Established Risk Assessment Research Articles

Transmission Line Overload Risk Assessment for Power Systems With Wind and Load-Power Generation Correlation

In the risk-based security assessment, probability and severity of events are the two main factors for measuring the security level of power systems. This paper presents a method for assessing line overload risk of wind-integrated power systems with the consideration of wind and load-power generation correlation. The established risk assessment model fully considers the probability and the consequence of wind uncertainties and line flow fluctuations. The point estimate method is employed to deal with the probability of line overload and the severity function is applied to quantify line flow fluctuations. Moreover, with the Cholesky decomposition, the correlation between loads and power generations are simulated by the spatial transformation of probability distributions of random variables. In addition, Nataf transformation is used to address wind resource correlation. Finally, the line overload risk index is obtained, which can be used as an indicator for quantifying power system security. Numerical results on the modified IEEE 30-bus system and the modified IEEE 118-bus system show that the types and the parameters of the wind speed distribution would affect the risk indices of line overload, and the risk indices obtained with the consideration of wind resource correlation and load correlation would reflect the system security more accurately.

Abstract P4-11-16: Low serum adiponectin level is an independent risk factor of DCIS in postmenopausal women at increased risk of breast cancer

Abstract Background:The assessment of breast cancer (BC) risk is a key step for an effective preventive treatment. Besides the established risk assessment models, validation of independent predictive factors such as circulating biomarkers would improve patient selection and treatment efficacy. Obesity and metabolic imbalance play an important role in BC risk in menopausal women. The role of adipocytes in energy homeostasis is currently under investigation for their emerging relationship with BC. Adipokines (such as leptin and adiponectin) are linked to insulin sensitivity and have been related to BC risk and prognosis. Adiponectin, a peptide hormone secreted by the adipose tissue, has been inversely related to BC risk both in observational studies and in a phase II chemoprevention trial in premenopausal women at increased risk. Aim:We measured baseline serum adiponectin and leptin levels as well as HOMA index, in 534 postmenopausal women enrolled in 16 Italian centers and randomized in one of the two international phase III trials for BC prevention -the IBIS-II(Prevention) and IBIS-II(DCIS) trials- to assess whether these biomarkers were different in the healthy women at increased risk for BC cohort compared to the DCIS cohort. Methods:Healthy postmenopausal women (aged 40-70) at increased risk for BC (on an age-dependent risk model; n=186) or DCIS patients who underwent radical surgery in the previous 6 months (n=348) were eligible according to the two separate protocol entry criteria. At baseline, fasting blood was collected, processed and stored at -80°C till biomarkers measurement. Insulin and glucose levels were measured with the Architect system (Abbott Laboratories, Abbott Park, IL 60064 USA). Serum adiponectin and leptin levels were determined with Immunoassays by R&D (Minneapolis, USA). Results:Participant characteristics and biomarker levels (median, IQ range) by disease status are reported below. Table 1Healthy (n=186)DCIS (n=348)Age at entry59 (55, 63)60 (56, 65)BMI (kg/m2)25.2 (22.9, 28.4)25.0 (22.4, 28.1)Adiponectin (ng/mL)13063 (10279, 18157)11498 (7722, 16909)Leptin (pg/mL)16181 (9594, 26391)17284 (9675, 26173)L/A ratio1.33 (0.60, 2.09)1.46 (0.69, 3.19)Glucose (mg/dL)89 (81, 97)93 (86, 103)Insulin (μU/mL)6.6 (5.0, 9.6)7.5 (5.4, 10.6)HOMA index1.39 (1.04, 2.02)1.79 (1.18, 2.61)L/A, Leptin/Adiponectin ratio Adiponectin was significantly negatively correlated with leptin, L/A ratio, HOMA index and BMI, while leptin was positively correlated with L-A ratio, BMI, HOMA. Logistic regression has been used and Odds Ratios (ORs) have been calculated to assess the association of DCIS with biomarkers.DCIS patients were significantly more frequent in the lowest quartile of adiponectin compared to the highest quartile (60% vs 75%; OR=2.49; 95% CI, 1.39-4.44, p= 0.0003) adjusting for center, BMI, HOMA index and age. Conclusions:Low serum adiponectin levels in postmenopausal women are more frequent in DCIS patients compared to healthy at risk subjects independently of BMI, HOMA index and age and results are similar to premenopausal women. Future investigations in both trials will assess whether adiponectin is also associated with BC events. Acknowledgments: J.Forbes and T.Howell, Co-Chairmen,IBIS-II Steering Committee. Citation Format: Aliana Guerrieri-Gonzaga, Debora Macis, Sara Gandini, Valentina Aristarco, Harriet Johansson, Giorgia Bollani, Teresa Roth, Maria-Teresa Sandri, Jill Knox, Jack Cuzick, Bernardo Bonanni. Low serum adiponectin level is an independent risk factor of DCIS in postmenopausal women at increased risk of breast cancer [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P4-11-16.

