8. CONCLUSION: In this pattern of care study in high risk NMIBC, 18% of the patients were treated with TUR as single treatment. Age and treatment in non-teaching hospitals were associated with less adjuvant treatment after TUR. None of the variables sex, age, comorbidity, hospital type, stage and year of treatment was associated with 5 year recurrence or progression rates.

  19. Tamoxifen for women at high risk of breast cancer

    OpenAIRE

    Nazarali, Safia A; Narod, Steven A

    2014-01-01

    Safia A Nazarali, Steven A Narod Women's College Research Institute, Women's College Hospital, and The University of Toronto, Toronto, Ontario, Canada Abstract: Tamoxifen has been used as a treatment for women who have been diagnosed with breast cancer for roughly four decades and has been approved as chemoprevention for over ten years. Although tamoxifen has been proven to be beneficial in preventing breast cancer in high-risk women, its use has not been widely embraced. To ...

  20. Mapping regional risks from climate change for rainfed rice cultivation in India.

    Science.gov (United States)

    Singh, Kuntal; McClean, Colin J; Büker, Patrick; Hartley, Sue E; Hill, Jane K

    2017-09-01

    Global warming is predicted to increase in the future, with detrimental consequences for rainfed crops that are dependent on natural rainfall (i.e. non-irrigated). Given that many crops grown under rainfed conditions support the livelihoods of low-income farmers, it is important to highlight the vulnerability of rainfed areas to climate change in order to anticipate potential risks to food security. In this paper, we focus on India, where ~ 50% of rice is grown under rainfed conditions, and we employ statistical models (climate envelope models (CEMs) and boosted regression trees (BRTs)) to map changes in climate suitability for rainfed rice cultivation at a regional level (~ 18 × 18 km cell resolution) under projected future (2050) climate change (IPCC RCPs 2.6 and 8.5, using three GCMs: BCC-CSM1.1, MIROC-ESM-CHEM, and HadGEM2-ES). We quantify the occurrence of rice (whether or not rainfed rice is commonly grown, using CEMs) and rice extent (area under cultivation, using BRTs) during the summer monsoon in relation to four climate variables that affect rice growth and yield namely ratio of precipitation to evapotranspiration ( PER ), maximum and minimum temperatures ( T max and T min ), and total rainfall during harvesting. Our models described the occurrence and extent of rice very well (CEMs for occurrence, ensemble AUC = 0.92; BRTs for extent, Pearson's r = 0.87). PER was the most important predictor of rainfed rice occurrence, and it was positively related to rainfed rice area, but all four climate variables were important for determining the extent of rice cultivation. Our models project that 15%-40% of current rainfed rice growing areas will be at risk (i.e. decline in climate suitability or become completely unsuitable). However, our models project considerable variation across India in the impact of future climate change: eastern and northern India are the locations most at risk, but parts of central and western India may benefit from increased

  1. Climate change impacts on risks of groundwater pollution by herbicides: a regional scale assessment

    Science.gov (United States)

    Steffens, Karin; Moeys, Julien; Lindström, Bodil; Kreuger, Jenny; Lewan, Elisabet; Jarvis, Nick

    2014-05-01

    Groundwater contributes nearly half of the Swedish drinking water supply, which therefore needs to be protected both under present and future climate conditions. Pesticides are sometimes found in Swedish groundwater in concentrations exceeding the EU-drinking water limit and thus constitute a threat. The aim of this study was to assess the present and future risks of groundwater pollution at the regional scale by currently approved herbicides. We identified representative combinations of major crop types and their specific herbicide usage (product, dose and application timing) based on long-term monitoring data from two agricultural catchments in the South-West of Sweden. All these combinations were simulated with the regional version of the pesticide fate model MACRO (called MACRO-SE) for the periods 1970-1999 and 2070-2099 for a major crop production region in South West Sweden. To represent the uncertainty in future climate data, we applied a five-member ensemble based on different climate model projections downscaled with the RCA3-model (Swedish Meteorological and Hydrological Institute). In addition to the direct impacts of changes in the climate, the risks of herbicide leaching in the future will also be affected by likely changes in weed pressure and land use and management practices (e.g. changes in crop rotations and application timings). To assess the relative importance of such factors we performed a preliminary sensitivity analysis which provided us with a hierarchical structure for constructing future herbicide use scenarios for the regional scale model runs. The regional scale analysis gave average concentrations of herbicides leaching to groundwater for a large number of combinations of soils, crops and compounds. The results showed that future scenarios for herbicide use (more autumn-sown crops, more frequent multiple applications on one crop, and a shift from grassland to arable crops such as maize) imply significantly greater risks of herbicide

  2. Single and Cumulative Relations of Social Risk Factors with Children's Dental Health and Care-Utilization Within Regions of the United States.

    Science.gov (United States)

    Yang, Alyssa J; Gromoske, Andrea N; Olson, Melissa A; Chaffin, Jeffrey G

    2016-03-01

    The purpose is to examine the relation of social risk factors, and the cumulative burden of social risk factors, on parent-reported dental health and dental care-seeking behavior. National Survey of Children's Health data (2011-2012) were analyzed for US children by Title V Block Grant regions. Multivariate logistic regressions were estimated for ten social risk factors, as well as a cumulative risk index, to find any associations with poor condition of teeth, presence of dental caries, and no dental care visits. Almost all of the risk factors were significantly associated with poor condition of teeth and presence of dental caries for the US. Models associating no dental care visits suggested that low family income (OR 1.58), poor maternal mental health (OR 1.54), high school education or less (OR 1.34), and multi-racial/other race (OR 1.18) were significant factors for the US. Regional variation existed for those risk factors and their association with the outcomes, but income, education, and poor maternal mental health consistently played a significant role in adverse outcomes. The cumulative risk index was strongly related to poor oral health outcomes, with a weaker relationship to dental care utilization. US children experiencing certain social risk factors, such as low family income, high school education or less, and poor maternal mental health, are likely to be at greater risk for poor dental health and low levels of dental-care seeking behavior. Children experiencing multiple social risks are at greater risk for poor oral outcomes than children who experience fewer social risks. An approach that involves the social determinants of health is needed to address these issues.

  3. Disrupted resting brain graph measures in individuals at high risk for alcoholism.

    Science.gov (United States)

    Holla, Bharath; Panda, Rajanikant; Venkatasubramanian, Ganesan; Biswal, Bharat; Bharath, Rose Dawn; Benegal, Vivek

    2017-07-30

    Familial susceptibility to alcoholism is likely to be linked to the externalizing diathesis seen in high-risk offspring from high-density alcohol use disorder (AUD) families. The present study aimed at comparing resting brain functional connectivity and their association with externalizing symptoms and alcoholism familial density in 40 substance-naive high-risk (HR) male offspring from high-density AUD families and 30 matched healthy low-risk (LR) males without a family history of substance dependence using graph theory-based network analysis. The HR subjects from high-density AUD families compared with LR, showed significantly reduced clustering, small-worldness, and local network efficiency. The frontoparietal, cingulo-opercular, sensorimotor and cerebellar networks exhibited significantly reduced functional segregation. These disruptions exhibited independent incremental value in predicting the externalizing symptoms over and above the demographic variables. The reduction of functional segregation in HR subjects was significant across both the younger and older age groups and was proportional to the family loading of AUDs. Detection and estimation of these developmentally relevant disruptions in small-world architecture at critical brain regions sub-serving cognitive, affective, and sensorimotor processes are vital for understanding the familial risk for early onset alcoholism as well as for understanding the pathophysiological mechanism of externalizing behaviors. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  4. Regional Variations in the Risk and Severity of Ciguatera Caused by Eating Moray Eels.

    Science.gov (United States)

    Chan, Thomas Y K

    2017-06-26

    Moray eels ( Gymnothorax species) from tropical waters have long been known to be high-risk species, and the consumption of particularly the viscera or ungutted eels can result in severe ciguatera (known as Gymnothorax or moray eel poisoning), characterized by prominent neurological features. In this review, the main objective was to describe the risk and severity of ciguatera caused by eating moray eels in different parts of the world. Moray eels can accumulate very high ciguatoxin (CTX) levels in the flesh and particularly the liver. Therefore, even the smaller ones can be toxic and the consumption of an average portion (particularly liver) can result in severe or fatal ciguatera. Moray eels (particularly when ungutted) must never be served in gatherings since they can cause mass poisoning because of their large sizes and high CTX levels. Apart from regulatory measures restricting or excluding access, the public should be repeatedly warned to avoid eating moray eels.

  5. Regional Variations in the Risk and Severity of Ciguatera Caused by Eating Moray Eels

    Directory of Open Access Journals (Sweden)

    Thomas Y. K. Chan

    2017-06-01

    Full Text Available Moray eels (Gymnothorax species from tropical waters have long been known to be high-risk species, and the consumption of particularly the viscera or ungutted eels can result in severe ciguatera (known as Gymnothorax or moray eel poisoning, characterized by prominent neurological features. In this review, the main objective was to describe the risk and severity of ciguatera caused by eating moray eels in different parts of the world. Moray eels can accumulate very high ciguatoxin (CTX levels in the flesh and particularly the liver. Therefore, even the smaller ones can be toxic and the consumption of an average portion (particularly liver can result in severe or fatal ciguatera. Moray eels (particularly when ungutted must never be served in gatherings since they can cause mass poisoning because of their large sizes and high CTX levels. Apart from regulatory measures restricting or excluding access, the public should be repeatedly warned to avoid eating moray eels.

