Exploring informal settlement fires in Indonesia: A study of fire risk assessment and fire resilient strategies in Medan

Background: Uptake of genetic testing for cancer susceptibility in family members of cancer patients is suboptimal. The GENetic Education, Risk Assessment, and TEsting (GENERATE) study evaluated two strategies of remote genetic education and testing in relatives of pancreatic ductal adenocarcinoma (PDAC) patients. Methods: Eligible participants had: a first-degree relative with PDAC or had a known pathogenic germline variant (PGV) in one of thirteen PDAC predisposition genes (APC, ATM, BRCA1, BRCA2, CDKN2A, EPCAM, MLH1, MSH2, MSH6, PALB2, PMS2, STK11, or TP53) and a first- or second-degree relative with PDAC. Participants were cluster-randomized by family into one of two arms. Arm 1 included an interactive telemedicine session with a genetic counselor, followed by genetic testing at a commercial laboratory. Arm 2 involved remote online genetic education and testing at the commercial laboratory without the interactive session. The primary outcome was uptake of genetic testing across study arms, which was compared by permutation tests and mixed-effects logistic regression models. Results: Between 5/8/2019 and 6/1/2021, 424 families were randomized, including 601 participants (n=296 Arm 1; n=305 Arm 2). The uptake of genetic testing was 87% (257/296) in Arm 1 and 93% (284/305) in Arm 2 (p=0.014). Participants in Arm 1 were significantly less likely to obtain genetic testing compared to Arm 2 (Adjusted ratio [Arm1/Arm2] 0.90, 95% confidence interval 0.78-0.98). BRCA2, ATM, CDKN2A and PALB2 were the most common PDAC susceptibility genes in which PGVs were identified. Conclusions: Remote methods of genetic education and testing are successful alternatives to traditional germline susceptibility testing. Citation Format: Nicolette J. Rodriguez, C. Sloane Furniss, Matthew B. Yurgelun, Chinedu Ukaegbu, Pamela E. Constantinou, Ileana Fortes, Alyson Caruso, Alison N. Schwartz, Jill E. Stopfer, Meghan Underhill-Blazey, Barbara Kenner, Scott H. Nelson, Sydney Okumura, Alicia Y. Zhou, Tara B. Coffin, Hajime Uno, Miki Horiguchi, Allyson J. Ocean, Florencia McAllister, Andrew M. Lowy, Scott M. Lippman, Alison P. Klein, Lisa Madlensky, Gloria M. Petersen, Judy E. Garber, Michael G. Goggins, Anirban Maitra, Sapna Syngal. A randomized study of two Strategies of remote Genetic Education, Risk Assessment, and Testing (GENERATE) for family members of patients with pancreatic cancer [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer; 2022 Sep 13-16; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2022;82(22 Suppl):Abstract nr A029.

Ecotoxicity tests are performed on vertebrates and invertebrates for the environmental risk assessment of pesticides and other chemicals and for a variety of ecotoxicological studies in the laboratory and in the field. Existing practices and strategies in ecotoxicity testing are reviewed, including an account of current requirements of the European Commission for the testing of pesticides and the recent REACH (Registration, Evaluation, Authorisation and Restrictions of Chemicals) proposals for industrial chemicals. Criticisms of existing practices have been made on both scientific and ethical grounds, and these are considered before dealing with the question of possible alternative methods and strategies both for environmental risk assessment and for ecotoxicological studies more generally. New approaches from an ecological point of view are compared with recent developments in laboratory-based methods such as toxicity tests, biomarker assays and bioassays. With regard to the development of new strategies for risk assessment, it is suggested that full consideration should be given to the findings of earlier long-term studies of pollution, which identified mechanisms of action by which environmental chemicals can cause natural populations to decline. Neurotoxicity and endocrine disruption are two cases in point, and biomarker assays for them could have an important role in testing new chemicals suspected of having these properties. In a concluding discussion, possible ways of improving testing protocols are discussed, having regard for current issues in the field of environmental risk assessment as exemplified by the debate over the REACH proposals. The importance of flexibility and the roles of ecologists and ecotoxicologists are stressed in the context of environmental risk assessment.

