Comprehensive Risk Evaluation Research Articles

Abstract PO4-11-08: Risk of second malignancies in breast cancer patients. A population-based retrospective cohort study between 2010-2020

Abstract Introduction: Breast cancer survivors live longer due to early detection programs and therapeutic advances. Staging and molecular classification are important for prognosis and treatment. At the same time these patients are at increased risk for second primary cancers. Comprehensive evaluation of second cancer risk among patients treated in recent decade with early detection and prevention programs of other tumors lacking. This study aims to identify, characterize and associate breast cancers with second primary malignancies based on different variables. Methods: We identified 3487 females with a first primary breast cancer between 2010 and 2020 in medical records at University Hospital of A Coruña in Spain. Over a median follow-up of 8 years, one hundred patients (2,9%) develop second cancer. According National Cancer Institute, second primary tumor (SPT) was defined as an invasive primary cancer after a first primary cancer. In our case a breast carcinoma. Second cancer risk was evaluated for all cancers (excluding ipsilateral breast carcinoma) which were diagnosed at least 12 months after primary breast tumor. We analyzed breast cancer subtype, family history and pathogenic genetic variants, tobacco use and second primary tumor type. Results: Several clinical characteristics were evaluated, including breast cancer stage, histological type and subtype. The incidence of breast cancer and SPT was increased with age with peaks in the 60’s and 70’s, respectively. Only 13% had SPT between 40-49 years. Approximately 10 women a year, in our study, developed second cancer. 52% of SPT patients had cancer family history. Pathogenic variant study was carried in 25% of women with SPT, 46% of them no mutation were found, but in 17% was detected a germline BRCA1 deleterious variant. Other pathogenic variants were founded: 4% in BRCA2, and 33% in others genes (CHEK2, MSH2, MSH6, PMS2, CDH1, FANC1 y SMAD4) Regards tobacco use, active smokers were 13% and 12% of women had been smoking years ago. Of these 13 active smokers, 10 develop lung cancer (77%) an 5 of former smokers (42%). Luminal subtype was the most common breast cancer (33% Luminal A, 34% Luminal B Her2 negative, 10% Luminal B Her2 positive, 4% Her2-enriched, 10% Triple negative and 3% carcinoma in situ with estrogen and progesterone expression) and stage I and II were most frequent (80%). The most usual second primary neoplasms were lung, colorectal and pancreatic carcinoma (21%, 17% and 7% respectively), and only 2% contralateral breast cancer, with an average of approximately 4 years between breast cancer and the SPT. In 11% of patients were found more than 2 tumors. At the time of the analysis, 73% of these patients are free of disease. In SPT study population few recurrences were described, 2 relapses of breast cancer and 9 of SPT. The median between breast cancer diagnosis and the SPT diagnosis was 54 months [0,7 – 129]. The median to relapse of breast cancer was 73 months [68 – 77]. The median between SPT diagnosis and relapse was 39,25 months [1 - 134]. STP recurrences were observed in colorectal and lung cancer, mainly. Data on recurrences and mutations were not significative. Conclusion: In our breast cancer population the incidence of second primary tumors is around 3% over a 10 – year period. The diagnosis of the SPT arises several years after breast cancer and generally has a worse prognosis. Elevated risks of second cancer among breast cancer survivors treated in recent decade suggests that heightened surveillance is warranted and continued efforts to reduce second cancers are needed. It is mandatory make an effort and focusing in recommendations and advise about tobacco consumption, healthy lifestyle and adherence to Pap test and stool test in survivors. Citation Format: Guadalupe Rama, Maria-Eva Perez-Lopez, Silvia Antolin Novoa, Cristina Reboredo, Beatriz Alonso, Sofia Silva Diaz, Begoña Graña, Lourdes Calvo, Tomas Garcia-Caballero. Risk of second malignancies in breast cancer patients. A population-based retrospective cohort study between 2010-2020 [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-11-08.

