Hidden Risk Research Articles

Pregnancy- and lactation-related bone fragility: The hidden risk

Pregnancy- and lactation-related bone fragility: The hidden risk

Uncover visit-to-visit blood pressure variability as the hidden risk factor/predictor for coronary artery disease, stroke and malignant tumor in patients with type 2 diabetes

Visit-to-visit blood pressure variability is a factor for a series of cardiovascular diseases in hypertensive patients. Hypertension is a common complication of patients with type 2 diabetes mellitus. Our research demonstrated that blood pressure variability is more important than systolic blood pressure to be associated with the occurrence of coronary artery disease and stroke. However, the importance of visit-to-visit blood pressure variability was easily overlooked. The results aimed to inform the health professionals the significance of stability blood pressure variability in the blood pressure management for patients with type 2 diabetes.

The hidden risk: Intracranial hemorrhage following durotomies in spine surgery

ObjectiveIntracranial hemorrhage (ICH) after durotomy in elective spine surgery, though rare, can pose a significant risk to patient outcomes. Spine surgeries bear a risk of dural tears (DT) with potential of postoperative cerebrospinal fluid leakage (PCSFL). Excessive PCSFL can precipitate a decrease in intracranial pressure, potentially leading to ICH. Literature on ICH as a postoperative complication is scarce. The aim was to assess the incidence and risk factors of ICH in patients undergoing elective spine surgery. MethodsUtilizing the 2020 National Impatient Sample (NIS) adults (>18 years) were selected by primary procedure category codes for spine fusion, discectomy, spinal cord decompression and cervicothoracic/lumbosacral nerve decompression. Exclusion criteria were trauma and malignancy. The primary outcome was occurrence of ICH. Comparative analysis and a multivariable logistic regression were used to identify independent risk. ResultsIn total, 40,990 patients met our criteria with an incidence of ICH at 0.08%. The ICH-group showed an increased length of stay and higher mortality compared to the control group. Spinal cord decompression, DT and PCSFL were significantly more frequent in patients with ICH. Alcohol, drug abuse and hypertension were significantly more prevalent in patients with ICH. DT, alcohol abuse and hypertension were independent risk factors for ICH. ConclusionsThis study underscores the rarity and severity of ICHs following elective spine surgery, emphasizing awareness and looking for possible preventive measures. Our finding suggests that DT, as a complication of surgical techniques, as well as alcohol abuse and hypertension are significant predictors of ICH.

The hidden risk: Changes in functional potentials of microbial keystone taxa under global climate change jeopardizing soil carbon storage in alpine grasslands

Climate change is endangering the soil carbon stock of alpine grasslands on the Qinghai-Tibetan Plateau (QTP), but the limited comprehension regarding the mechanisms that sustain carbon storage under hydrothermal changes increases the uncertainty associated with this finding. Here, we examined the relative abundance of soil microbial keystone taxa and their functional potentials, as well as their influence on soil carbon storage with increased precipitation across alpine grasslands on the QTP, China. The findings indicate that alterations in precipitation significantly decreased the relative abundance of the carbon degradation potentials of keystone taxa, such as chemoheterotrophs. The inclusion of keystone taxa and their internal functional potentials in the two best alternative models explained 70% and 63% of the variance in soil organic carbon (SOC) density, respectively. Moreover, we found that changes in chemoheterotrophs had negative effects on SOC density as indicated by a structural equation model, suggesting that some specialized functional potentials of keystone taxa are not conducive to the accumulation of carbon sink. Our study offers valuable insights into the intricate correlation between precipitation-induced alterations in soil microbial keystone taxa and SOC storage, highlighting a rough categorization is difficult to distinguish the hidden threats and the importance of incorporating functional potentials in SOC storage prediction models in response to changing climate.

Syphilis epidemic among men who have sex with men: A global systematic review and meta-analysis of prevalence, incidence, and associated factors.