Supply Chain Risk Assessment Based on AHP and Fuzzy Comprehensive Assessment Mode: A Case Study of the Chemical Supply Chain

Recently, there have been frequent accidents in energy chemical industry, hence the emergency management become normalized. Risk assessment provides basis for policy makers to make decision in the cases of the uncertain information and emergency. The chemical supply chain are influenced by many risk factors. In order to make the assessment of chemical supply chain risk by combining the qualitative method with quantitative method, this paper summarizes the characteristics of the chemical supply chain, applies analytic hierarchy process (AHP) to establish risk assessment system, carries the quantitative analysis on risk factors and their weights, establishes the fuzzy comprehensive evaluation model. Analysis of examples shows that in the complicated system of a variety of risks, risk assessment model that based on the AHP can realize the assessment of the individual risk and the comprehensive risk. The validity and science of the model can be verified through comparing evaluation results with actual results.

Improving Patient Safety through Human-factor-based Risk Management

National and international efforts under the initiative ‘patient safety’ aim for more safety and transparency within healthcare systems for both patients and professionals. Within the healthcare sector, workflows become more and more complex, while time and money become scarce. As the consequence, the risk awareness, fault management and quality aspects in general become more important. One of the most established risk assessment methods is Failure Mode and Effect Analysis (FMEA) – a reliability analysis and risk assessment tool widely used in various industries. The traditional FMEA is using a Risk Priority Number (RPN) ranking system to evaluate and identify the risk level of failures, and to prioritize actions. However, there are shortcomings in obtaining a quality estimate of the failure ratings with FMEA, especially when human factors play a role, as it is in healthcare. Thus, a new risk assessment method named HFdFMEA (Human Factor dependent FMEA) based on dependency of used parameters and observation of human factors, is proposed to address these drawbacks. The results of this paper show that the HFdFMEA does not only increase risk level of failures based on the inclusion of human-factors but also gives the possibility to reduce the risk level of failures through means of addressing human-factors via trainings, motivation, etc. Finally, we discuss the opportunity to improve patient safety as result of the proposed HFdFMEA, used as technique for Human-Factor-based Risk Management (RiDeM).

Construction of the Factors Affecting China's Hydropower Projects and Overseas Investment Risk Assessment Index System

In this paper, power projects overseas investment risk as the research object, starting from the risk assessment and prevention, integrated use of risk theory of knowledge, power projects overseas investment to do a systematic risk identification and analysis. On this basis, the analytic hierarchy process, fuzzy comprehensive evaluation of knowledge and econometrics to establish risk assessment model, a comprehensive assessment of power projects overseas investment risks.

Effects and risk evaluation of oil spillage in the sea areas of Changxing Island.

