Actual Risk Research Articles

Exploration of the relationship between tumor-infiltrating lymphocyte score and histological grade in breast cancer

BackgroundThe histological grade is an important factor in the prognosis of invasive breast cancer and is vital to accurately identify the histological grade and reclassify of Grade2 status in breast cancer patients.MethodsIn this study, data were collected from 556 invasive breast cancer patients, and then randomly divided into training cohort (n = 335) and validation cohort (n = 221). All patients were divided into actual low risk group (Grade1) and high risk group (Grade2/3) based on traditional histological grade, and tumor-infiltrating lymphocyte score (TILs-score) obtained from multiphoton images, and the TILs assessment method proposed by International Immuno-Oncology Biomarker Working Group (TILs-WG) were also used to differentiate between high risk group and low risk group of histological grade in patients with invasive breast cancer. Furthermore, TILs-score was used to reclassify Grade2 (G2) into G2 /Low risk and G2/High risk. The coefficients for each TILs in the training cohort were retrieved using ridge regression and TILs-score was created based on the coefficients of the three kinds of TILs.ResultsStatistical analysis shows that TILs-score is significantly correlated with histological grade, and is an independent predictor of histological grade (odds ratio [OR], 2.548; 95%CI, 1.648–3.941; P < 0.0001), but TILs-WG is not an independent predictive factor for grade (P > 0.05 in the univariate analysis). Moreover, the risk of G2/High risk group is higher than that of G2/Low risk group, and the survival rate of patients with G2/Low risk is similar to that of Grade1, while the survival rate of patients with G2/High risk is even worse than that of patients with G3.ConclusionOur results suggest that TILs-score can be used to predict the histological grade of breast cancer and potentially to guide the therapeutic management of breast cancer patients.

Evaluation Research on Energy-Saving Retrofitting of Roofs of Traditional Wood-Structured Dwellings Based on the Continuation of Historical Features: A Case Study of Guangdu Village No. 280 Dwelling in Zhejiang

China has numerous traditional wooden dwellings located in regions with hot summers and cold winters. The historic dwellings lack proper thermal insulation and have excessive energy consumption in the building structure, failing to suit the needs of modern people. Hence, it is crucial to enhance their energy efficiency through essential actions. Roofs, being the fifth side of the building envelope, are frequently neglected when it comes to enhancing their insulating capabilities. The study aimed to implement energy-efficient roof alterations while preserving the historical features of traditional structures. This study focuses on enhancing the energy efficiency of a traditional wood-structured dwelling in Guangdu Village, Zhejiang Province, China, by installing composite thermal insulation panels on the interior of the roof using an easy restoration approach. The actual risk of condensation and the impact of retrofit processes on historical features determine the choice and limitations of energy-saving retrofit materials and methods. This study evaluates the transformation using two indicators: energy efficiency and economic feasibility. The numerical simulation results indicate that traditional dwellings have an annual energy savings rate of 16.66% and an investment payback period of 7.25 years. This study demonstrates the feasibility of energy-saving roof renovation measures for these traditional wood-structured dwellings. The measures improve energy efficiency and are affordable for residents. This study can offer technical suggestions for enhancing the energy efficiency of traditional wood-structured dwellings.

Support and employment preferences in online platform work: A cluster analysis of German‐speaking workers

AbstractOnline platform work is an emerging field of non‐standard employment. Up to now, there has been little knowledge of the perspective of online platform workers on social protection and regulation. We provide quantitative data (n = 1727) on their needs for support and on their employment status preferences. Given the heterogeneity of German‐speaking online platform workers, we have conducted a cluster analysis to group workers according to task length, hourly wage, working hours and experience on online platforms. Most of the respondents are solo‐self‐employed and hybrid workers. They prefer support instruments that improve their skills and income over those that aim to strengthen their rights. The majority of platform workers are in favour of working outside of platforms. The study also shows that despite the low dependence on platform income, the actual poverty risk is relatively high.

Establishment and verification of a nomogram that predicts the risk for coronary slow flow.

