Domino Effect Research Articles

Ice-shelf freshwater triggers for the Filchner–Ronne Ice Shelf melt tipping point in a global ocean–sea-ice model

Abstract. Some ocean modeling studies have identified a potential tipping point from a low to a high basal melt regime beneath the Filchner–Ronne Ice Shelf (FRIS), Antarctica, with significant implications for subsequent Antarctic ice sheet mass loss. To date, investigation of the climate drivers and impacts of this possible event have been limited because ice-shelf cavities and ice-shelf melting are only now starting to be included in global climate models. Using a global ocean–sea-ice configuration of the Energy Exascale Earth System Model (E3SM) that represents both ocean circulations and melting within ice-shelf cavities, we explore freshwater triggers (iceberg melt and ice-shelf basal melt) of a transition to a high-melt regime at FRIS in a low-resolution (30 km in the Southern Ocean) global ocean–sea-ice model. We find that a realistic spatial distribution of iceberg melt fluxes is necessary to prevent the FRIS melt regime change from unrealistically occurring under historical-reanalysis-based atmospheric forcing. Further, improvement of the default parameterization for mesoscale eddy mixing significantly reduces a large regional fresh bias and weak Antarctic Slope Front structure, both of which precondition the model to melt regime change. Using two different stable model configurations, we explore the sensitivity of FRIS melt regime change to regional ice-sheet freshwater fluxes. Through a series of sensitivity experiments prescribing incrementally increasing melt rates from the smaller, neighboring ice shelves in the eastern Weddell Sea, we demonstrate the potential for an ice-shelf melt “domino effect” should the upstream ice shelves experience increased melt rates. The experiments also reveal that modest ice-shelf melt biases in a model, especially at coarse ocean resolution where narrow continental shelf dynamics are not well resolved, can lead to an unrealistic melt regime change at downstream ice shelves. Thus, we find that remote connections between melt fluxes at different ice shelves are sensitive to baseline model conditions. Our results highlight both the potential and the peril of simulating prognostic Antarctic ice-shelf melt rates in a low-resolution global model.

Unmasking the Subconscious Fallacies Within Critical Infrastructure Protection

Cybersecurity, a vital challenge in today’s ever-changing digital world, it has gained prominence with the global shift towards cyber-enabled critical infrastructures. Critical infrastructure protection efforts are fundamental for the continuation of essential services. Traditionally constituted as separate sectors, these infrastructures are increasingly interconnected, leading to potential domino effects during security breaches. For instance, failures within the power grid could have cascading effects on multiple sectors that depend on electricity for their operations, creating large-scale failures that affect functions on which society depends. The multidimensional nature of the infrastructures presents complex challenges for solutions, given their status as long-established legacy systems needing further development and enhancements to withstand the digital world. The lack of a concerted and focused infrastructure enhancement strategy has led to incremental approaches versus a comprehensive revamp to ensure a holistic cyber protection program. A lack of national focus has created inconsistencies that can lead to potentially catastrophic consequences. Understanding the decision-making processes within a complex environment is critical to the mission success. One significant risk is the cognitive roadblocks that have the potential to influence one’s judgements as this often outweighs balanced decisions. This study aims to investigate the subconscious biases that arise from a perceived resolution of the problem which can lead to de-prioritization within the decision-making processes. The study employs a convergent parallel mixed methods design to collect and analyse the data. The study then will compare the results allowing for the exploration of various aspects of the research. This approach is aligned to provide a thorough understanding of the challenges associated with protecting the infrastructures and the underlying subconscious fallacies in the digital age, thereby devising effective mitigation strategies, and fostering a more sustainable and resilient critical infrastructure that is useful for a variety of stakeholders, including policymakers, infrastructure owners and operators, cybersecurity professionals, and researchers