  6. Regional Variations in the Risk and Severity of Ciguatera Caused by Eating Moray Eels

    Science.gov (United States)

    Chan, Thomas Y. K.

    2017-01-01

    Moray eels (Gymnothorax species) from tropical waters have long been known to be high-risk species, and the consumption of particularly the viscera or ungutted eels can result in severe ciguatera (known as Gymnothorax or moray eel poisoning), characterized by prominent neurological features. In this review, the main objective was to describe the risk and severity of ciguatera caused by eating moray eels in different parts of the world. Moray eels can accumulate very high ciguatoxin (CTX) levels in the flesh and particularly the liver. Therefore, even the smaller ones can be toxic and the consumption of an average portion (particularly liver) can result in severe or fatal ciguatera. Moray eels (particularly when ungutted) must never be served in gatherings since they can cause mass poisoning because of their large sizes and high CTX levels. Apart from regulatory measures restricting or excluding access, the public should be repeatedly warned to avoid eating moray eels. PMID:28672845

  7. Governance of innovation and appropriateness of hospitalization for high-risk pregnancy: the TOCOMAT system.

    Science.gov (United States)

    Tagliaferri, Salvatore; Ippolito, Adelaide; Cuccaro, Patrizia; Annunziata, Maria Laura; Campanile, Marta; Di Lieto, Andrea

    2013-07-01

    Over the last 30 years, a great increase in the application of technologies in public health, with an undisputed impact on both the effectiveness of performance and the investment and management costs, has occurred. This evidence has induced the development of assessment tools to clarify the relationships among resources, outputs, and outcomes of technological innovations. This analysis was developed in order to examine the use of a telematic system for reporting remotely transmitted cardiotocographic traces, specifically (1) its impact on the health organization and on the appropriateness of the care setting used and (2) the efficiency of its adoption in a regional network. We adopted a case-control study on patients' medical records during the first 4 months of 2009, 2010, and 2011 and a cost analysis of resources used for the creation of a computerized telecardiotocography network connecting eight peripheral areas to the operations center. The case-control study showed a reduction in the average hospital stay days for high-risk patients (1.32) and for low-risk patient (1.7) with a total of cost savings of €89,628 for high-risk patients and €170,170 for low-risk patients. The cost savings of the regional network was €20,769.04. The adoption of a remote transmission system of cardiotocography provided a managerial and economic advantage in the reduction of inappropriate admissions for prepartum symptoms and an improvement in the admission indicators (hospital stay days).

  8. Hepatitis B Infection among high risk population: a seroepidemiological survey in Southwest of Iran

    Directory of Open Access Journals (Sweden)

    Khosravani Abdolmajid

    2012-12-01

    Full Text Available Abstract Background Hepatitis B virus (HBV infection remains a major global health problem. This study aimed to assess the prevalence and risk behaviors for HBV infection among high risk groups in Kohgiloyeh and Boyerahmad province, in Southwest of Iran. Methods Blood samples were collected from 2009 subjects, between 2009 and 2010 in Kohgiloyeh and Boyerahmad province, in southwest of Iran. Recruited subjects were the high risk groups for HBV infection, including inmates, injecting drug users, health care workers, patients on maintenance haemodialysis, hemophilic patients and patients with a history of blood transfusion. Their serum samples were tested for the presence of antibodies to hepatitis B core antigen (HBc IgM, IgG by enzyme-linked immunosorbent assay (ELISA. Seropositive specimens were tested for HBsAg. Demographic features of participants were recorded during sample collecting. Results HBsAg was detected in 24 of the 2009 subjects, giving an overall prevalence of 1.2%. All HBsAg positive cases were males. The prevalence of HBsAg among injection drug users was 3.2%. Significant correlation was found between HBV infection and drug abuse, level of education and place of residence (p Conclusion Based on the findings of this study, incarceration and drug abuse are the most important risk factors for acquiring HBV infection in this region. Modifying behavior, improving the individual education and expanding the HBV vaccination coverage may reduce the rate of infection in the region.

  9. Forecasting Value-at-Risk Using High-Frequency Information

    Directory of Open Access Journals (Sweden)

    Huiyu Huang

    2013-06-01

    Full Text Available in the prediction of quantiles of daily Standard&Poor’s 500 (S&P 500 returns we consider how to use high-frequency 5-minute data. We examine methods that incorporate the high frequency information either indirectly, through combining forecasts (using forecasts generated from returns sampled at different intraday interval, or directly, through combining high frequency information into one model. We consider subsample averaging, bootstrap averaging, forecast averaging methods for the indirect case, and factor models with principal component approach, for both direct and indirect cases. We show that in forecasting the daily S&P 500 index return quantile (Value-at-Risk or VaR is simply the negative of it, using high-frequency information is beneficial, often substantially and particularly so, in forecasting downside risk. Our empirical results show that the averaging methods (subsample averaging, bootstrap averaging, forecast averaging, which serve as different ways of forming the ensemble average from using high-frequency intraday information, provide an excellent forecasting performance compared to using just low-frequency daily information.

  10. Can Regional Climate Models be used in the assessment of vulnerability and risk caused by extreme events?

    Science.gov (United States)

    Nunes, Ana

    2015-04-01

    Extreme meteorological events played an important role in catastrophic occurrences observed in the past over densely populated areas in Brazil. This motived the proposal of an integrated system for analysis and assessment of vulnerability and risk caused by extreme events in urban areas that are particularly affected by complex topography. That requires a multi-scale approach, which is centered on a regional modeling system, consisting of a regional (spectral) climate model coupled to a land-surface scheme. This regional modeling system employs a boundary forcing method based on scale-selective bias correction and assimilation of satellite-based precipitation estimates. Scale-selective bias correction is a method similar to the spectral nudging technique for dynamical downscaling that allows internal modes to develop in agreement with the large-scale features, while the precipitation assimilation procedure improves the modeled deep-convection and drives the land-surface scheme variables. Here, the scale-selective bias correction acts only on the rotational part of the wind field, letting the precipitation assimilation procedure to correct moisture convergence, in order to reconstruct South American current climate within the South American Hydroclimate Reconstruction Project. The hydroclimate reconstruction outputs might eventually produce improved initial conditions for high-resolution numerical integrations in metropolitan regions, generating more reliable short-term precipitation predictions, and providing accurate hidrometeorological variables to higher resolution geomorphological models. Better representation of deep-convection from intermediate scales is relevant when the resolution of the regional modeling system is refined by any method to meet the scale of geomorphological dynamic models of stability and mass movement, assisting in the assessment of risk areas and estimation of terrain stability over complex topography. The reconstruction of past extreme

  11. Racial and gender discrimination: risk factors for high blood pressure?

    Science.gov (United States)

    Krieger, N

    1990-01-01

    Despite controversy as to the biologic and/or social meaning of 'race' and 'sex', few public health studies have directly examined the impact of racial or gender discrimination on health. One plausible condition they might affect is hypertension, since stress and internalized anger may constitute important risk factors for this disease. The present investigation therefore sought to determine the feasibility of asking questions pertaining to race- and gender-biased treatment plus response to unfair treatment, and to assess their predictive value regarding self-reported high blood pressure. Using random-digit dialing, 51 black and 50 white women, ages 20-80, who resided in Alameda County, CA in 1987, were identified and interviewed by phone. Among black respondents, those who stated they usually accepted and kept quiet about unfair treatment were 4.4 times more likely to report hypertension than women who said they took action and talked to others (P = 0.01 for linear trend); no clear association existed among white respondents. The age-adjusted risk of high blood pressure among black respondents who recounted experiencing zero instances of race- and gender-biased treatment was 2.6 times greater than that of black women who reported one or more such instances (95% CI = 0.7, 10.5). Among white respondents, gender discrimination was not associated with hypertension. These results suggest that an internalized response to unfair treatment, plus non-reporting of race and gender discrimination, may constitute risk factors for high blood pressure among black women. They also bolster the view that subjective appraisal of stressors may be inversely associated with risk of hypertension.

  12. 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…

  13. Risk factors of maternal mortality in Sistan region: 10-year report

    Directory of Open Access Journals (Sweden)

    Mohammad Sarani

    2014-12-01

    Conclusion: Based on our findings, some factors including multiparity, pregnancy his-tory more than 4 times, short interval between pregnancies lower than 2 years and ma-ternal age more than 35 years were some risk factors for maternal death. Maternal mortality in the postpartum period was more than pre-delivery period. Bleeding was the main cause of maternal mortality. Therefore monitoring of vital signs in the post-partum period and the proper management of bleeding are very important. It is sug-gested that risk assessment should be done for pregnant women in delivery ward for detecting high risk pregnant women. Suitable management for these women especially for patients with postpartum hemorrhage plays an important role to decrease the ma-ternal mortality.