Coronary slow flow (CSF) has gained significance as a chronic coronary artery disease, but few studies have integrated both biological and anatomical factors for CSF assessment. This study aimed to develop and validate a simple-to-use nomogram for predicting CSF risk by combining biological and anatomical factors. In this retrospective case-control study, 1042 patients (614 CSF cases and 428 controls) were randomly assigned to the development and validation cohorts at a 7:3 ratio. Potential predictive factors were identified using least absolute shrinkage and selection operator regression and subsequently utilized in multivariate logistic regression to construct the nomogram. Validation of the nomogram was assessed by discrimination and calibration. N-terminal pro brain natriuretic peptide, high density lipoprotein cholesterol, hemoglobin, left anterior descending artery diameter, left circumflex artery diameter, and right coronary artery diameter were independent predictors of CSF. The model displayed high discrimination in the development and validation cohorts (C-index 0.771, 95% CI: 0.737-0.805 and 0.805, 95% CI: 0.757-0.853, respectively). The calibration curves for both cohorts showed close alignment between predicted and actual risk estimates, demonstrating improved model calibration. Decision curve analysis suggested high clinical utility for the predictive nomogram. The constructed nomogram accurately and individually predicts the risk of CSF for patients with suspected CSF and may be considered for use in clinical care.

Relationships between medications used in a mental health hospital and types of medication errors: A cross-sectional study over an 8-year period

BackgroundParticularities in psychiatry care can increase the risk of medication errors (MEs). ObjectiveTo analyze the MEs that occurred in a psychiatric hospital and to quantify relationships between the use of certain types of medication and the type of MEs. MethodsWe conducted a retrospective register based cross-sectional study in a French psychiatric hospital (2014–2021). All MEs were analyzed using ALARM method to identify type, stage of occurring and interception (defenses), consequences, drug involved and root causes. The prevalence-odds ratio (POR) was calculated to estimate relationships between five selected medication situations (long-acting injectable antipsychotics (LAIA), oral liquid dosage forms in a multiple-unit-container (OLDS-MC), psychotropic drugs (PD), controlled medicines (CM) or high-alert drugs) and the type of MEs occurred. ResultsAmong the 609 MEs reported, wrong dose (32.2%), wrong drug (30.3%), omission (14.2%) and wrong patient (12.9%) were frequently observed. The ME occurrence stage were prescribing (55.3%) and administration (30.2%). Medication order review intercepted 77.9% of MEs. CM or LAIA increased the risk of medication omission (POR: 3.9, 95%CI: 1.8–8.4 and 2.5, 95%CI; 1.2–5.1, respectively) while the use of high-alert medications decreased it (0.2, 95%CI: 0.1–0.8). OLDS-MC and PD were more likely to be administered to the wrong patient (6.1, 95%CI: 3.3–11.4 and 16.1, 95%CI: 7.2–35.8). LAIA were associated with an increased risk of wrong dose (3.4, 95%CI: 1.8–6.3). Actual errors risk was lower with high-alert drugs (0.5, 95%CI: 0.3–09), but higher with CM (3.5, 95%CI: 1.5–8.0), OLDS-MC (2.1, 95%CI: 1.2–3.8) and PD (2.5, 95%CI: 1.8–3.5). Patients exposed to high-alert drugs were likely to have a serious error (3.5, 95%CI: 1.2–10.4). ConclusionsThis study sheds an innovative approach to analyze MEs by demonstrating that certain medication situations were more likely to lead to certain types of error. This enables the most appropriate prevention barriers to be put in place to intercept ME.

Actual and Perceived Risk of Cardiovascular Disease among Sample of Iraqi Patients with Rheumatoid Arthritis