Comprehensive evaluation of coal burst risk using optimized linear weighted model

The assessment of coal burst risk is a complex and systematic process; the variations among the indicator systems and the stability of the evaluation models used can influence the results. In this study, an index system for the analytic hierarchy process was constructed based on 21 geomechanically influential factors on rock bursts. The multi-weight combination optimization model was used to synthesize the subjective weights derived by the four experts using AHP and the objective weights derived through the inter-criteria correlation method to obtain the unique optimization weights. After normalizing the original evaluation data, the Gram–Schmidt orthogonalization method was employed to eliminate correlations among factors. The optimized factor weights and data were subsequently input into a linearly weighted comprehensive evaluation model to determine the coal burst risk. The proposed method was applied to assess the coal burst risk of a coal seam in the Liang Jia Coal Mine. These results align with those of the actual coal mine scenario. Indeed, the proposed linear weighted comprehensive evaluation model provided enhanced accuracy and reliability with improved practicality compared to previously proposed methods.

Associations between Atmospheric PM2.5 Exposure and Carcinogenic Health Risks: Surveillance Data from the Year of Lowest Recorded Levels in Beijing, China.

Scant research has pinpointed the year of minimum PM2.5 concentration through extensive, uninterrupted monitoring, nor has it thoroughly assessed carcinogenic risks associated with analyzing numerous components during this nadir in Beijing. This study endeavored to delineate the atmospheric PM2.5 pollution in Beijing from 2015 to 2022 and to undertake comprehensive evaluation of carcinogenic risks associated with the composition of atmospheric PM2.5 during the year exhibiting the lowest concentration. PM2.5 concentrations were monitored gradually in 9 districts of Beijing for 7 consecutive days per month from 2015 to 2022, and 32 kinds of PM2.5 components collected in the lowest PM2.5 concentration year were analyzed. This comprehensive dataset served as the basis for carcinogenic risk assessment using Monte Carlo simulation. And we applied the Positive Matrix Factorization (PMF) method to identity the sources of atmospheric PM2.5. Furthermore, we integrated this source appointment model with risk assessment model to discern the origins of these risks. The findings revealed that the annual average PM2.5 concentration in 2022 stood at 43.1μg/m3, marking the lowest level recorded. The mean carcinogenic risks of atmospheric PM2.5 exposure calculated at 6.30E-6 (empirical 95% CI 1.09E-6 to 2.25E-5) in 2022. The PMF model suggested that secondary sources (35.4%), coal combustion (25.6%), resuspended dust (15.1%), biomass combustion (14.1%), vehicle emissions (7.1%), industrial emissions (2.0%) and others (0.7%) were the main sources of atmospheric PM2.5 in Beijing. The mixed model revealed that coal combustion (2.41E-6), vehicle emissions (1.90E-6) and industrial emissions (1.32E-6) were the main sources of carcinogenic risks with caution. Despite a continual decrease in atmospheric PM2.5 concentration in recent years, the lowest concentration levels still pose non-negligible carcinogenic risks. Notably, the carcinogenic risks associated with metals and metalloids exceeded that of PAHs. And the distribution of risk sources did not align proportionally with the distribution of PM2.5 mass concentration.

Suicide risk screening and evaluation among patients accessing VHA services and identified as being newly homeless.

To evaluate universal suicide risk screening and evaluation processes among newly homeless Veterans. Not applicable. Examination of Veterans Health Administration (VHA) using newly homeless patients' health record data in Calendar Year 2021. Not applicable. Health record data. Most patients received suicide risk screening and/or evaluation in the year prior to and/or following homeless identification (n = 49,505; 87.4%). Smaller percentages of patients were screened and/or evaluated in close proximity to identification (n = 7358; 16.0%), 1-30 days prior to identification (n = 12,840; 39.6%), or 1-30 days following identification (n = 14,263; 34.3%). Common settings for screening included primary care, emergency and urgent care, and mental health services. Of positive screens (i.e., potentially elevated risk for suicide), 72.6% had a Comprehensive Suicide Risk Evaluation (CSRE) completed in a timely manner (i.e., same day or within 24 h). Age, race, and sex were largely unrelated to screening and/or evaluation. Although many newly identified homeless patients were screened and/or evaluated for suicide risk, approximately 13% were not screened; and 27% of positive screens did not receive a timely CSRE. Continued efforts are warranted to facilitate suicide risk identification to ensure homeless patients have access to evidence-based interventions.