This paper evaluated the oil spillage risk in the waters near the island of Changxing in Dalian (China) based on the established risk assessment index. Four wind regimes (windless, northerly wind, westerly wind and southerly wind) were selected as weather conditions for the dynamic prediction of oil drift. If an oil spill occurs near the Koumen (a place near the island of Changxing), the forecast and evaluation are conducted based on a three-dimensional mathematical model of oil spillage, and the results obtained show the scope of the affected area when winds from various directions are applied. The oil spillage would, under various conditions, flow into the northern and western sea area of Changxing Island Bay, namely the Dalian harbor seal National Nature Reserve, and create adverse effects on the marine ecological environment. The rationality of combining the established oil spillage risk comprehensive index system with model prediction is further confirmed. Finally, preventive measures and quick fixes are presented in the case of accidental oil spillages. The most effective method to reduce environment risk is to adopt reasonable preventive measures and quick fixes.

W3: The French experience of establishing an oral fluid roadside drug test

Introduction In 2005, following on from the findings of the ROSITA and DrUID projects, the French government made the decision to investigate possible alternative matrices to urine for drug screening at the roadside. A special committee, which included French ministerial representatives, was established in 2006 and they decided to use a special procurement contract in the form of a “competitive dialogue”: this allowed manufacturers of screening devices to improve their product in accordance with the committee’s recommendations. From initial investigations carried out, oral fluid (OF) was found to be the best alternative matrix (non invasive sample taking, difficult to adulterate, existing prototypes), and so this was chosen for this work. The devices included in the work were screening tests based on immunochromatographic methods. Method In France the four major categories of drugs tested for are cannabis, cocaine, opiates and amphetamines therefore the devices selected had to detect these compounds. The French gendarmerie and police played an important role in this previously unfamiliar testing and 3 OF devices remained for evaluation in the final step of the selection process. For this step, 2 field evaluation studies were carried out in 3 of the most active territorial road units by the Centre of Research and Expertise on Logistic (CREL). In the first study, approximately 500 individuals were involved. A urine sample was collected for screening, if positive a blood sample for confirmation and one of the OF devices was tested. In the second study, 100 participants were involved and standard urine and blood confirmation was carried out but also OF was tested against all three of the devices for a comparative study. The toxicology unit of our laboratory performed more than 400 of the confirmatory analyses by a validated GC-MS method. For both of the field studies, CREL processed the findings from the roadside units carrying out the screening and determined sensitivity, specificity and efficacy of the 3 devices. As a result, the Rapid Stat ® (Mavand) screening device was introduced for roadside drug testing. French law was subsequently modified in July 2008 to allow the use of an OF screening test operated by a police officer (as opposed to medical personnel). Results & discussion This change in legislation has resulted in a dramatic increase in the number of roadside drug tests performed and consequently the number of confirmatory analyses in blood (an increase from 15,000 in 2004 to 76,000 in 2010). Although OF has a number of factors requiring consideration when collecting, analysing and interpreting findings, it has become an accepted matrix for this type of testing and one which we are investigating. In March 2011, a new public contract was announced. A new device (Drugwipe5S ® , Securetec) was appointed, for 2011 to 2015. Last year, the Directorate General of the French Gendarmerie tasked our laboratory to carry out a feasibility study on the use of OF in confirmatory analyses. This includes evaluating financial, organisational and philosophical implications and establishing risk assessment criteria. With help from laboratories in Belgium and Switzerland, the analytical component of this study is now underway and several steps are planned, including the selection of the OF collection device, the choice of biological markers and the validation of both field testing devices and analytical methods. At this time, the collection device has already been chosen, the biological markers are being established and analytical method development is in progress. Since the work is in the early stages, no conclusion can be drawn as yet however, OF analysis offers us an interesting alternative matrix for future screening and confirmation.

Urban Power Supply System Risk Assessment

Urban power supply system has close relationship with urban public safety. The main risk factors, accident types and the risk degree of failures or accidents in urban power supply system are analyzed. And, it has established the public safety risk assessment system of urban power supply system. In order to show that the assessment system has good applicability in the risk assessment of urban power supply system, the power supply system safety of one urban is assessed using established risk assessment system.