We aimed to estimate the prevalence and incidence of syphilis at global, regional and national levels for human immunodeficiency virus (HIV)-positive and HIV-negative men who have sex with men (MSM) and explore the association between demographic and social behavioural factors and syphilis infection. We searched PubMed, Embase, and the Cochrane Library from 1 January 2012 to 31 December 2022 for studies of reported crude syphilis prevalence or incidence in MSM or with sufficient data to calculate prevalence or incidence rate in MSM. We included 376 articles reporting on 409 records from 62 countries to calculate syphilis prevalence and incidence in MSM. The pooled prevalence of syphilis in MSM was 10.4%, with substantial differences between countries and regions. Syphilis prevalence was substantially higher in HIV-positive than in HIV-negative MSM. The pooled incidence of syphilis in MSM was 76.4 per 1000 person-years. Older age, lower education, nitrite or recreational drug use, group sex, and multiple sexual partners were identified as risk factors for syphilis infection. A disproportionate geographic pattern of syphilis infection in MSM and significant threats of syphilis infection were revealed. The 'hidden risk' in specific regions and the inadequately elucidated drivers of high-risk behaviours, need to be fully acknowledged and addressed. PROSPERO: CRD42023422218.

The hidden risk: Cranial hemorrhages following spine surgery

The hidden risk: Cranial hemorrhages following spine surgery

A hidden risk in climate change: The effect of daily rainfall shocks on industrial activities

This paper examines the impact of extreme precipitation on Chinese industrial output and its total factor productivity (TFP) using data from the annual survey of industrial firms (ASIF) and daily weather data. The findings demonstrate a significant reduction in industrial firm output as a result of precipitation, with extreme daily precipitation decreasing output by approximately 1.22%. We provide an explanation for this precipitation-industrial output relationship from four perspectives: per capita wages, labor productivity, inventory, and depreciation. The effects of extreme precipitation are more pronounced in high-income and high-precipitation regions, as well as among foreign firms and low-technology firms. Our research suggests that extreme daily precipitation poses a serious obstacle to the development of the manufacturing industry. These results are crucial for understanding the economic impact and concealed costs of climate change, highlighting that extreme precipitation should be recognized as one of the primary sources of damage associated with climate change in the future.

“Insurers” hidden risk from reinsurance recaptures – the perspective of UK annuity writers’

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A hidden risk? Evidence of respiratory depression at baseline in a methadone-maintained opioid dependent cohort

A hidden risk? Evidence of respiratory depression at baseline in a methadone-maintained opioid dependent cohort

When everyday-life troubles get even bigger: Being a young woman with a disability during Covid times

Abstract One day I found myself in the middle of thousands of people crowded into a stadium to watch a match. The next day. . . a roaring silence. This was my beginning of it all. On February 21, 2020, Italy experienced the first Covid-positive case. Everything changed within hours; the entire country was frozen in sheer dread. After almost eighty days of lockdown, I started evaluating the implications that the pandemic was going to have in my life of a young, visually impaired woman. Though the long-term consequences of Covid-19 require time to fully process, in this article I examine two main changes that I can already qualify as a direct result of the hard times we have just lived through. First, the repeated lockdowns determined an abrupt halt in hiring. At the time of the Spring 2020 lockdown, I was seeking employment, as were many fellow fresh graduates. However, both public and private recruitment was suspended. Therefore, most of us had to wait months before finally getting a job. But one year of (forced) gap can be very detrimental to the career of a young person. Second, technology has proved to be very useful in times of isolation. I argue, however, that technology, itself, can determine isolation. For people with a disability, in particular, there is a hidden risk in relying too much on technology, as the hard, real life is gradually replaced by a virtual life, with fewer challenges but, at the same time, with fewer socialization and integration opportunities.

Co-Occurrence of Staphylococcus aureus and Ochratoxin A in Pasteurized Milk.

Pathogens and mycotoxins are serious public health risks for humans and food safety in milk. This study concentrated on detecting Staphylococcus aureus and Ochratoxin A (OTA) in 210 pasteurized milk from ten urban Beijing districts to suggest the co-occurrence of S. aureus with toxin-producing genes and OTA in milk and the possible risk. S. aureus was identified by physiological and biochemical experiments and molecular biology experiments, and enterotoxin genes were identified by PCR. OTA was detected by LC-MS/MS. The study found 29 isolates of S. aureus, of which 17.24% had the sea gene encoding enterotoxin A. OTA was detected in 31 out of 120 samples and the maximum amount of detection was 18.8 μg/kg. The results of this study indicate that when failing to guarantee the cold chain, the presence of S. aureus with enterotoxin genes in milk will present a risk to food safety. Furthermore, the high detection rates and levels of OTA in milk suggest that OTA is a hidden risk. The co-occurrence of S. aureus and OTA in milk is a food safety concern and there is a need to control the occurrence of these two biohazards in milk.