Assessing the collision risk of mixed lane-changing traffic in the urban inter-tunnel weaving section using extreme value theory

Urban inter-tunnel weaving (UIW) sections are characterized by short lengths and frequent lane-changing behaviors in the area, commonly used for fast through traffic. These features increase the likelihood of collisions, however, collision risk assessment in this area has been inadequate. The aim of this study was to evaluate the potential collision risk of urban inter-tunnel weaving (UIW) sections in mixed lane-changing traffic conditions in morning rush hours, utilizing surrogate safety measures. The investigation involved the collection of trajectory data via an unmanned aerial vehicle (UAV). Time to collision (TTC) and extended time to collision (ETTC) were chosen as surrogate safety indicators. The estimation of collision risk was conducted using Extreme Value Theory (EVT) by means ofsurrogate safety indicators. It was found that the threshold of TTC and ETTC in this area was 1.25 s. Furthermore, a comprehensive evaluation of collision risks associated with various vehicle types was performed, revealing an inverse relationship between thecollisions riskof vehicles in mixed traffic and their size. It was worth noting that while heavy vehicles exhibit a lower collision risk, they resulted in the highest energy loss and inflicted greater harm in the event of a collision. By an examination of the distribution features pertaining to conflict types during the operation of heavy vehicles, it showed that the highest likelihood of conflict with heavy vehicles occurred when adjacent lanes are involved. Consequently, the implementation of assisted driving technology for heavy vehicles was imperative in order to mitigate the risk associated with side collisions.

THUBreast: an open-source breast phantom generation software for x-ray imaging and dosimetry

Objective. Establishing realistic phantoms of human anatomy is a continuing concern within virtual clinical trials of breast x-ray imaging. However, little attention has been paid to glandular distribution within these phantoms. The principal objective of this study was to develop breast phantoms considering the clinical glandular distribution. Approach. This research introduces an innovative method for integrating glandular distribution information into breast phantoms. We have developed an open-source software, THUBreast 4 4 http://github.com/true02Hydrogen/THUBreast/ , which generates breast phantoms that accurately replicate both the structural texture and glandular distribution, two crucial elements in breast x-ray imaging and dosimetry. To validate the efficacy of THUBreast, we assembled three groups of breast phantoms (THUBreast, patient-based, homogeneous) for irradiation simulation and calculated the power-law exponents ( β ) and mean glandular dose ( Dg ), indicators of texture realism and radiation risk, respectively, utilizing MC-GPU. Main results. Upon the computation of the Dg for the THUBreast phantoms, it was found to be in agreement with that absorbed by the phantoms based on patients, with an average deviation of 4%. The estimates of average Dg thus obtained were on average 23% less than those computed for the homogeneous phantoms. It was observed that the homogeneous phantoms did overestimate the average Dg by 30% when compared to the phantoms based on patients. The mean value of β for the images of THUBreast phantoms was found to be 2.92 ± 0.08, which shows a commendable agreement with the findings of prior investigations. Significance. It is evidently clear from the results that THUBreast phantoms have a preliminary good performance in both imaging and dosimetry in terms of indicators of texture realism and glandular dose. THUBreast represents a further step towards developing a powerful toolkit for comprehensive evaluation of image quality and radiation risk.

Potential Immunohistochemical Biomarkers for Grading Oral Dysplasia: A Literature Review.

Oral cancer is a prevalent global health issue, with significant morbidity and mortality rates. Despite available preventive measures, it remains one of the most common cancers, emphasising the need for improved diagnostic and prognostic tools. This review focuses on oral potentially malignant disorders (OPMDs), precursors to oral cancer, specifically emphasising oral epithelial dysplasia (OED). The World Health Organisation (WHO) provides a three-tier grading system for OED, and recent updates have expanded the criteria to enhance diagnostic precision. In the prognostic evaluation of OED, histological grading is presently regarded as the gold standard; however, its subjectivity and unreliability in anticipating malignant transformation or recurrence pose notable limitations. The primary objective is to investigate whether specific immunohistochemical biomarkers can enhance OED grading assessment according to the WHO classification. Biomarkers exhibit significant potential for comprehensive cancer risk evaluation, early detection, diagnosis, prognosis, and treatment optimisation. Technological advancements, including sequencing and nanotechnology, have expanded detection capabilities. Some analysed biomarkers are most frequently chosen, such as p53, Ki-67, cadherins/catenins, and other proteins used to differentiate OED grades. However, further research is needed to confirm these findings and discover new potential biomarkers for precise dysplasia grading and minimally invasive assessment of the risk of malignant transformation.

