Important Risk Research Articles

GSST system to reduce the level of risk in the Ceramicos San Pedro company, San Pedro de Lloc, 2023

The present investigation has been carried out in the company Ceramicos San Pedro, in which an Occupational Health and Safety Management System was implemented, in order to reduce the level of risk. This research is of experimental design and pre-experimental type. The investigation begins with the recognition of the current situation of the company, through the guidelines of Law No. 29783 (Check List), afterwards, the SGSST is implemented. Finally, we proceed to carry out the second measurement of the Check List tools and the IPERC matrix, this in order to be able to corroborate and compare the results obtained before and after implementing the GSST System. The GSST System implemented in Ceramics San Pedro has managed to reduce risk levels, the most notorious being intolerable and important risks in their total reduction, 49% moderate risks and 51% tolerable risks. In addition, it allowed most of the guidelines based on Law 29783 to be fulfilled.

Incidence, predictors and health outcomes of delirium in very old hospitalized patients: a prospective cohort study

BackgroundDelirium is a common complication that leads to poor health outcomes in older patients undergoing treatment. Due to severe consequences, early recognition of high-risk patients and risk factors for delirium are crucial in the prompt initiation of prevention measures. However, research in medically hospitalized patients aged ≥80 years remains limited. This study aimed to determine the incidence, predictors and health outcomes of delirium in very old (aged ≥80 years) hospitalized patients in China.MethodsA prospective study was conducted in individuals aged ≥80 years admitted to geriatric departments. Potential risk factors were assessed within 24 h after hospital admission. Screening for delirium was performed on admission and every 48 h thereafter for 14 days and assessed if acute mental status changes were observed. During hospitalization, health outcomes were recorded daily.ResultsIncident delirium occurred in 109 of 637 very old hospitalized patients (17.1%). The independent predictors of delirium in hospitalized patients aged 80 and over were cognitive function impairment [OR 17.42, 95% CI:(7.47–40.64)], depression [OR 9.30, 95% CI: (4.59–18.84)], CCI ≥ 5 [OR 4.21, 95% CI: (1.48–12.01)], sleep deprivation [OR 3.89, 95% CI: (1.71–8.82)], infection [OR 3.33, 95% CI: (1.70–6.54)], polypharmacy (≥5 medications) [OR 2.85, 95% CI: (1.51–5.39)], constipation [OR 2.58, 95% CI: (1.33–5.02)], and emergency admission [OR 2.13, 95% CI: (1.02–4.45)]. Patients with delirium had significantly longer hospital stays(P < 0.001) and higher percentages of physical restraint use(P < 0.001) and falls (P = 0.001) than those without delirium,.ConclusionThe incidence of delirium was high in hospitalized patients aged ≥80 years admitted to the geriatric department and was associated with prolonged hospital stay and higher rates of physical restraint use and falls. In this population, the most important independent risk factors for incident delirium were cognitive function impairment and depression. Health care professionals should recognize and initiate interventions for delirium early in geriatric patients.

Physical Inactivity as a Wicked Problem in Sub-Sahara Africa: Overview and Recommendations

Physical Activity (PA) is a public health concern and has been listed as the fourth primary risk feature for Non-Communicable Diseases (NCDs). Physical inactivity has been understood as one of the wicked problems of the 21st century. The worldwide load of illnesses connected with physical inactivity is significant. This paper, from a viewpoint, discusses what can be done to reduce the wicked problem of physical inactivity in sub-Saharan African (SSA) nations. Physical inactivity is a wicked problem because it avoids direct suppression and is difficult to resolve in a way that is modest or absolute. Physical inactivity may be comprehended as the continuum of any decline in a person’s movement that yields a reduction in energy outflow regarding basal level, which is a direct opposite of physical activity definition. Physical inactivity has been documented several years ago and was believed that regular light and moderate exercise could present confrontation with disease and counter physical deterioration. Despite PA’s defensive factors for the avoidance and management of the foremost NCDs, other important NCD risk factors, and psychological health (WHO, 2002), many people still do not participate. In sub-Saharan Africa, physical inactivity and low levels of physical activity were among the 10 top-ranked risk factors for the attributable burden of disease. One review paper recently published documents that the prevalence of physical inactivity stands at twenty-two percent, which is close to the global average of twenty-seven percent and has been projected to increase in the nearest decades. Therefore, confronting “wicked problems” of physical inactivity in the sub-Sahara Africa region requires an urgent collaborative transdisciplinary approach backed up with good policy implementation and resources.