Building local capacity for managing environmental risk: a transferable framework for participatory, place-based, narrative-science knowledge exchange

This paper evaluates a unique, transdisciplinary participatory research and knowledge exchange methodology developed in the Drought Risk and You (DRY) project and offers it as a transferable framework for others engaging stakeholders and systemic connections with environmental risk. Drought in the UK is a complex, diffuse and hidden risk, involving multiple stakeholders and systemic connections across diverse sectors. Historically, drought risk management has been underpinned by specialist science and technology implemented by statutory stakeholders. This paper critically evaluates the social learning from a longitudinal research process that involved co-working with seven river catchment-based, multi-stakeholder groups. The DRY project was a creative experiment in bringing drought science and stories into the same space, aiming to reveal different knowledges—specialist science, practical sector-level insight, and local knowledge—as a new evidence base to support better decision-making in UK drought risk management. An evaluative multi-method research methodology was overlaid on this process, using surveys, within meeting reflective evaluations, and summative semi-structured narrative interviews. This paper reflects on participant experiences of the ‘open’ scientific modelling development, ‘storying’ approaches, and their iterative interaction. It outlines the enablers, inhibitors and required support for this engagement process, which aimed to facilitate integration of different forms of knowledge as evidence, with social and sustainability learning among diverse stakeholders at its core. The process offered opportunity for valuable experiential learning as researchers of the nuanced impacts of intersecting factors on participatory place-based methods. It showed that similar approaches to science-narrative dialogic processes can play out locally to integrate aspects of social and sustainability learning in different ways. This sustainability learning provided a valuable platform for creative multi-stakeholder scenario-ing possible drought futures for increased local climate resilience. It then proposes a transferable research framework that promotes participatory, place-based, narrative-science knowledge exchange for building local capital for managing systemic environmental risk.

The Risk Analysis and Regulation Suggestions of Network Mutual Aid Platform

As an emerging inclusive financial model, network mutual aid has a wide range of beneficiaries and low risk protection threshold, which can satisfies the healthcare needs of the long-tail people excluded by traditional insurance. However, these risks like financial risk, information risk, operation risk and other hidden risk are induced due to network mutual aid platform unified legal nature and imperfect regulatory system. We should build a sound regulatory system, clarify the network mutual platform regulatory agency, take the protection of consumer interests as the basic value and rely on the principle of transparency to strengthen the platform information disclosure obligation. Meanwhile, It is necessary to improve regulatory capabilities and promote development of network mutual aid platforms by actively adopting innovative concepts such as regulatory technology and inclusive supervision.

Serious Games with SysML: Gamifying Threat Modelling in a Small Business Setting

AbstractThis paper describes using casual games to capture and disseminate expert security knowledge with a digital model at a small company. Most companies in the global supply chain are Very Small Entities (VSE), meaning they employ five (5) to twenty‐five (25) people. These companies represent a risk because they have little to no security proficiency and limited resources and incentive to prioritize system security. Moreover, this is a hidden risk because the companies higher up in the supply chain rely on contractual mechanisms to enforce compliance with security requirements. Small companies rely on informal methods in their daily work and are resistant to change. Threat modelling in the context of Agile Model‐Based Systems Engineering (AMBSE) can provide VSEs with a structure that allows them to retain their informal operational agility. When modelling using games, the security expert plays the dual role of modeler and educator, and the engineering team is gaining security proficiency, improving the quality of both their current and future work. Players reported improved understanding of other stakeholders' perspectives. Agility, proficiency, and stakeholder alignment are among the critical foundation concepts identified by the INCOSE led Future of Systems Engineering Initiative (FuSE) to improve system security.