The rise of China’s status: a relational approach

To what extent has China’s status risen, and how? Despite the pivotal role of China’s status in shaping its foreign policy and global phenomena, there is no scholarly consensus on where China is ranked in the global hierarchy and how it attains such a position. Building on empirical studies that use diplomatic exchanges and extending them by employing social network analysis, this article provides the first systematic analysis of China’s standing in the global status hierarchy. My findings show that China’s status has experienced significant growth with a substantial increase in the number of diplomatic recognitions received. While the United States garnered more recognition than China, the gap between the two has narrowed significantly over the last three decades, and, when considering the quality of diplomatic ties, China’s status even surpassed that of the United States by 2005. Additionally, my findings suggest that both exogenous and endogenous factors worked in concert to elevate China’s status. The rise of China’s status did not occur automatically with its economic or military capabilities’ growth. Instead, relational dynamics were also important: recognition from the most prestigious country, the United States, in the 1970s triggered a domino effect, prompting other countries to recognize China. Furthermore, China’s emphasis on aligning with the developing Third World enables it to uniquely position itself in diplomatic networks by engaging with both well-connected and marginalized countries. This diplomatic portfolio, in turn, equips China with significant social and brokerage power, suggesting that its influence is far more formidable than its material capabilities alone would imply.

The Effect of Macroeconomic Variables on Stock Returns of The Jakarta Islamic Index: A Panel Vector Error Correction Model Approach

Introduction: This study was conducted because there were differences in stock return trends in JII during 2016-2018, where stock return movements simultaneously decreased, but different conditions occurred in 2019-2022, where trend returns experienced different conditions between companies. This was caused by the domino effect of the Covid-19 Pandemic, which resulted in changes in Indonesia's BI Rate and Inflation. Thus, this study aims to analyze the long and short-term effects of BI Rate and Inflation on changes in the return of company shares in JII. Research Methods: This study uses the Panel Vector Error Correction Model (VECM) method, secondary data in the form of a Panel of Stock Return of 4 companies, BI Rate and Inflation during 2016-2022. Results: The long and short-term results in the previous two and three-quarters of the BI Rate were significantly positive for stock returns. While in the long and short term, inflation was significantly negative for stock returns. Conclusion: The research found that the BI Rate does not always negatively affect return. When the BI Rate increases, it gives investors confidence that the value of their investment is protected from depreciation. This can create a positive environment for the stock market so that it has an impact on rising stock prices.

CFD Simulation to Assess the Effects of Asphalt Pavement Combustion on User Safety in the Event of a Fire in Road Tunnels

This paper presents a specific 3D computational fluid dynamics model to quantify the effects of the combustion of asphalt road pavement on user safety in the event of a fire in a bi-directional road tunnel. Since the consequences on tunnel users and/or rescue teams might be affected not only by the tunnel geometry but also by the type of ventilation and traffic flow, the environmental conditions caused by the fire in the tunnel under natural or longitudinal mechanical ventilation, as well as congested traffic conditions, were more especially investigated. The simulation results showed that the combustion of the asphalt pavement in the event of a 100 MW fire, compared to the case of a non-combustible road pavement, caused (i) an increase in smoke concentrations; (ii) a greater number of users exposed to the risk of incapacity to escape from the tunnel; (iii) a more difficult situation for the firefighters entering the tunnel upstream of the fire source in the case of natural ventilation; (iv) a higher probability of the domino effect for vehicles queued downstream of the fire when the tunnel is mechanically ventilated.

An extended model for crowded evacuation considering stampede on inclined staircases

An extended floor field cellular automata (FFCA) model considering the stampede accidents on inclined staircases is proposed to study shoving behavior and pedestrian dynamics. In this model, two stampede evolution pathways are investigated: Pedestrians falling after losing balance, and falling directly due to being crowded. The results show that this model could trigger some characteristics of real irrational evacuation processes, such as: (1) the mutual crowding and shoving among pedestrians; (2) the unbalance phenomenon on inclined staircases; (3) the effect of pedestrians falling like dominoes, which is consistent with the findings of most stampede investigations to some extent. The proposed model considers the impact of fallen pedestrians on the movement of ordinary pedestrians, which shows a reduction in the overall evacuation efficiency. Moreover, the steeper the slope, the greater the risk and severity of injuries during the crowded evacuation in this scenario. Additionally, falling phenomena of pedestrians show a certain lag related to the state of unbalance. Unbalanced pedestrians tend to appear from the rear to the front successively, and fallings often occur some time later the onset of unbalance, progressing from front to rear. This pattern reflects the “domino effect” among pedestrians. Lastly, unbalanced pedestrians constitute a significant portion of the total injured pedestrians. Considering the time delay of fallings after being unbalanced, the importance of early emergency response and intervention during crowded evacuations is emphasized. It is expected to provide some theoretical support for safety management.

