Important Risk Research Articles

Determination of mycotoxins in breakfast cereals by LC-MS/MS

Breakfast cereals, attributed to low microbiological risk due to their low water activity, are not very innocent due to their components such as cereal, dried fruit and cocoa. Secondary fungal metabolites called mycotoxins are one of the most important risks that these foods can carry. The multimycotoxin level of 140 breakfast cereal samples sold in local markets in Istanbul, Turkiye, was analysed.Samples were tested using the LC-MS/MS technique. Contamination levels of aflatoxin B1, B2, G1, G2, ochratoxin (OTA), zearalenone (ZEN), deoxynivalenol (DON), fumonisin B1, B2, citrinin, HT-2 and T-2 toxins were determined in breakfast cereal.As a result, 71% (n = 100) of the samples were contaminated with at least one mycotoxin. Aflatoxin B1 levels in 17% of the samples and total aflatoxin levels in 31% were determined to exceed the limits defined in the “Turkish Food Codex Contaminants Regulation”. The sample rate containing all toxins (except CIT) above the detection limit was 24%. ZEN + DON + OTA was found in 24% of the samples, total aflatoxins (TAF) + OTA + ZEN in 25%, fumonisins (FUM) + OTA + DON in 29%, and TAF + FUM + OTA + DON + ZEN + HT-2+T-2 in 24% of the samples.Our findings indicate that breakfast cereal samples are susceptible to mycotoxin contamination and necessitate consistent monitoring to ensure safety. The presence of other mycotoxins not included in the legal regulation is noteworthy. Action is needed to prepare a legal regulation on the co-occurrence of mycotoxins.

Trastuzumab Deruxtecan With Nivolumab in HER2-Expressing Metastatic Breast or Urothelial Cancer: Analysis of the Phase Ib DS8201-A-U105 Study.

This multicenter phase Ib study investigated trastuzumab deruxtecan (T-DXd) plus nivolumab in patients with HER2-expressing metastatic breast cancer (mBC) and metastatic urothelial cancer (mUC). Part 1 determined the recommended dose for expansion (RDE) of T-DXd plus nivolumab. Part 2 evaluated efficacy and safety; the primary endpoint was confirmed objective response rate (cORR) by independent central review. Seven patients with mBC were enrolled in part 1 and received T-DXd 3.2 mg/kg (4 patients) or 5.4 mg/kg (3 patients) plus nivolumab. The RDE for T-DXd was 5.4 mg/kg plus nivolumab 360 mg intravenously/3 weeks. In part 2, 32 patients with HER2-positive mBC (cohort 1; inclusive of 3 administered 5.4 mg/kg in part 1), 16 with HER2-low mBC (cohort 2), 30 with HER2-high mUC (cohort 3), and 4 with HER2-low mUC (cohort 4) were enrolled. At data cutoff (July 22, 2021), the cORR (95% CI) for cohorts 1-4 was 65.6% (46.8%-81.4%), 50.0% (24.7%-75.3%), 36.7% (19.9%-56.1%), and not assessed due to small sample size, respectively. Median treatment duration (range) with T-DXd in cohorts 1-4 was 8.9 (1-23), 6.9 (1-21), 3.9 (1-21) months, and not assessed; most common treatment-emergent adverse event was nausea (55.2%, 62.5%, 73.3%, 75.0%). Adjudicated drug-related ILD/pneumonitis rates (cohorts 1-3) were 20.7%, 0%, and 20.0% (1 grade 5 each, cohorts 1 and 3). T-DXd plus nivolumab demonstrated promising antitumor activity in HER2-expressing mBC or mUC and safety consistent with the known profile of T‑DXd. ILD/pneumonitis is an important risk and requires careful monitoring and prompt intervention.