Purpose The Organisation for Economic Co-operation and Development (OECD) Adverse Outcome Pathway (AOP) Development Programme is being explored in the radiation field, as an overarching framework to identify and prioritize research needs that best support strengthening of radiation risk assessment and risk management strategies. To advance the use of AOPs, an international horizon-style exercise (HSE) was initiated through the Radiation/Chemical AOP Joint Topical Group (JTG) formed by the OECD Nuclear Energy Agency (NEA) High-Level Group on Low Dose Research (HLG-LDR) under the auspices of the Committee on Radiological Protection and Public Health (CRPPH). The intent of the HSE was to identify key research questions for consideration in AOP development that would help to reduce uncertainties in estimating the health risks following exposures to low dose and low dose-rate ionizing radiation. The HSE was conducted in several phases involving the solicitation of relevant questions, a collaborative review of open-ended candidate questions and an elimination exercise that led to the selection of 25 highest priority questions for the stated purpose. These questions were further ranked by over 100 respondents through an international survey. This final set of questions was judged to provide insights into how the OECD’s AOP approach can be put into practice to meet the needs of hazard and risk assessors, regulators, and researchers. This paper examines the 25 priority questions in the context of hazard/risk assessment framework for ionizing radiation. Conclusion By addressing the 25 priority questions, it is anticipated that constructed AOPs will have a high level of specificity, making them valuable tools for simplifying and prioritizing complex biological processes for use in developing revised radiation hazard and risk assessment strategies.

Antiphospholipid antibodies (aPL) are a cluster of autoantibodies directed against plasma proteins with affinity for membrane phospholipids. The most frequently tested aPL are lupus anticoagulant (LA), anti-cardiolipin antibodies (aCL), and anti-β2-glycoprotein I antibodies (anti-β2GPI). aPL play a key pathogenic role in the development of the antiphospholipid syndrome (APS), a systemic autoimmune disease characterized by recurrent thrombotic and/or pregnancy complications in patients with persistent aPL. However, aPL positivity is occasionally documented in patients with no previous history of thrombotic or pregnancy morbidity. LA activity, multiple aPL positivity, high-titer aPL, and a concomitant systemic autoimmune disease are recognized risk factors for future thrombotic events in asymptomatic carriers. Moreover, an accelerated atherosclerosis with increased cardiovascular (CV) risk has also been associated with aPL positivity, thus exposing aPL carriers to fatal complications and chronic disability requiring cardiac rehabilitation. Overall, an accurate risk stratification is recommended for aPL-positive subjects in order to prevent both venous and arterial thrombotic complications. In this review, we provide an overview of the main antithrombotic and risk assessment strategies in aPL carriers.

Introduction: A 20-year liposuction single-surgeon experience investigating physician qualifications, identifying a preoperative risk assessment, and confirming a perioperative surgical management protocol with Part 1 of the project. The progression of surgical technique and implementation of new technologies optimized the aesthetic results while minimizing complications and side effects in Part 2. Materials and Methods: Both retrospective and prospective clinical studies and PubMed literature searches were carried out on all variables involved in the different surgical techniques to include microcannula suction-assisted liposuction (mSAL), standard cannula size suction-assisted liposuction (SAL), water-jet–assisted liposuction (WAL), third-generation ultrasound (Vibration Amplification of Sound Energy at Resonance [VASER]) liposuction, laser-assisted liposuction (LAL), nutational infrasonic liposuction (NIL), high-definition VASER liposuction, helium-based plasma radiofrequency technology (HBT), and lipoabdominoplasty. Results: The evolution of liposuction reviewing the historical transformations in surgical technique and technologies is presented. Physician qualifications regarding training and education guidelines highlighting interspecialty published differences. Noting the minimum accepted duration, degree, and type of liposuction training to practice liposuction safely for our patients. Identifying the standard of care controversies to avoid medical malpractice litigation. The preoperative evaluation details a comprehensive body analysis, weight loss consultation reviewing all options for medical and surgical weight loss management, liposuction clinical indications, informed consent process, risk assessment strategies regarding avoiding lidocaine toxicity prevention, fluid overload prevention, minimizing and estimating blood loss and bruising, analyzing maximum fat output, thromboembolism risk calculation and prophylaxis, and analysis of simultaneous and staged ancillary aesthetic procedures. The day of surgery includes preoperative medical assessment, photographic documentation, surgical marking, anesthesia delivery and airway concerns, postsurgical therapeutic options, and postoperative pain management to minimize narcotic use with the risk of addiction, all to minimize side effects and complications and optimize aesthetic outcomes. Discussion: Review of the medical literature reviewing the historical highlights on the evolution of the liposuction technique and implementation of new technologies and use of personal clinical studies comparing different variables in a controlled setting, identified best practices. Conclusions: The current clinical liposuction technique used by the author offers a superior methodology in both an awake patient in an office-based setting and surgery setting environment by implementing a comprehensive preoperative risk assessment and risk avoidance strategies to minimize side effects and complications in Part 1 of this liposuction protocol. Employing the optimal defined surgical step variables with VASER high-definition liposculpting to achieve a slender, muscular appearance and adding HBT to maximize skin tightening along with postoperative maneuvers using fitted compression, therapeutic ultrasound, and lymphatic massage attains best practices in liposuction.