O-183 Frequent spontaneous abortion in pregnancies followed by ICSI using frozen sperm from patients with testicular germ cell tumor (TGCT)

Abstract Study question Despite the high rate of sperm chromosome abnormalities in testicular germ cell tumor (TGCT), why is newborn aneuploidy rate in pregnancies with TGCT patient normal? Summary answer Miscarriage rate is higher in the pregnancy of TGCT patients than of non-TGCT cancer patients, although the pregnancy rate in ICSI was not significantly different. What is known already Previous reports showed higher sperm aneuploidy in TGCT patients than control males. The sperm aneuploidy rate is high before treatment, and after radical treatments peaked at 6 months after treatment and remained high until 24 months after treatment. However, in the Swedish government base study, the rate of newborn malformations including aneuploidy in all pregnancy with TGCT patients was higher than without TGCT, but not statistically significant. In only natural pregnancies, the rate was not significantly different between the two groups. The cause for discrepancy within sperm aneuploidy and newborn aneuploidy was not well clarified. Study design, size, duration To clarify the mechanism for the purifying selection of aneuploid sperm in conception, we examined ICSI cases with TGCT patients that did not include natural sperm competition and compared to controls with non-TGCT cancer patient, who have normal rate of aneuploid sperm. By investigating ICSI outcomes, we aimed to determine which stage of embryonic development are affected by the sperm of TGCT patients. Participants/materials, setting, methods Under ethical review of Yokohama city university, the 10 TGCT patients (123 oocytes) and 16 non-TGCT cancer patients (251 oocytes) who underwent ICSI with their frozen sperm from 2012 to 2021 were enrolled. Fertilization, embryo viability and embryo transfer outcomes (pregnancy and miscarriage rate) were examined between two groups underwent ICSI with cryopreserved sperm for fertility preservation. Clinical information was retrospectively collected from medical records. Main results and the role of chance The patients' age of sperm cryopreservation was 21-56 years old. 10 cases of TGCT were diagnosed as seminoma (3), non seminoma (6), and unknown (2). 15 cases of non-TGCT were diagnosed as malignant blood diseases (9), prostate cancer (2), bladder cancer (1), and others (3). In both groups, all patients were treated by ICSI with cryopreserved sperm obtained prior to chemotherapy. The mean age of female partners in TGCT was 33.2±3.5 years and not different with 35.8±3.4 years in non-TGCT meaning no different age factor. The fertilization rate, viable embryo rate, pregnancy rate and chemical abortion rate of TGCT vs non-TGCT group were 76.4% vs 67.7%, 64.3% vs 61.7%, 37.1% vs 21.7%, 7.1% vs 23.1%, respectively. Those developmental evaluations were not significantly different between two groups. However, spontaneous abortion rate was significantly higher 46.2% in TGCT group than 10% in non-TGCT group (p < 0.05). Further, in our follow-up, no congenital malformations in the babies born in either group (5 babies in TGCT vs 7 babies in non-TGCT group). The outcome of ICSI using sperm in TGCT patients show normal pregnancy rate but include higher spontaneous abortions rate, suggesting aneuploid embryo were negatively purifying selected under post-implantation stage. Limitations, reasons for caution Because ICSI with fertility-preserving frozen sperm in TGCT patient is rare even in reproduction center in general university hospital, single center analysis is still small and limited. More case reports and studies for TGCT fertility preservation are needed for more accurate evaluation. Wider implications of the findings In TGCT patients, chromosome aberrations and DNA fragmentation of sperm may not be apparent in natural pregnancies with normal sperm competition, but may become apparent as spontaneous abortions when ICSI were performed, suggesting PGT-A can predict and avoid the hidden risk of repeated pregnancy loss in ICSI to TGCT patients. Trial registration number not applicable

Engineering Poster E12: A holistic approach to reducing small-bore fitting and tubing failures in oil and gas facilities