  14. INSTRUMENTS OF HIGH RISK SEXUAL BEHAVIOR ASSESSMENT: A SYSTEMATIC REVIEW.

    Science.gov (United States)

    Mirzaei, Mojtaba; Ahmadi, Khodabakhsh; Saadat, Seyed-Hassan; Ramezani, Mohammad Arash

    2016-02-01

    Sexual behavior is a complex activity affecting all aspects of human's life. Risky sexual behaviors impose negative outcomes on family, relationships and health. Unsafe sex is the second most leading cause of disability adjusted life years worldwide. Valid and reliable tools for assessment of risky sexual behaviors are necessary for implementing preventive measures. we searched Medline and the Cochrane Library of Systematic Reviews, with the keywords of "risky sexual behavior assessment", "sexual risk assessment", "high risk sexual behavior", "sexual risk taking". By reviewing references of the articles, some complementary studies were added. Assessment can be performed by questionnaire or non-questionnaire instruments. Questionnaires vary depending on their target population, evaluation of risky sexual behavior as a whole or focusing on an associated risk factor. In order to avoid usual biases in self reports, objective biomarker assessment of unprotected sex are employed. These markers include prostate specific antigen, chromosome Y DNA and Seminogelin. Risky sexual behavior can be assessed by various subjective and objective methods. While self-reports are more feasible, objective methods offer a higher degree of reliability. Further studies for finding more feasible methods of using biomarkers are recommended.

  15. WEAK LINE QUASARS AT HIGH REDSHIFT: EXTREMELY HIGH ACCRETION RATES OR ANEMIC BROAD-LINE REGIONS?

    International Nuclear Information System (INIS)

    Shemmer, Ohad; Trakhtenbrot, Benny; Netzer, Hagai; Anderson, Scott F.; Brandt, W. N.; Schneider, Donald P.; Diamond-Stanic, Aleksandar M.; Fan Xiaohui; Lira, Paulina; Plotkin, Richard M.; Richards, Gordon T.; Strauss, Michael A.

    2010-01-01

    We present Gemini-North K-band spectra of two representative members of the class of high-redshift quasars with exceptionally weak rest-frame ultraviolet emission lines (WLQs), SDSS J114153.34+021924.3 at z = 3.55 and SDSS J123743.08+630144.9 at z = 3.49. In both sources, we detect an unusually weak broad Hβ line and place tight upper limits on the strengths of their [O III] lines. Virial, Hβ-based black hole mass determinations indicate normalized accretion rates of L/L Edd =0.4 for these sources, which is well within the range observed for typical quasars with similar luminosities and redshifts. We also present high-quality XMM-Newton imaging spectroscopy of SDSS J114153.34+021924.3 and find a hard-X-ray photon index of Γ = 1.91 +0.24 -0.22 , which supports the virial L/L Edd determination in this source. Our results suggest that the weakness of the broad emission lines in WLQs is not a consequence of an extreme continuum-emission source but instead due to abnormal broad emission line region properties.

  16. Health effects in residents of high background radiation regions

    International Nuclear Information System (INIS)

    Hanson, G.P.

    1984-01-01

    Although the health effects of radiation doses in occupationally exposed persons had received attention, it was not until the 1950s, when the atmospheric atom bomb tests of the United States and the Soviet Union had raised the level of environmental radioactivity, that the long-term effects of low-level radiation dosage became a matter of popular concern throughout the world. The United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) was created, and the World Health Organization (WHO) appointed an expert committee to provide advice concerning radiation and human health. In its first report, the WHO expert committee identified several areas of high natural radiation where studies of the exposed population might possibly provide information concerning the effects of chromic low-level radiation dosage

  17. [Nutritional status and food intake of populations from high altitude regions of the Northwest of Argentia].

    Science.gov (United States)

    Bassett, Maria Natalia; Gimenez, Maria Alejandra; Romaguera, Dora; Sammán, Norma

    2013-06-01

    The purpose of this work was to study the nutritional status and food intake of Andean populations of Northwest ofArgentine. A cross-sectional nutritional survey was carried out in representative samples of populations of highland from Argentine. Also anthropometric measurements, a food intake, a semi-quantitative food frequency questionnaire were performed and recorded. Stunting (height-for-age Z-score 85th and 95th percentile respectively, were the main nutritional problems among adolescents in the Valleys. Adult populations showed higher prevalence of overweight and obesity according to BMI determined. These are important risk factors for cardiovascular and chronic diseases.Usually the typical composition of the main food dish of regions has a base of rice, pasta, flour or corn, accompanied by tubers or eggs, or a few vegetables and beef. This dish varies little from one day to another, constituting a monotonous diet with a high intake of sugar (sugary drinks and sweets) and refined grains. Results suggest that these populations would be in early stages of nutritional transition and could be the starting point to promote them healthier food consumption and a diet less monotonous. It would be recommendable reincorporate native products of the region.

  18. Sero-prevalence, risk factors and distribution of sheep and goat pox in Amhara Region, Ethiopia.

    Science.gov (United States)

    Fentie, Tsegaw; Fenta, Nigusie; Leta, Samson; Molla, Wassie; Ayele, Birhanu; Teshome, Yechale; Nigatu, Seleshe; Assefa, Ashenafi

    2017-12-11

    Sheep pox and goat pox are contagious viral diseases of sheep and goats, respectively. The diseases result in substantial economic losses due to decreased milk and meat production, damage to hides and wool, and possible trade restriction. A study was undertaken in Amhara region of Ethiopia. A cross-sectional study design was used to estimate the sero-prevalence and identify associated risk factors, while retrospective study design was used to assess the temporal and spatial distribution of the disease. A total of 672 serum samples were collected from 30 Kebeles and tested using virus neutralization test. From a total of 672 sera tested, 104 (15.5%) were positive for sheep and goat pox virus antibody; from which 56 (17%) were sheep and 48 (14%) were goats. The diseases were prevalent in all study zones, the highest sero-prevalence was observed in South Gondar (20.9%) and the lowest in North Gondar and West Gojjam zones (11.9% each). From the potential risk factors considered (species, sex, age, agro-ecology and location); only sex and age were significantly associated (p pox is one of the most prevalent and widespread diseases of sheep and goats in the study area. Hence, annual mass vaccination program must be implemented for economic and viable control of sheep and goat pox diseases in the Amhara region in particular and at a national level in general.

  19. High familial risk for mood disorder is associated with low dorsolateral prefrontal cortex serotonin transporter binding

    DEFF Research Database (Denmark)

    Frokjaer, Vibe G; Vinberg, Maj; Erritzoe, David

    2009-01-01

    at risk for developing depression. The aim of this study was to explore whether abnormalities in SERT might be present in healthy individuals with familial predisposition to mood disorder. Nine individuals at high familial risk (mean age 32.2+/-4.2 years) and 11 individuals at low risk (mean age 32......Mood disorders are elicited through a combination of genetic and environmental stress factors, and treatment with selective serotonin reuptake inhibitors ameliorates depressive symptoms. Changes in the serotonin transporter (SERT) binding may therefore occur in depressive patients and in subjects.......4+/-5.0 years) for developing mood disorder were included. The subjects were healthy twins with or without a co-twin history of mood disorder identified by linking information from the Danish Twin Register and the Danish Psychiatric Central Register. Regional in vivo brain serotonin transporter binding...

  20. Assessing Risk in Costing High-energy Accelerators: from Existing Projects to the Future Linear Collider

    CERN Document Server

    Lebrun, Philippe

    2010-01-01

    High-energy accelerators are large projects funded by public money, developed over the years and constructed via major industrial contracts both in advanced technology and in more conventional domains such as civil engineering and infrastructure, for which they often constitute one-of markets. Assessing their cost, as well as the risk and uncertainty associated with this assessment is therefore an essential part of project preparation and a justified requirement by the funding agencies. Stemming from the experience with large circular colliders at CERN, LEP and LHC, as well as with the Main Injector, the Tevatron Collider Experiments and Accelerator Upgrades, and the NOvA Experiment at Fermilab, we discuss sources of cost variance and derive cost risk assessment methods applicable to the future linear collider, through its two technical approaches for ILC and CLIC. We also address disparities in cost risk assessment imposed by regional differences in regulations, procedures and practices.

  1. Early Primary Care Provider Follow-up and Readmission After High-Risk Surgery

    Science.gov (United States)

    Brooke, Benjamin S.; Stone, David H.; Cronenwett, Jack L.; Nolan, Brian; DeMartino, Randall R.; MacKenzie, Todd A.; Goodman, David C.; Goodney, Philip P.

    2014-01-01

    IMPORTANCE Follow-up with a primary care provider (PCP) in addition to the surgical team is routinely recommended to patients discharged after major surgery despite no clear evidence that it improves outcomes. OBJECTIVE To test whether PCP follow-up is associated with lower 30-day readmission rates after open thoracic aortic aneurysm (TAA) repair and ventral hernia repair (VHR), surgical procedures known to have a high and low risk of readmission, respectively. DESIGN, SETTING, AND PARTICIPANTS In a cohort of Medicare beneficiaries discharged to home after open TAA repair (n = 12 679) and VHR (n = 52 807) between 2003 to 2010, we compared 30-day readmission rates between patients seen and not seen by a PCP within 30 days of discharge and across tertiles of regional primary care use. We stratified our analysis by the presence of complications during the surgical (index) admission. MAIN OUTCOMES AND MEASURES Thirty-day readmission rate. RESULTS Overall, 2619 patients (20.6%) undergoing open TAA repair and 4927 patients (9.3%) undergoing VHR were readmitted within 30 days after surgery. Complications occurred in 4649 patients (36.6%) undergoing open TAA repair and 4528 patients (8.6%) undergoing VHR during their surgical admission. Early follow-up with a PCP significantly reduced the risk of readmission among open TAA patients who experienced perioperative complications, from 35.0% (without follow-up) to 20.4% (with follow-up) (P < .001). However, PCP follow-up made no significant difference in patients whose hospital course was uncomplicated (19.4% with follow-up vs 21.9% without follow-up; P = .31). In comparison, early follow-up with a PCP after VHR did not reduce the risk of readmission, regardless of complications. In adjusted regional analyses, undergoing open TAA repair in regions with high compared with low primary care use was associated with an 18% lower likelihood of 30-day readmission (odds ratio, 0.82; 95% CI, 0.71–0.96; P = .02), whereas no significant