Cardiovascular Effects of Metformin

Type 2 diabetes mellitus is one of the most important independent risk factors for the development, progression and mortality from cardiovascular diseases (CVD). The world communities are faced with the question of developing the optimal management tactics for such comorbidity patients. Thus, the prescribed drug should not only have an adequate hypoglycemic effect, but also have a number of cardioprotective properties, be safe in patients with CVD, and possibly even improve the prognosis and reduce mortality rates. This review is devoted to a representative of the biguanide class - metformin, which is one of the earliest and most effective antihyperglycemic drugs, both as monotherapy and in combination with other antihyperglycemic drugs and insulin; while the evidence base for its cardiovascular profile is only gaining momentum. Thus, the purpose of this review is to highlight the cardiovascular effects of metformin in the context of recent research.

Current status of herbal medicine research for respiratory diseases induced by particulate matter: a protocol for a scoping review

BackgroundParticulate matter (PM) is an important environmental risk factor for the initiation and exacerbation of respiratory disease. Various herbal medicines have exhibited a reduction in symptoms of respiratory diseases induced by PM in animal models. However, the types and characteristics of studies on herbal medicine for respiratory diseases by PM have not been reviewed. This scoping review will focus on the currents status and research gap of herbal medicines for respiratory diseases caused by PM.MethodsWe will follow the scoping review framework developed by Arksey and O’Malley. MEDLINE (via PubMed), EMBASE, and the Cochrane Central Register of Controlled Trials will be searched for relevant English-language publications, and only peer-reviewed, controlled comparative in vivo/in-vitro/human studies examining the effects of herbs on respiratory disease induced by PM will be included. The basic characteristics, research methods, detailed regimens, possible mechanisms, outcomes, and results will be extracted using a predefined standardized data extraction form. Outcomes will be presented in the following categories: pulmonary function, inflammatory markers, reactive oxygen species, histology and mechanisms, and adverse events. Two researchers will independently perform the study selection, data extraction, and quality assessment. We will also present the research map and implications for further study.Ethics and disseminationEthical approval is not required because individual patient data will not be included. The findings will be disseminated through peer-reviewed publications or conference presentations.Systematic review registrationThis review protocol has been registered with the Open Science Framework on February 12, 2021 (https://osf.io/s7uvk/)

Abstract TMP22: Genetic Predisposition To Cardiovascular Disease Is Associated With Higher Risk Of Stroke In Persons With COVID-19

Background and Purpose: Stroke is a serious complication of COVID-19. However, the risk factors for this complication are poorly understood. We hypothesize that genetic predisposition to cardio- and cerebrovascular disease (CVD) leads to an increased risk of stroke in patients with COVID-19 infection. Methods: We evaluated data from a nested cohort study conducted within the UK Biobank focused on persons with documented COVID-19. Incident strokes (ischemic and hemorrhagic) were identified by combining inpatient data (including critical care and discharge diagnostic codes) and primary care data, the latter entered by providers within 30 days of a positive COVID-19 test. Genetic predisposition to CVD was evaluated through a polygenic risk score that integrated genomic information on 2,176 independent genetic risk variants for stroke, coronary artery disease and cardiometabolic risk factors. This score was divided into low (0-20 th percentile), intermediate (20 th -80 th percentile), and high (80 th -100 th percentile) genetic risk. Results: A total of 11,882 study participants (mean age 65.8, SD [8.6], female sex 6,306 [53.1%]) with documented COVID-19 infection were included in this study, including 99 (0.8%) persons that sustained a stroke during the infection. Compared to persons with low genetic predisposition to CVD, those with intermediate and high genetic risk had 35% (OR 1.35, 95%CI 1.14-1.55) and 2.4-fold (OR 2.38, 95% CI 1.71-3.05) higher risk of stroke (test for trend p=0.004). Sub-scoring analyses evaluating one polygenic risk score per CVD trait of interest indicated that genetic predisposition to hypertension (p=0.017) and smoking (p=0.03) were the most important genetic risk factors. Conclusions: Genetic predisposition to CVD is associated with a higher risk of stroke in persons with acute COVID-19 infection. Genetic risk factors for hypertension and smoking appear to mediate a significant portion of this association. Genetic information should be considered in the multiple ongoing efforts to create risk-stratification strategies to identify COVID-19 patients at high risk of stroke.