European Heart Rhythm Association (EHRA)/Heart Rhythm Society (HRS)/Asia Pacific Heart Rhythm Society (APHRS)/Latin American Heart Rhythm Society (LAHRS) expert consensus on risk assessment in cardiac arrhythmias: use the right tool for the right outcome, in the right population

We explore the optimal decision-making of a repurchase contract coordinated supply chain under stochastic price conditions with asymmetric cost-of-sale information and risk aversion of suppliers. A new repurchase contract model is constructed on the basis of the premise assumptions, solved and verified by simulation with examples, and the effects of information asymmetry and risk aversion on the relevant decision variables of the supply chain are considered after the coupling of information asymmetry and risk aversion. The results of the study show that: under the condition of random price, no matter whether the information is symmetric or not, as long as the suppliers are risk-averse, the decision variables related to the supply chain undergo bifurcation; no matter whether the market price is random or not, and no matter whether the suppliers are risk-averse or not, as long as the retailers conceal the information of private cost of goods sold, it will bring extra benefits to themselves, but it will bring damages to the suppliers and the entire supply chain; the The more asymmetric the information, the greater the oscillation of the relevant decision variables in the bifurcation mutation region. The bifurcation mutation phenomenon is a unique phenomenon after the coupling of market price stochasticity and supplier risk aversion; retailers are able to take advantage of the information asymmetry to bring additional benefits to themselves, but it will damage the interests of suppliers and the supply chain; the best countermeasure for suppliers to guard against this kind of detrimental self-interested behavior of retailers is to prompt retailers to make the cost of goods sold openly available in the least costly way by designing a cooperative mechanism; In addition, suppliers are better able to improve their own decision-making by responding to external risks with a smooth mindset.

258EMF Students’ Perspectives of a First Year Firearm Injury Prevention, Risk Assessment and Counseling Curricular Intervention

Risk assessment and management strategy of two new NDSRIs in a pharmaceutical drug product for the treatment of a rare disease: From prediction to control.

A new method for IVUS-based coronary artery disease risk stratification: A link between coronary & carotid ultrasound plaque burdens

What is needed to reduce the risk of anterior cruciate ligament injuries in children? – Hearing from experts

Advances in nonlinear dynamic analysis of dams have not completely resolved concerns over modeling confidence and analysis accuracy. Verification and validation offer accuracy assessment, but uncertainties persist during performance evaluation due to both epistemic (modeling) and aleatory (parametric) sources. Epistemic uncertainties arise from simplifications and modeling techniques. This paper addresses epistemic uncertainties in a gravity dam seismic analysis using data from the International Comnission on Large Dams (ICOLD) benchmark study. While the benchmark formulation included the finite element model of the dam, mechanical material properties, and dynamic loads, participants retained the flexibility to opt for best‐practice modeling assumptions, simplifications, and other specifics. Notable response variability emerged, particularly in crack profiles and damage predictions. This study examines sources of variability, quantifying modeling uncertainty for the benchmark problem. More specifically, the modeling variability is quantified using the logarithmic standard deviation, also known as dispersion. This metric enables its incorporation into other seismic risk assessment and fragility studies. Under relatively low‐intensity motion (peak ground acceleration [PGA] of 0.18 g in this case), modeling dispersion of 0.45, 0.30, 0.32, and 0.30 were calculated for the maximum dynamic crest displacement, maximum hydrodynamic pressure at the heel, heel and crest maximum acceleration, respectively. Additionally, the dispersion of the failure PGA was determined to be 0.7. Findings underscore the need for systematic seismic response modeling in dam engineering to enhance prediction accuracy. A better understanding of the sources and magnitudes of modeling uncertainties can help improve the reliability of dam seismic analysis and contribute to the development of more effective risk assessment and mitigation strategies.