Increasing First Case On Time Starts in the Operating Room Using an Electronic Readiness Dashboard: A Quality Improvement Project

IntroductionFirst case surgical delays cause domino effects resulting in subsequent case delays, staff overtime pay, and patient dissatisfaction. A total of 23,690 minutes were lost during March to June 2022. The project goal was to implement the surgical enhanced readiness dashboard (SERD) to increase efficiency, resulting in the increased first case on-time starts (FCOTS) by 5% in the March-June/fiscal year (FY) 2022 versus March-June/FY 2021. Materials/MethodsFCOTS were captured by an institutional data analysis program. Data was pulled from the electronic health record from when the nurse recorded time the in the operating room (OR) time. A pre-and post-implementation survey was distributed to OR nurses and analyzed. Data was collected for one quarter and compared to the previous year's quarter. A statistical T-test was used to compare the pre-and post-implementation data and the pre-and post-implementation surveys. Theory/CalculationThe Donabedian Model evaluated the safety and quality of the SERD's structure, process, and outcome. Data collected from the project provided quality metrics that led to transformative change. ResultsOf the 35 anonymous surveys submitted, 54.3% of participants value using the SERD as a surgical readiness tool to improve their workflow. FCOTS during the implementation period of FY 2022 March-June averaged 72.3%, an overall increase of 0.6 % of the same time frame in FY 2021 (71.7%). DiscussionThe SERD's central location in the preoperative area and incorporation into the nursing workflow standardize the preoperative process and bridge communication gaps between nurses, anesthesia, residents, and surgeons. Efficient transitions through the preoperative area decrease healthcare organizations' overall costs. ConclusionDelays in patient surgery are costly to healthcare organizations. Patients scheduled for first surgical cases arrive early and expect to be prepared for surgery efficiently. Implementing an electronic dashboard to increase the number of FCOTS will be instrumental in streamlining patients throughout the perioperative stay. The data collected will help drive perioperative nurses to decrease costly delays in patient care.

Caught in the Act of Substitution: Interadsorbate Effects on an Atomically Precise Fe/Co/Se Nanocluster.

Directing groups guide substitution patterns in organic synthetic schemes, but little is known about pathways to control reactivity patterns, such as regioselectivity, in complex inorganic systems such as bioinorganic cofactors or extended surfaces. Interadsorbate effects are known to encode surface reactivity patterns in inorganic materials, modulating the location and binding strength of ligands. However, owing to limited experimental resolution into complex inorganic structures, there is little opportunity to resolve these effects on the atomic scale. Here, we utilize an atomically precise Fe/Co/Se nanocluster platform, [Fe3(L)2Co6Se8L'6]+ ([1(L)2]+; L = CN t Bu, THF; L' = Ph2PN(-)Tol), in which allosteric interadsorbate effects give rise to pronounced site-differentiation. Using a combination of spectroscopic techniques and single-crystal X-ray diffractometry, we discover that coordination of THF at the ligand-free Fe site in [1(CN t Bu)2]+ sets off a domino effect wherein allosteric through-cluster interactions promote the regioselective dissociation of CN t Bu at a neighboring Fe site. Computational analysis reveals that this active site correlation is a result of delocalized Fe···Se···Co···Se covalent interactions that intertwine edge sites on the same cluster face. This study provides an unprecedented atom-scale glimpse into how interfacial metal-support interactions mediate a collective and regiospecific path for substrate exchange across multiple active sites.