Risk of relapse and patient selection for metastatic colorectal cancer liver surgery.

96 Background: Previous data on surgery for colorectal cancer (CRC) liver metastases (CRLM) documented improvement in overall survival (OS) and low perioperative mortality, but patient (pt) selection requires complex multidisciplinary work. Predictive scores such as the Comprehensive Evaluation of Relapse Risk (CERR) estimate relapse risk after surgery and help in the pre-operative decision. Objectives: This study aims to evaluate OS and progression-free survival (PFS) in a population of pts who had surgery for CRLM, and to analyse survival outcomes by risk groups, according to the CERR score. We identified individual, anatomic and biological factors with potential prognostic impact. Methods: We retrospectively analysed the medical records of pts who had CRLM surgery between January 2012 and December 2021 in two Portuguese reference centres. Outcomes for CRLM surgery were analysed by risk groups according to the CERR score of each pt (based on nodal status, preoperative CEA/CA 19.9 values, KRAS/BRAF status, presence of extrahepatic disease and modified tumour burden score). Univariate and multivariate survival analyses were performed with the log-rank test and Cox proportional-hazards regression models. Results: A total of 174 pts were included: 66,1% (n=115) male, mean age at CRLM diagnosis 62,1 (±11,5) years, 80,5% (n=140) with isolated liver metastases. Thirty-three pts (19%) had a second surgery, independently of the CERR score (chi-square p = 0,60). Eighteen (10,3%) pts had a CERR score of 0-1 (low-risk, LR), 96 (55,2%) of 2-3 (medium-risk, MR) and 60 (34,5%) of 4-5 (high-risk, HiR). With a median (MED) follow-up of 85,1 (15,6-186,5) months (mo), 100 (57.5%) pts have died. MED OS was 88,0 mo (95% confidence interval [CI] 40,6-135,4) for LR, 46,4 mo (95% CI 38,7-54,1) for MR and 30,7 mo (95% CI 23,1-38,4) for HiR pts (p=0,02); ECOG performance status was an independent prognostic factor (p=0,002) for OS. Median PFS was 88,0 mo (95% CI 6,9-169,0) for LR, 12,9 mo (95% CI 9,1-16,7) for MR and 7,7 mo (95% CI 5,9-9,4) for HiR pts (p<0,001); positive resection margins and prior induction chemotherapy (CT) were additional independent negative prognostic factors for PFS (p<0,001). Conclusions: These results suggest a significant association between relapse risk after surgery for CRLM and both OS and PFS. The CERR score can be used to select potential candidates for CRLM surgery and improve the impact of this intervention in pts with CRC. The link between induction CT and worse survival may reflect selection bias as these pts possibly had a higher volume of disease and therefore received initial systemic therapy. Prospective studies are required to confirm these results.

Prenatal EGCG consumption impacts hepatic glycogen synthesis and lipid metabolism in adult mice

In this study, the impact of prenatal exposure to Epigallocatechin gallate (EGCG) on the liver of adult offspring mice was investigated. While EGCG is known for its health benefits, its effects of prenatal exposure on the liver remain unclear. Pregnant C57BL/6 J mice were exposed to 1 mg/kg of EGCG for 16 days to assess hepatotoxicity effects of adult offspring. Transcriptomics and metabolomics were employed to elucidate the hepatotoxicity mechanisms. The findings revealed that prenatal EGCG exposure led to a decrease in liver somatic index, enhanced inflammatory responses and disrupted liver function through increased glycogen accumulation in adult mice. The integrated omics analysis revealed significant alterations in key pathways involved in liver glucose lipid metabolism, such as gluconeogenesis, dysregulation of insulin signaling, and induction of liver inflammation. Furthermore, the study found a negative correlation between the promoter methylation levels of Ppara and their mRNA levels, suggesting that EGCG could reduce hepatic lipid content through epigenetic modifications. The findings suggest that prenatal EGCG exposure can have detrimental impacts on the liver among adult individuals and emphasize the need for a comprehensive evaluation of the potential risks associated with EGCG consumption during pregnancy.