Background: Independent of conventional risk factors, patients with rheumatoid arthritis (RA) have a significantly increased risk of cardiovascular disease (CVD). Aims of the Study: To evaluate the actual and perceived 10-year CVD risk among Iraqi patients with RA as well as their level of knowledge about CVD risk. Patients and methods: This cross-sectional study included 100 RA patients (85 females and 15 males) who visited Baghdad Teaching Hospital/Rheumatology Unit from January 2021 to July 2021. The Framingham Risk Score (FRS) was used to calculate the actual 10-year risk of CVD. The Heart Disease Fact-Rheumatoid Arthritis Questionnaire (HDFQ-RA) was used to assess the subjects' knowledge of cardiovascular disease. Results: Among hundred Iraqi patients with RA, the median age was 51.23 8.4 years. The study's findings revealed that 23% had a high risk for CVD and 27% &amp; 50% had moderate and low risk, respectively, based on the FRS calculator. The risk of CVD was significantly affected by the age of disease onset and seropositivity and steroid use (p-value 0.001). When the perceived risk was compared to the actual risk of cardiovascular disease, there was a weak agreement between them; only 31% had corresponding answers. Conclusions: The study showed an elevated risk of CVD in rheumatoid arthritis patients and a gap between actual and perceived CVD risk.

Determinants of livestock depredation risk by Persian leopards in southern Iran

Human-wildlife conflict is a major conservation challenge worldwide, with negative consequences for people and wildlife alike. Large carnivores, despite their key role in ecosystem functioning, are persecuted throughout their ranges as a response to perceived or actual risks to livestock and humans. To promote human-carnivore coexistence, a better understanding of the determinants of conflict is necessary. A range of factors have been hypothesized to influence livestock depredation risk, including carnivore habitat suitability and connectivity, prey availability, and anthropogenic factors. Yet, the relative importance of these factors is often unclear. We analyzed and mapped livestock depredation risk for the Persian leopard (Panthera pardus tulliana) in southern Iran using a species distribution modeling framework. We used livestock depredation reports and interviews (n = 199) from 25 randomly selected villages together with predictors capturing leopard habitat suitability, movement corridors, wild and domestic prey, and anthropogenic pressure. Our leopard habitat suitability and connectivity analyses predicted 28 core habitat patches (>250km2) associated with mountainous and conserved areas, with partly severed corridors between them. Our risk mapping indicated that the chance of livestock depredation increased in areas with higher leopard habitat suitability. Conversely, depredation risk was lower in areas with more wild prey. We predicted the highest depredation risk in about 12 % of the landscape where urgent conflict mitigation measures would be most beneficial. More generally, our study shows that while conservation areas provide refuge for carnivores, these areas can also lead to higher levels of conflict, hence mitigation measures should be prioritized in their surroundings.

Clinical-Radiologic Morphology-Radiomics Model on Gadobenate Dimeglumine-Enhanced MRI for Identification of Highly Aggressive Hepatocellular Carcinoma: Temporal Validation and Multiscanner Validation.

Highly aggressive hepatocellular carcinoma (HCC) is characterized by high tumor recurrence and poor outcomes, but its definition and imaging characteristics have not been clearly described. To develop and validate a fusion model on gadobenate dimeglumine-enhanced MRI for identifying highly aggressive HCC. Retrospective. 341 patients (M/F = 294/47) with surgically resected HCC, divided into a training cohort (n = 177), temporal validation cohort (n = 77), and multiscanner validation cohort (n = 87). 3T, dynamic contrast-enhanced MRI with T1-weighted volumetric interpolated breath-hold examination gradient-echo sequences, especially arterial phase (AP) and hepatobiliary phase (HBP, 80-100 min). Clinical factors and diagnosis assessment based on radiologic morphology characteristics associated with highly aggressive HCCs were evaluated. The radiomics signatures were extracted from AP and HBP. Multivariable logistic regression was performed to construct clinical-radiologic morphology (CR) model and clinical-radiologic morphology-radiomics (CRR) model. A nomogram based on the optimal model was established. Early recurrence-free survival (RFS) was evaluated in actual groups and risk groups calculated by the nomogram. The performance was evaluated by receiver operating characteristic curve (ROC) analysis, calibration curves analysis, and decision curves. Early RFS was evaluated by using Kaplan-Meier analysis. A P value <0.05 was considered statistically significant. The CRR model incorporating corona enhancement, cloud-like hyperintensity on HBP, and radiomics signatures showed the highest diagnostic performance. The area under the curves (AUCs) of CRR were significantly higher than those of the CR model (AUC = 0.883 vs. 0.815, respectively, for the training cohort), 0.874 vs. 0.769 for temporal validation, and 0.892 vs. 0.792 for multiscanner validation. In both actual and risk groups, highly and low aggressive HCCs showed statistically significant differences in early recurrence. The clinical-radiologic morphology-radiomics model on gadobenate dimeglumine-enhanced MRI has potential to identify highly aggressive HCCs and non-invasively obtain prognostic information. 4 TECHNICAL EFFICACY: Stage 2.