Development of brain metastases in patients managed with non-curative thoracic radiotherapy for stage II/III non-small cell lung cancer

BackgroundThis retrospective study analyzed the incidence of subsequent brain metastases after palliative radiotherapy or chemoradiation in patients with stage II/III non-small cell lung cancer (NSCLC). Risk factors for brain metastases development and survival after diagnosis were evaluated.MethodsDifferent baseline parameters including but not limited to age, stage and target volume size were assessed. Outcomes were abstracted from electronic health records. Uni- and multivariate tests were performed.ResultsThe study included 102 patients and found an actuarial risk of brain metastases of 15% (standard error ± 4) at one year and 20% (± 5) at two years. The maximum time interval was 15 months from start of radiation treatment. A non-significant survival difference was observed (median 12 months without versus 8.3 months with brain metastases, p = 0.21). Incidence was higher in patients with N2/3 stage, larger planning target volume size, and younger age (univariately significant factors). Trends were seen for stage III and adenocarcinoma histology. The multivariate analysis confirmed age as the most important risk factor.ConclusionThe risk of brain metastases development was comparable to that reported in studies of curative chemoradiation. All events occurred within 15 months of follow-up, suggesting that long-term surveillance imaging may not be warranted. Patients younger than 60 years had a very high risk of brain metastases development.

The Role of Cloud Computing in Shaping Network Security: Implications for Organizational Behavior

Cloud computing is currently provided consumer or business IT support via social media or by using the internet. Cloud computing on the other hand, is increasing the level of the network security risk due to the services are basically presented by a third party. This results in hard to control the privacy and data security. In addition, to maintain the service availability and support data collections. Cloud computing clouts several technologies such as virtualization, SOA, and Web 2.0, it is also claimed their security risk matters. In this paper, the most serious and important risks and threats of cloud computing are discussed. The main vulnerability is identifying through a review of the published works on the cloud computing environment with possible solutions to overcome these threats and risks.

Enhancing infection control practices and biosecurity plans on Swedish pig farms: insights, challenges, and strategies

BackgroundAfrican swine fever (ASF) poses a threat to the global pig industry, leading to significant economic losses and widespread disruptions in pig farming and associated sectors. In September 2023, the first case of ASF in Swedish wild boar triggered immediate responses from authorities, including the establishment of restricted zones and culling measures. A new ASF certification programme for pig herds was initiated to improve biosecurity and proactive disease management. This survey aimed to assess the sentiments and actions of Swedish pig farmers six months post-outbreak, particularly regarding biosecurity measures. Such information is important to improve preparedness for future disease threats. A questionnaire was distributed to members of the Swedish pig producers' organisation.ResultsA total of 113 farmers responded (response rate 27%), with the majority considering the risk of ASF reappearing in Sweden as high. The estimated cost for connecting the farms to the ASF certification programme varied greatly, with a majority identifying cost as a substantial hurdle. While many farmers sought biosecurity advice from veterinarians, 43% had not implemented suggested measures. Over one third had not received concrete measures that would fit their farms, and 14% had not received any biosecurity advice from veterinarians at all. Discussions among farmers emphasized concerns about ASF outbreaks, transmission mechanisms, and regulatory compliance, highlighting the importance of ongoing communication and knowledge exchange to address the challenges posed by ASF effectively. Additionally, participants also mentioned the role of dense wild boar populations and shortcomings in municipal food waste management as important risk factors.ConclusionsThe responding farmers expressed widespread concern about new ASF outbreaks. A majority identified cost as a substantial hurdle for joining the ASF certification programme. While many farmers consulted veterinarians for advice on biosecurity, a significant number had yet to implement suggested measures and one third had not received specific guidance suitable for their farms. Stakeholder conversations highlighted concerns about ASF outbreaks, transmission, and compliance. They also discussed the role of dense wild boar populations and issues with municipal food waste management as significant risk factors for ASF.

The Determinants of Liquidity: A Comparison of Islamic and Conventional Banks Covering the COVID-19 Period

Banking and risk are synonymous concepts. The risk concepts for both conventional and Islamic banks are broadly similar, and liquidity risk is among the most important risks that all banks are exposed to. The management process of liquidity risk, which arises when banks do not have enough assets to meet their liabilities at maturity, may differ in conventional and Islamic banks. This study aims to present a comparative analysis of the liquidity determinants of conventional and Islamic banks operating in Turkey. Using the data of 3 Islamic and 17 conventional banks for the period between 2011Q1-2022Q2, the analysis, which also aims to see the short and long-term effects, concludes that the determinants of liquidity risk for conventional and Islamic banks are largely similar. However, the liquidity of Islamic banks is more sensitive to bank-specific variables. The findings showed that Islamic banks, which cannot use all of the conventional liquidity management tools in the liquidity management process for different reasons, have to hold higher liquid assets than conventional banks in the short term, even if they are balanced in the long term.