Year-round carryover effects are driven by migration phenology for Hirundo rustica (Barn Swallow) wintering in West Africa

Abstract Recently, population declines have been reported for many migratory birds. Because of complex life cycles, determining the causes for such declines is often difficult. Thus, migratory birds are of special conservation interest. We studied the migratory behavior of Hirundo rustica (Barn Swallow) tagged with solar geolocators and determined carryover effects during the entire annual cycle from one breeding season to the next. We used a partial least squares path model (PLS-PM) to disentangle migratory and breeding events that occur in chronological order. In addition, we controlled for broad environmental conditions in the wintering grounds (NDVI and latitude) and the specific molting habitat (δ13C). We did not find a carryover effect from reproduction investment in the attachment year to breeding success in the subsequent year. Individuals that invested more in reproduction departed earlier from the breeding colonies, but this in turn did not affect the onset of autumn migration. Thus, the premigratory period should be acting as a buffer stage counteracting any previous carryover effects from reproduction investment. On the other hand, we found a long-lasting domino effect from the onset of autumn migration to subsequent breeding success, consistent with the notion of a migratory race. Specifically, individuals which started earlier in the autumn migration arrived earlier to the wintering grounds, started earlier in the spring migration arrived earlier to the breeding colonies, and had a higher breeding success. We highlight that the premigratory period (i.e., the time elapsed between departure from breeding areas and the onset of autumn migration) should be important for the life cycle of migratory species, but it has been frequently overlooked.

Social media-based implosion of Silicon Valley Bank and its domino effect on bank stock indices: evidence from advanced machine and deep learning algorithms

Social media-driven speculations play a crucial role in triggering the collapse of the banking system and stock markets. In this paper, we investigate the effect of Twitter-based investor sentiment on the collapse of Silicon Valley Bank (SVB), the 16th largest bank in the US. Additionally, we examine the spillover effect of the social media-based investor sentiment and SVB collapse on the bank stock indices from twelve countries where Global Systemically Important Banks (G-SIBs) operate. Advanced machine and deep learning models are employed to model the social media-based investors’ sentiment regarding SVB implosion and its spillover effect on the G-SIBs’ bank stock indices. Our results reveal that social media-based negative investors’ sentiment played an important role in SVB implosion. Our results further show that the negative investors’ sentiment persisted, and its systemic shock was transmitted to the G-SIBs bank stock indices. Importantly, our results provide a lead and lag relationship between investors’ sentiment and returns of G-SIBs bank stock indices. The findings of this study offer crucial insights for policymakers to consider the external shocks associated with social media-based investors’ sentiment when devising policies related to bank runs, thus helping to prevent future financial crises and cross-border contagion.

Can Facebook's community standards keep up with legal certainty? Content moderation governance under the pressure of the Digital Services Act

AbstractContent moderation by social media companies is a challenge for regulators around the world. The European Union is trying to tackle this challenge with its Digital Services Act (DSA). Notably, Article 14 DSA aims to impose language requirements based on the principle of legal certainty to social media companies' terms and conditions, of which community standards (CS) are a part. The principle of legal certainty is one of the building blocks of international human rights law, and its inclusion in the DSA illustrates the human rights‐based approach anchored in this European regulation. Based on a content analysis of Facebook's CS, this paper shows that their standards do not meet European requirements for legal certainty and argues that important changes in content moderation governance would be needed for proper compliance. Such changes could generate a domino effect beyond the European Union and on Facebook's content moderation governance itself. At the same time, the DSA could also generate a boomerang effect on the legal certainty principle as such. From this perspective, the paper contributes to the literature on regulatory governance studies, and on international human rights law in social media studies from a European Union perspective.

Tumor Microenvironment Specific Regulation Ca-Fe-Nanospheres for Ferroptosis-Promoted Domino Synergistic Therapy and Tumor Immune Response.