Ecological interactions of Triatoma sanguisuga (Hemiptera: Reduviidae) and risk for human infection with Trypanosoma cruzi (Kinetoplastida: Trypanosomatidae) in Illinois and Louisiana.

Triatoma sanguisuga (Leconte) is one of the most widely distributed kissing bugs in the United States, associated with an extensive zoonotic circulation of Trypanosoma cruzi, the agent of Chagas disease, in a large part of the country. However, the actual risk for human infection in the United States is poorly understood. Here, we further assessed the ecology of T. sanguisuga bugs collected in residents' houses in Illinois and Louisiana, using a metagenomic approach to identify their blood-feeding sources, T. cruzi parasites and gut microbiota. Blood meal analysis revealed feeding on domestic animals (dogs, cats, pigs, goats, and turkeys), synanthropic species (raccoons, opossums, and squirrels), as well as the more sylvatic white-tail deer. Human blood was identified in 11/14 (78%) of bugs, highlighting a frequent vector-human contact. The infection rate with T. cruzi was 53% (8/15), and most infected bugs (6/8) had fed on humans. A total of 41 bacterial families were identified, with significant differences in microbiota alpha and beta diversity between bugs from Louisiana and Illinois. However, predicted metabolic functions remained highly conserved, suggesting important constraints to fulfill their role in bug biology. These results confirmed a significant risk for vector-borne transmission of T. cruzi to humans in Louisiana and Illinois, which warrants more active screening for human infections. Also, while there is broad plasticity in the bacterial composition of T. sanguisuga microbiota, there are strong constraints to preserve metabolic profile and function, making it a good target for novel vector control strategies.

Machine Learning-Based Risk Management of Credit Sales in Small and Midsize Business

Sustaining and expanding the finances of small and midsize companies (SMBs) depends on efficient credit risk management. This study redefines credit risk assessment for SMBs via the use of machine learning (ML), hence introducing a disruptive methodology. The all-inclusive approach includes feature selection, preprocessing, data collecting, and the use of ML models, with an emphasis on behavioral insights integration and real-world applicability. The results imply that Random Forests and other machine learning models are superior at predicting credit risk, which may lead to a sea shift in the way SMBs handle credit risk. Improving the research's practical implications involves applying models to actual credit risk management systems and incorporating insights from behavioral economics. Possible future research directions include studying how models adapt dynamically, using different types of data, enhancing explain ability via XAI, and fostering collaborative efforts to develop industry-specific best practices. By outlining the ins and outs of credit sales, this research helps small and medium-sized companies (SMBs) adjust and remain resilient in the face of changing market conditions.

A meta-analysis on the risk of infection associated with intravenous iron therapy in cancer-associated anaemia: a double-edged sword?

The increased use of i.v. iron in the treatment of cancer-associated anemia raises concerns about its risk of infectious complications. High levels of circulating iron could increase the risk of infection by compromising natural defence mechanisms and promoting pathogen growth. Since the risk of infection is particularly high in the oncological population, we have examined whether the use of i.v. iron increases the risk of infectious complications among cancer patients. Among 18 randomized trials in our systematic review, only 8 reported infectious complications, with no significant difference linked to the type of i.v. iron preparation. Two trials showed a statistically significant increase in infectious complications, one trial found a lower risk, while the remaining 5 reported no significant difference. Our meta-analysis revealed a numerical increase in infectious complications in the i.v. iron group, but the lack of statistical significance and significant heterogeneity among the trials limit definitive conclusions on the actual infection risk. Our findings suggest some increased risk in infectious complications after the administration of i.v. iron for cancer associated anaemia. However, i.v. iron therapy appears generally safe and effective in cancer-associated anaemia.