An improved failure mode and effect analysis method for group decision-making in utility tunnels construction project risk evaluation

The risk factors of utility tunnels construction project (UTCPs) are diverse and complex, which can easily lead to serious accidents. And these accidents are usually the result of ignoring the most serious risk sources due to the lack of comprehensive risk evaluations. Therefore, this paper proposes an improved failure mode and effect analysis (FMEA) multi-criteria group decision model for utility tunnels construction project risk evaluation. First, expert groups are invited to evaluate the project risk failure modes, and k-means clustering is used to group the experts and form the aggregated matrix. Then, the CCSD (correlation coefficient and standard deviation) method, regret theory and MULTIMOORA method are used to rank the failure modes. Subsequently, the superiority of the model is illustrated by sensitive and comparative analyzes through a case study of the utility tunnels construction project for Beijing Winter Olympics. Finally, a systematic application model is proposed to provide some decision basis for project risk management.

Real-time spatiotemporal forecast of natural gas jet fire from offshore platform by using deep probability learning

Blow-outs occurred on offshore platform and associated fires have been recurrent during the previous few decades, and poses a potential safety hazard to humans, property and the surrounding environment. Although the real-time forecast based on deep learning have shown promise in the fields of fire modelling and hazardous area evaluations, jet fire spatio-temporal modelling has not yet undergone sufficient investigation in complex ocean engineering cases like offshore platforms. This research therefore proposes a deep learning-based framework for jet fire spatio-temporal probabilistic real-time forecast by developing the Hybrid-VB-ConvSTnn model, which integratesConvGRU and variational Bayesian inference. And the significant hyperparameters were locally optimized through sensitivity analysis and finally identified as Monte Carlo (MC) sampling number m = 100 and dropout probability p = 0.1. By performance comparison with different models, the Hybrid-VB-ConvSTnn model shows competitive spatio-temporal forecasting capabilities in terms of both real-time (Inference time = 0.83s) and accuracy (R2 = 0.982). Moreover, the Hybrid-VB-ConvSTnn model could provide the additional uncertainty inferences based on the probability density of the Bernoulli distribution, which avoids the inherent shortcomings of “overconfidence” for traditional point-estimate models and lends credibility to flame boundary identification. The proposed framework could support the digital twin-based fire emergency management on offshore platforms by more comprehensive and robust risk evaluation.

Groundwater Environment and Health Risk Assessment in an In Situ Oil Shale Mining Area

To clarify the risk posed to groundwater in oil shale in situ mining areas, we examine five leached pollutants: Fe, Mn, Cr, sulfate, and ammonia nitrogen. Potential groundwater contents of these five pollutants were evaluated using an improved Nemero comprehensive index method and a health risk assessment method. The results show that, compared with the Class III groundwater quality standard (GB/T 14848-2017) used in the People’s Republic of China, average values of Fe, Mn, and sulfate in leaching solution from Fuyu oil shale exceed the standard, while Cr and ammonia nitrogen do not exceed the standard, and the leaching solution is within Class V groundwater quality. The average values of Fe and Mn in the leaching solution from Fushun oil shale exceed the Class III standard, while Cr, sulfate, and ammonia nitrogen values from this oil shale do not exceed the standard, and the leaching solution is Class IV in terms of groundwater quality. The weighting value used in the Nemero assessment method for the heavy metal Cr is the largest as its potential to cause harm to groundwater quality is the largest. The weight value for sulfate is the smallest as the harm degree is the smallest. The chemical carcinogen Cr has the greatest potential impact on human health. The health risk caused by the chemical non-carcinogen Mn is greater than that caused by Fe and ammonia nitrogen. When high pyrolysis temperatures are used, Mn will be released into groundwater in large quantities. Therefore, supervision and control should be strengthened. The results presented here can provide a reference for the comprehensive evaluation of groundwater risks caused by in situ oil shale mining.

Integrative Multi-Information Fusion for Enhanced Risk Assessment: A Multi-Criteria Decision-Making Framework

This study addresses the burgeoning challenges in autonomous Maritime navigation by employing information fusion methodologies to assess and manage multifaceted risks. The proliferation of autonomous maritime systems has led to a complex interplay among maritime-related, shore-based remote control, environmental, and emergency management factors, necessitating a comprehensive risk evaluation framework. Leveraging a multi-criteria decision-making approach and employing the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS), this research presents a methodical analysis of the coupling coordination degree among these risk variables. Through a meticulous examination of historical accident data and information fusion techniques, our study reveals dynamic trends in the comprehensive risk evaluation index, showcasing the evolving nature of risks inherent in autonomous Maritime navigation. The predictive insights gleaned from these analyses forecast an initial increase followed by a peak in accidents, underscoring the urgency for proactive risk mitigation strategies. This study's conclusions emphasize the pivotal role of information fusion methodologies in comprehensively assessing, understanding, and managing risks within autonomous Maritime navigation.