  2. Specialized surveillance for individuals at high risk for melanoma: a cost analysis of a high-risk clinic.

    Science.gov (United States)

    Watts, Caroline G; Cust, Anne E; Menzies, Scott W; Coates, Elliot; Mann, Graham J; Morton, Rachael L

    2015-02-01

    Regular surveillance of individuals at high risk for cutaneous melanoma improves early detection and reduces unnecessary excisions; however, a cost analysis of this specialized service has not been undertaken. To determine the mean cost per patient of surveillance in a high-risk clinic from the health service and societal perspectives. We used a bottom-up microcosting method to measure resource use in a consecutive sample of 102 patients treated in a high-risk hospital-based clinic in Australia during a 12-month period. Surveillance and treatment of melanoma. All surveillance and treatment procedures were identified through direct observation, review of medical records, and interviews with staff and were valued using scheduled fees from the Australian government. Societal costs included transportation and loss of productivity. The mean number of clinic visits per year was 2.7 (95% CI, 2.5-2.8) for surveillance and 3.8 (95% CI, 3.4-4.1) for patients requiring surgical excisions. The mean annual cost per patient to the health system was A $882 (95% CI, A $783-$982) (US $599 [95% CI, US $532-$665]); the cost discounted across 20 years was A $11,546 (95% CI, A $10,263-$12,829) (US $7839 [95% CI, US $6969-$8710]). The mean annual societal cost per patient (excluding health system costs) was A $972 (95% CI, A $899-$1045) (US $660 [95% CI, US $611-$710]); the cost discounted across 20 years was A $12,721 (95% CI, A $12,554-$14,463) (US $8637 [95% CI, US $8523-$9820]). Diagnosis of melanoma or nonmelanoma skin cancer and frequent excisions for benign lesions in a relatively small number of patients was responsible for positively skewed health system costs. Microcosting techniques provide an accurate cost estimate for the provision of a specialized service. The high societal cost reflects the time that patients are willing to invest to attend the high-risk clinic. This alternative model of care for a high-risk population has relevance for decision making about health policy.

  3. Risk factors of urinary bladder cancer in Peshawar region of Khyber Pukhtoonkhawa

    International Nuclear Information System (INIS)

    Ahmad, M.R.; Pervaiz, M.K.

    2010-01-01

    Background: Urinary Bladder cancer is a fatal disease. No work about its risk factors has been conducted in northern Pakistan. This case control study was conducted in order to investigate the risk factors of the urinary bladder cancer in that area. Method: For this study 150 subjects including 50 cases and 100 controls were interviewed from the 2 tertiary care hospitals of Peshawar and the information was collected about the characteristics like gender, age, smoking habits, family history of cancer, etc. Descriptive and inferential statistics were used to explain the risk factors of the disease. Odds ratios and 95% Confidence Intervals were computed by using logistic regression model. Results: The odds ratio and 95% confidence interval for chemical exposure are 4.637 and (1.022-21.053), for cigarette smoking 19.526 and (4.688-81.329), for lifestyle 0.171 and (0.031-0.943), for fluid consumption 0.025 and (0.005-0.115), for fried items 5.934 and (1.429-4.648), and for fruits are 0.173 (0.045-0.660), respectively. Conclusions: Chemical exposure, cigarette smoking, and high use of fried items increase the risk of urinary bladder cancer. Moderate lifestyle, high fluid consumption and use of fruits are protective against the disease. (author)

  4. Perceptions of risk from workers in high risk industries with work related musculoskeletal disorders.

    Science.gov (United States)

    Hunter, D; Silverstein, B

    2014-01-01

    Work-related musculoskeletal disorders (WMSDs) remain a major occupational health problem, despite decades of research, outreach, and intervention. The aim of this study is to promote early identification and prevention of WMSDs by developing education and outreach materials grounded in interview data collected from workers that have recently filed for workers compensation (WC) for WMSDs. We conducted semi-structured telephone interviews with WC claimants (n=66) from high risk industries identified through the use of a Prevention Index (PI) in Washington state with WMSDs of the back, shoulder, hand/wrist, or knee. Perceptions regarding the degree of exposure to WMSD risk factors, the social construction of pain, and the potential to implement injury-prevention measures varied widely. Many workers dismissed their injuries as the result of "fluke" or "freak" occurrences and framed their exposure to risk factors for WMSDs as either inevitable or "just part of the job." Workers in high-risk industries for WMSDs described their work conditions in ways that suggested: (1) a lack of awareness of the potential for developing a WMSD, (2) a view of work-related pain as normal, and/or (3) a pattern of self-blame for WMSD onset. A paradigm that either asserts the inevitability of WMSDs or dismisses potential control measures presents both a significant barrier to injury prevention efforts as well as a major opportunity for future occupational health research.

  5. [Prevalence and risk factors for urinary incontinence in women living in the South Priaralye region].

    Science.gov (United States)

    Gaibullaev, A A; Iskandarova, G T; Abdurizaev, A A

    2016-04-01

    To estimate prevalence and types of urinary incontinence (UI) among women living in the South Priaralye region, and to analyze risk factors associated with UI. The population-based study was conducted by nested-typological method. Analysis was carried out on the data of 1487 women collected by a standard ICIQ-SF questionnaire, an assessment tool for female urinary incontinence recommended by the European Association of Urology. The study showed that the prevalence of UI among women aged 18 years and older in the South Priaralye region was 27%. The predominant type of the disease was stress UI since in 44.8% of women, the uncontrolled urine loss occurred during exercise. In 16.1% of women urgent type UI was observed, and in 38.6% mixed type of UI was found. The most significant risk factors for UI were recurrent urinary tract infection (odds ratio (OR) of 5.9 (95% confidence interval (CI) 4.12-8.38), gynecological disease (OR 2.7 (95% CI 1.99-3.59), enuresis in childhood (OR 2.4 (95% CI 1.21-4.88), constipation (OR = 2.1 (95% CI 1.45-2.93) the number of births (OR = 1.2 (95% CI 1,05-1.28), and occupation, namely work involving physical strain (odds ratio of 1.2 (95% CI 1.04-1.43). In the area of the South Priaralye, more than a fourth of adult females were found to have a UI. Understanding the nature and risk factors for UI will allow planning the resources required to provide treatment and preventive measures in the future.

  6. A statistical approach to evaluate flood risk at the regional level: an application to Italy

    Science.gov (United States)

    Rossi, Mauro; Marchesini, Ivan; Salvati, Paola; Donnini, Marco; Guzzetti, Fausto; Sterlacchini, Simone; Zazzeri, Marco; Bonazzi, Alessandro; Carlesi, Andrea

    2016-04-01

    Floods are frequent and widespread in Italy, causing every year multiple fatalities and extensive damages to public and private structures. A pre-requisite for the development of mitigation schemes, including financial instruments such as insurance, is the ability to quantify their costs starting from the estimation of the underlying flood hazard. However, comprehensive and coherent information on flood prone areas, and estimates on the frequency and intensity of flood events, are not often available at scales appropriate for risk pooling and diversification. In Italy, River Basins Hydrogeological Plans (PAI), prepared by basin administrations, are the basic descriptive, regulatory, technical and operational tools for environmental planning in flood prone areas. Nevertheless, such plans do not cover the entire Italian territory, having significant gaps along the minor hydrographic network and in ungauged basins. Several process-based modelling approaches have been used by different basin administrations for the flood hazard assessment, resulting in an inhomogeneous hazard zonation of the territory. As a result, flood hazard assessments expected and damage estimations across the different Italian basin administrations are not always coherent. To overcome these limitations, we propose a simplified multivariate statistical approach for the regional flood hazard zonation coupled with a flood impact model. This modelling approach has been applied in different Italian basin administrations, allowing a preliminary but coherent and comparable estimation of the flood hazard and the relative impact. Model performances are evaluated comparing the predicted flood prone areas with the corresponding PAI zonation. The proposed approach will provide standardized information (following the EU Floods Directive specifications) on flood risk at a regional level which can in turn be more readily applied to assess flood economic impacts. Furthermore, in the assumption of an appropriate

  7. Treatment recommendations in patients diagnosed with high-risk cutaneous squamous cell carcinoma

    International Nuclear Information System (INIS)

    Veness, M.J.