Abstract 108: Home Blood Pressure Telemonitoring-enhanced Versus Usual Post-acute Stroke Care In An Underserved Setting: The Telehealth After Stroke Care Pilot Randomized Clinical Trial

Introduction: Hypertension is the most important modifiable risk factor for recurrent stroke. However, it remains poorly controlled after stroke, especially among Black and Hispanic patients. Black and Hispanics have a higher prevalence of uncontrolled BP and limited access to care. Interventions that promote equitable access are needed to improve outcomes. Aim: We tested whether a randomized trial of post-acute stroke care that integrates nurse-supported home BP telemonitoring, tailored infographics, and video visits with a multidisciplinary team including pharmacy (Telehealth After Stroke Care (TASC intervention) was feasible. Methods: Acute stroke patients with hypertension were randomized prior to discharge to usual care or TASC. Usual care patients received a video visit with primary care at 1-2 weeks and stroke specialist at 6 and 12 weeks after discharge. TASC patients received a tablet that wirelessly transmits BP data to the electronic health record, supported by remote telehealth nurse monitoring along with BP infographics, developed through community participatory design, at first visit and pharmacist visits. Outcomes included recruitment feasibility, visit adherence, and retention. Generalized linear modeling was used to evaluate within-patient home BP change. Results: Of 67 eligible patients, 6 were discharged before recruitment, 8 refused and 3 engaged in other studies. Fifty enrolled patients included 44% Hispanic, 32% Black and 36% women with mean age 64.3 (±14.0) yrs. About half had ≤ a high school education and 30% had commercial insurance. Baseline SBP was similar in TASC (140 ± 19 mmHg) vs. usual care (142 ± 19 mmHg). Retention rate was higher in TASC vs. usual care (84% vs 64%, p=0.11). Adherence to video visits was also higher in TASC (91% vs 75%, p=0.14). SBP control was better in TASC (76% vs. 25%, p&lt;0.01). At 12 weeks, home SBP declined by 16 ± 19 mmHg from baseline in TASC vs increased by 3 ± 24 mmHg (p&lt;0.01) in usual care. SBP control in Black patients improved from 40% at baseline to 100% in TASC vs from 14% to 29% in usual care. Conclusion: Enhancing post-acute stroke care with home BP telemonitoring is a promising approach to improving hypertension control in an underserved setting that should be tested in a definitive randomized trial.

Abstract WP213: Risk For Recurrent Stroke In Subjects Newly Diagnosed With Cancer Varies Significantly According To Previous History Of Stroke

Background: Cancer is an important yet understudied risk factor for ischemic stroke. We sought to examine the relationship between previous stroke and risk for future stroke in individuals newly diagnosed with cancer. Methods: Using a provincial administrative database, we conducted a population-based matched cohort study of adults in Ontario, Canada, from 2010-2019. Individuals with a new diagnosis of cancer and a history of ischemic stroke were matched (1:4) by age, sex, year of cancer diagnosis, cancer stage, and cancer site to cancer patients without a history of stroke. The cohort was followed until death, stroke, or March 31, 2020, whichever occurred first. Cumulative incidence function (CIF) curves were created for the incidence of stroke (primary outcome), with the date of cancer diagnosis as the index date. Sub-distribution adjusted hazard ratios (aHR) and 95% confidence intervals (CI) were calculated, where death was treated as a competing event. We further stratified those with a history of stroke by the timing of their most recent stroke: 0-1 years, 1-2 years, 2-5 years, or 5-10 years. Regression analyses were adjusted for baseline characteristics. Results: We examined 65,525 individuals with a new diagnosis of cancer, including 13,105 with a history of ischemic stroke and 52,420 without; the incidence of stroke outcome following cancer diagnosis was 5.5% and 1.8%, respectively. Cancer patients with a history of previous stroke had an increased risk for stroke after cancer diagnosis compared to those without a history of stroke (aHR 2.70 95%CI [2.42-3.00]). Individuals with stroke within the preceding 1 year of the cancer diagnosis had the highest risk of recurrent stroke with aHR 3.64 (95%CI 3.17-4.17). Conclusion: Individuals who have a history of stroke prior to a diagnosis of cancer were more likely to suffer stroke after cancer diagnosis, especially if that stroke had occurred within the year preceding the cancer diagnosis. This finding has potentially important implications for advancing strategies to prevent stroke in patients with cancer.