Neglecting hydrological errors can severely impact predictions of water resource system performance

Risk-based decision making for water resource systems often relies on streamflow predictions from hydrological models. These predictions are integral for estimating the frequency of high consequence extreme events, such as floods and droughts. However, streamflow predictions are known to have errors due to various factors such as incomplete hydrological understanding, parameter misspecification, and uncertain data. Despite these errors being well known, they are frequently neglected when undertaking risk-based decision-making. This paper demonstrates that neglecting hydrological errors can impact on drought risk estimation for high stakes decisions with potentially severe consequences for water resource system performance. A generic framework is introduced to evaluate the impact of hydrological errors for a wide range of water resource system properties. This framework is applied in two Australian case study catchments, where we use a stochastic rainfall model, the GR4J hydrological model, a residual error model, and a simplified reservoir storage model to estimate water resource performance metrics (risk and yield). The results underscore the impact of neglecting hydrological errors on decision-making. In one case study catchment, the yield was over-estimated by ∼15%–55%, resulting in the (actual) risk of running out of water being ∼2–30 times larger than reservoir design. The magnitude of these errors in water resource performance metrics is striking, especially considering that the streamflow predictions appear reasonable based on typical performance metrics (e.g., NSE of ∼0.7). The errors in performance metrics stem from the complex propagation of hydrological errors through the water resource system modelling chain. By accounting for critically important hydrological errors we can mitigate highly erroneous risk estimates and improve decision-making related to water resource management.

E-Government and Entrepreneurship: The Perspective of Risk

ABSTRACT Risk is an important factor that hinders entrepreneurial activities, especially for entrepreneurs with high aspirations. This study examines e-government’s impact on entrepreneurship from a risk perspective. Based on individual data from the Global Entrepreneurship Monitor, results show that e-government promotes new ventures, especially those with aspirations to grow and innovate, thus enhancing the quantity and quality of entrepreneurship. Furthermore, mechanism analysis reveals that e-government significantly reduces actual risk and fear of failure, suggesting that it creates a stable environment and decreases risk aversion, which encourages starting new ventures and high-quality entrepreneurial activities. E-government reduces entrepreneurial risk by improving country governance in three dimensions: efficiency of public services, regulatory quality, and control of corruption. Besides, e-government has larger effects on enhancing the quality of entrepreneurship in developing economies. This study provides new insight into e-government’s effects on entrepreneurship and the mechanism.

A prospective investigation of the effects of soccer heading on cognitive and sensorimotor performances in semi-professional female players.

Repetitive head impacts (RHI) from routine soccer (football) heading have been suggested to contribute to the long-term development of neurodegenerative disorders. However, scientific evidence concerning the actual risk of these RHI on brain health remains inconclusive. Moreover, female athletes-despite a presumably increased vulnerability toward the effects of RHI-are largely underrepresented in previous approaches. Therefore, our aim was to prospectively investigate the effects of heading on cognitive and sensorimotor performances, health perception, and concussion symptoms in semi-professional female soccer players. An extensive test battery was used to assess cognitive and sensorimotor performances as well as health status (SF-36) and concussion symptoms (SCAT3) of a total of 27 female soccer players (22.2 ± 4.2 years) and 15 control subjects (23.2 ± 3.0 years) before and after one-and-a-half years. Throughout this period, soccer players' heading exposure was determined using video analysis. Subgroup comparisons (control [n = 12], low exposure [n = 7], high exposure [n = 8]) showed no time-dependent differences in SF-36 or SCAT3 scores. Similarly, across most behavioral tests, soccer players' performances evolved equally or more favorably as compared to the control subjects. However, there were significant effects pointing toward slightly negative consequences of heading on aspects of fine motor control (p = 0.001), which were confirmed by correlation and multiple regression analyses. The latter, further, yielded indications for a relationship between heading exposure and negative alterations in postural control (p = 0.002). Our findings do not provide evidence for negative effects of soccer heading on female players' health perception, concussion symptoms, and cognitive performances over the course of one-and-a-half years. However, we found subtle negative alterations in fine motor and postural control that could be attributed to heading exposure. Other factors, like the number of previous head injuries, were not linked to the observed changes. Given the reduction of our initial sample size due to player fluctuation, the results need to be interpreted with caution and validated in larger-scale studies. These should not only focus on cognitive outcomes but also consider sensorimotor changes as a result of RHI from soccer heading.