One-leg standing time and hip-fracture prediction

A hip fracture results in a lower quality of life and a cost of £30,000. In this study, one-leg standing time (OLST) had a negative linear relationship to the risk of a hip fracture. OLST could be a useful tool to assess the need for fracture-preventive interventions. A hip fracture immobilizes, restricts autonomy, shortens life expectancy, and results in a cost of £30,000 in the UK health care system. However, effective preventive treatments can be offered to high-risk individuals. Impaired postural balance is an important risk factor for hip fractures, and the aim of this study was to evaluate whether OLST can predict hip fractures in elderly women. FRAX is the most established fracture risk assessment tool worldwide and a secondary aim was to relate the predictive ability of OLST to that of FRAX in this population. Three hundred fifty-one women aged between 69 and 79 years were timed standing on one leg up to 30 s with eyes open and assessed with FRAX. Fracture data was obtained from registers. The main outcome, a hip fracture, occurred in 40 of the 351 participants (11.4%). The age-adjusted risk of a hip fracture was 5% lower with 1 s longer OLST (Hazard ratio 0.95, 95% CI 0.927-0.978). The relation between OLST and hip fracture risk was linear. Harrell's c was 0.60 for FRAX and 0.68 for OLST adjusted for age. With 1 s longer OLST, the risk of a hip fracture decreased significantly by 5%. This risk reduction was not explained by differences in the classic fracture risk factors included in FRAX. OLST had a predictive ability similar to FRAX. OLST is an easily performed balance test which may prove to be valuable in the assessment of hip fracture risk.

Dental Students’ and Faculty Members’ Concepts and Emotions Associated with a Caries Risk Assessment Program

The objective of this study was to identify concepts and emotions associated with using an established Caries Risk Assessment (CRA) and Caries Risk Management (CRM) program in a dental school. Five focus groups with students and faculty members were conducted. Transcripts of the focus group discussions were qualitatively analyzed for emotions, using Plutchik's wheel of emotions, and were inductively evaluated for concepts (stability coefficients, Scott's π, 0.65-0.71). A total of twenty-five students took part in three focus groups (D2, D3, and D4 separately), and fifteen faculty members participated in two groups. Few frequency differences existed across students and faculty in terms of emotions (278 in faculty members' discourse; 276 in students'). From these, 535 concepts were assembled in seven groups of semantically distinct concepts. Faculty members verbalized more numerous concepts than students (300 vs. 235). Skepticism about the effectiveness of the CRA/CRM program represented the most significant barrier to comprehensive student and faculty support. The findings also suggested that, in order to dispel misconceptions, clearer messages, simpler forms and systems, and better tailored foci of the program for diverse patient, student, and faculty subgroups are needed. Ultimately, buy-in from users depends on CRA forms and programs that are seen as relevant, useful, and simple, offering tangible outcomes for patients and clinicians.

The Sediment Disaster Risk Evaluation on the Occurrence of Debris Flow at Taimali Watershed in Taitung County, Taiwan

Taitung County with the total area of 3,515.24 km2 lies in the eastern Taiwan. The topography of hillslopes at Taitung County is quite steep combined with fragile geological structure. After Typhoon Morakot, Taimali watershed located at the southern part of Taitung County was selected as major study area. The mechanism, behavior, and scale of sediment disasters are analyzed to rule out their interaction of the factors regarding to the debris flow occurrence in Taitung area. In this study, 522 disaster prevention engineering sites were investigated from the field and analyzed by using the Multiple Linear Regression Analysis. Finally, GPS/GIS/RS integrated with the digital terrain data was used to establish risk assessment model which can be utilized as an indication of sediment disasters occurred at Taimali watershed attacked by Typhoon Morakot in 2009. The accuracy of this model estimation is more than 80%. All results established by this study can help Taitung Country set up its own disaster prevention system and keep well development of rural and city in the eastern Taiwan.