Is repeat serum urate testing superior to a single test to predict incident gout over time?

Elevated serum urate is the most important causal risk factor for developing gout. However, in longitudinal cohort studies, a small proportion of people with normal urate levels develop gout and the majority of those with high urate levels do not. These observations may be due to subsequent variations in serum urate over time. Our analysis examined whether single or repeat testing of serum urate more accurately predicts incident gout over time. Individual participant data from three publicly-available cohorts were included. Data from paired serum urate measures 3–5 years apart, followed by an assessment of gout incidence 5–6 years from the second urate measure were used to calculate the predictive ability of four measures of serum urate on incident gout: the first measure, the second measure, the average of the two measures, and the highest of the two measures. Participants with prevalent gout prior to the second measure were excluded. Receiver operator characteristic (ROC) curves and area under the curve (AUC) statistics were computed to compare the four measures. A total of 16,017 participants were included across the three cohorts, with a mean follow-up from the first serum urate test of 9.3 years (range 8.9–10.1 years). Overall, there was a small increase in the mean serum urate between the first and second measures (322 μmol/L (5.42 mg/dL) vs. 340 μmol/L (5.71 mg/dL), P<0.001) which were a mean of 3.5 years apart, but the first and second measures were highly correlated (r = 0.81, P<0.001). No differences were observed in the predictive ability of incident gout between the four measures of serum urate measurement with ROC curve AUC statistics ranging between 0.81 (95% confidence intervals: 0.78–0.84) and 0.84 (95% confidence intervals: 0.81–0.87). These data show that repeat serum urate testing is not superior to a single measure of serum urate for prediction of incident gout over approximately one decade.

Patient and Caregiver Experiences With and Perceptions of Risk Evaluation and Mitigation Strategy Programs With Elements to Assure Safe Use

The US Food and Drug Administration (FDA) Amendments Act of 2007 authorized the FDA to impose safety requirements on drugs with important risks, such as prescriber certification or routine laboratory testing, to ensure that the benefits of use outweighed the risks. However, little is known about patient and caregiver experiences with these Risk Evaluation and Mitigation Strategy (REMS) programs with Elements to Assure Safe Use (ETASU). To understand patient and caregiver experiences with and perceptions of REMS programs with ETASU. This qualitative study included semistructured qualitative phone interviews conducted between 2016 and 2017, with initial analysis performed in 2017 and reanalysis performed in 2021. Adult patients prescribed natalizumab or sodium oxybate, adult patients or caregivers of adult patients prescribed vigabatrin, and adult female patients of reproductive age prescribed riociguat were included. Assessment of knowledge, decision-making, medication access, and perceptions of medical privacy. Among 63 participants, 46 (73%) were female. Twenty-five participants (40%) had taken natalizumab, 10 (16%) riociguat, 15 (24%) sodium oxybate, and 10 (16%) vigabatrin. One participant had taken both natalizumab and vigabatrin; 4 (6%) were caregivers of patients using vigabatrin. Most participants expressed knowledge of REMS program requirements, but many lacked the insight that these requirements were part of an FDA-mandated special safety program and expressed difficulty understanding program education materials. REMS requirements made some participants more likely to initiate treatment. However, many reported burdens accessing medication, including the need to travel to certified prescribers or pharmacies. Manufacturer access to personal health information was also controversial, although some participants expressed an altruistic desire to assist others. This qualitative study found that REMS programs with ETASU reassured patients and their caregivers about drug safety and helped support medication initiation. However, steps are needed to improve the quality of REMS educational materials, promote efficient medication access, and protect patient privacy.

The Impact of Cloud Computing on Network Security and the Risk for Organization Behaviors

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.