Health Risk Assessment for an Arsenic-contaminated Site Based on Monte Carlo Simulation and Parameters Optimization

Risk assessment is a critical part of risk management for contaminated sites. However， in the specific management practice of As-contaminated sites， it is difficult to obtain realistic health risks for contaminated sites based on the total amount of pollutants and determined values of the model， thus preventing the control requirements of later remediation to be met. An increasing number of studies have recently been conducting risk assessments by considering bioavailability， modification parameters， and combined probabilistic models. To improve the accuracy of risk assessment results， taking a large As-contaminated site as a case， 432 sampling sites were set up and collected at different depths to analyze the level and distribution characteristics of As pollution， and probabilistic risk assessment was conducted with the modification of model parameters through literature research and Monte Carlo simulation. Then， the impact of traditional methods and probabilistic methods on health risk assessment was explored in comparison. The results indicated that ω（As） in the top soil of the study area ranged from 2.70-97.0 mg·kg-1， with a spatial variation coefficient of 0.61 and weaker spatial continuity. The carcinogenic risk and hazard index obtained by the traditional risk assessment method were 2.12E-4 and 8.36， respectively， which obviously overestimated the actual risk level and were not conductive to the refined management of As-contaminated sites. Combined with modification of model parameters and probabilistic risk assessment， the non-carcinogenic risk for adults and children was found to be at an acceptable level， and the carcinogenic risk was reduced by nearly an order of magnitude compared to that in the conventional method. Considering the relative biological effectiveness （RBA） of As， the 95% quantile of the total carcinogenic risk was 1.24E-5， a reduction of up to 36.41% compared to the uncorrected corresponding risk value of 1.95E-5. The carcinogenic risk of soil As for adults and children in the study area exceeded acceptable risk levels 1E-6， with oral ingestion of soil being the primary route of exposure. In addition， the results of the sensitivity analysis of the parameters showed that As concentration， daily oral ingestion rate of soils， and exposure duration of children had relatively larger effects for health risks. This work will provide a methodological and theoretical basis for achieving accurate risk assessment of As-contaminated sites and provide concepts for refined risk management.

In temperate Europe, fire is already here: The case of The Netherlands

Landscape fires are usually not associated with temperate Europe, yet not all temperate countries record statistics indicating that actual risks remain unknown. Here we introduce new wildfire statistics for The Netherlands, and summarize significant events and fatalities. The period 2017–2022 saw 611 wildfires and 405 ha burned per year, which Copernicus’ European Forest Fire Information System satellite data vastly underestimate. Fires burned more heathland than forest, were small (mean fire size 1.5 ha), were caused by people, and often burned simultaneously, in Spring and in Summer drought. Suppression, restoration and traffic delays cost 3 M€ year−1. Dozens of significant events illustrate fire has never been away and has major societal impact amidst grave concerns for firefighter safety. Since 1833, 31 fatalities were reported. A legal framework is needed to ensure continuity of recordkeeping, as the core foundation of integrated fire management, to create a baseline for climate change, and to fulfill international reporting requirements.

Prevalence and associated factors of worry for cancer in patients with a Barrett’s esophagus