Molecular and Functional Characterization of a Novel Aryl Hydrocarbon Receptor Isoform, AHR1β, in the Chicken (Gallus gallus)

Dioxins including 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) cause toxic effects through activation of the aryl hydrocarbon receptor (AHR)-mediated signaling pathway. Our previous studies have investigated the function of 2 AHR isoforms (AHR1 and AHR2) in avian species and identified a third AHR in the chicken (Gallus gallus) genome. Knowledge of multiple avian AHRs is indispensable to understand molecular mechanisms of AHR-mediated toxic effects and establish risk assessment framework for environmental AHR ligands in avian species. In this study, we successfully isolated a third novel AHR1-like cDNA from chicken and designated it as chicken AHR1 beta (ckAHR1β). The mRNA expression of ckAHR1β was primarily detected in the liver, and the hepatic protein expression was confirmed by Western blotting. Although mRNA expression of ckAHR1β was not altered by in ovo TCDD exposure, ckAHR1β exhibited specific binding to [(3)H]TCDD, TCDD-dependent nuclear translocation, and interaction with xenobiotic responsive elements (XREs) and AHR nuclear translocators (ARNTs). In vitro XRE-driven reporter gene assays revealed ckAHR1β-mediated transactivation of TCDD in a dose-dependent manner, showing a 10-fold reduced sensitivity (high EC50) compared with that mediated by ckAHR1. The mutation of Val(371) to Ser(371) in the ligand-binding domain of ckAHR1β shifted the TCDD-EC50 toward the value observed in ckAHR1, indicating the critical roles of the amino acid in sensitivity. Furthermore, ckAHR1β-mediated transactivation of TCDD was enhanced by 17β-estradiol (E2)-activated chicken estrogen receptor α (ckERα), suggesting a positive cross talk between ckERα and ckAHR1β signaling pathway. Both TCDD-induced and its enhanced activities by E2 were suppressed by the ckAHR repressor in a manner similar to ckAHR1. Collectively, our findings discover the role of ckAHR1β in dioxin toxicity and give an insight into the evolutionary history of the AHR signaling pathway.

Risk management of land subsidence in Shanghai

Land subsidence resulting from over-exploited groundwater has become a leading factor restricting the sustainable development of resources, environment, and economy in Shanghai. To design management plans to control the environment geology calamity problems arisen by land subsidence effectively, this research constructed risk index system on the basis of risk source identification of subsidence and then established risk assessment model. The risk index system is composed of hazardous conditions and vulnerability of land subsidence. Results from comprehensive consideration of the model calculations, subsidence distribution and local socio-economic trends showed that the controlling district of land subsidence in Shanghai can be divided into three subsidence—primary control zone (Zone Ⅰ), second control zone (Zone II), and normal control district (Zone III), corresponding with a high, moderate, low subsidence risk, respectively. On the basis of Shanghai urban and rural planning, the control target scheme of land subsidence with each zone in the future, different groundwater, resources management schemes are put forward, which mainly refer to control groundwater exploitation, to perform artificial recharge and to strengthen construction of recharge wells.

Comparison of Constant and Transient‐Source Zones on Simulated Contaminant Plume Evolution in Groundwater: Implications for Hydrogeological Risk Assessment

AbstractContaminant fate and transport models used for hydrogeological risk assessment commonly include an assumed constant source concentration to predict downgradient concentrations in groundwater. This assumption is unrealistic in many cases where nonaqueous phase liquids (NAPLs) are the contaminant source. In this study the effect of a constant and transient (declining) source term on contaminant plume chemistry and groundwater impacts predicted by a hydrogeological risk assessment model is investigated for the release of dissolved phase constituents from an unleaded petroleum fuel light nonaqueous phase liquid (LNAPL). Two transient source models were developed: a mass balance model and an exponential decay model. Both use Raoult's Law to describe the aqueous phase partitioning and depletion of organic compounds from a multicomponent LNAPL source to groundwater. The models were used to estimate the changing LNAPL composition and effective aqueous solubility of six common constituents (benzene, toluene, ethylbenzene, xylene, methyl‐tert‐butyl‐ether, and tert‐amyl‐methyl‐ether) in a representative unleaded petroleum fuel. The predicted source concentrations were then compared with groundwater quality data from a contaminated site. The source concentrations estimated from these models were propagated into a hydrogeological risk assessment model using the Remedial Targets Worksheet v3.1 developed by the Environment Agency of England and Wales. Different groundwater impacts and associated estimates of risk were predicted between the constant and transient source simulations. These are illustrated using simple calculations and established risk assessment methods. The constant‐source model predicted higher contaminant concentrations at the compliance point, which also persisted over a much longer duration. Consequently, there was a greater requirement for remedial action estimated using the hydrogeological model in scenarios that assumed a constant‐source. This could result in unnecessary remedial action in cases where no unacceptable risk is predicted when a more representative description of a declining source is used.