A model-based assessment of social isolation practices for COVID-19 outbreak response in residential care facilities

BackgroundResidential aged-care facilities (RACFs, also called long-term care facilities, aged care homes, or nursing homes) have elevated risks of respiratory infection outbreaks and associated disease burden. During the COVID-19 pandemic, social isolation policies were commonly used in these facilities to prevent and mitigate outbreaks. We refer specifically to general isolation policies that were intended to reduce contact between residents, without regard to confirmed infection status. Such policies are controversial because of their association with adverse mental and physical health indicators and there is a lack of modelling that assesses their effectiveness.MethodsIn consultation with the Australian Government Department of Health and Aged Care, we developed an agent-based model of COVID-19 transmission in a structured population, intended to represent the salient characteristics of a residential care environment. Using our model, we generated stochastic ensembles of simulated outbreaks and compared summary statistics of outbreaks simulated under different mitigation conditions. Our study focuses on the marginal impact of general isolation (reducing social contact between residents), regardless of confirmed infection. For a realistic assessment, our model included other generic interventions consistent with the Australian Government’s recommendations released during the COVID-19 pandemic: isolation of confirmed resident cases, furlough (mandatory paid leave) of staff members with confirmed infection, and deployment of personal protective equipment (PPE) after outbreak declaration.ResultsIn the absence of any asymptomatic screening, general isolation of residents to their rooms reduced median cumulative cases by approximately 27%. However, when conducted concurrently with asymptomatic screening and isolation of confirmed cases, general isolation reduced the median number of cumulative infections by only 12% in our simulations.ConclusionsUnder realistic sets of assumptions, our simulations showed that general isolation of residents did not provide substantial benefits beyond those achieved through screening, isolation of confirmed cases, and deployment of PPE. Our results also highlight the importance of effective case isolation, and indicate that asymptomatic screening of residents and staff may be warranted, especially if importation risk from the outside community is high. Our conclusions are sensitive to assumptions about the proportion of total contacts in a facility accounted for by casual interactions between residents.

Molecular Detection of Anaplasma phagocytophilum in Cats in Europe and Associated Risk Factors.

Infections with Anaplasma (A.) phagocytophilum in cats seem to be rare. The study aimed to determine whether infections in cats are underestimated and to identify the risk factors for infection. Blood samples of 1015 cats across Europe (2017-2022), sent to IDEXX Laboratories, Germany, were tested for A. phagocytophilum DNA. The influence of the cats' origin on A. phagocytophilum infection was assessed by univariable analysis, while multivariable logistic regression evaluated associations with the cats' sex and age, and the years, and seasonality of the samples' submission. Furthermore, univariable linear regression was used to determine patterns in PCR orders. The number of submitted samples increased significantly during the 6 years (p = 0.042). Anaplasma phagocytophilum DNA was detected in 76/1015 of cats (7.5%, 95% CI 6.0-9.3%). Infections were significantly more common in Northern compared to Central (p < 0.001, OR: 8.70) and Southern Europe (p < 0.001, OR: 39.94). A significantly higher likelihood for infections during the summer compared with winter (p = 0.047, OR: 3.13) was found. Bacteremia with A. phagocytophilum in European cats is not uncommon. Anaplasma phagocytophilum infection should be considered an important risk, particularly in Northern Europe. Effective tick prevention is crucial for managing feline health across Europe, not just in the Mediterranean region.

Mortality Surveillance for the COVID-19 Pandemic: Review of the Centers for Disease Control and Prevention's Multiple System Strategy.

Mortality surveillance systems can have limitations, including reporting delays, incomplete reporting, missing data, and insufficient detail on important risk or sociodemographic factors that can impact the accuracy of estimates of current trends, disease severity, and related disparities across subpopulations. The Centers for Disease Control and Prevention used multiple data systems during the COVID-19 emergency response-line-level case‒death surveillance, aggregate death surveillance, and the National Vital Statistics System-to collectively provide more comprehensive and timely information on COVID-19‒associated mortality necessary for informed decisions. This article will review in detail the line-level, aggregate, and National Vital Statistics System surveillance systems and the purpose and use of each. This retrospective review of the hybrid surveillance systems strategy may serve as an example for adaptive informational approaches needed over the course of future public health emergencies. (Am J Public Health. Published online ahead of print July 25, 2024:e1-e10. https://doi.org/10.2105/AJPH.2024.307743).