Larval habitats, species composition and distribution of malaria vectors in regions with autochthonous and imported malaria in Roraima state, Brazil

BackgroundMalaria control requires local action. Assessing the vector diversity and abundance provides information on the local malariogenic potential or risk of transmission. This study aimed to determine the Anopheles species composition, habitats, seasonal occurrence, and distribution in areas with autochthonous and imported malaria cases in Roraima State.MethodsA longitudinal study was conducted from January 2017 to October 2018, sampling larvae and adult mosquitoes in three municipalities of Roraima State: Boa Vista, Pacaraima and São João da Baliza. These areas have different risks of malaria importation. Four to six mosquito larval habitats were selected for larval sampling at each municipality, along with two additional sites for adult mosquito collection. All larval habitats were surveyed every two months using a standardized larval sampling methodology and MosqTent for adult mosquitoes.ResultsA total of 544 Anopheles larvae and 1488 adult mosquitoes were collected from the three municipalities studied. Although the species abundance differed between municipalities, the larvae of Anopheles albitarsis s.l., Anopheles nuneztovari s.l. and Anopheles triannulatus s.l. were collected from all larval habitats studied while Anopheles darlingi were collected only from Boa Vista and São João da Baliza. Adults of 11 species of the genus Anopheles were collected, and the predominant species in Boa Vista was An. albitarsis (88.2%) followed by An. darlingi (6.9%), while in São João da Baliza, An. darlingi (85.6%) was the most predominant species followed by An. albitarsis s.l. (9.2%). In contrast, the most abundant species in Pacaraima was Anopheles braziliensis (62%), followed by Anopheles peryassui (18%). Overall, the majority of anophelines exhibited greater extradomicile than peridomicile-biting preference. Anopheles darlingi was the only species found indoors. Variability in biting times was observed among species and municipalities.ConclusionThis study revealed the composition of anopheline species and habitats in Boa Vista, Pacaraima and São João da Baliza. The species sampled differed in their behaviour with only An. darlingi being found indoors. Anopheles darlingi appeared to be the most important vector in São João da Baliza, an area of autochthonous malaria, and An. albitarsis s.l. and An. braziliensis in areas of low transmission, although there were increasing reports of imported malaria. Understanding the diversity of vector species and their ecology is essential for designing effective vector control strategies for these municipalities.

High-Throughput Sequencing Haplotype Analysis Indicates in LRRK2 Gene a Potential Risk Factor for Endemic Parkinsonism in Southeastern Moravia, Czech Republic

Parkinson’s disease and parkinsonism are relatively common neurodegenerative disorders. This study aimed to assess potential genetic risk factors of haplotypes in genes associated with parkinsonism in a population in which endemic parkinsonism and atypical parkinsonism have recently been found. The genes ADH1C, EIF4G1, FBXO7, GBA, GIGYF2, HTRA2, LRRK2, MAPT, PARK2, PARK7, PINK1 PLA2G6, SNCA, UCHL1, and VPS35 were analyzed in 62 patients (P) and 69 age-matched controls from the researched area (C1). Variants were acquired by high-throughput sequencing using Ion Torrent workflow. As another set of controls, the whole genome sequencing data from 100 healthy non-related individuals from the Czech population were used (C2); the results were also compared with the Genome Project data (C3). We observed shared findings of four intron (rs11564187, rs36220738, rs200829235, and rs3789329) and one exon variant (rs33995883) in the LRRK2 gene in six patients. A comparison of the C1–C3 groups revealed significant differences in haplotype frequencies between ratio of 2.09 for C1, 1.65 for C2, and 6.3 for C3, and odds ratios of 13.15 for C1, 2.58 for C2, and 7.6 for C3 were estimated. The co-occurrence of five variants in the LRRK2 gene (very probably in haplotype) could be an important potential risk factor for the development of parkinsonism, even outside the recently described pedigrees in the researched area where endemic parkinsonism is present.

Prevalence and risk factors of early childhood caries in the Middle East region: A systematic review.

The purpose of this systematic review was to assess the prevalence and risk factors of early childhood caries (ECC) in the Middle East region in the age group 0-6 years. A systematic literature search was performed in three major databases, Web of Science, PubMed, and Cochrane database, from January 1, 1960 to December 31, 2020, to identify the published literature on the prevalence and risk factors of ECC. All preschool children of 0-6 years of age irrespective of gender and socioeconomic status from the selected geographics were included. A total of 26 full-text articles with a study population of 14,479, age group 0-6 years, were included in the study. The overall ECC prevalence in the Middle East region ranged from 26.50 to 99% in the 0-6-years age group. The mean decayed missing filled teeth ranged from 0.95 to 16.9, reported in studies from Jeddah, West Province, and Al-Jouf, Northern region of Saudi Arabia. In the United Arab Emirates, the prevalence ranged from 41 to 83%. The evaluation of the included studies revealed a total of 103 risk factors for ECC. Low socioeconomic status, dietary habits, poor oral hygienic attitude and behaviors, and poor access and availability of dental care services were the major risk factors. Most studies found low socioeconomic status, gender, age of the child, parents' education, low maternal education, and type of school to be significant risk factors for ECC. Children attending public schools were at a greater risk of having ECC. Gender (male) was another important risk factor. ECC can be prevented by focusing on prevention programs of dental caries, developing awareness-generating programs focusing on oral health education, and increasing access and availability of dental care services.