Assessing the Risks of Airport Airside through the Fuzzy Logic-Based Failure Modes, Effect, and Criticality Analysis

To identify risk items, measure risk value objectively, and establish risk assessment matrix of airports is the major task of airport safety. This paper first extracts 14 risk items of airports from the International Civil Aviation Organization (ICAO) aviation accidents database and then applies Failure Modes, Effect and Criticality Analysis (FMECA) to define the decision factors of probability, severity and detectability of airport risks. This paper also designs a questionnaire and applies fuzzy logic to discover the importance of decision factors, to find out the threshold value of Risk Assessment Matrix, and to prioritize the airport risks. This paper uses Taiwan Taoyuan International Airport as a case study to demonstrate the modeling process and analyze the results.

Respiratory rate predicts outcome after acute myocardial infarction: a prospective cohort study

Risk stratification after acute myocardial infarction (MI) remains imperfect and new indices are sought that might improve the post-MI risk assessment. In a contemporarily-treated cohort of acute MI patients, we tested whether the respiratory rate provides prognostic information and how this information compares to that of established risk assessment. A total of 941 consecutive patients (mean age 61 years, 19% female) presenting with acute MI were enrolled between May 2000 and March 2005. The last follow-up was performed May 2010. Main outcome measure was total mortality during a follow-up period of 5 years. Patients underwent 10-min resting recordings of the respiratory rate within 2 weeks after MI in addition to the measurement of the left ventricular ejection fraction (LVEF) and standard clinical assessment including the GRACE score. During the follow-up, 72 patients died. The respiratory rate was a significant predictor of death in univariable analysis (hazard ratio 1.19 per 1/min, 95% confidence interval: 1.12-1.27) as was the GRACE score [1.04 (1.03-1.05) per point], LVEF [0.96 (0.94-0.97) per 1%], and the diagnosis of diabetes mellitus [2.78 (1.73-4.47)], all P < 0.0001. On multivariate analysis, the GRACE score (P < 0.0001), respiratory rate (P < 0.0001), LVEF (P = 0.013), and diabetes (P = 0.016) were independent prognostic markers. The respiratory rate provides powerful prognostic information which is independent and complementary to that of existing risk assessment. Simple and inexpensive assessment of the respiratory rate should be considered a complementary variable for the assessment of risk after acute MI.

Prognostic value of neutrophil/lymphocyte ratio in patients with ST-elevated myocardial infarction undergoing primary coronary intervention: A prospective, multicenter study

The pre-procedural neutrophil to lymphocyte ratio (N/L) is associated with adverse outcomes among patients with coronary artery disease but its prognostic value in ST-segment elevation myocardial infarction (STEMI) has not been fully investigated. This study evaluated the relations between pre-procedural N/L ratio and the in-hospital and long-term outcomes in STEMI patients undergoing primary percutaneous coronary intervention (PCI). A total of 682 STEMI patients presented within the first 6h of symptom onset were enrolled and stratified according to tertiles of N/L ratio based on the blood samples obtained in the emergency room upon admission. The mean follow-up period was 43.3 months (1-131 months). In-hospital in-stent thrombosis, non-fatal myocardial infarction, and cardiovascular mortality increased as the N/L tertile ratio increased (p<0.001, p<0.001, p=0.003, respectively). Long-term in-stent thrombosis, non-fatal myocardial infarction and cardiovascular mortality also increased as the N/L ratio increased (p<0.001, p<0.001, p=0.002, respectively). On multivariate analysis, N/L ratio remained an independent predictor for both in-hospital (OR 1.189, 95% CI 1.000-1.339; p<0.001) and long-term major (OR 1.228, 95% CI 1.136-1.328; p<0.001) adverse cardiac events. The N/L ratio was an independent predictor of both in-hospital and long-term adverse outcomes among STEMI patients undergoing primary PCI. Our findings suggest that this inexpensive, universally available hematological marker may be incorporated into the current established risk assessment model for STEMI.