Reactive oxygen species (ROS)-mediated emerging treatments exhibit unique advantages in cancer therapy in recent years. While the efficacy of ROS-involved tumor therapy is greatly restricted by complex tumor microenvironment (TME). Herein, a dual-metal CaO2@CDs-Fe (CCF) nanosphere, with TME response and regulation capabilities, are proposed to improve ROS lethal power by a multiple cascade synergistic therapeutic strategy with domino effect. In response to weak acidic TME, CCF will decompose, accompanied with intracellular Ca2+ upregulated and abundant H2O2 and O2 produced to reverse antitherapeutic TME. Then the exposed CF cores can act as both Fenton agent and sonosensitizer to generate excessive ROS in the regulated TME for enhanced synergistic CDT/SDT. In combination with calcium overloading, the augmented ROS induced oxidative stress will cause more severe mitochondrial damage and cellular apoptosis. Furthermore, CCF can also reduce GPX4 expression and enlarge the lipid peroxidation, causing ferroptosis and apoptosis in parallel. These signals of damage will finally initiate damage-associated molecular patterns to activate immune response and to realize excellent antitumor effect. This outstanding domino ROS/calcium loading synergistic effect endows CCF with excellent anticancer effect to efficiently eliminate tumor by apoptosis/ferroptosis/ICD both in vitro and in vivo.

Unveiling the domino effect: a nine-year follow-up on pentalogy of central nervous system induced by a large unruptured cerebral arteriovenous malformation: a case report and literature review

BackgroundThe disruption of intracranial fluid dynamics due to large unruptured cerebral arteriovenous malformation (AVM) commonly triggers a domino effect within the central nervous system. This phenomenon is frequently overlooked in prior clinic and may lead to catastrophic misdiagnoses. Our team has documented the world’s first case of so-called AVM Pentalogy (AVMP) induced by a AVM.Clinical presentation and resultA 30-year-old female was first seen 9 years ago with an occasional fainting, at which time a huge unruptured AVM was discovered. Subsequently, due to progressive symptoms, she sought consultations from several prestigious neurosurgical departments in China, where all consulting neurosurgeons opted for conservation treatment due to perceived surgical risks. During the follow-up period, the patient gradually presented with hydrocephalus, empty sella, secondary Chiari malformation, syringomyelia, and scoliosis (we called as AVMP). When treated in our department, she already displayed numerous symptoms, including severe intracranial hypertension. Our team deduced that the hydrocephalus was the primary driver of her AVMP symptoms, representing the most favorable risk profile for intervention. As expected, a ventriculoperitoneal shunt successfully mitigated all symptoms of AVMP at 21-months post-surgical review.ConclusionDuring the monitoring of unruptured AVM, it is crucial to remain vigilant for the development or progression of AVMP. When any component of AVMP is identified, thorough etiological studies and analysis of cascade reactions are imperative to avert misdiagnosis. When direct AVM intervention is not viable, strategically addressing hydrocephalus as part of the AVMP may serve as the critical therapeutic focus.

Inequity in clinical research access for service users presenting comorbidity within alcohol treatment settings: findings from a focused ethnographic study

BackgroundWhile healthcare policy has fostered implementation strategies to improve inclusion and access of under-served groups to clinical care, systemic and structural elements still disproportionately prevent service users from accessing research opportunities embedded within clinical settings. This contributes to the widening of health inequalities, as the absence of representativeness prevents the applicability and effectiveness of evidence-based interventions in under-served clinical populations. The present study aims to identify the individual (micro), organisational (meso) and structural (macro) barriers to clinical research access in patients with comorbid alcohol use disorder and alcohol-related liver disease.MethodsA focused ethnography approach was employed to explore the challenges experienced by patients in the access to and implementation of research processes within clinical settings. Data were collected through an iterative-inductive approach, using field notes and patient interview transcripts. The framework method was utilised for data analysis, and themes were identified at the micro, meso and macro levels.ResultsAt the micro-level, alcohol-related barriers included encephalopathy and acute withdrawal symptoms. Alcohol-unrelated barriers also shaped the engagement of service users in research. At the meso-level, staff and resource pressures, as well as familiarity with clinical and research facilities were noted as influencing intervention delivery and study retention. At the wider, macro-level, circumstances including the ‘cost of living crisis’ and national industrial action within healthcare settings had an impact on research processes. The findings emphasise a ‘domino effect’ across all levels, demonstrating an interplay between individual, organisational and structural elements influencing access to clinical research.ConclusionsA combination of individual, organisational and structural barriers, exacerbated by the COVID-19 pandemic, and the socioeconomic landscape in which the study was conducted further contributed to the unequal access of under-served groups to clinical research participation. For patients with comorbid alcohol use disorder and alcohol-related liver disease, limited access to research further contributes towards a gap in effective evidence-based treatment, exacerbating health inequalities in this clinical population.