Assessment of Computed Tomography and Ultrasonography in Detection of Ureteric Calculi

Background: Urolithiasis, a common urological condition, presents diagnostic challenges. While CT scans are considered the gold standard for detecting ureteric calculi, the role of ultrasonography is also significant, especially in varied clinical scenarios. Objective: This study aims to assess the diagnostic accuracy of ultrasonography compared to CT scans in the detection of ureteric calculi. Methods: An observational study was conducted on 200 patients at the Combined Military Hospital, Peshawar. Participants included males and females aged 18-60 years, presenting with acute renal pain. Exclusion criteria included individuals without informed consent, multiple comorbidities, a history of kidney donations, or a family history of renal calculi. Ultrasonography was performed using an Ecoste Mylab 7 color Doppler machine with 3.5, 5, and 7.5 MHz probes. CT scans were conducted using the Siemens CT Somatom Sensation 64, without the administration of any contrast medium. Data were analyzed using SPSS version 26.0. Results: Ultrasonography detected ureteric calculi in 33% of patients (66 calculi), while CT scans detected 60% (118 calculi). The breakdown of calculi location for ultrasonography included 20 renal, 15 pelvic ureteric junction, 12 upper ureter, 8 lower ureter, 7 vesicoureteric junction obstruction, and 4 bladder. CT scan results showed 45 renal, 25 pelvic ureteric junction, 20 upper ureter, 11 lower ureter, 9 vesicoureteric junction obstruction, and 8 bladder calculi. The gender distribution in the study was 55% male and 45% female, with the mean age being 35 ± 16.79 years for males and 36 ± 17.24 years for females. The most common presenting complaints were flank pain (36%), lower back pain (25%), and burning micturition (15%). Conclusion: CT scans exhibit higher diagnostic accuracy for ureteric calculi compared to ultrasonography, thus reaffirming their role as the gold standard in this context. However, the radiation risks and economic implications of CT scanning necessitate a balanced approach to its use, emphasizing the importance of comprehensive patient evaluation and physician awareness of radiation risks.

Fault complexity degree in a coal mine and the implications for risk assessment of floor water inrush

Faults significantly affect the stability of surrounding rock and stress distribution, which increases the possibility of water inrush disasters in a coal mine. Also, the precisely advanced prevention and control of floor limestone water become the foundation of ensuring mine safety and efficient production in coal mines. Fault development evaluation is one of the elements that control further transparent and fine studies. In this paper, the fault control index (FCI) is built based on the fractal dimension (Ds) and fault influence factor (E), which is determined according to the measured water inflow of water inrush points. The box meshing level is analyzed to calculate and compare the FCI. The results show that the box-meshing level affects the value of Ds and FCI and a meshing level of 6 seems to be the minimum standard of Ds for high accuracy. To verify the results, a comprehensive risk evaluation model of floor water inrush is established to illustrate the implications of fault complexity degree on safety mining. A stricter meshing grade when using the box-counting method in fault complexity degree is necessary for further studies in the precise prevention and control of mine hazards.

Comprehensive and cumulative risk evaluation of dietary exposure to aflatoxins and ochratoxin A on fermented teas worldwide by a new assessment model

Recently, mycotoxin risks in fermented tea have received high attention, but mycotoxin transfer rates from tealeaf to infusion during brewing were rarely considered. In addition, the assessment data (i.e., mycotoxin occurrences and tea consumption) in previous assessments were usually limited. Here, a comprehensive and cumulative risk assessment of aflatoxins and ochratoxin A was performed using a tea assessment model, by which mycotoxin transfer rates were included and the assessment data were collected worldwide. By 10 times of brewing, the aflatoxin transfer rate was only 2.94% and OTA was 63.65%. Besides the extreme case, hazard quotients (HQs) from all consumers were lower than the threshold of 1.0, indicating no noncarcinogenic risk; the P95 cumulative margin of exposure (1/MoET) values were 2.52E-04 (30–39 years of age) and 2.42E-04 (≥50 years of age) for two high exposure groups under the upper bound scenario, which a little higher than the carcinogenic risk threshold of 1.00E-04. Notably, the P95 cumulative 1/MoET values (3.24E-03 -7.95E-03) by food assessment model were ten times higher than those of by tea assessment model. The comparative results showed that mycotoxin dietary risks on tea consumption by food assessment model were much overestimated. The result of this study indicated that the contaminants transfer rates should be considered for risk assessment on tea consumption in future work.