Particulate matters generated during cooking contain various carcinogens. These particles consist of both ultrafine particles (nanoparticle) and coarse particles. Exposure and risk-assessment studies often use particle mass concentration as dosimetry, which ignores the impact of ultrafine particles due to their insignificant mass compared to coarse particles. This study aims at characterizing the cancer risk toward cooking-generated particulate matter using Hong Kong homes as an example. A risk-assessment scheme modified from an existing risk model was developed to consider the cancer risk contributed from both fine ultrafine and coarse particles. Exposure assessment was conducted based on particle concentration data measured in 16 Hong Kong homes. The predicted cancer risk was then compared to the cancer incidence rate in Hong Kong to examine its appropriateness. It was found that the ultrafine particles contribute a much higher risk than that of coarse particles, and the modified risk-assessment scheme gives an estimate much closer to the incidence rate than the conventional scheme. Use of grease extractor cannot completely contain the particles, and a significant portion of particles can be transported from kitchens to other regions of the homes. The modified risk assessment scheme can serve as a tool in assessing environmental quality as well as setting up design and ventilation guidelines and exposure standards on particulate matters.

The lack of long-term, sustainable strategic planning and development for sports and tourism in Kenya is a challenge for Kenya's sports tourism industry. The purpose of the study was thus to determine the impact of risk assessment methodologies on sporting tourism events. The specific objectives of the study were: to create a profile of the sports tourism events and venues, to establish the effect of crowd management and risk assessment strategies on sports tourism events in Nairobi County, Kenya; and to determine the moderating effect of financial capability on the relationship between crowd management, risk assessment strategies, and sports tourism events in Nairobi County, Kenya. In this study, a descriptive research approach was utilized, and the population of interest consisted of 17 prominent sporting event venues located within Nairobi County. The research focused its attention on a total of 340 participants in addition to 69 managers. The participants in the study, which consisted of 17 managers and 105 sportspeople, were chosen using a technique called purposeful sampling. In order to obtain data that reflect the ideas and opinions of the respondents in an unfiltered manner, questionnaires and an interview guide were used. A linear regression model was used to link the independent variable to the dependent variable. Result outputs were represented in tables, charts, and bars. The multiple linear regression analysis findings revealed a coefficient of determination of 0.700, implying that the independent variable used in this study; crowd management and risk management strategies, explains 70% of the variation in sports tourism events in Nairobi County, Kenya. The study established that there was a positive and statistically significant relationship between Crowd management and risk management strategies and the success of sports tourism events in Nairobi County (β=0.837, p=0.000<0.05). The study also established that financial capability had moderating effect on the relationship between crowd management and risk assessment strategies and the success of sports tourism events in Nairobi County. The study thus recommends a multi-agency approach to strengthen risk assessment and crowd management protocols. Keywords: Crowd Management, Sports Tourism Events, Risk Assessment Strategies, Kenya Sports Tourism Safety, Nairobi County Sports Events

BackgroundThe search for biologic endpoints and biomarkers in the study of breast cancer risk assessment and risk reduction strategies has led to an interest in obtaining cytologic information and other biomarkers from nipple aspirate fluid (NAF).MethodsThis descriptive study examined factors associated with an increased ability to obtain NAF in a cohort of 3043 women between the ages of 15 and 89 years of age. The majority of women were between the ages of 30–49 (N = 1529/50.2%). Variables examined in relation to obtaining fluid include: age, marital status, age at menarche, menopausal status, a history of pregnancy, a history of breast-feeding, estrogen use, oral contraceptive use, endocrine disorders and tranquilizer use.ResultsOn average, women from whom breast fluid was obtained were younger than women from whom breast fluid was attempted but not obtained (mean = 41.9 years versus 46.5 years, p < 0.0001). In unadjusted and age-adjusted comparisons, being married, a history of pregnancy, younger age at menarche (12 years of age or younger), tranquilizer use, oral contraceptive pill (OCP) use and endocrine problems were associated with an increased ability to obtain breast fluid. Post-menopausal status and exogenous estrogen use were associated with a decreased ability to obtain breast fluid. After age-adjustment, oral contraceptive use was no longer significantly associated with an increased ability to obtain fluid and post-menopausal status was no longer associated with a decreased ability to obtain breast fluid. After multivariate adjustment, age, being married, a history of pregnancy, tranquilizer use and a history of endocrine problems remained positively associated with the ability to obtain breast fluid. In addition, menopausal women who took estrogen were less likely to yield fluid than premenopausal women.ConclusionFour variables (being married, history of pregnancy, tranquilizer use and endocrine disorders) remained positively associated with the ability to obtain NAF in all analyses. A younger age was consistently associated with a greater ability to obtain NAF in this and other studies.