Development of Lithium and Its Downstream Power Battery Industry Chain in China

The high-quality development of lithium resources and the downstream power battery industry chain is crucial for China’s economic transformation and the steady development of strategic emerging industries. This paper analyzes the implications of lithium and its downstream power battery industry chain, which comprise resource, smelting processing, key material and product, and recycling ends. Based on this, the necessity of high-quality development of relevant industrial chain and its basic situation are expounded. Due to natural and ecological constraints, the expansion of domestic lithium ore production is restricted. The international competition for resources has led to a sharp increase in China's import risks. The core patents on technologies such as cathode materials and electrolytes are monopolized by foreign companies. There remains a gap between domestic and international advanced level in key materials and battery technology, and the accumulation of emerging technologies is inadequate. The secondary recycling system of waste power battery resources is incomplete, and the industrial order needs to be regulated. Focusing on the high-quality development of lithium and its downstream power battery industry chain, the stage development goals for 2025 and 2035 are demonstrated. The construction path proposed includes constructing a safe and stable resource supply system using multiple dimensions, developing key materials and new battery technologies by strengthening the lithium battery technology system and talent reserves, and promoting the coordinated development of all links of the industrial chain while focusing on innovation of key materials and products. Furthermore, we propose the following suggestions: (1) improving the top-level design to form an integrated management model of the entire industry chain, (2) increasing financial support to enable the mutual promotion of basic and applied research, (3) encouraging cooperation among enterprises in the upstream and downstream links to enhance the synergy effect of the industrial chain, and (4) strengthening industry-university-research cooperation to cultivate interdisciplinary talents for the industrial chain.

Padrões alimentares e fatores de risco cardiometabólicos em funcionários de uma instituição pública federal na região norte do Brasil

ABSTRACT Objective To identify dietary patterns in an adult population and assess those patterns association with cardiometabolic risk factors. Methods Cross-sectional study conducted with 130 workers of a university in Tocantins, Brazil, aged 20-59 years. Dietary patterns were identified by principal component analysis based on a food frequency questionnaire. Body mass index, waist circumference, blood pressure, fasting glycemia, triacylglycerols, low-density lipoprotein and high-density lipoprotein cholesterol were measured. Multinomial logistic regression was used to assess the association between dietary patterns and cardiometabolic risk factors. Results Three dietary patterns were identified that together explained 78.74% of total variance: healthy, western and fit dietary patterns. In the adjusted model, greater adherence to the healthy pattern was associated with lower fasting glucose values (OR: 0.89; 95%IC: 0.82-0.97; p=0.009) and with higher concentrations of low-density lipoprotein cholesterol (OR: 1.02; 95%IC: 1.00-1.04; p=0.024); the western dietary pattern was associated with higher fasting glucose values (OR: 1.06; 95%IC: 1.00-1.13; p=0.05) and the fit pattern was associated with lower concentrations of low-density lipoprotein cholesterol (OR: 0.98; 95%IC: 0.97-0.99; p=0.048). Conclusion Food was an important risk and protective factor for cardiometabolic changes.