Online school sport club in South Korea: policy adaptation towards youth development through sport during touchless era

ABSTRACT Using Bronfenbrenner’s bioecological theory, this qualitative case study aimed to explore how the online school sport clubs (O-SSC) were developed and administered as a counteraction against the pandemic and the meanings of the O-SSC from stakeholders’ perspectives in South Korea. Data were collected from official and open-source O-SSC materials, working-level meeting logs, and in-depth interviews with six policy stakeholders that included superintendents and teachers in Seoul, South Korea. The findings revealed four themes regarding the development of the policy and perceived changes as a result of the implementation of O-SSC: (a) thinking outside the box beyond traditional sports, (b) melting the frozen gym, (c) setting the stage beyond stereotypes in sport and physical spaces, and (d) unlimited opportunities to challenge: ‘you can try it again tomorrow’. The discussion addressed the following: (a) O-SSC as a domino effect for youth development through sport and (b) balance between sportisation and healthisation. The O-SSC generated a transformative chain of changes, providing youths with a new sporting developmental asset and prioritising students’ basic psychological needs and motivation. Furthermore, it embraced the inclusiveness, a quality missing in traditional school sport, and integrated aspects of physical fitness to tackle the adolescents’ physical inactivity caused by COVID-19. To conclude, it is imperative to call for the development of school sport policy that is more adaptive, inclusive, and future-oriented, not just to prepare for future contingencies but to embrace new possibilities of school sport for the benefit of school-age adolescents.

Analisis Struktur Industri Unggulan Pada Pembangunan Negara

Leading industries play an important role in a country’s economic development. The comparative and competitive advantages of this industry produce production output, employment opportunities and a domino effect that benefits other sectors. This research aims to analyze the structure f leading industries and identify the factors driving and inhibiting their growth. The benefits of research are also felt by policy makers and practitioners in formulating industrial growth strategies, as well as by academics and researchers in enriching theoretical studies of economic and industrial development

Comparative and phylogenetic analyses of Loranthaceae plastomes provide insights into the evolutionary trajectories of plastome degradation in hemiparasitic plants

BackgroundThe lifestyle transition from autotrophy to heterotrophy often leads to extensive degradation of plastomes in parasitic plants, while the evolutionary trajectories of plastome degradation associated with parasitism in hemiparasitic plants remain poorly understood. In this study, phylogeny-oriented comparative analyses were conducted to investigate whether obligate Loranthaceae stem-parasites experienced higher degrees of plastome degradation than closely related facultative root-parasites and to explore the potential evolutionary events that triggered the ‘domino effect’ in plastome degradation of hemiparasitic plants.ResultsThrough phylogeny-oriented comparative analyses, the results indicate that Loranthaceae hemiparasites have undergone varying degrees of plastome degradation as they evolved towards a heterotrophic lifestyle. Compared to closely related facultative root-parasites, all obligate stem-parasites exhibited an elevated degree plastome degradation, characterized by increased downsizing, gene loss, and pseudogenization, thereby providing empirical evidence supporting the theoretical expectation that evolution from facultative parasitism to obligate parasitism may result in a higher degree of plastome degradation in hemiparasites. Along with infra-familial divergence in Loranthaceae, several lineage-specific gene loss/pseudogenization events occurred at deep nodes, whereas further independent gene loss/pseudogenization events were observed in shallow branches.ConclusionsThe findings suggest that in addition to the increasing levels of nutritional reliance on host plants, cladogenesis can be considered as another pivotal evolutionary event triggering the ‘domino effect’ in plastome degradation of hemiparasitic plants. These findings provide new insights into the evolutionary trajectory of plastome degradation in hemiparasitic plants.