    2005-01-01

    Non-melanoma cutaneous cancers occur at an epidemic rate in Australia. With an ageing population, more Australians will develop these cancers and at an increasing rate. In the majority of cases local treatment is highly curative. However, a subset of the population will be diagnosed with a high-risk cutaneous squamous cell carcinoma. These can be defined as patients at risk of having subclinical metastases to regional lymph nodes based on unfavourable primary lesion features (including inadequately excised and recurrent lesions), patients with metastatic squamous cell carcinoma to regional lymph nodes, and squamous cell carcinoma in immunosuppressed patients. The mortality and morbidity associated with high-risk cutaneous squamous cell carcinoma is usually as a consequence of uncontrolled metastatic nodal disease and, to a lesser extent, distant metastases. Radiotherapy has an essential role in treating these patients and in many cases the addition of adjuvant radiotherapy may be life saving. It is therefore important that all clinicians treating skin cancers have an understanding and awareness of the optimal approach to these patients. The aim of this article is to present treatment recommendations based on an overview of the current published literature. Copyright (2005) Blackwell Science Pty Ltd

  8. Early detection of psychosis: finding those at clinical high risk.

    Science.gov (United States)

    Addington, Jean; Epstein, Irvin; Reynolds, Andrea; Furimsky, Ivana; Rudy, Laura; Mancini, Barbara; McMillan, Simone; Kirsopp, Diane; Zipursky, Robert B

    2008-08-01

    In early detection work, recruiting individuals who meet the prodromal criteria is difficult. The aim of this paper was to describe the development of a research clinic for individuals who appear to be at risk of developing a psychosis and the process for educating the community and obtaining referrals. The outcome of all referrals to the clinic over a 4-year period was examined. Following an ongoing education campaign that was over inclusive in order to aid recruitment, approximately 27% of all referrals met the criteria for being at clinical high risk of psychosis. We are seeing only a small proportion of those in the community who eventually go on to develop a psychotic illness. This raises two important issues, namely how to remedy the situation, and second, the impact of this on current research in terms of sampling bias and generalizability of research findings. © 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Asia Pty Ltd.

  9. Risk assessment methodology for Hanford high-level waste tanks

    International Nuclear Information System (INIS)

    Bott, T.F.; Mac Farlane, D.R.; Stack, D.W.; Kindinger, J.

    1992-01-01

    A methodology is presented for applying Probabilistic Safety Assessment techniques to quantification of the health risks posed by the high-level waste (HLW) underground tanks at the Department of Energy's Hanford reservation. This methodology includes hazard screening development of a list of potential accident initiators, systems fault trees development and quantification, definition of source terms for various release categories, and estimation of health consequences from the releases. Both airborne and liquid pathway releases to the environment, arising from aerosol and spill/leak releases from the tanks, are included in the release categories. The proposed methodology is intended to be applied to a representative subset of the total of 177 tanks, thereby providing a baseline risk profile for the HLW tank farm that can be used for setting clean-up/remediation priorities. Some preliminary results are presented for Tank 101-SY

  10. Risk Factors Associated with Incident Syphilis in a Cohort of High-Risk Men in Peru

    Science.gov (United States)

    Konda, Kelika A.; Roberts, Chelsea P.; Maguiña, Jorge L.; Leon, Segundo R.; Clark, Jesse L.; Coates, Thomas J.; Caceres, Carlos F.; Klausner, Jeffrey D.

    2016-01-01

    Background Syphilis is concentrated among high-risk groups, but the epidemiology of syphilis reinfection is poorly understood. We characterized factors associated with syphilis incidence, including reinfection, in a high-risk cohort in Peru. Methods Participants in the NIMH CPOL trial were assessed at baseline and 2 annual visits with HIV/STI testing and behavioral surveys. Participants diagnosed with syphilis also attended 4- and 9-month visits. All participants underwent syphilis testing with RPR screening and TPPA confirmation. Antibiotic treatment was provided according to CDC guidelines. Reinfection was defined as a 4-fold titer increase or recurrence of seroreactivity after successful treatment with subsequent negative RPR titers. The longitudinal analysis used a Possion generalized estimating equations model with backward selection of variables in the final model (criteria P <0.02). Results Of 2,709 participants, 191 (7.05%) were RPR-reactive (median 1:8, range 1:1–1:1024) with TPPA confirmation. There were 119 total cases of incident syphilis, which included both reinfection and first-time incident cases. In the bivariate analysis, the oldest 2 quartiles of age (incidence ratio (IR) 3.84; P <0.001 and IR 8.15; P <0.001) and being MSM/TW (IR 6.48; P <0.001) were associated with higher risk of incident syphilis infection. Of the sexual risk behaviors, older age of sexual debut (IR 12.53; P <0.001), not being in a stable partnership (IR 1.56, P = 0.035), higher number of sex partners (IR 3.01; P <0.001), unprotected sex in the past 3 months (IR 0.56; P = 0.003), HIV infection at baseline (IR 3.98; P <0.001) and incident HIV infection during the study period (IR 6.26; P = 0.003) were all associated with incident syphilis. In the multivariable analysis, older age group (adjusted incidence ratio (aIR) 6.18; P <0.001), men reporting having sex with a man (aIR 4.63; P <0.001), and incident HIV infection (aIR 4.48; P = 0.008) were significantly associated

  11. Risk Factors for Malnutrition in Seniors Aged 75+ Living in Home Environment in Selected Regions of the Czech Republic.

    Science.gov (United States)

    Brabcová, Iva; Trešlová, Marie; Bártlová, Sylva; Vacková, Jitka; Tóthová, Valerie; Motlová, Lenka

    2016-09-01

    Nutrition is an important social determinant of health that influences the ageing process. The aim of this study was to evaluate the nutritional condition of a group of seniors and identify the bio-psycho-social factors that increase the risk of malnutrition. The research was conducted using a quantitative method. The standardised scales Mini Nutritional Assessment - Short Form (MNA-SF) and the Geriatric depression scale (GDS-5) were used to evaluate the nutritional condition and tendency towards depression of the tested group. This group consisted of seniors aged 75 and above living in home environment in the České Budějovice region. The group was comprised of 320 seniors, 115 men (35.9%) and 205 women (64.1%), which corresponds to the composition of the population in the chosen region of the Czech Republic. Statistical data analysis was conducted using SASD 1.4.10 and SPSS 15.0 programs. Pearson's chi-squared test (Χ²) and Cramér's V were chosen for statistical testing. The significance level was set at 5%. The average BMI value of the seniors was 26.2 kg/m² (overweight). This value decreased with age. More than one third of the respondents were evaluated as being at risk of malnutrition (36.3%). Unintended weight loss was determined as the strongest risk factor of malnutrition. Seniors who had lowered their food intake stated unintended weight loss 10 times more often than respondents with no noticeable reduction in food intake. Seniors who showed signs of depression indicated weight loss three and a half times more often than respondents without depression. Meanwhile acute illness increased the risk by three times. Depression was found to be the cause and also the consequence of malnutrition. Despite the high prevalence of overweight and obesity, a large proportion of the respondents were running the risk of malnutrition. It was concluded that the strongest risk factors for malnutrition in the respondents were unintended weight loss, depression and

  12. Rapid Global River Flood Risk Assessment under Climate and Socioeconomic Scenarios: An Extreme Case of Eurasian region

    Science.gov (United States)

    Kwak, Young-joo; Magome, Jun; Hasegawa, Akira; Iwami, Yoichi

    2017-04-01

    Causing widespread devastation with massive economic damage and loss of human lives, flood disasters hamper economic growth and accelerate poverty particularly in developing countries. Globally, this trend will likely continue due to increase in flood magnitude and lack of preparedness for extreme events. In line with risk reduction efforts since the early 21st century, the monitors and governors of global river floods should pay attention to international scientific and policy communities for support to facilitate evidence-based policy making with a special interest in long-term changes due to climate change and socio-economic effects. Although advanced hydrological inundation models and risk models have been developed to reveal flood risk, hazard, exposure, and vulnerability at a river basin, it is obviously hard to identify the distribution and locations of continent-level flood risk based on national-level data. Therefore, we propose a methodological possibility for rapid global flood risk assessment with the results from its application to the two periods, i.e., Present (from 1980 to 2004) and Future (from 2075 to 2099). The method is particularly designed to effectively simplify complexities of a hazard area by calculating the differential inundation depth using GFID2M (global flood inundation depth 2-dimension model), despite low data availability. In this research, we addressed the question of which parts in the Eurasian region (8E to 180E, 0N to 60N) can be found as high-risk areas in terms of exposed population and economy in case of a 50-year return period flood. Economic losses were estimated according to the Shared Socioeconomic Pathways (SSP) scenario, and the flood scale was defined using the annual maximum daily river discharge under the extreme conditions of climate change simulated with MRI-AGCM3.2S based on the Representative Concentration Pathways (RCP8.5) emissions scenario. As a preliminary result, the total potential economic loss in the

  13. Regional cooperation to reduce the safety and security risks of Orphan radioactive sources

    International Nuclear Information System (INIS)

    Howard, Geoffrey; Hacker, Celia; Murray, Allan; Romallosa, Kristine; Caseria, Estrella; Africa del Castillo, Lorena

    2008-01-01

    ANSTO's Regional Security of Radioactive Sources (RSRS) Project, in cooperation with the Philippine Nuclear Research Institute (PNRI), has initiated a program to reduce the safety and security risks of orphan radioactive sources in the Philippines. Collaborative work commenced in February 2006 during the Regional Orphan Source Search and Methods Workshop, co-hosted by ANSTO and the US National Nuclear Security Administration. Further professional development activities have occurred following requests by PNRI to ANSTO to support improvements in PNRI's capability and training programs to use a range of radiation survey equipment and on the planning and methods for conducting orphan source searches. The activities, methods and outcomes of the PNRI-ANSTO cooperative program are described, including: i.) Delivering a training workshop which incorporates use of source search and nuclide identification equipment and search methodology; and train-the-trainer techniques for effective development and delivery of custom designed training in the Philippines; ii.) Support and peer review of course work on Orphan Source Search Equipment and Methodology developed by PNRI Fellows; iii.) Supporting the delivery of the inaugural National Training Workshop on Orphan Source Search hosted by PNRI in the Philippines; iv.) Partnering in searching for orphan sources in Luzon, Philippines, in May 2007. The methods employed during these international cooperation activities are establishing a new model of regional engagement that emphasises sustainability of outcomes for safety and security of radioactive sources. (author)