Factors Associated with Virological Suppression of HIV Viral Load in Patients on Antiretroviral Therapy in Conakry, Guinea

Viral load testing is a key indicator for assessing ART success and diagnosing drug resistance in people living with HIV/AIDS on antiretroviral therapy. This study aimed to assess virological suppression among people living with HIV / AIDS on antiretroviral therapy in Guinea. This was a three years descriptive cross-sectional that involved adult HIV-positive patients treated in different sites in Conakry. The study population consisted of patients living with HIV/AIDS, followed up at Conakry ART care and treatment sites, samples collected from the study population were sent to the National Institute of Public Health for viral load testing between January 2018 and June 2021. The viral load was quantified by the Generic Biocentric technique and the detection threshold set at 350 copies/ml. Factors associated with virological suppression were analysed by univariate or multivariate logistic regression. Statistical analysis were performed by R software version R4.0.3. A total of 9815 samples were collected and viral load data analyzed at the national public health laboratory. The sample was dominated by women (72%), with an average age of 29. Of these, 6,706 (68%) of people on ART had viral load suppression. The univaried analysis showed that women were (22%) more likely to have VL suppression (p-value < 0.001) moreover, the chance for all HIV-positive people on treatment to achieve viral load suppression was related to the length of treatment. The results of this study show viral load suppression greater than 68%. The length of antiretroviral therapy, female gender, and advancing age of PLHIV were associated with VL suppression. Targeted awareness raising actions must be undertaken with patients who have an important risk.

Artificial Flora Optimization Algorithm with Functional Link Neural Network for DoS Attack Classification in WSN

Wireless sensor networks (WSN) is widely utilized for collecting data related to physical parameters from the environment. Security remains a challenging issue in the design of WSN. Security in WSN from Denial of Service (DoS) attack is an important security risk. This study introduces an artificial flora optimization algorithm with functional link neural network (AFOA-FLNN) model for DoS attack classification in WSN. The presented AFOA-FLNN model initially undergoes data pre-processing to transform the data into meaningful way. Secondly, the FLNN model is utilized for the effective recognition and classification of intrusions in WSN. Finally, the AFOA is exploited for optimally tuning the parameters involved in the FLNN model and results in enhanced performance. In order to demonstrate the better outcomes of the AFOA-FLNN model, a wide-ranging experimentation assessment on test data and the results pointed out the improved outcomes of the AFOA-FLNN model.

Risk assessment of R&amp;D projects: a new approach based on IVIF AHP and fuzzy axiomatic design

Both national and international encouragements for research and development (R&amp;D) projects have been growing worldwide. Since R&amp;D projects include various uncertainties related to time, technology, finance, and knowledge, risk management studies are highly significant for the success of these projects. In risk management, all of the potential actions that might have negative impacts on the processes or outputs of a project should be determined, and if it is possible, their negative impacts should be reduced before the project starts. In this study, after risks in R&amp;D projects are determined, the alternative projects are prioritized with respect to these risks by using an approach based on interval-valued intuitionistic fuzzy AHP and fuzzy information axiom. Interval-valued Intuitionistic Fuzzy Analytic Hierarchy Process (IVIF AHP) is used to determine the importance degrees of the determined risk factors while fuzzy information axiom is used to evaluate R&amp;D projects considering these risk factors. It is revealed that the most important risk is “Abnormal changes in cost” while the least important one is “Deficiencies in contract articles”.

Institutional Digital Transformation and the Relationship between the Digital Economy and Sustainable Development

At a time when the rate of technological growth worldwide is accelerating in its various forms (internet, IoT, artificial intelligence, cloud computing, digital transformation, blockchain, and big data), our institutions and administrative units are experiencing a complex struggle; It is not able to leave its traditional frameworks for a long time, nor is it able to catch up with the advanced technology every day, but perhaps every hour or minute. This dialectic posed an explicit challenge to the state's institutions, and placed it in the eye of the event. The Digital Transformation project will move “institutions from the traditional stage of interaction between citizens and management to a more modern, transparent, and more in line with technological progress in our world today, in which technology is the key to more achievements at a lower cost (make more for less). The research includes four sections. In the first topic, the researcher explains the different concepts of digital transformation, which no matter how many, they have one content, and also reviews the rules of change required for the digital transformation process, as well as a statement of the positive effects and possibilities offered by this transformation to the national economy. In the second topic, the researcher shows the relationship between the digital economy and both development and sustainable development, and the goals of sustainable development 2030. In the third topic, the researcher deals with the future trends of digital transformation and the foundations of the relevant national strategy, and reviews the most important risks that this transformation poses to the security and sovereignty of countries. In the fourth topic, the researcher provides the conclusions and recommendations that the most important of them are: monitoring the necessary investments and funds in the general budget; In order to implement the digital economy strategy and its requirements, and in conclusion, the relevant sources were mentioned.