Promising for patients or deeply disturbing? The ethical and legal aspects of deepfake therapy

Deepfakes are hyper-realistic but fabricated videos created with the use of artificial intelligence. In the context of psychotherapy, the first studies on using deepfake technology are emerging, with potential applications...

Oral Antioxidant and Lutein/Zeaxanthin Supplements Slow Geographic Atrophy Progression to the Fovea in Age-Related Macular Degeneration

PurposeThe only treatments approved to slow geographic atrophy (GA) progression in age-related macular degeneration (AMD) require frequent intraocular injection and suffer from modest efficacy, important risks, and high costs. The purpose of this study was to determine whether oral supplements slow GA progression in AMD. DesignPost hoc analysis of the Age-Related Eye Diseases Study (AREDS) and AREDS2, multi-center randomized placebo-controlled trials of oral micronutrient supplementation, each with 2x2 factorial design. Participants392 eyes (318 participants) with GA in AREDS; 1210 eyes (891 participants) with GA in AREDS2. MethodsAREDS participants were randomly assigned to oral antioxidants (500 mg vitamin C; 400 IU vitamin E; 15 mg β-carotene); 80 mg zinc; combination; or placebo. AREDS2 participants were randomly assigned to 10 mg lutein/2 mg zeaxanthin; 350 mg docosahexaenoic acid/650 mg eicosapentaenoic acid; combination; or placebo. Consenting AREDS2 participants were also randomly assigned to alternative AREDS formulations: original; no beta-carotene; 25 mg zinc instead of 80 mg; both. Main outcome measures(1) Change in GA proximity to central macula over time, and (2) change in square root GA area over time, each measured from color fundus photographs at annual visits and analyzed by mixed-model regression according to randomized assignments. ResultsIn AREDS eyes with non-central GA (n=208), proximity-based progression towards the central macula was significantly slower with randomization to antioxidants versus none, at 50.7 μm/year (95% CI 38.0-63.4 μm/year) versus 72.9 μm/year (95% CI 61.3-84.5 μm/year; p=0.012), respectively. In AREDS2 eyes with non-central GA, in participants assigned to AREDS antioxidants without β-carotene (n=325 eyes), proximity-based progression was significantly slower with randomization to lutein/zeaxanthin versus none, at 80.1 μm/year (95% CI 60.9-99.3 μm/year) versus 114.4 μm/year (95% CI 96.2-132.7 μm/year; p=0.011), respectively. In AREDS eyes with any GA (n=392), area-based progression was not significantly different with randomization to antioxidants versus none (p=0.63). In AREDS2 eyes with any GA, in participants assigned to AREDS antioxidants without β-carotene (n=505 eyes), area-based progression was not significantly different with randomization to lutein/zeaxanthin versus none (p=0.64). ConclusionsOral micronutrient supplementation slowed GA progression towards the central macula, likely by augmenting the natural phenomenon of foveal sparing.

Determining Risk Management Priorities and Suggesting Strategies in the Management of Family Health Centres

Aim: The purpose of this study is to identify the risks faced by decision-makers in the management of Family Health Center (FHC) and to propose strategies according to their relative importance. Materials and Methods: Eight different risks were identified as a result of the literature review. In order to evaluate the identified risks, four different physicians with at least ten years of managerial experience in FHCs and two health managers with at least ten years of experience in their field were included in the study. SWARA (Stepwise Weight Assessment Ratio Analysis) method was used to evaluate and analyze the opinions. SWARA method is a weight calculation method based on expert opinions developed for the finalization of decision problems. Results: According to the results of the analysis, experts ranked financial risks (%27), clinical and patient safety risks (%21), and operational risks (%15) as the most important risks, respectively. Hazard risks (%4) were assessed as the least risky in relative terms. For FHCs to carry out their activities effectively, financial risks should be minimized first. Conclusions: Additional measures should be taken by the public for the use and rental of FHCs. Diversification of other sources of income can be ensured by expanding the health services provided beyond the resource transfer linked to the public budget. Regional investment and incentives can be developed by municipalities. Strengthening data protection policies to assess the compliance of medical practices with legal standards and to ensure the security of personal patient data can also reduce legal risks. In FHCs, general safety issues, especially patient safety, are also priority issues that should be investigated and legislation should be developed. In addition, management courses/training can be added to the family medicine specialty curriculum to improve the managerial skills of physicians.