  14. Rethinking International Counterterrorism Assistance to the Greater Horn of Africa: Toward a Regional Risk Reduction Strategy

    Directory of Open Access Journals (Sweden)

    Matthew Schwartz

    2013-12-01

    Full Text Available The Horn of Africa has long been a recipient of foreign security assistance, with significant funds increasingly devoted to supporting subregional civilian-oriented counterterrorism efforts over the past decade. Despite efforts to better coordinate delivery, counterterrorism programming in the subregion generally remains fragmented, short-term, and siloed in implementation. This article argues that it is time to rethink the international community’s approach to counterterrorism assistance to the Horn of Africa and calls for a cohesive regional approach that not only bridges the gap between security and development, but also the gap between counterterrorism and human security. It emphasizes that the international community must not only better coordinate existing streams of counterterrorism assistance to the region, but also rethink how this assistance is designed and the ways it can be delivered to complement broader subregional development and security agendas. After a brief introduction to international counterterrorism assistance to the Horn of Africa, the article examines linkages across three thematic streams of programming being delivered to the subregion: anti-money laundering and countering the financing of terrorism; criminal justice capacity building assistance to counter terrorism; and, countering violent extremism. This discussion will highlight the need for a regional risk reduction strategy for the Horn of Africa that not only builds on the interplay of different streams of counterterrorism assistance, but on synergies across broader subregional development and security agendas as well.

  15. Impact of End-of-Life manoeuvres on the collision risk in protected regions

    Science.gov (United States)

    Frey, Stefan; Lemmens, Stijn; Bastida Virgili, Benjamin; Flohrer, Tim; Gass, Volker

    2017-09-01

    The Inter-Agency Space Debris Coordination Committee (IADC) Space Debris Mitigation Guidelines, issued in 2002 and revised in 2007, address the post mission disposal of objects in orbit. After their mission, objects crossing the Low Earth Orbit (LEO) should have a remaining lifetime in orbit not exceeding 25 years. Objects near the Geostationary Orbit (GEO) region should be placed in an orbit that remains outside of the GEO protected region. In this paper, the impact of satellites and rocket bodies performing End-of-Life (EOL) orbital manoeuvres on the collision risk in the LEO and GEO protected regions is investigated. The cases of full or partial compliance with the IADC post mission disposal guideline are studied. ESA's Meteoroid and Space Debris Terrestrial Environment Reference (MASTER) model is used to compare the space debris flux rate of the object during the remaining lifetime estimated for the pre-EOL-manoeuvre and for the post-EOL-manoeuvre orbit. The study shows that, on average, the probability of collision can be significantly decreased by performing an EOL-manoeuver.

  16. A Novel Risk Stratification to Predict Local-Regional Failures in Urothelial Carcinoma of the Bladder After Radical Cystectomy

    International Nuclear Information System (INIS)

    Baumann, Brian C.; Guzzo, Thomas J.; He Jiwei; Keefe, Stephen M.; Tucker, Kai; Bekelman, Justin E.; Hwang, Wei-Ting; Vaughn, David J.; Malkowicz, S. Bruce; Christodouleas, John P.

    2013-01-01

    Purpose: Local-regional failures (LF) following radical cystectomy (RC) plus pelvic lymph node dissection (PLND) with or without chemotherapy for invasive urothelial bladder carcinoma are more common than previously reported. Adjuvant radiation therapy (RT) could reduce LF but currently has no defined role because of previously reported morbidity. Modern techniques with improved normal tissue sparing have rekindled interest in RT. We assessed the risk of LF and determined those factors that predict recurrence to facilitate patient selection for future adjuvant RT trials. Methods and Materials: From 1990-2008, 442 patients with urothelial bladder carcinoma at University of Pennsylvania were prospectively followed after RC plus PLND with or without chemotherapy with routine pelvic computed tomography (CT) or magnetic resonance imaging (MRI). One hundred thirty (29%) patients received chemotherapy. LF was any pelvic failure detected before or within 3 months of distant failure. Competing risk analyses identified factors predicting increased LF risk. Results: On univariate analysis, pathologic stage ≥pT3, <10 nodes removed, positive margins, positive nodes, hydronephrosis, lymphovascular invasion, and mixed histology significantly predicted LF; node density was marginally predictive, but use of chemotherapy, number of positive nodes, type of surgical diversion, age, gender, race, smoking history, and body mass index were not. On multivariate analysis, only stage ≥pT3 and <10 nodes removed were significant independent LF predictors with hazard ratios of 3.17 and 2.37, respectively (P<.01). Analysis identified 3 patient subgroups with significantly different LF risks: low-risk (≤pT2), intermediate-risk (≥pT3 and ≥10 nodes removed), and high-risk (≥pT3 and <10 nodes) with 5-year LF rates of 8%, 23%, and 42%, respectively (P<.01). Conclusions: This series using routine CT and MRI surveillance to detect LF confirms that such failures are relatively common in

  17. A Novel Risk Stratification to Predict Local-Regional Failures in Urothelial Carcinoma of the Bladder After Radical Cystectomy

    Energy Technology Data Exchange (ETDEWEB)

    Baumann, Brian C. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Guzzo, Thomas J. [Department of Urology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); He Jiwei [Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Keefe, Stephen M. [Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Tucker, Kai; Bekelman, Justin E. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Hwang, Wei-Ting [Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Vaughn, David J. [Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Malkowicz, S. Bruce [Department of Urology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Christodouleas, John P., E-mail: christojo@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2013-01-01

    Purpose: Local-regional failures (LF) following radical cystectomy (RC) plus pelvic lymph node dissection (PLND) with or without chemotherapy for invasive urothelial bladder carcinoma are more common than previously reported. Adjuvant radiation therapy (RT) could reduce LF but currently has no defined role because of previously reported morbidity. Modern techniques with improved normal tissue sparing have rekindled interest in RT. We assessed the risk of LF and determined those factors that predict recurrence to facilitate patient selection for future adjuvant RT trials. Methods and Materials: From 1990-2008, 442 patients with urothelial bladder carcinoma at University of Pennsylvania were prospectively followed after RC plus PLND with or without chemotherapy with routine pelvic computed tomography (CT) or magnetic resonance imaging (MRI). One hundred thirty (29%) patients received chemotherapy. LF was any pelvic failure detected before or within 3 months of distant failure. Competing risk analyses identified factors predicting increased LF risk. Results: On univariate analysis, pathologic stage {>=}pT3, <10 nodes removed, positive margins, positive nodes, hydronephrosis, lymphovascular invasion, and mixed histology significantly predicted LF; node density was marginally predictive, but use of chemotherapy, number of positive nodes, type of surgical diversion, age, gender, race, smoking history, and body mass index were not. On multivariate analysis, only stage {>=}pT3 and <10 nodes removed were significant independent LF predictors with hazard ratios of 3.17 and 2.37, respectively (P<.01). Analysis identified 3 patient subgroups with significantly different LF risks: low-risk ({<=}pT2), intermediate-risk ({>=}pT3 and {>=}10 nodes removed), and high-risk ({>=}pT3 and <10 nodes) with 5-year LF rates of 8%, 23%, and 42%, respectively (P<.01). Conclusions: This series using routine CT and MRI surveillance to detect LF confirms that such failures are relatively common

  18. 2017 Taiwan lipid guidelines for high risk patients

    Directory of Open Access Journals (Sweden)

    Yi-Heng Li

    2017-04-01

    Full Text Available In Taiwan, the prevalence of hyperlipidemia increased due to lifestyle and dietary habit changes. Low density lipoprotein cholesterol (LDL-C and non-high density lipoprotein cholesterol (non-HDL-C are all significant predicting factors of coronary artery disease in Taiwan. We recognized that lipid control is especially important in patients with existed atherosclerotic cardiovascular diseases (ASCVD, including coronary artery disease (CAD, ischemic stroke and peripheral arterial disease (PAD. Because the risk of ASCVD is high in patients with diabetes mellitus (DM, chronic kidney disease (CKD and familial hypercholesterolemia (FH, lipid control is also necessary in these patients. Lifestyle modification is the first step to control lipid. Weight reduction, regular physical exercise and limitation of alcohol intake all reduce triglyceride (TG levels. Lipid-lowering drugs include HMG-CoA reductase inhibitors (statins, cholesterol absorption inhibitors (ezetimibe, proprotein convertase subtilisin/kexin type 9 (PCSK9 inhibitors, nicotinic acids (niacin, fibric acids derivatives (fibrates, and long-chain omega-3 fatty acids. Statin is usually the first line therapy. Combination therapy with statin and other lipid-lowering agents may be considered in some clinical settings. For patients with acute coronary syndrome (ACS and stable CAD, LDL-C 40 in men and >50 mg/dL in women in DM. LDL-C increased CV risk in patients with CKD. In adults with glomerular filtration rate (GFR < 60 mL/min/1.73m2 without chronic dialysis (CKD stage 3–5, statin therapy should be initiated if LDL-C ≥ 100 mg/dL. Ezetimibe can be added to statin to consolidate the CV protection in CKD patients. Mutations in LDL receptor, apolipoprotein B and PCSK9 genes are the common causes of FH. Diagnosis of FH usually depends on family history, clinical history of premature CAD, physical findings of xanthoma or corneal arcus and high levels of LDL-C. In addition to conventional lipid

  19. Entropy measure of credit risk in highly correlated markets

    Science.gov (United States)

    Gottschalk, Sylvia

    2017-07-01

    We compare the single and multi-factor structural models of corporate default by calculating the Jeffreys-Kullback-Leibler divergence between their predicted default probabilities when asset correlations are either high or low. Single-factor structural models assume that the stochastic process driving the value of a firm is independent of that of other companies. A multi-factor structural model, on the contrary, is built on the assumption that a single firm's value follows a stochastic process correlated with that of other companies. Our main results show that the divergence between the two models increases in highly correlated, volatile, and large markets, but that it is closer to zero in small markets, when asset correlations are low and firms are highly leveraged. These findings suggest that during periods of financial instability, when asset volatility and correlations increase, one of the models misreports actual default risk.