Instability Risk Assessment for Deep Excavation of Soil–Rock Combinations Containing Groundwater

Dynamic risk assessment is a pivotal tool for enhancing construction safety and minimizing the potential for partial failure during deep and extensive excavation projects. To enhance the efficacy of dynamic risk assessment in deep excavation, this study introduces a novel risk assessment model designed to evaluate instability risk in extensive excavations. It comprises a risk factor selection model for identifying the most pertinent factors and an instability risk assessment model for gauging the extent of instability risk throughout the construction process. Then, the model was deployed in the construction of Anshan Road Station of the Qingdao Metro. To pinpoint the factors with the most pronounced impact on excavation instability, a risk factor selection model was employed, yielding a comprehensive risk evaluation index system. For real-time assessment of risk, the monitoring data were used as the primary source of evidence. A comprehensive comparative analysis involving actual data and predictions from conventional RBF and back propagation neural networks was performed. The outcome of this analysis underscored the superior accuracy and predictive capabilities of the assessment model. The instability risk assessment model offers the ability to dynamically evaluate the instability risk associated with extensive excavations featuring a combination of soil and rock. It can serve as a valuable methodological tool, furnishing essential support for the systematic prevention and mitigation of excavation instability disasters.

Probabilistic mapping of life loss due to dam-break flooding

AbstractAssessment of flood damage caused by dam failures is typically performed deterministically on the basis of a single preselected scenario, neglecting uncertainties in dam-break parameters, exposure information, and vulnerability model. This paper proposes a probabilistic flood damage model for the estimation of life loss due to dam-break flooding with the aim of overcoming this limitation and performing a more comprehensive and informative evaluation of flood risk. The significant novelty lies in the fact that the model combines uncertainties associated with all three components of risk: hazard, exposure, and vulnerability. Uncertainty in flood hazard is introduced by considering a set of dam-break scenarios, each characterized by different breach widths and reservoir levels. Each scenario is linked to a probability, which is assumed conditional on the dam-break event. Uncertainty in exposure is accounted for using dasymetric maps of the population at risk for two socio-economic states (representing business and non-business hours of a typical week), along with associated likelihood. Vulnerability to flooding is described through a well-established empirical hazard-loss function relating the fatality rate of the population at risk to the flood hazard, the flood severity understanding, and the warning time; a confidence band provides quantitative information about the associated uncertainty. The probabilistic damage model was applied to the case study of the hypothetical collapse of Mignano concrete gravity dam (northern Italy). The main outcome is represented by probabilistic flood damage maps, which show the spatial distribution of selected percentiles of a loss-of-life risk index coupled with the corresponding uncertainty bounds.

Bibliometric analysis of residual cardiovascular risk: trends and frontiers.

The presence of residual cardiovascular risk is an important cause of cardiovascular events. Despite the significant advances in our understanding of residual cardiovascular risk, a comprehensive analysis through bibliometrics has not been performed to date. Our objective is to conduct bibliometric studies to analyze and visualize the current research hotspots and trends related to residual cardiovascular risk. This will aid in understanding the future directions of both basic and clinical research in this area. The literature was obtained from the Web of Science Core Collection database. The literature search date was September 28, 2022. Bibliometric indicators were analyzed using CiteSpace, VOSviewer, Bibliometrix (an R package), and Microsoft Excel. A total of 1167 papers were included, and the number of publications is increasing rapidly in recent years. The United States and Harvard Medical School are the leading country and institution, respectively, in the study of residual cardiovascular risk. Ridker PM and Boden WE are outstanding investigators in this field. According to our research results, the New England Journal of Medicine is the most influential journal in the field of residual cardiovascular risk, whereas Atherosclerosis boasts the highest number of publications on this topic. Analysis of keywords and landmark literature identified current research hotspots including complications of residual cardiovascular risk, risk factors, and pharmacological prevention strategies. In recent times, global attention toward residual cardiovascular risk has significantly increased. Current research is focused on comprehensive lipid-lowering, residual inflammation risk, and dual-pathway inhibition strategies. Future efforts should emphasize strengthening international communication and cooperation to promote the comprehensive evaluation and management of residual cardiovascular risk.