Systematic Review And Analysis Of Risk Management In Port Construction Projects

In construction projects, there will be no good risks or any risks. In this potential risk will cause problems, the smaller the potential risk faced, the smaller the problem and a large increase in the construction project from the budget and implementation of development. Moreover, the greater the risk, the bigger the problem and the smaller the profit, if not handled properly, it will hinder the development. Based on this research, the risks taken are in several categories, the most important risk is the technical project of 14 journals, then the second place is the technical internal risk of 7 journals. In this study, several journals were analyzed based on the category of Indonesia and China, with 3 journals and the second in Greece with 2 journals. Journals based on an analysis of the category of object themes in industry are 48%, then second in academics are 24%.

Early change in gastric-specific anxiety sensitivity as a predictor of eating disorder treatment outcome.

Eating disorders (EDs) are often accompanied by gastrointestinal (GI) distress. Anxiety sensitivity is the tendency to interpret sensations of anxiety as threatening or dangerous, and includes both broad physical symptoms (e.g., elevated heartrate) and GI-specific symptoms. Physical and GI-specific anxiety sensitivity may be important risk and maintaining factors in EDs. This study tested the hypothesis that greater reductions in both types of anxiety sensitivity during the first month of treatment would predict lower ED symptoms and trait anxiety at discharge and 6-month follow-up. Patients (n=424) in ED treatment reported physical and GI-specific anxiety sensitivity, ED symptoms, and trait anxiety at treatment admission, 1-month into treatment, discharge, and 6-month follow-up. Analyses were conducted with hierarchical linear regression with imputation, controlling for relevant covariates. Results indicated that early reduction in GI-specific but not general physical anxiety sensitivity predicted both lower ED symptoms and lower trait anxiety at discharge and 6-month follow-up. These findings demonstrate the importance of GI-specific anxiety sensitivity as a potential maintaining factor in EDs. Developing and refining treatments to target GI-specific anxiety sensitivity may have promise in improving the treatment not only of EDs, but also of commonly co-morbid anxiety disorders.

Desired Employment and Local Social Support: The Strongest Predictors for Wellbeing Outcomes Amongst the Partners of Australian Military Members

Enhancing wellbeing amongst partners of current serving military personnel is a growing area of interest and concern. Because of their military connection, partners of Australian Defence Force (ADF) personnel experience unique challenges compared to those faced by the broader civilian community. This paper sought to undertake an investigation of the most important risk and protective factors, which influence wellbeing in this cohort. This cross-sectional study gathered responses from 444 participants (partners of current serving military members) through an online survey. Bivariate and multivariate regression models found higher wellbeing scores were associated with younger partners, higher military member rank brackets, existing social support in their location, and partners who were in their desired employment status. Additionally, higher COVID-19 impacts were associated with lower wellbeing scores. Moving forward, interventions, which target social support, desired employment, and periods of national crisis requiring a military response should be the focus. The findings of this study impact policy and programs which aim to provide support to military-connected families.

Are Indian ports safe? Identifying, analysing and prioritizing the risks affecting India's major ports

Seaports are exposed to multiple risks that may affect security and operations. This research aims to develop a framework for identifying, ranking, and prioritizing the risks. Also, this study ranks the 12 major Indian ports based on the identified risk factors. The study follows an extensive literature review, prioritization by Fuzzy TOPSIS (Technique for Order of Preference by Similarity to Ideal Solution), and sensitivity analysis for robustness. Thirty-two risks were identified and classified into five categories: natural disasters, geographical risks, security risks, operational and financial risks, and socio-political risks. The analysis suggests that the most important risk that the ports in India should consider is natural disasters. The risk of cyclones and tsunamis occupied the first two ranks among the global risks. Operational and financial risks, such as complex and lengthy approval procedures and infrastructure risks, are ranked third and fourth. Mumbai is ranked first as the riskiest Indian port, followed by Kolkata, JNPT (Jawaharlal Nehru Port Trust), and Vishakapatnam Port

ESG and anti-financial crime: Two sides of the same coin?