  20. Soft Skills in Health Careers Programs: A Case Study of A Regional Vocational Technical High School

    Science.gov (United States)

    Park, Chong Myung

    2017-01-01

    The purpose of this study is to develop an understanding of the ways in which educational experiences might differ between a regional vocational technical high school (RVTH) and short-term career-training programs. A particular regional vocational technical high school was selected for its outstanding academic records and placement rates, and a…

  1. Network Connectedness, Sense of Community, and Risk Perception of Climate Change Professionals in the Pacific Islands Region

    Science.gov (United States)

    Corlew, L. K.; Keener, V. W.; Finucane, M.

    2013-12-01

    The Pacific Regional Integrated Sciences and Assessments (Pacific RISA) Program conducted social network analysis research of climate change professionals (broadly defined) who are from or work in Hawaii and the U.S.-Affiliated Pacific Islands (USAPI) region. This study is supported by the National Oceanic and Atmospheric Administration (NOAA) and the Pacific Islands Climate Science Center (PICSC) to address an identified need for a resource that quantifies the region's collaborative network of climate change professionals, and that supports the further development of cross-regional and inter-sectoral collaborations for future research and adaptation activities. A survey was distributed to nearly 1,200 people who are from and/or work in climate change related fields in the region. The Part One Survey questions (not confidential) created a preferential attachment network by listing major players in Hawaii and the USAPI, with additional open fields to identify important contacts in the greater professional network. Participants (n=340) identified 975 network contacts and frequency of communications (weekly, monthly, seasonally, yearly, at least once ever). Part Two Survey questions (confidential, n=302) explored climate change risk perceptions, Psychological Sense of Community (PSOC), sense of control over climate change impacts, sense of responsibility to act, policy beliefs and preferences regarding climate change actions, concern and optimism scales about specific impacts, and demographic information. Graphical representations of the professional network are being developed for release in September 2013 as a free online tool to promote and assist collaboration building among climate professionals in the region. The graphs are partitioned according to network 'hubs' (high centrality), participant location, and profession to clearly identify network strengths and opportunities for future collaborations across spatial and professional boundaries. For additional

  2. A systematic review of childhood obesity in the Middle East and North Africa (MENA) region: Prevalence and risk factors meta-analysis.

    Science.gov (United States)

    Farrag, Nesrine S; Cheskin, Lawrence J; Farag, Mohamed K

    2017-01-01

    Obesity rates are rising globally, but there is evidence that young people in the Middle East and North Africa (MENA) region are at particularly high risk. We systematically searched the literature to map the MENA region for prevalence of childhood overweight and obesity, and examine the underlying risk factors and adverse effects associated with obesity in this region. Inclusion criteria were: English-language, non-basic-science focused articles that used any of the standard obesity definitions and were conducted in the MENA countries within the last five years. We searched PubMed using combinations of key terms ((childhood) OR adolescence) AND obesity) AND (MENA or each country) AND ("last five years" [PDat]). Studies demonstrated an increasing prevalence of obesity among many countries in the MENA region, especially in the Gulf area. Notably, in Kuwait, prevalence rates of overweight and obesity were 25.6% and 34.8% among young males and 20.8% and 20.5% among females. A meta-analysis revealed that physical inactivity, increased screen time, and higher social status were risk factors for childhood obesity. Childhood and adolescent obesity is a major challenge facing countries of the MENA region. Further research is needed to fully investigate the role of nutrition and other specific risk factors and evaluate various interventions to manage this pervasive and growing health problem.

  3. Identifying risk factors of highly pathogenic avian influenza (H5N1 subtype) in Indonesia.

    Science.gov (United States)

    Loth, Leo; Gilbert, Marius; Wu, Jianmei; Czarnecki, Christina; Hidayat, Muhammad; Xiao, Xiangming

    2011-10-01

    Highly pathogenic avian influenza (HPAI), subtype H5N1, was first officially reported in Indonesia in 2004. Since then the disease has spread and is now endemic in large parts of the country. This study investigated the statistical relationship between a set of risk factors and the presence or absence of HPAI in Indonesia during 2006 and 2007. HPAI was evaluated through participatory disease surveillance (PDS) in backyard village chickens (the study population), and risk factors included descriptors of people and poultry distribution (separating chickens, ducks and production sectors), poultry movement patterns and agro-ecological conditions. The study showed that the risk factors "elevation", "human population density" and "rice cropping" were significant in accounting for the spatial variation of the PDS-defined HPAI cases. These findings were consistent with earlier studies in Thailand and Vietnam. In addition "commercial poultry population", and two indicators of market locations and transport; "human settlements" and "road length", were identified as significant risk factors in the models. In contrast to several previous studies carried out in Southeast Asia, domestic backyard ducks were not found to be a significant risk factor in Indonesia. The study used surrogate estimates of market locations and marketing chains and further work should focus on the actual location of the live bird markets, and on the flow of live poultry and poultry products between them, so that patterns of possible transmission, and regions of particular risk could be better inferred. Copyright © 2011 Elsevier B.V. All rights reserved.

  4. The carcinogenic risks of low-LET and high-LET ionizing radiations

    International Nuclear Information System (INIS)

    Fabrikant, J.I.

    1991-08-01

    This report presents a discussion on risk from ionizing radiations to human populations. Important new information on human beings has come mainly from further follow-up of existing epidemiological studies, notably the Japanese atomic bomb survivors and the ankylosing spondylitis patients; from new epidemiological surveys, such as the patients treated for cancer of the uterine cervix; and from combined surveys, including workers exposed in underground mines. Since the numerous and complex differences among the different study populations introduce factors that influence the risk estimates derived in ways that are not completely understood, it is not clear how to combine the different risk estimates obtained. These factors involve complex biological and physical variables distributed over time. Because such carcinogenic effects occur too infrequently to be demonstrated at low doses, the risks of low-dose radiation can be estimated only by interpolation from observations at high doses on the basis of theoretical concepts, mathematical models and available empirical evidence, primarily the epidemiological surveys of large populations exposed to ionizing radiation. In spite of a considerable amount of research, only recently has there has been efforts to apply the extensive laboratory data in animals to define the dose-incidence relationship in the low dose region. There simply are insufficient data in the epidemiological studies of large human populations to estimate risk coefficients directly from exposure to low doses. The risk estimates for the carcinogenic effects of radiation have been, in the past, somewhat low and reassessment of the numerical values is now necessary

  5. Risks for cancer induction by pion radiation in the peak- and plateau region

    International Nuclear Information System (INIS)

    Cottier, H.; Fritz-Niggli, H.; Froehlich, E.; Heinzell, F.; Nichel, C.; Rao, K.

    In the foreground of an evaluation of the suitability of negative protons for cancer therapy there is, beside the analysis of pion effect on malignant cells, also the reaction of healthy tissue. The observation that neutrons at the lowest dose-rate can induce breast cancer and our own results after pion radiation in the peak-region necessitate a broadly planned, urgent investigation of these delayed damages. We will consider radiations at the plateau- and peak-region, the results of which should be of utmost interest for the comparison of neutron- and pion therapy. There are indications that the RBE of a high LET radiation is extremely large for the tumor induction. We will investigate especially the development of mammary cancers in variously aged mice with a low spontaneous tumor rate and C 3 H mice with a high cancer expectancy

  6. [Residual risk: The roles of triglycerides and high density lipoproteins].

    Science.gov (United States)

    Grammer, Tanja; Kleber, Marcus; Silbernagel, Günther; Scharnagl, Hubert; März, Winfried

    2016-06-01

    In clinical trials, the reduction of LDL-cholesterol (LDL-C) with statins reduces the incidence rate of cardiovascular events by approximately one third. This means, that a sizeable "residual risk" remains. Besides high lipoprotein (a), disorders in the metabolism of triglyceride-rich lipoproteins and high density liproteins have been implicated as effectors of the residual risk. Both lipoprotein parameters correlate inversely with each other. Therefore, the etiological contributions of triglycerides and / or of HDL for developing cardiovascular disease can hardly be estimated from either observational studies or from intervention studies. The largely disappointing results of intervention studies with inhibitors of the cholesteryl ester transfer protein and in particular the available set of genetically-epidemiological studies suggest that in the last decade, the importance of HDL cholesterol has been overvalued, while the importance of triglycerides has been underestimated. High triglycerides not always atherogenic, but only if they are associated with the accumulation relatively cholesterol-enriched, incompletely catabolized remnants of chylomicrons and very low density lipoproteins (familial type III hyperlipidemia, metabolic syndrome, diabetes mellitus). The normalization of the concentration of triglycerides and remnants by inhibiting the expression of apolipoprotein C3 is hence a new, promising therapeutic target. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Genetic variants in regulatory regions of microRNAs are associated with lung cancer risk.