Recurrence of Diabetic Foot Complications: A Domino Effect Leading to Lethal Consequences-Insights From a National Longitudinal Study.

Foot complications are common in people with diabetes mellitus (DM), leading to increased health care utilization, heightened mortality risk, and notable recurrence rates even after treatment. This retrospective cohort study aimed to investigate the impact of repeated occurrence of DM-related foot complications on the risk of all-cause mortality and to identify the potential risk factors associated with repeated events. People with DM admitted with foot complications (ulcer, skin and soft tissue infection, or osteomyelitis) from 2012 to 2014 were identified from Taiwan's National Health Insurance Research Database, with a 3-year follow-up for repeated events. We categorized the study subjects based on their cumulative number of hospital admissions with foot complications. Logistic regression was conducted to explore the potential risk factors associated with repeated diabetic foot events. Kaplan-Meier curves and Cox proportional hazard models were used to examine the associations between repeated diabetic foot events and all-cause mortality. In this study, 28 754 eligible individuals were enrolled and classified into 3 groups: no repeated diabetic foot events (76.1%), 1 repeated event (16.0%), and 2 or more repeated events (7.9%). Logistic regression revealed that advanced age, male sex, congestive heart failure, dyslipidemia, hypertension, nephropathy, retinopathy, neuropathy, peripheral vascular disease, diabetes-related preventable hospitalizations, and outpatient visits due to diabetic foot were significantly associated with repeated events of diabetic foot complications. Compared with those with no repeated events, the adjusted hazard ratios for all-cause mortality were 1.26 (95% CI, 1.19-1.34) for 1 repeated event and 1.36 (95% CI, 1.26-1.47) for 2 or more repeated events. The significant association between repeated diabetic foot and elevated mortality risk highlights the critical necessity for proactive and targeted patient care within clinical practice. More research to delve into the predictive factors related to the repeated occurrence of diabetic foot is needed to provide additional insights for prevention strategies.

A miscellaneous model for comprehensive attractiveness assessment of chemical plants: Integrating chemical hazards, domino effects and plant traits

The growing threat of intentional attacks on major petrochemical plants underscores the urgent need for robust security risk assessments (SRA). Such assessments are widely acknowledged as crucial for risk mitigation and are currently a focus of active research. This study introduces a methodology for assessing the attractiveness of the petrochemical sector to intentional attacks, considering chemical hazards, domino effects, and plant traits. Within this framework, we have identified 12 risk factors that capture the multifaceted nature of targeting incentives, relating to the enterprise, location, population, and other key features. We have developed a hybrid decision-making model that analyzes the interrelationships among these factors and determines their weights, integrating the Decision-Making Trial and Evaluation Laboratory (DEMATEL) and the Analytic Network Process (ANP). The applicability of this method is demonstrated through a detailed case study. The results indicate that our method can effectively rank the attractiveness of chemical plants within a specific region, serving as a preliminary screening phase in the SRA. The findings of the attractiveness assessment may assist in identifying potential targets among numerous existing plants and support the allocation of security resources and the formulation of defensive measures.

Risk Management for the Petrodiesel-Biodiesel Fuel Blend Supply Chain in Indonesia

This research addresses the management of risks within inter-business unit networks, focusing on two key levels of risk mitigation: strategic and operational. Prior research primarily explored risk management within specific fuel industry units supplied by a single source. This study represents a novel approach, delving into dual-source fuel strategies and engaging various supply chain stakeholders to identify and mitigate operational risks accordingly. The research findings demonstrate that stakeholders can reduce risks through integrated planning and collaboration among business units, with government support further reducing inter-unit risks. This study’s main contribution is establishing a basis for future research in eco-friendly fuel supply chains, specifically examining the long-term viability of blending petrofuel with biofuel. This extends risk analysis to supply chain networks involving multiple business units. Moreover, this research emphasizes the significance of case studies covering end-to-end product flows in fuel blend supply, encompassing various supply chain functions. Additionally, it investigates stakeholder perceptions of operational risks associated with different business unit types, addressing potential domino effects. It highlights the importance of information technology in risk reduction through collaborative information exchange within the supply chain.