Over the past years the fields of environmental, social and corporate governance (ESG) and anti-financial crime (AFC) have grown to encompass major concepts which various business entities have struggled to grapple with. Both ESG and AFC developed separately, against different backgrounds and for different reasons. ESG is still a growing area (when compared to AFC) and much of the focus so far has been on investments within the ‘environmental’ criteria. Hence, it has not come naturally to most industry players to consider these two important risks together and highlight similarities between these two concepts. This paper looks into each of the factors making up the ‘ESG’ domain and assesses further how these are linked to AFC considerations. The aim of this paper is ultimately to get financial services market players to think about how to manage ESG and AFC together rather than in silos, in the hope of reaping even more benefits and avoiding duplication of similar workstreams.

Data Sharing in a Decentralized Public Health System: Lessons From COVID-19 Syndromic Surveillance.

The COVID-19 pandemic revealed that data sharing challenges persist across public health information systems. We examine the specific challenges in sharing syndromic surveillance data between state, local, and federal partners. These challenges are complicated by US federalism, which decentralizes public health response and creates friction between different government units. The current policies restrict federal access to state and local syndromic surveillance data without each jurisdiction's consent. These policies frustrate legitimate federal governmental interests and are contrary to ethical guidelines for public health data sharing. Nevertheless, state and local public health agencies must continue to play a central role as there are important risks in interpreting syndromic surveillance data without understanding local contexts. Policies establishing a collaborative framework will be needed to support data sharing between federal, state, and local partners. A collaborative framework would be enhanced by a governance group with robust state and local involvement and policy guardrails to ensure the use of data is appropriate. These policy and relational challenges must be addressed to actualize a truly national public health information system.

The risk of mpox importation and subsequent outbreak potential in Chinese mainland: a retrospective statistical modelling study

BackgroundThe 2022–2023 mpox (monkeypox) outbreak has spread rapidly across multiple countries in the non-endemic region, mainly among men who have sex with men (MSM). In this study, we aimed to evaluate mpox’s importation risk, border screening effectiveness and the risk of local outbreak in Chinese mainland.MethodsWe estimated the risk of mpox importation in Chinese mainland from April 14 to September 11, 2022 using the number of reported mpox cases during this multi-country outbreak from Global.health and the international air-travel data from Official Aviation Guide. We constructed a probabilistic model to simulate the effectiveness of a border screening scenario during the mpox outbreak and a hypothetical scenario with less stringent quarantine requirement. And we further evaluated the mpox outbreak potential given that undetected mpox infections were introduced into men who have sex with men, considering different transmissibility, population immunity and population activity.ResultsWe found that the reduced international air-travel volume and stringent border entry policy decreased about 94% and 69% mpox importations respectively. Under the quarantine policy, 15–19% of imported infections would remain undetected. Once a case of mpox is introduced into active MSM population with almost no population immunity, the risk of triggering local transmission is estimated at 42%, and would rise to > 95% with over six cases.ConclusionsOur study demonstrates that the reduced international air-travel volume and stringent border entry policy during the COVID-19 pandemic reduced mpox importations prominently. However, the risk could be substantially higher with the recovery of air-travel volume to pre-pandemic level. Mpox could emerge as a public health threat for Chinese mainland given its large MSM community.Graphical

The role of risk in nature sports

ABSTRACT In this article, I will examine the role of risk in the risky nature sports. Risky nature sports are identified as nature sports where participants may reckon with the possibility of severe injury or death if things go wrong. The first part of the article identifies some evolutionary, historical, and conceptual characteristics of nature sports and risk. In the second part of the article, I discuss the concept of risk and its meaning in risky nature sports. Additionally, I address questions concerning the moral tone and context of risk-taking. In most academic disciplines, risk is typically understood as something negative that should always be avoided. But risk also includes positive possibilities, which may, such as in risk sports, outweigh the negative or can even be inherently positive and a value in itself. In the third part, I discuss how important risk is in nature sports. Is it a defining core or more peripheral? This leads to the question of the value. Does the risk element add to the value of the sport? I finally discuss how risk sports can be meaningful parts of the participants’ lives.