Although the risk of cancer progression in a Barrett’s esophagus (BE) is very low, worrying about cancer is known as an important factor affecting HRQoL. The aim of this study was to determine the proportion of BE patients with high levels of worry for cancer, to compare outcomes of patients endoscopically treated for BE neoplasia (DBE), non-dysplastic BE patients (NDBE) and patients with reflux symptoms, and to examine associated factors. We performed a cross sectional, exploratory, self-administered questionnaire study using the cancer worry scale, and the reflux disease questionnaire. A total of 192 DBE patients, 213 NDBE patients and 111 refractory reflux symptom patients were included from October 2019 until July 2021, 76.8% of BE participants were male and aged 66.9 years. High cancer worry was reported in 40.6% of the DBE patients and 36.2% of NDBE patient. Reflux patients scored statistically significant worse with 56.6% stated high cancer worry. Positive correlations were found between reflux symptoms and cancer worry in NDBE patients and reflux patients. In DBE patients’ negative correlations were found between higher cancer worry and younger age as well as a family history of esophageal carcinoma. A clinically significant group of BE patients reported high cancer worry, which was associated with reflux symptoms in NDBE patients and a younger age and a (family) history of esophageal carcinoma diagnosis in BE patients treated for (early) neoplasia. Physicians should communicate about the actual cancer risk, which leads to greater patient understanding and therefore may have a positive impact on health outcomes.

Effectiveness of simulation-based medical education perceptions and attitudes

Simulation is a highly effective method often used in medical training. Simulation-based medical education (SBME) provides a way for healthcare professionals and patients to experience medical scenarios without actual risk to health or safety. This study focuses on comparing the views and opinions about SBME and traditional medical education (TME) among students from various levels and programs within medical colleges at Majmaah University in Saudi Arabia. A survey was used to gather information on students' perceptions and attitudes towards SBME and TME. The study analyzed responses from 472 healthcare students using Statistical Analysis System software. Of these participants, 52.33% were male and 47.67% were female. Most of the students, 80.30%, were pursuing bachelor's degrees, while 19.70% were in master's programs. The breakdown of their fields of study was as follows: 17.80% in medicine, 71.82% in applied medical sciences, and 10.38% in dentistry. A large majority, 93.43%, were familiar with SBME in general, and 90.89% knew about SBME in their specific field, indicating high awareness. Despite the challenges in using and maintaining SBME, the study found overall positive perceptions and attitudes towards it among healthcare students. Additionally, most participants believed that SBME offers a better learning environment, helps in reducing future medical mistakes, and supports every student's right to access SBME training.

A quantitative study to assess cardiovascular risks among older African American women living in rural black belt areas of Alabama.

Limited information is available regarding the knowledge of Cardiovascular Disease (CVD)risk factors and the actual risk behaviors among African American (AA) older women living in rural areas of Alabama. A pilot study of needs assessment for CVD prevention behaviors was conducted to collect such data from rural AA women. This paper reports the quantitative part of the needs assessment of this pilot study. We recruited participants (N=30) using convenience sampling.Data collection measures included: i) American Heart Association's CVD-related knowledge questionnaire, ii) Five Times Sit to Stand Test to measure dynamic balance and iii) Six minute walk test (6MWT) to assess exercise endurance iv) standard weighing scale to measure body weight and v) standard measurements scale to measure height. Descriptive and inferential statistics were used to analyze the data. The majority (76%) of participants had hypertension (70%), diabetes (60%), poor balance (70%), and low exercise endurance (100%). Most of the participants had low knowledge related to CVD risk factors. This study demonstrated the need to conduct a large-scale study to assess knowledge related to heart health and the actual needs and preferences of these individuals. Conducting such a study would lay the foundation for developing a need-based program for these underserved individuals while incorporating their preferences and the strategies that would help engage them in a heart health intervention.

Hazards and Risks Investigation of the Fit Out Project of RMM Construc-tion: Basis for Creation of an Occupational Construction and Health and Safety Program

The existence of hazards and risks in businesses is inevitable, specifically, in the construction industry. The research is qualitative by nature which aimed the identification and investigation of the actual hazards and risks in the workplace as experienced by the select construction workers as main participants in the research. A total of eleven (11) constructions workers were utilized in the research and selected by way of purposive sampling. During the focus discussions, participants are divided into three groups. Among others, results revealed the following construction-related hazards: Scattered Broken Tiles, Unstable Scaffolding, Scattered Nails, Insufficient Lightning, Exposed Extension Wire and Chiselling and Grinding, No Insulation and Physical Transport of Heavy materials. The research further investigated the level of risks in the identified hazard using the probability and severity matrix. At average, the identified risks obtained a high level of probability while severity at average is to medium or moderate only. Occupational Construction and Health and Safety Program was developed based on the results of this research.