Decades of Improvement in Cardiovascular Morbidity and Mortality in Leukemia Patients Reversed in 2020: Covid? Novel Agents? Neither?

Introduction: The incidence of many types of leukemia increases with age. Intensive induction chemotherapy containing cytarabine and an anthracycline has been part of the upfront and salvage treatment of AML for decades. Regimens for the treatment of ALL are also often anthracycline-based. Anthracyclines are associated with a significant risk of cardiotoxicity including anthracycline-related left ventricular dysfunction. Comprehensive baseline evaluation of cardiac function and risk may lead to better risk stratification and selection of patients who are best suited to anthracycline-based therapy. With the advent of more effective, yet less chemo-intense regimens for the management of older or unfit adults with leukemia, for example hypomethylator and venetoclax-based combinations, which gained widespread use with their accelerated approval in November 2018, one would hypothesize decreased rates of cardiovascular complications associated with the treatment of adult leukemia. To further investigate this hypothesis, we performed a nationwide analysis for adults age 25 and older with leukemia of all types and their associated cardiovascular disease related mortality. Methods: We utilized the Wide-ranging Online Data for Epidemiologic Research from the CDC. Patients were identified using ICD codes: C91 (Lymphoid leukaemia, C92 (Myeloid leukaemia), C93 (Monocytic leukaemia), C94 (Other leukaemias of specified cell type), and C95 (Leukaemia of unspecified cell type) with an underlying cause of death I00-I99 (Diseases of the circulatory system). Data was reviewed between 1999 to 2020 and included patients who were aged ≥25. We analyzed the age adjusted mortality rate (AAMR) per 100,000 people and stratified the data by sex, race/ethnicity, and geographical location within the USA by census region. Results: There were a total of 19,368 cardiovascular related deaths in leukemia patients between 1999 and 2020. There has been a decreasing trend in overall mortality associated with cardiovascular diseases from 1999 to 2019, falling from 4.6 to 3.9 deaths per 100,000 people, with an annual percent change of -2.89% (Figure 1). Both sexes mirrored this trend, with female mortality rates improving from 3.4 to 2.7 (APC -3.26%) and male rates from 6.5 to 5.6 (APC -3.07%) between 1999 and 2019. In 2020, it was observed that leukemia patients had an increased cardiovascular related mortality: 4.5 AAMR overall, 3.0 AAMR in females, and 6.5 AAMR in males . There was not a statistically significant difference in mortality changes by race (Table 1). Conclusion: Our study reveals a decrease in mortality rates from cardiovascular disease in leukemia patients from 1999 to 2018 followed by a relatively sharp increase noted in 2020. The steady improvements noted from the early 2000s to the 2010s may be attributable to awareness of known toxicities that led to enhanced screening and active monitoring for cardiovascular complications. Electrocardiograms, echocardiograms, and cardiotoxic markers including troponins and natriuretic peptides have served as diagnostic and risk-stratification tools. In 2020 leukemia patients exhibited a sudden increase in mortality across all sub-groups. One may postulate that this is related to COVID-19-related complications/delays in treatment, however, another possible explanation may be incompletely recognized toxicities of novel therapeutics. Interestingly, preclinical data have demonstrated that venetoclax treatment resulted in cardiac damage as evidenced by major changes in histopathology and markedly elevated cardiac enzymes and hypertrophic genes markers. Moreover, a drastic increase in oxidative stress, as well as inflammatory and apoptotic markers, with a remarkable decline in the levels of Bcl-2 has been observed (AlAsmari et al Int J Mol Sci 2022). Clearly, continued monitoring and further exploration is needed to identify the reason or reasons for the noted 2020 phenomenon. Continued data collection in the post-Covid vaccine era is likely to help to further elucidate the reasons for the unexpected uptick in cardiovascular-related morbidity and mortality in our leukemia patients.