    Science.gov (United States)

    Xie, Kaipeng; Wang, Cheng; Qin, Na; Yang, Jianshui; Zhu, Meng; Dai, Juncheng; Jin, Guangfu; Shen, Hongbing; Ma, Hongxia; Hu, Zhibin

    2016-07-26

    Genetic variants in regulatory regions of some miRNAs might be associated with lung cancer risk and survival. We performed a case-control study including 1341 non-small cell lung cancer (NSCLC) cases and 1982 controls to evaluate the associations of 7 potentially functional polymorphisms in several differently expressed miRNAs with NSCLC risk. Each SNP was also tested for the association with overall survival of 1001 NSCLC patients. We identified that rs9660710 in miR-200b/200a/429 cluster and rs763354 in miR-30a were significantly associated with NSCLC risk [odds ratio (OR) = 1.17, 95% confidence interval (CI) = 1.06-1.30, P = 0.002; OR = 0.88, 95% CI = 0.80-0.98, P = 0.017; respectively]. However, no significant association between variants and NSCLC death risk was observed in survival analysis. Functional annotation showed that both rs9660710 and rs763354 were located in regulatory elements in lung cancer cells. Compared to normal tissues, miR-200a-3p, miR-200a-5p, miR-200b-3p, miR-200b-5p and miR-429 were significantly increased in The Cancer Genome Atlas (TCGA) Lung Adenocarcinoma (LUAD) tumors, whereas miR-30a-3p and miR-30a-5p were significantly decreased in tumors (all P < 0.05). Furthermore, we observed that rs9660710 is an expression quantitative trait locus (eQTL) or methylation eQTL for miR-429 expression in TCGA normal tissues. Our results indicated that rs9660710 in miR-200b/200a/429 cluster and rs763354 in miR-30a might modify the susceptibility to NSCLC.

  8. A moni-modelling approach to manage groundwater risk to pesticide leaching at regional scale.

    Science.gov (United States)

    Di Guardo, Andrea; Finizio, Antonio

    2016-03-01

    Historically, the approach used to manage risk of chemical contamination of water bodies is based on the use of monitoring programmes, which provide a snapshot of the presence/absence of chemicals in water bodies. Monitoring is required in the current EU regulations, such as the Water Framework Directive (WFD), as a tool to record temporal variation in the chemical status of water bodies. More recently, a number of models have been developed and used to forecast chemical contamination of water bodies. These models combine information of chemical properties, their use, and environmental scenarios. Both approaches are useful for risk assessors in decision processes. However, in our opinion, both show flaws and strengths when taken alone. This paper proposes an integrated approach (moni-modelling approach) where monitoring data and modelling simulations work together in order to provide a common decision framework for the risk assessor. This approach would be very useful, particularly for the risk management of pesticides at a territorial level. It fulfils the requirement of the recent Sustainable Use of Pesticides Directive. In fact, the moni-modelling approach could be used to identify sensible areas where implement mitigation measures or limitation of use of pesticides, but even to effectively re-design future monitoring networks or to better calibrate the pedo-climatic input data for the environmental fate models. A case study is presented, where the moni-modelling approach is applied in Lombardy region (North of Italy) to identify groundwater vulnerable areas to pesticides. The approach has been applied to six active substances with different leaching behaviour, in order to highlight the advantages in using the proposed methodology. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Trends in the risk of mortality due to cardiovascular diseases in five Brazilian geographic regions from 1979 to 1996

    Directory of Open Access Journals (Sweden)

    Maria de Fátima Marinho de Souza

    2001-12-01

    Full Text Available OBJECTIVE - To analyze the trends in risk of death due to cardiovascular diseases in the northern, northeastern, southern, southeastern, and central western Brazilian geographic regions from 1979 to 1996. METHODS - Data on mortality due to cardiovascular, cardiac ischemic, and cerebrovascular diseases in 5 Brazilian geographic regions were obtained from the Ministry of Health. Population estimates for the time period from 1978 to 1996 in the 5 Brazilian geographic regions were calculated by interpolation with the Lagrange method, based on the census data from 1970, 1980, 1991, and the population count of 1996, for each age bracket and sex. Trends were analyzed with the multiple linear regression model. RESULTS - Cardiovascular diseases showed a declining trend in the southern, southeastern, and northern Brazilian geographic regions in all age brackets and for both sexes. In the northeastern and central western regions, an increasing trend in the risk of death due to cardiovascular diseases occurred, except for the age bracket from 30 to 39 years, which showed a slight reduction. This resulted from the trends of cardiac ischemic and cerebrovascular diseases. The analysis of the trend in the northeastern and northern regions was impaired by the great proportion of poorly defined causes of death. CONCLUSION - The risk of death due to cardiovascular, cerebrovascular, and cardiac ischemic diseases decreased in the southern and southeastern regions, which are the most developed regions in the country, and increased in the least developed regions, mainly in the central western region.

  10. High-Risk Driving Behaviors among Adolescent Binge-Drinkers

    Science.gov (United States)

    Marcotte, Thomas D.; Bekman, Nicole M.; Meyer, Rachel A.; Brown, Sandra A.

    2013-01-01

    Background Binge drinking is common among adolescents. Alcohol use, and binge-drinking in particular, has been associated with neurocognitive deficits as well as risk-taking behaviors, which may contribute to negative driving outcomes among adolescents even while sober. Objectives To examine differences in self-reported driving behaviors between adolescent binge-drinkers and a matched sample of controls, including (a) compliance with graduated licensing laws, (b) high risk driving behaviors, and (c) driving outcomes (crashes, traffic tickets). Methods The present study examined driving behaviors and outcomes in adolescent recent binge drinkers (n=21) and demographically and driving history matched controls (n=17), ages 16-18. Results Binge drinkers more frequently violated graduated licensing laws (e.g., driving late at night), and engaged in more “high risk” driving behaviors, such as speeding and using a cell-phone while driving. Binge drinkers had more traffic tickets, crashes and “near crashes” than the control group. In a multivariate analysis, binge drinker status and speeding were the most robust predictors of a crash. Conclusion Binge drinking teens consistently engage in more dangerous driving behaviors and experience more frequent crashes and traffic tickets. They are also less compliant with preventative restrictions placed on youth while they are learning critical safe driving skills. Scientific Significance These findings highlight a need to examine the contribution of underlying traits (such as sensation seeking) and binge-related cognitive changes to these high-risk driving behaviors, which may assist researchers in establishing alternative prevention and policy efforts targeting this population. PMID:22324748

  11. Multi scale Disaster Risk Reduction Systems Space and Community based Experiences over HKH Region

    OpenAIRE

    Gurung, D. R.; Shrestha, M.; Shrestha, N.; Debnath, B.; Jishi, G.; Bajracharya, R.; Dhonju, H. K.; Pradhan, S.

    2014-01-01

    An increasing trend in the recurrence of natural disasters and associated impacts due to Floods, Glacier Lake out bursts, landslides and forest fire is reported over Hindu Kush Himalyan (HKH) region. Climate change and anthropogenic coupled factors are identified as primary factors for such increased vulnerability. The large degree of poverty, lack of infrastructure, poor accessibility and uncertainties involved in understanding high altitude land surface and climate dynamics poses s...

  12. Coupling HYDRUS-1D with ArcGIS to estimate pesticide accumulation and leaching risk on a regional basis.

    Science.gov (United States)

    Anlauf, Ruediger; Schaefer, Jenny; Kajitvichyanukul, Puangrat

    2018-07-01

    HYDRUS-1D is a well-established reliable instrument to simulate water and pesticide transport in soils. It is, however, a point-specific model which is usually used for site-specific simulations. Aim of the investigation was the development of pesticide accumulation and leaching risk maps for regions combining HYDRUS-1D as a model for pesticide fate with regional data in a geographical information system (GIS). It was realized in form of a python tool in ArcGIS. Necessary high resolution local soil information, however, is very often not available. Therefore, worldwide interpolated 250-m-grid soil data (SoilGrids.org) were successfully incorporated to the system. The functionality of the system is shown by examples from Thailand, where example regions that differ in soil properties and climatic conditions were exposed in the model system to pesticides with different properties. A practical application of the system will be the identification of areas where measures to optimize pesticide use should be implemented with priority. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. Regional spore dispersal as a factor in disease risk warnings for potato late blight: A proof of concept

    NARCIS (Netherlands)

    Skelsey, P.; Kessel, G.J.T.; Holtslag, A.A.M.; Moene, A.F.; Werf, van der W.

    2009-01-01

    This study develops and tests a novel approach for including regional risk factors in operational disease risk warnings against potato late blight. The central premise is that fungicide inputs can be reduced by omitting applications on days when conditions are unsuitable for the atmospheric

  14. Regional spore dispersal as a factor in disease risk warnings for potato late blight : A proof of concept

    NARCIS (Netherlands)

    Skelsey, P.; Kessel, G. J. T.; Holtslag, A. A. M.; Moene, A. F.; van der Werf, W.

    2009-01-01

    This study develops and tests a novel approach for including regional risk factors in operational disease risk warnings against potato late blight. The central premise is that fungicide inputs can be reduced by omitting applications on days when conditions are unsuitable for the atmospheric