Surgery in patients with hemophilia: Is thromboprophylaxis mandatory?

Patients with hemophilia are considered low risk for thromboembolic complications. However, in the presence of risk factors for thrombosis, such as surgical procedures, and intensive replacement therapy this complication has been reported. Major orthopedic surgeries are often required in patients with hemophilia, due to the presence of hemophiliac arthropathy. In individuals that do not have hemophilia, orthopedic surgeries are particularly well recognized as high risk for venous thromboembolism, and the use of thromboprophylaxis for this condition is recommended. However, for hemophilia patients the use of venous thrombosis prophylaxis during major surgeries, including orthopedic procedures remains controversial. For the majority of the patients the use of gradated compression stockings and early mobilization can be sufficient to prevent venous thromboembolism. The use of anticoagulant prophylaxis should be considered just for patients with relevant additional risk factor for thrombosis. However, for hemophilia patients with inhibitor, pharmacologic thromboprophylaxis is not recommended. For patients with von Willebrand disease receiving factor concentrates replacement therapy undergoing surgical procedures, the FVIII plasma levels should be monitored and thromboprophylaxis should be considered if any other thrombosis risk factor is present. It is important for the future to establish risk assessment tools that can help to determine the most effective and safe practice to prevent venous thrombosis in patients with hemophilia and other bleeding disorders who undergo surgical procedures.

Metals in residential soils and cumulative risk assessment in Yaqui and Mayo agricultural valleys, northern Mexico

This investigation examines the extent of soil metal pollution associated with the Green Revolution, relative to agricultural activities and associated risks to health in the most important agricultural region of Mexico. Metal contents in bulk soil samples are commonly used to assess contamination, and metal accumulations in soils are usually assumed to increase with decreasing particle size. This study profiled the spatial distribution of metals (Ni, Cr, Pb, Cu, Fe, Cd, V, Hg, Co, P, Se, and Mn) in bulk soil and fine-grained fractions (soil-derived dust) from 22 towns and cities. The contamination of soil was assessed through the use of a geoaccumulation index (Igeo) and pollution index (PI). The results of this study indicated that a number of towns and cities are moderately to highly polluted by soil containing Be, Co, Hg, P, S, V, Zn, Se, Cr, and Pb in both size fractions (coarse and fine). Hazard index in fine fraction (HIchildren=2.1) shows that risk assessment based on Co, Mn, V, and Ni spatially related to power plants, have the potential to pose health risks to local residents, especially children. This study shows that risk assessment based on metal content in bulk soil could be overestimated when compared to fine-grained fraction. Our results provide important information that could be valuable in establishing risk assessment associated with residential soils within agricultural areas, where children can ingest and inhale dust.

The Utility of Risk Assessment Instruments for the Prediction of Recidivism in Sexual Homicide Perpetrators

To examine the predictive accuracy of four well established risk assessment instruments (PCL-R, HCR-20, SVR-20, and Static-99) in an important subgroup of sexual offenders, these instruments were assessed retrospectively based on information from forensic psychiatric court reports in a sample of 90 released male sexual homicide offenders (out of an original sample of 166) in Germany. Follow-up information about criminal reconvictions after release were obtained from the federal criminal records. Total scores as well as subscales and single items of these risk assessment instruments did not predict sexual recidivism, and only some of them had moderate predictive power regarding nonsexual violent recidivism. Possible explanations for these unexpected results are the retrospective study design with missing information about influences during the long duration of detention and time after release, the small sample size as well as the possibility that the risk assessment instruments investigated were valid for general sex offender samples, but not for the particular subgroup of offenders with sexually motivated homicides.