Poster E12 Small-bore piping and instrument tubing vibration failures are not just a hidden risk to production, reliability, and safety, but also a frequent source of emissions through leaks and plant flaring when issues arise. Vibration-induced failure risks are often overlooked and detected too late, despite making up a significant portion of leaks and lost production incidents. Conventional approaches to managing these hidden risks have resulted in recurring failures and unplanned downtime at process plants. Large inventories of Small-Bore Fittings (SBFs) and tubing generally require management as most are integral parts of the plant and can be classed as safety and/or production critical. Small-bore tubing assemblies are at risk of fatigue failure due to a general lack of awareness of the best-practice design for reducing vibration response and how to manage this risk. A holistic approach to manage and pro-actively reduce small-bore piping and tubing vibration anomalies in the field is presented in this paper. This involves a risk-based assessment approach combined with the use of digital tools to register, manage, and visualise the status of the risk to the plant and the improvement in risk with the implementation of remedial actions. Best-practice and a short case study is discussed to demonstrate how the approach can be implemented to effectively reduce and manage vibration-induced small-bore piping and tubing failure incidents. To access the poster click the link on the right. To read the full paper click here

A holistic approach to reducing small-bore fitting and tubing failures in oil and gas facilities

Small-bore piping and instrument tubing vibration failures are not just a hidden risk to production, reliability, and safety, but also a frequent source of emissions through leaks and plant flaring when issues arise. Vibration-induced failure risks are often overlooked and detected too late, despite making up a significant portion of leaks and lost production incidents. Conventional approaches to managing these hidden risks have resulted in recurring failures and unplanned downtime at process plants. Large inventories of Small-Bore Fittings (SBFs) and tubing generally require management as most are integral parts of the plant and can be classed as safety and/or production critical. Small-bore tubing assemblies are at risk of fatigue failure due to a general lack of awareness of the best-practice design for reducing vibration response and how to manage this risk. A holistic approach to manage and pro-actively reduce small-bore piping and tubing vibration anomalies in the field is presented in this paper. This involves a risk-based assessment approach combined with the use of digital tools to register, manage, and visualise the status of the risk to the plant and the improvement in risk with the implementation of remedial actions. Best-practice and a short case study is discussed to demonstrate how the approach can be implemented to effectively reduce and manage vibration-induced small-bore piping and tubing failure incidents.

Benchmarking ISO Risk Management Systems to Assess Efficacy and Help Identify Hidden Organizational Risk

The overall aim of this article is to contribute to the further development of the area of benchmarking in risk management. The article introduces a two-step benchmarking model to assess the efficacy of ISO risk management systems. It furthermore aims at verifying its usefulness in terms of finding hidden risk issues and improvement opportunities. The existence of all key elements of an ISO 31000-based risk management system is examined at the beginning of this study. Then, the quality in terms of efficacy of important aspects of the risk management system is examined in more detail with special benchmarks. The application of the model to six ISO-certified organizations follows and reinforces the novelty of this study, which is to combine risk science knowledge with benchmarking theory in the application of ISO risk management standards in organizations. The results show that the benchmarking model developed in this study provides rigor when assessing and evaluating the efficacy of an ISO risk management system. By applying the model, risk issues and risk factors can be found that had not previously been identified. The findings are of importance for risk management, the benchmarking science, and for the development of ISO risk management standards.

Analysis and Consequences on Some Aggregation Functions of PRISM (Partial Risk Map) Risk Assessment Method

The PRISM (partial risk map) methodology is a novel risk assessment method developed as the combination of the failure mode and effect analysis and risk matrix risk assessment methods. Based on the concept of partial risks, three different aggregation functions are presented for assessing incident risks. Since the different aggregation functions give different properties to the obtained PRISM numbers and threshold surfaces (convex, concave, linear), the description of these properties is carried out. Similarity analyses based on the sum of ranking differences (SRD) method and rank correlation are performed and robustness tests are applied related to the changes of the assessment scale lengths. The PRISM method provides a solution for the systematically criticized problem of the FMEA, i.e., it is not able to deal with hidden risks behind the aggregated RPN number, while the method results in an expressive tool for risk management. Applying new aggregation functions, proactive assessment can be executed, and predictions can be given related to the incidents based on the nature of their hidden risk. The method can be suggested for safety science environments where human safety, environmental protection, sustainable production, etc., are highly required.

Insurers’ hidden risk from reinsurance recaptures

Abstract There is a lack of publicly available information covering the practices insurers employ to manage their exposure to reinsurance recapture risk. A working party was set-up to shed light on the different approaches insurers use to mitigate this complicated to manage risk. This report is intended to form part of a publicly available information repository that market practitioners can refer to and reflect on as best practice evolves and develops.